Season post mortem
Due to illness, I was unable to return to action ...
July 7. Warmed up for a baseball game, feeling great, best I've felt in years. Walking back to the field after a trip to the port-a-potty, I started to feel tired. Within seconds, my arms and legs felt like jelly. I felt "flushed". My joints, especially my knees, felt achy. Rough estimate in loss of strength and speed -- about 25% (for example, instead of a 6.0 40 yard dash, closer to 7.5). That night I had very mild chest congestion. I occasionally coughed up clear phlegm (but I often do this when I'm healthy!).
The next day I had to stop a personal training workout because I couldn't work hard enough to get my heart rate to 75% of my usual maximum (180), let alone 90%.
Ten days with little progress. I got in some exercise, 30 minute bike rides at 60% to 65% of maximum heart rate were quite exhausting. Very mild chest congestion continued. Joint aches were intermittent, I'd only notice them for a few minutes on and off every two or three days.
After that, I started to make uneven progress. Some days I could exercise pretty hard, such as cycling 50 minutes at 75% of maximum heart rate. Other days had a hard time exceeding 65% for 30 minutes. Sometimes I could exercise anaerobically (90%+ of maximum), such as 200 meter sprint, but still had trouble with aerobic exercise. Very mild chest congestion continued. Joint aches less frequent.
Often low body temperature readings -- sometimes in the 97's, often in the 96's, a few times in the 95's.
Friday, August 7. Was finally feeling close to full recovery, except for general decline in fitness (aerobic and anaerobic). In terms of exercise, it was a rest day. Early afternoon, I started feeling weak and flushed again. Again, a very noticeable onset. This time the fatigue and weakness don't seem to be quite as severe. But the chest congestion is a bit worse and I feel some tightness/pain in my lungs/chest.
Sunday, August 9 (e-mail). I've had some sort of illness for the past 5 weeks. Main symptom is fatigue. It seemed like I was starting to recover over the past couple of weeks, but on Friday I had a recurrence of the initial onset. I'm going to schedule a visit with my doctor ASAP on Monday.
Monday, August 10. Visit doctor. Several tests. EKG is normal. X-rays show no pneumonia; sent to specialist for further review. Urinalysis and blood test -- results later this week. Begain taking Zithromax as prescribed. Body temperature 97.7.
[September 10]
I tested positive for mycoplasma pneumonia.
http://en.wikipedia.org/wiki/Mycoplasma_pneumonia
This infection (which for me caused a milder form of pneumonia than I would have thought possible!) initiated a cascade of additional problems, particularly impaired thyroid and adrenal function (whence fatigue and loss of muscle strength), but also mild arthritis, particularly in the knees, contributing to inflammation of the left thigh bone, along with hamstring tendinitis and locking of the knee cap.
I also tested positive for two Lyme disease markers. However, there are 15 markers, and the current CDC standard for conclusive diagnosis is five (heh, any five ... but I'm pretty sure some are more telling than others!). (Trivia: my doctor mentioned that one of my positive markers corresponds to the tail of the spirochete.)
Fortunately, the same antiobitic (Doxycycline) is used to treat both infections. I'm taking it for three weeks ... hoping to start feeling better before that, but I don't know what to expect.
The hamstring and knee cap have already improved considerably from several physical therapy sessions, and should recover completely as the bone inflammation subsides over the next two to three months.
Note: Although it's over two months since I got sick, throughout the entire time I had to be very aggressive about getting medical help for my problems in order to resolve things this "quickly". For example, seeing four different physicians (on my initiative, not via referral), all of whom were helpful ... the last two much more so!
[Current]
I received the latest test results on Thursday.
One of the main findings is a huge level of thyroglobulin antibody (609, where less than 20 is normal). This means my immune system is attacking my thyroid. Possible causes are Hashimoto's thyroiditis (the first auto-immune disease ever discovered) or thyroid cancer. It's most likely Hashimoto's (my doctor could not feel any nodules; also, mycoplasma pneumonia infection can trigger auto-immune reactions such as this), but I will have an ultrasound scan of my thyroid performed early next week.
The symptoms of thyroid impairment that I've experienced include fatigue, elevated cholesterol (my level is considered fine compared to the general population, but has increased a bit since my annual physical in January), joint pain (very mild for the most part), muscle weakness, weight gain (from eating more and exercising less!), depression (this has been mild but noticeable, starting a couple weeks ago), low blood pressure and low body temperature. So it sounds like we've caught it fairly early, although it's possible my thyroid has been impaired a bit for years until the substantial recent decline.
