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Wednesday, February 1, 2012

HIDA scan and Mycoplasma

Sick for a long time this patient had already been to many doctors. Previous treatments included 9 months of Rocephin. She first saw me two months ago. Prominent symptoms included: cognitive dysfunction,depression, weakness, seizures, "TIA", headaches, tingling, joint pain, palpitations, neuropathic pains and gastrointestinal issues. The depression was profound, associated with suicidal ideation at times.

She had a history of sporadic abnormal liver test with marked abdominal pain. Belly symptoms including bloating, nausea, anorexia and difficulty eating which was chronic.

She had dysautonomia and POTS.

There is much more to the story.Of course.

Lyme has been confirmed by IgeneX and Stony Brook. A recent Western Blot showed IgM bands: 41,18,20,30,31,37,38,58,60, The test showed 5 IgG bands.

Physical examination showed tenderness over the gallbladder.

The abdominal sonogram was negative for gall stones (it always is).

The HIDA scan was entirely normal. Here's the catch. The injection of CCK which makes the gallbladder contract reproduced her severe pain.

A surgeon friend has found this sign may be associated with gallbladder disease even with normal studies.

Her gallbladder was removed.

Then - something remarkable happened: she felt great, even off antibiotics.

Weakness,cognitive dysfunction,neuropathic pains were all better. Orthostatic tachycardia had improved significantly.

No longer using a cane, she was playing the piano - first time in over a year.

She sent a piece of gallbladder to Clongen for PCR testing for "everything."

The result was surprising: Mycoplasma species. I have no idea what to make of this unexpected finding.

Mycoplasma is an intracellular bacteria. You can never get rid of it.


glytzhkof said...

I really wonder how this woman would have responded to Cholestyramine / Questran. Could it be that the toxins in her systems were so strong that they caused the vast majority of her symptoms?

Did she actually have Lyme at all, or was it all triggered by a similar immune response to all the Mycoplasma?

I remember very bad days and very good days in distinct cycles of about 20 days when I was at my worst. Some days I would have an uncomfortable light headedness with a slight whitish tint to my vision. I know it sounds crazy, but it was sort of like a very bad hangover. Everything is out of balance. It would peak and I would normally get a couple of very good days where I would function almost normally - only to crash again with new symptoms a few days later. I believe I had a parasite of some sort, in addition to Lyme, and a few other pathogens. A coctail-trigger of immune dysfunction and toxin-accumulation in my body.

With testing like this, how can doctors even try to help us? Good thing some of them do, and don't just quote the insurance mantra with their bureaucratized treatment regimes.

glytzhkof said...

This really makes you wonder...

Is the treatment of chronic infection really more of a toxin management exercise than anything else??

Are we carpet bombing our bodies with antibiotics that do little but more damage to an unstable system when we are dealing with intracellular pathogens??

What are the best ways to rid the body of toxins? Exercise and sweating? Cholestyramine? Other medication?

Could toxins in bile be involved in the mysterious "fatigue attacks" seen in ME sufferers? They eat something with fat and immediately suffer from circulating toxic bile?

Surely things are way more complicated, but for the layman these are some of the questions that pop up when you read this.

Fantastic post. Look forward to reading more of your thoughts.

worriedmom said...

Ok. those were alot of WB bands....will she relapse?

Ryan Hartmann said...

I see a LLMD and she found Mycoplasma Pneumoniae in my blood using an Igg/Igc (sp?) test. I have been on 600mg of Rifampin and 400 mg of Minocycline per day since April and will continue for several more months. Also taking LV-GB liver detox which contains milk thistle and VSL probiotic. Also on Serrapeptase to break up the biofilm that the Mycoplamsa forms.

I believe I have been steadily improving and hopefully it will be cured. Although I have only had the infection for 10 months before treatment, idk how long you need to have it before it becomes chronic.