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Post viral thyroiditis and friends

8709 Views 54 Replies 10 Participants Last post by  staticsea
Hi everyone, sorry for the long story.

I had been especially healthy in the last few years. Lots of energy, exercising, sleeping well and not remotely concerned about my health. At the beginning of this year, I got some kind of viral infection. It just felt like the flu, nothing too bad and I had seemed to have recovered from it within a few weeks. I then got a panic attack seemingly out of the blue. I don't remember ever having one before (maybe when I was a teenager). I wasn't too concerned, I thought whatever it was would resolve quickly. I got the all clear from the doctor and was given lorazepam (Ativan) to take as needed but I didn't want to take any as I didn't want to mask whatever was happening to me I took maybe 2 or 3 1mg doses over the course of about six weeks. The panic attacks started getting worse. It felt like I had been taking stimulants. I had awareness of my heartbeat, strange missed heartbeat sensations, odd chest pains etc I also started having trouble concentrating. I went back to the doctor and was had blood tests. I was also given beta blockers but they made me feel strange. The blood tests were all okay except for low leucocytes and slightly high ft4 (still in normal range). I had a chest xray and everything was fine. I ended up seeing a cardiologist and he gave me the all clear for my heart. I felt a bit better after this and began trying to exercise again.

After a couple of weeks of feeling a bit better, I was hit with vertigo and flu like symptoms. I was also obviously feeling quite anxious. (This was probably in the middle of april). I went to the doc for more tests, and my ft4 was now high. I made an appointment with an endocrinologist. I started to take the Ativan at night to try and get to sleep more easily. I started to feel terrible. I stopped the Ativan after a few nights because I thought that the feeling may have something to do with that but continued to feel like I have never felt before. I felt like being conscious was pure torture. My appointment with the endo came up and he diagnosed me with thyroiditis with transient thyrotoxicosis but said that this didn't explain how I was feeling. He tested my vitamin D and it was low (18) and put me on 50,000iu twice a week as well as a selenium supplement for my thyroid and pregenenolone for my adrenals. I also decided to go on Cipralex (escitalopram) and was given Azor (alprazolam, xanax) by my GP. I started the cirpalex and also the azor as needed and I started to feel much better. The terrible feeling left but I still had anxiety, brainfog, palpitations etc. I also started getting horrible headaches, more sinus issues and horrible tinnitus. I felt like i was making headway and tried to take as little of the Azor as I could.

I went to see an ENT to check my sinuses and he said they were a bit inflamed but looked okay, he said my tinnitus, headaches, dizziness could be from a tmj type issue and gave me celebrex, an anti-inflammatory. I was actually feeling pretty good for a couple of days but then had a mini panic attack one night and thought that it may be due to the celebrex so I stopped that. A couple of days later, I had a the worst panic attack that I have ever had (I think it was triggered by a particularly bad headache). It was one that I could not control. I was sure that iI would die that night. I could not even count my heartbeat and I was very cold and tingling all over. I went to the ER and was given Ativan (I think about 2 mg) and within a couple of hours I felt fantastic. The docs said I looked fine and did some blood tests. The next day I felt okay but then the terrible feelings that I had previously had after Ativan use came back along with terrible anxiety. At that point I felt that a huge part of how I had been feeling was due to the Ativan. I decided that I wanted off all of these psychotropic drugs especially because I got lab results back from the ER and my ft4 was now in the normal range. I started tapering off the cipralex and then the azor and I started to feel a lot better. I even managed to get out of the house a couple of times. I have been of the cipralex for about 2 and a half weeks and the azor for about 10 days.

I felt like I was on my road to recovery but over the last few nights I have felt pretty bad. I have had anxiety, dizziness, strange headaches, flu like symptoms, weakness and horrible tingling in my face, upper back, hands and occasionally feet. These symptoms seem to come and go (usually worse as the day goes on) the only thing that is constant is my tinnitus. I am not sure what my thyroid levels are like at the moment but I have a feeling that I could be hypo (I know that if it is indeed post viral thyroiditis that I have then I would likely be in a hypo phase at the moment). I am hoping that some of these symptoms (especially the tingling) can be explained by this. My endo wants to wait until the end of this month before I test all of my levels again but I am hoping to go sooner. I have an appointment with a neurolgist next week.