The initial treatment is thyroid hormone replacement (oral tablets). The conventional treatment is a synthetic version, but my doctor has prescribed the natural form -- I think it's slightly more expensive, but still seems pretty cheap ($18 per month). He's also prescribed a vitamin and herbal "thyroid support complex" that provides iodine (my diet is usually very low in salt) and assists conversion of thyroid hormone to its more active form.
I may have to take this forever, but it's possible for the auto-immune attack to subside with this treatment over the next few weeks. If not, then we may try a followup (low dose naltrexone) that has eliminated the autoimmune response for some, but not all, patients.
The other major finding is confirmation (suggested by previous results) of adrenal exhaustion.
The test involved collecting urine for 24 hours to establish a baseline, then taking a shot of adrenocorticotropic hormone (ACTH) and collecting urine for another 24 hours to see how my body responded. (In order not to overflow the containers, I reduced my water intake, but I still collected 3 liters. Fun!)
When healthy, the ACTH injection sets off a cascade of hormone production -- about 40 different hormones appear in the chart the lab provided, of which they measured 17 -- increasing levels of the tested hormones by 100% or more.
None of my levels doubled, and in fact, a number of hormones, including DHEA and Androsterone, declined in response to the shot.
Also, almost all of my baseline levels are low. (The urine test was nearly a month ago, and my levels have probably fallen further.) In particular, testosterone was about 6% of the mid-range value for healthy men.
So what is happening is that instead of ramping up in response to exertion or stress, my body is throwing in the towel.
Similar to the thyroid treatment, treating this also involves hormone replacement -- in this case, pregnenolone (near the top of the cascade), DHEA (a testosterone precursor), and hydrocortisone -- plus a nutritional supplement.
In addition, walking is the most strenuous exercise I'm permitted for the next 6 weeks or so.
I'm supposed to see improvement in a short time, but I need to make sure not to overdo things just because I feel better.
Over all, the outlook seems quite good. Given how bad some of my results came out, I'm surprised I don't feel worse. So I'm really looking forward to how healthy I will be once I recover.
July 7. Warmed up for a baseball game, feeling great, best I've felt in years. Walking back to the field after a trip to the port-a-potty, I started to feel tired. Within seconds, my arms and legs felt like jelly. I felt "flushed". My joints, especially my knees, felt achy. Rough estimate in loss of strength and speed -- about 25% (for example, instead of a 6.0 40 yard dash, closer to 7.5). That night I had very mild chest congestion. I occasionally coughed up clear phlegm (but I often do this when I'm healthy!).
The next day I had to stop a personal training workout because I couldn't work hard enough to get my heart rate to 75% of my usual maximum (180), let alone 90%.
Ten days with little progress. I got in some exercise, 30 minute bike rides at 60% to 65% of maximum heart rate were quite exhausting. Very mild chest congestion continued. Joint aches were intermittent, I'd only notice them for a few minutes on and off every two or three days.
After that, I started to make uneven progress. Some days I could exercise pretty hard, such as cycling 50 minutes at 75% of maximum heart rate. Other days had a hard time exceeding 65% for 30 minutes. Sometimes I could exercise anaerobically (90%+ of maximum), such as 200 meter sprint, but still had trouble with aerobic exercise. Very mild chest congestion continued. Joint aches less frequent.
Often low body temperature readings -- sometimes in the 97's, often in the 96's, a few times in the 95's.
Friday, August 7. Was finally feeling close to full recovery, except for general decline in fitness (aerobic and anaerobic). In terms of exercise, it was a rest day. Early afternoon, I started feeling weak and flushed again. Again, a very noticeable onset. This time the fatigue and weakness don't seem to be quite as severe. But the chest congestion is a bit worse and I feel some tightness/pain in my lungs/chest.
Sunday, August 9 (e-mail). I've had some sort of illness for the past 5 weeks. Main symptom is fatigue. It seemed like I was starting to recover over the past couple of weeks, but on Friday I had a recurrence of the initial onset. I'm going to schedule a visit with my doctor ASAP on Monday.
Monday, August 10. Visit doctor. Several tests. EKG is normal. X-rays show no pneumonia; sent to specialist for further review. Urinalysis and blood test -- results later this week. Begain taking Zithromax as prescribed. Body temperature 97.7.
