Should we build an ark?? I have all the animals!!
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Should we build an ark?? I have all the animals!!
Hehehe I Know you do Patti!
Well, we did get water in the basement but not bad and I was able to mop it up. I just cannot figure where it is coming in at.
No way do I want to finish off the basement as long as I don't know and can't fix it. We've had the side around the house dug out and gravel laid, so should have good drainage. I don't know.
Molly is fine, rain stopped for today. We had our walk. She had her dinner and now I'll be starting to cook our dinner. Hubs has to get packed as he is out of town for the next few days.
hugs
Sharlene and molly muffin
Next heavy rain, you need to stand inside the basement and see where the flow is coming from. I would think you could see the area that first gets wet and correspond that to outside where a drain may be needed. A French Drain system is fairly easy to do yourself and could help if you can find where the water builds up.
I hope Molly's toe is better!
Hugs,
Leslie and the gang
I hope you guys are ready for the next chapter in the molly saga, because U of Tenn results are in and Molly continues to Baffle. Here goes:
ACTH (2 draws - this is due to the agent used by the vet) June 2012
Cor1 - Cortisol (base) 172 (30 - 300) 6.23 ug
Cor 21 - Cortisol (ACTH) - 1 hour 924 33.49 ug
Cor 22 - Cortisol (ACTH) - 2 hour 1014 36.75 ug
ACTH april 2014
Pre 29.5nmol range 2.1 - 58.8 1.06ug
1hr 283.1nmol range 65.0 - 174.6 10.26ug
2hr 345.6nmol range 65.0 - 174.6 12.52ug
This has actually decreased
Pre levels that are off:
Estradiol 103.4 baseline 30.8 - 69.9
Aldosterone <11.0 11-139.9pg/ml (normal range baseline 72, post 23 (she is close on the post at 23.7)
Estradiol being raised isn't abnormal usually as Lori mentioned was found in recent study.
The POST number that are out of range are as follows:
Androstenedione base .41 (range .05 - .57) 1hr 4.54 2hr 5.97 (range .27 - 3.97) HIGH
Estradiol base 103.4 (range 30.8 - 69.9) 1hr 105.2 2hr 129.1 (range 27.9 - 89.2) HIGH
Progesterone base .29 (range .03 - .49) 1hr 3.83 2hr 3.94 (range .10 - 1.50) HIGH
17 OH Progesterone base .38 (range .08 - .77) 1hr >25. 2hr >25. (range .40 - 1.62)
Aldosterone pg base <11. (range 11 - 139.9 1 hr 23.7 2hr 57.4 (range 72.9 - 398.5)
Comments: Baseline values are within reference range except for moderate estradiol
elevation. On the contrary, most of the post ACTH values (either after 1 or 2 hours) are
significantly elevated except for aldosterone that is lower than the reference range. Although
estradiol may contribute to clinical signs, it is not a good indicator for adrenal activity, since estradiol may be secreted
also by peripheral tissues (adipose, skin). In this case the source is not known.
Occasionally aldosterone concentration may be related to Na/K/water balnce.
page 3 of my upload lists treatment options.
My IMS said a couple things. Her ACTH cortisol levels have actually gone down since the previous
ACTH.
With the high other levels of hormones, there is concern that this Might be what is causing
the liver and adrenals to be enlarged. That what we want at the moment is to see if
we can get her liver enzymes to come down and have an actual decrease in the enlargement.
Her suggestion and what we discussed is to start with melatonin and lignans and give it 4 months
with a retest on the liver enzymes (i think I'd like before and after) and see if there
is any effect. She doesn't want to go to lysodren, even the maintenance dose Yet, but if there is
no reaction in the time suggested by Tennessee, then that could be on the plate at a very small dose.
Vetroyl, she feels would not be a good option, because it causes the adrenals usually to enlarge and we don't want
that with the tumor there.
Molly continues to be a puzzle, by not displaying signs of cushings other than on ultrasound, so no clinical signs
her cortisol lowering on it's own, even as a tumor shows up.