I just feel like my life has been taken away from me and I am hoping that I recover to the point where I can live some vague form of my former life soon. I wonder if anyone has been through something similar? Hope you are all making good progress with your thyroid issues.
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Hi and welcome.

Do you by chance have copies of all the lab work done? If so, could you post them with the reference ranges? Outside of TSH, free t4 and free t3, I'm wondering if they ever tested your antibodies? And were you ever given an ultrasound of your thyroid?

Does anyone in your family have a history of Grave's? You should awful hyper, just based on your symptoms.
TSI
Normally, there is no TSI in the blood. If TSI is found in the blood, this indicates that the thyroid stimulating immunoglobulin is the cause of the of a person's hyperthyroidism.
http://labtestsonline.org/understanding/analytes/thyroid-antibodies/tab/test
(Copy and paste into your browser)

Trab
http://www.ncbi.nlm.nih.gov/pubmed/17684583
(Copy and paste into your browser)

TBG (thyroxine binding globulin) up, hypo............down, hyper
http://www.nlm.nih.gov/medlineplus/ency/article/003374.htm
(Copy and paste into your browser)

TBII
http://www.ncbi.nlm.nih.gov/pubmed/9364248
http://en.wikipedia.org/wiki/Anti-thyroid_autoantibodies

Understanding the Thyroid: Why You Should Check Your Free T3
http://breakingmuscle.com/health-medicine/understanding-thyroid-why-you-should-check-your-free-t3
(Copy and paste into your browser)

Substances not found in normal serum (scroll down to autoantibodies)
http://www.thyroidmanager.org/chapter/evaluation-of-thyroid-function-in-health-and-disease/
(Copy and paste into your browser)

********
Thyroid Storm Symptoms
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001437
(Copy and paste into your browser) *****

Advanced hyper.
http://www.ucsfhealth.org/conditions/hyperthyroidism/signs_and_symptoms.html
(Copy and paste into your browser)

myxedema coma
http://www.drugs.com/cg/myxedema-coma.html
(Copy and paste into your browser)

Myopathy from hyper.
http://www.medicalonly.com/2007/07/27/thyrotoxicmyopathy_hyperthyroidism
(Copy and paste into your browser)

Take your time and read through this stuff when you feel up to it.

Welcome to the board. I am sorry you are so ill.

It is a very strange thing that no doctor has run your FREE T3. Nor have they run antibodies' tests for hyperthyroid (thyrotoxicosis) and appt. for an ultra-sound of your thyroid was not set up.

It would seem that some of your symptoms are what is referred to as peripheral neuropathy from hyperthyroid.

I am going to provide a lot of information and I hope you read it as you are going to have to advocate for your self here.
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Hi Joplin

Thanks for the welcome! My results are below, as you can see it never really got too high but I may be particularly sensitive to it. My sister had grave's disease and I think at the highest point her ft4 was 65. I haven't had an ultrasound or an uptake test.

28/01/2014

TSH - 2.44 uIU/mL (range 0.27 - 4.20)

FT4 - 20.7 pmol/L (range 10.16 - 22.0)

18/03/2014

TSH - 1.79 uIU/mL (range 0.27 - 4.20)

FT4 - 23 pmol/L (range 10.16 - 22.0)

FT3 - 4.5 pmol/L (range 2.8 -7.1)

Fetoprotein - 2.0 kU/L (range 0.0 - 13)

TG Antibody - <1.00 IU/mL (range < 4.11)

TPO Antibody - 0.60 IU/mL (range < 5.61)

14/04/2014

FT4 - 24.1 pmol/L (range 10.16 - 22.0)

TSH - 2.14 uIU/mL (range 0.27 - 4.20)

23/04/2014

Vitamin D 25 - 18.2 ng/mL (range 30 - 100)

11/05/2014 (Don't have copies and can't remember TSH value)

FT4 - 19 pmol/L (range 10.16 - 22.0)

EDIT:

27/06/2014

TSH - 1.73 uIU/mL (range 0.27 - 4.20)

FT4 - 24.1 pmol/L (range 10.16 - 22.0)

12/07/2014

TSH - 1.90 uIU/mL (range 0.27 - 4.20)

FT4 - 21.8 pmol/L (range 10.16 - 22.0)

FT3 - 5.4 pmol/L (range 2.8 -7.1)

Vitamin D 25 - 33.4 ng/mL (range 30 - 100)

I feel bit different now than when I knew that it was high. Definitely not as physically wired as I was.