[September 10]
I tested positive for mycoplasma pneumonia.
http://en.wikipedia.org/wiki/Mycoplasma_pneumonia
This infection (which for me caused a milder form of pneumonia than I would have thought possible!) initiated a cascade of additional problems, particularly impaired thyroid and adrenal function (whence fatigue and loss of muscle strength), but also mild arthritis, particularly in the knees, contributing to inflammation of the left thigh bone, along with hamstring tendinitis and locking of the knee cap.
I also tested positive for two Lyme disease markers. However, there are 15 markers, and the current CDC standard for conclusive diagnosis is five (heh, any five ... but I'm pretty sure some are more telling than others!). (Trivia: my doctor mentioned that one of my positive markers corresponds to the tail of the spirochete.)
Fortunately, the same antiobitic (Doxycycline) is used to treat both infections. I'm taking it for three weeks ... hoping to start feeling better before that, but I don't know what to expect.
The hamstring and knee cap have already improved considerably from several physical therapy sessions, and should recover completely as the bone inflammation subsides over the next two to three months.
Note: Although it's over two months since I got sick, throughout the entire time I had to be very aggressive about getting medical help for my problems in order to resolve things this "quickly". For example, seeing four different physicians (on my initiative, not via referral), all of whom were helpful ... the last two much more so!
[Current]
I received the latest test results on Thursday.
One of the main findings is a huge level of thyroglobulin antibody (609, where less than 20 is normal). This means my immune system is attacking my thyroid. Possible causes are Hashimoto's thyroiditis (the first auto-immune disease ever discovered) or thyroid cancer. It's most likely Hashimoto's (my doctor could not feel any nodules; also, mycoplasma pneumonia infection can trigger auto-immune reactions such as this), but I will have an ultrasound scan of my thyroid performed early next week.
The symptoms of thyroid impairment that I've experienced include fatigue, elevated cholesterol (my level is considered fine compared to the general population, but has increased a bit since my annual physical in January), joint pain (very mild for the most part), muscle weakness, weight gain (from eating more and exercising less!), depression (this has been mild but noticeable, starting a couple weeks ago), low blood pressure and low body temperature. So it sounds like we've caught it fairly early, although it's possible my thyroid has been impaired a bit for years until the substantial recent decline.
The initial treatment is thyroid hormone replacement (oral tablets). The conventional treatment is a synthetic version, but my doctor has prescribed the natural form -- I think it's slightly more expensive, but still seems pretty cheap ($18 per month). He's also prescribed a vitamin and herbal "thyroid support complex" that provides iodine (my diet is usually very low in salt) and assists conversion of thyroid hormone to its more active form.
I may have to take this forever, but it's possible for the auto-immune attack to subside with this treatment over the next few weeks. If not, then we may try a followup (low dose naltrexone) that has eliminated the autoimmune response for some, but not all, patients.
The other major finding is confirmation (suggested by previous results) of adrenal exhaustion.
The test involved collecting urine for 24 hours to establish a baseline, then taking a shot of adrenocorticotropic hormone (ACTH) and collecting urine for another 24 hours to see how my body responded. (In order not to overflow the containers, I reduced my water intake, but I still collected 3 liters. Fun!)
When healthy, the ACTH injection sets off a cascade of hormone production -- about 40 different hormones appear in the chart the lab provided, of which they measured 17 -- increasing levels of the tested hormones by 100% or more.
None of my levels doubled, and in fact, a number of hormones, including DHEA and Androsterone, declined in response to the shot.
Also, almost all of my baseline levels are low. (The urine test was nearly a month ago, and my levels have probably fallen further.) In particular, testosterone was about 6% of the mid-range value for healthy men.
So what is happening is that instead of ramping up in response to exertion or stress, my body is throwing in the towel.
Similar to the thyroid treatment, treating this also involves hormone replacement -- in this case, pregnenolone (near the top of the cascade), DHEA (a testosterone precursor), and hydrocortisone -- plus a nutritional supplement.
In addition, walking is the most strenuous exercise I'm permitted for the next 6 weeks or so.
I'm supposed to see improvement in a short time, but I need to make sure not to overdo things just because I feel better.
Over all, the outlook seems quite good. Given how bad some of my results came out, I'm surprised I don't feel worse. So I'm really looking forward to how healthy I will be once I recover.