I have a meeting to discuss with her over phone on Friday, so I have till them to come up with what I want to do.
Get your input hats on peeps.
One of my questions will be, is the cortisol, hormones embalance, feeding the adrenal glands possibly feeding the tumor.
Could these have led to the creation of the tumor itself.
If we try this melatonin and lignans and they don't work we can also go to an aspiration of the liver or biopsy option, which my husband does
not want to do.
It was funny, the IMS, said, I want to email this to you, give you time to review and study and then discuss.
I understand that I am talking with someone who has more knowledge of these issues than most people.
I just laughed. I mean what can you say, but I thought it was nice that she recognized that and didn't
try to BS me about anything and just say, lets do this or that.
So, that is where we stand right now.
I think the IMS showed a lot of respect for you. I would take that as quite a complement.
I wish I had some insight. Molly is just amazing!
Renee, I definitely take it as a complement and it makes it much easier to exchange opinions and have frank discussions. My other IMS though was also very good with discussing options and opinions, but this one seems to go the extra mile, with calls, emails, etc and just being open and honest in her opinions. If she doesn't know, she says so, and then says, what she thinks and ask the same back from me. Her first words today was how is molly and do you have a minute to talk. Then followed up conversation with I want to send this to you, give you time to read and see what you think, and then can we talk tomorrow and I begged off till Friday, since my thursday is swamped at work. And she was like sure, call me.
I feel very lucky to have gotten her this time as my prior IMS was unavailable for the day I wanted. Glad I took the chance.
hugs
sharlene and molly muffin
Hi Sharlene, I am just now getting home late so will wait until tomorrow to look over Molly's results more carefully. But her huge decrease in cortisol per the repeat ACTH is indeed a surprise. One thing I am noting, though, is the low aldosterone. Per Dr. Oliver, that abnormality can be found in conjunction with a primary adrenal tumor that is affecting the adrenal cortex. So that finding actually may not be a big surprise since you already know about the presence of the tumor.
MarianneQuote:
For hyperadrenocorticoid cases that also have low aldosterone levels, this pattern can be indicative of a primary adrenal tumor, and ultrasound is indicated to confirm a tumor's presence or absence.
Hi Marianne. Do you have a link for that quote I can send on to the IMS. In treatment options they mention an ultrasound but not this specifically. I wonder though.... Wouldn't that mean the adrenal gland should be functional and active and how would that play into her cortisol dropping which I haven't heard or read of outside of treatment unless it was non cushings related. It is very bizarre. I was ready to say yea it must be secreting but then this and still no clinical symptoms. There is in fact both food and water in her bowls from today's meals.
Did I mention she is bizarre?! Lol
Hugs
Sharlene and Molly muffin
Is there any chance a pheo could cause these results? The decrease in cortisol is puzzling in the face of the tumor - unless it is not a cortisol secreting tumor after all. Do pheo's ever cause such fluctuations in the level? I'm just navel gazing as I really don't have any real insight. Hopefully Marianne and Glynda will be able to help - our amazing gurus.
I think it is just wonderful that the IMS is so open to working with you and understands that you are special....just as we do. I have no doubt you will figure this out and make the very best decisions for sweet Molly Moo. You always have, ya know. ;)
I wish I could help more, but I am basically useless to you and Molly. :o BUT I can, and do, keep you both in my prayers and thoughts.
Hugs,
Leslie and the gang
Woweee now that is a tricky one to get your head around, so pleased you are onto it as I have never got these adrenal hormone results in any sort of order in my head! Interesting about how it might be related to the adrenal nodule. I think I might get these done for Flynn at some stage. I have read that hepatic nodules can be linked to adrenal hyperplasia. I will dig out the study on the weekend when I get a chance to sit at my own computer!
Sharlene, I really like your new IMS, I love how she is taking your own knowledge base into consideration. Yes, your old one was great too, lucky you have two good people you can connect with. x