EDIT:

High Andros. Thanks for the welcome. My lab results are above. I did have a ft3 test but that was a few of months ago and it was normal. I was also told that all of the antibodies were normal too. Not sure if the ones tested cover everything though. The tingling has really only become an issue over the last few days. I don't feel like I am hyper but is it possible that these symptoms can also present in a hypo phase? I did have a back spasm two weeks ago and I geuss this could have damaged some nerves. Maybe the tmj is also playing a part.Thanks.
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Oh, and thanks for the links Andros! I will check them out.
and my ft4 was now high.
I take replacement meds and when my FT-4 gets to HIGH range I have horrible anxiety. i say this so you realize that even having a mid range FT-3 but a high range FT-4 it can cause anxiety.

What are they doing to raise your D? You need to be in upper range.
Antibodies make the numbers look good. After you read "all" that stuff (sorry to inundate you); you will see that this is true and most importantly that is why you must have these tests.

And cancer has to also be ruled out via ultra-sound or RAIU (radioactive uptake.)

This is daunting; I know all too well. Hopefully we can be of assistance and supportive.

Hugs,
You are welcome. As I am often apt to say, "We live to serve!" LOL!
I take replacement meds and when my FT-4 gets to HIGH range I have horrible anxiety. i say this so you realize that even having a mid range FT-3 but a high range FT-4 it can cause anxiety.

What are they doing to raise your D? You need to be in upper range.
Hi Lovlkn.

Thanks, I definitely think that initially the anxiety and panic attacks were due to the highish FT-4. i guess I expected it to go away when the level went down but it hasn't exactly panned out like that.

I am on 50,000 IU of calciferol twice a week. I'm keen to see what my vit d is currently because I have a feeling that the calciferol might be contributing to the headaches and other strange sensations.

Antibodies make the numbers look good. After you read "all" that stuff (sorry to inundate you); you will see that this is true and most importantly that is why you must have these tests.

And cancer has to also be ruled out via ultra-sound or RAIU (radioactive uptake.)

This is daunting; I know all too well. Hopefully we can be of assistance and supportive.

Hugs,
You are welcome. As I am often apt to say, "We live to serve!" LOL!
Haha, thanks Andros.
Hi there.

Something to keep in mind is that blood tests are essentially snapshots of what your body is doing during those few seconds the blood is being taken. While your FT4 did drop a little (and it's still at the end of the high range of normal), doesn't mean it's not bouncing around on all the days you aren't having it tested. Both Hyper and Hypo can and do come with anxiety issue and most likely you wont see a complete improvement until your thyroid issues are fully addressed. And high FT4 can definitely make one feel jittery and anxious.

Have they not done a RAI uptake on you to see more of how it's functioning or an ultrasound? Definitely would be something I would ask for.

As for the numbness/tingling - both hyper as Andros pointed out and hypo thyroid patients can experience this lovely symptom. While there is an off chance that pulling up the vitamin D would reverse this, to be honest I would suspect the thyroid more. I'm the opposite of you with uncontrolled Hashimoto's and the tingling for me doesn't get worse when my vitamin D drops. It gets worse when my thyroid starts malfunctioning more then normal. It's one of the markers for me that my thyroid has taken another nose dive when the sensations get worse.
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More light reading for you, this one is from Dr. Richard Hall, titled "Anxiety and Endocrine Disease": http://www.drrichardhall.com/anxiety.htm

The Cliff Notes version is that once things (such as thyroid) are addressed and properly treated, many of the symptoms like anxiety should reduce or completely vanish. I can tell you that when things were perfectly lined up for me, there was no anxiety to be found anywhere. And when I was over-medicated on T4 the anxiety was bad.

As I read through your posts, I partly felt like I was reading a page out of my own book. Especially the post-viral part. I think you are wise to look for the root problem(s) instead of masking them with psychotropic or other drugs. Sure, they may help in the short-term, but come with a laundry list of warnings and side-effects on their own. Another area to look at is cortisol/adrenals (24-hr urine or saliva collection, broken into different time periods), as well as sex hormones (estrogen, testosterone, E2 estradiol, SHBG, etc.). Either of those being out of balance can cause nasty anxiety, too. Glad they are tackling the low Vitamin D.
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Hi there.

Something to keep in mind is that blood tests are essentially snapshots of what your body is doing during those few seconds the blood is being taken. While your FT4 did drop a little (and it's still at the end of the high range of normal), doesn't mean it's not bouncing around on all the days you aren't having it tested. Both Hyper and Hypo can and do come with anxiety issue and most likely you wont see a complete improvement until your thyroid issues are fully addressed. And high FT4 can definitely make one feel jittery and anxious.

Have they not done a RAI uptake on you to see more of how it's functioning or an ultrasound? Definitely would be something I would ask for.

As for the numbness/tingling - both hyper as Andros pointed out and hypo thyroid patients can experience this lovely symptom. While there is an off chance that pulling up the vitamin D would reverse this, to be honest I would suspect the thyroid more. I'm the opposite of you with uncontrolled Hashimoto's and the tingling for me doesn't get worse when my vitamin D drops. It gets worse when my thyroid starts malfunctioning more then normal. It's one of the markers for me that my thyroid has taken another nose dive when the sensations get worse.
Thanks Airmid. I am going to the neurologist this afternoon but I am going to contact my endo this week and ask to try and get my thyroid under control. I am keen to get an ultrasound or uptake test so I will ask my endo. My numbness and tingling have gotten better over the last few days but flu-like symptoms, headaches dizziness are worse. My sinuses don't feel great so that may have something to do with it.

I have also been thinking that maybe the high dose of vitamin D is exacerbating a magnesium deficiency (even though I have been supplementing with mag). I had a terrible headache last night and it was one of my vit D dosing days.

More light reading for you, this one is from Dr. Richard Hall, titled "Anxiety and Endocrine Disease": http://www.drrichardhall.com/anxiety.htm

The Cliff Notes version is that once things (such as thyroid) are addressed and properly treated, many of the symptoms like anxiety should reduce or completely vanish. I can tell you that when things were perfectly lined up for me, there was no anxiety to be found anywhere. And when I was over-medicated on T4 the anxiety was bad.

As I read through your posts, I partly felt like I was reading a page out of my own book. Especially the post-viral part. I think you are wise to look for the root problem(s) instead of masking them with psychotropic or other drugs. Sure, they may help in the short-term, but come with a laundry list of warnings and side-effects on their own. Another area to look at is cortisol/adrenals (24-hr urine or saliva collection, broken into different time periods), as well as sex hormones (estrogen, testosterone, E2 estradiol, SHBG, etc.). Either of those being out of balance can cause nasty anxiety, too. Glad they are tackling the low Vitamin D.
Hi bigfoot. Thanks for the link! I skimmed it as i am getting ready to go to the neuro but it looks very interesting.

I am hoping that when my levels are all balanced that I feel normal again. I need to remind myself that I do have a thyroid issue and that it is very likely the cause of many of my symptoms.

Did your thyroid issues manifest after a virus too?
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I also just want to thank everyone again for reading my story and offering support. Sometimes I feel that people just think that I have had a nervous breakdown or something and that I need to snap out of it. It helps a lot to hear from people that have gone through or are going through similar things.
Did your thyroid issues manifest after a virus too?
Yup, caught an unknown "flu-like illness", and after that the real fun began. Like you, I was feeling pretty darn healthy, leading a normal life. Got sick and WHAM, everything changed. I also noticed awful anxiety shortly thereafter, and I was never one to have anxiety whatsoever. This stuff doesn't happen in a vacuum, and I don't think there is such a thing as a coincidence. Somehow it was all tied in.

Another angle you may wish to investigate is finding a good infectious disease doc for a consult. They love to look in depth at things, and are likely to do some thorough investigating. So even if you don't have (or ever had) an infectious disease per se, they are familiar with many more detailed tests than the average PCP. Also, look into testing catecholamines. They could possibly be out of balance, too.

I'd treat the anxiety as a short-term symptom from a longer-term problem. I wouldn't be the least bit surprised if you got a lot of relief once things are straightened out. AFAIK, people don't just wake up one morning and suddenly have massive anxiety out of nowhere. There has to be a cause, and it is more than likely a physical one if it was a sudden onset like that.
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Yup, caught an unknown "flu-like illness", and after that the real fun began. Like you, I was feeling pretty darn healthy, leading a normal life. Got sick and WHAM, everything changed. I also noticed awful anxiety shortly thereafter, and I was never one to have anxiety whatsoever. This stuff doesn't happen in a vacuum, and I don't think there is such a thing as a coincidence. Somehow it was all tied in.

Another angle you may wish to investigate is finding a good infectious disease doc for a consult. They love to look in depth at things, and are likely to do some thorough investigating. So even if you don't have (or ever had) an infectious disease per se, they are familiar with many more detailed tests than the average PCP. Also, look into testing catecholamines. They could possibly be out of balance, too.

I'd treat the anxiety as a short-term symptom from a longer-term problem. I wouldn't be the least bit surprised if you got a lot of relief once things are straightened out. AFAIK, people don't just wake up one morning and suddenly have massive anxiety out of nowhere. There has to be a cause, and it is more than likely a physical one if it was a sudden onset like that.
Thanks for the suggestions bigfoot. I do think that my anxiety was triggered by my thyroid initially but think that it may have (along with the bad reaction to ativan) progressed into its own issue.

I went to the neuro yesterday and he wants me to do an MRI and 24 Hour EEG on friday to rule out the scary stuff. I think that will help with the "you are going to die tonight" feeling (if everything is clear). I will also be getting my thyroid levels checked again so I am very interested to see what they are at the moment.
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"sometimes we can't see why normal isn't normal" ~ Dr. House

Try not to accept "normal" as an answer. Each one of us are different. Range are huge and there is a correct spot for your body. You are the best judge of how you feel and know when something is not right. I hope you will get the help you need, soon.
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"sometimes we can't see why normal isn't normal" ~ Dr. House

Try not to accept "normal" as an answer. Each one of us are different. Range are huge and there is a correct spot for your body. You are the best judge of how you feel and know when something is not right. I hope you will get the help you need, soon.
Thanks webster.

Funny you should mention House. I love that show but wouldn't dream of watching it at the moment. It's all a bit too real (would love to have him on my case though). I am definitely not myself at the moment, I just hope that I can find the cause and resolve it.
Hi staticsea,

Just wanted to chime in and say that your symptoms and disease progression have been very similar to what I've been going through - even down to the tmj! My first endo assumed I had some autoimmune problem and put me on methimazole in March because my TSH was low, although my FT4 never went out of range. I felt miserable for the next two months. My FT4 never budged in that time even with increasing doses of methimazole. Then, all of a sudden, it dropped rapidly. I got a second opinion, and he believes it's thyroiditis and took me off the methimazole. We aren't sure what caused it; I don't remember being sick prior. And my hypo stage hasn't progressed how he'd expected either. But thyroiditis seems to be the most likely cause at this point.

I had the sudden onset of anxiety as my primary initial symptom, with jitteriness, heart palpitations, nausea, etc. I'd never had a panic attack in my life prior to that (I'm 37). It's horrible, and I can't imagine dealing with full-fledged panic disorder. I lost weight and I didn't sleep more than a few hours a night for weeks. I was super forgetful and a bit dazed. My vit D was also low, but my first endo (who ran it) didn't comment on it. My second endo is waiting to see if I can rebuild it naturally this summer before he starts me on supplements.

As I've come out of hyper, and headed hypo, I definitely get weird tingling/numbing sensations in my arms, hands, and feet. I still have palpitations all the time. I feel physically weak. I have mild insomnia now. I've been having more headaches and jaw trouble than normal. I seem to have problems regulating my body temp. I'm either too hot, or too cold, or I feel hot except for my feet being too cold. I also feel like I get irritated more easily and I still struggle to really concentrate.

I still have bouts of anxiety as well, but it is definitely more mild and I've not had any panic attacks since I went hypo. Right now, it seems to mainly be a nervous, jittery sensation in my chest that comes and goes. Thankfully, before I even saw my GP back in Feb, a psychiatrist friend told me that sudden anxiety that starts after 35 is more likely to be caused by disease than to be an anxiety disorder. That makes me optimistic that the anxiety will resolve when my thyroid gets regulated. I'm not there yet, but things are getting better.

We'll make it back to normal, I'm sure of it.
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Thanks webster.

Funny you should mention House. I love that show but wouldn't dream of watching it at the moment. It's all a bit too real (would love to have him on my case though). I am definitely not myself at the moment, I just hope that I can find the cause and resolve it.
Eventually, I started my little "intro" with new doctors by mentioning how my case needed somebody like House on TV. Some got a chuckle out of that. :)
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Hi staticsea,

Just wanted to chime in and say that your symptoms and disease progression have been very similar to what I've been going through - even down to the tmj! My first endo assumed I had some autoimmune problem and put me on methimazole in March because my TSH was low, although my FT4 never went out of range. I felt miserable for the next two months. My FT4 never budged in that time even with increasing doses of methimazole. Then, all of a sudden, it dropped rapidly. I got a second opinion, and he believes it's thyroiditis and took me off the methimazole. We aren't sure what caused it; I don't remember being sick prior. And my hypo stage hasn't progressed how he'd expected either. But thyroiditis seems to be the most likely cause at this point.

I had the sudden onset of anxiety as my primary initial symptom, with jitteriness, heart palpitations, nausea, etc. I'd never had a panic attack in my life prior to that (I'm 37). It's horrible, and I can't imagine dealing with full-fledged panic disorder. I lost weight and I didn't sleep more than a few hours a night for weeks. I was super forgetful and a bit dazed. My vit D was also low, but my first endo (who ran it) didn't comment on it. My second endo is waiting to see if I can rebuild it naturally this summer before he starts me on supplements.

As I've come out of hyper, and headed hypo, I definitely get weird tingling/numbing sensations in my arms, hands, and feet. I still have palpitations all the time. I feel physically weak. I have mild insomnia now. I've been having more headaches and jaw trouble than normal. I seem to have problems regulating my body temp. I'm either too hot, or too cold, or I feel hot except for my feet being too cold. I also feel like I get irritated more easily and I still struggle to really concentrate.

I still have bouts of anxiety as well, but it is definitely more mild and I've not had any panic attacks since I went hypo. Right now, it seems to mainly be a nervous, jittery sensation in my chest that comes and goes. Thankfully, before I even saw my GP back in Feb, a psychiatrist friend told me that sudden anxiety that starts after 35 is more likely to be caused by disease than to be an anxiety disorder. That makes me optimistic that the anxiety will resolve when my thyroid gets regulated. I'm not there yet, but things are getting better.

We'll make it back to normal, I'm sure of it.
Hi Jolie. I'm sorry that you are going through a similar thing, I know how tough it is. I have been thinking that maybe my vitamin D deficiency was actually caused by a magnesium deficiency because I was getting plenty of sun (I was actually on holiday at the beach before all this started) but still low. So maybe my body was forced to lower the vit d in order to conserve magnesium then when I started vit d supplementation my magnesium crashed and triggered a whole lot of my symptoms. I say that but mag doesn't seem to bring much relief so who knows.

One thing that helps my palpitations (pretty much stops them) is potassium. I have found that if I miss a couple of days of potassium, my palpitations come back. I do think that I was more prone to them when my ft4 was higher though.

Did you have a period of feeling normal between being hyper and hypo even though it was a rapid change?

Glad things are getting better for you! The good thing about this type of thyroiditis is that it has a really good prognosis so I am sure we will get there!

Eventually, I started my little "intro" with new doctors by mentioning how my case needed somebody like House on TV. Some got a chuckle out of that. :)
Haha, if only they would rise to the challenge.

Well I have my MRI and EEG tomorrow along with an overnight stay in the hospital. Not keen at all but I guess it is an important step. Hopefully my next post will be about how smoothly the whole thing went.
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