I'm losing weight unintentionally and am worried

[Anonymous]

If her A1c is in the normal range (under 6.4 or something), she doesn't have US-defined diabetes. She may have blood sugar issues, but she doesn't have consistently high blood sugar.

[Anonymous]

I’m still following and with you, OP! Thanks for posting your update and I’m glad the results were normal. Waiting sucks but it’s good you have the appointments coming up.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Also curious if they do endoscopic ultrasounds in ER since only specialists do those.

Of course not. In medicine, ER doctors motto is “treat em and street em” meaning you make sure the patient is stable and discharge them asap. They will not be doing extra testing like MRIs or endoscopic US if it is not an emergency situation.

You’re wrong. That’s why it’s called an emergency room.

[Anonymous]

Your A1c isn't diabetic but what is it? High pre-diabetic?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Also curious if they do endoscopic ultrasounds in ER since only specialists do those.

Of course not. In medicine, ER doctors motto is “treat em and street em” meaning you make sure the patient is stable and discharge them asap. They will not be doing extra testing like MRIs or endoscopic US if it is not an emergency situation.

You’re wrong. That’s why it’s called an emergency room.

What? Yes, it's called an emergency room, because it is designed to stabilize emergencies. You got shot? Come into the trauma bay in the ER, get a ton of emergency care, head off to the OR, and then go to the unit. You're having a bad asthma attack? Come to the ER, get a ton of nebulizer treatments, augmented by more aggressive therapies if indicated, and then either get discharged with instructions to follow up with your primary care doctor within 24 hours and continue the treatment regimen that was prescribed to you at discharge ("treat em and street em"), or go to the unit. You're having abdominal pain? Come into the ER, get an ultrasound and some bloodwork and a urine. After those results, and a physical exam, maybe you'll also get a CT scan or some pain medications or some other medications, and be observed for a while. After that, either you are discharged home with instructions to follow up with your primary care doctor within 24 hours (because you're stable and either the problem we found doesn't require further hospital treatment right now- but does require follow up- or we couldn't find a problem at all and have ruled out a surgical abdomen), or go to the unit (because we found something that does, in fact, require further hospital treatment right now).

ERs are not the place for multi day workups for longstanding problems. Nor should they be. That doesn't mean that OP doesn't need more of a workup. Or that a trip to the ER is a bad idea, if she is aggressively losing weight and having abdominal pain and can't get in to see anyone within the week. Because she'll get the basic workup and if she has something ominous, it's almost certainly going to show up in the scans and/or bloodwork. And if those are clear- great! It's probably safe for her to wait a few weeks to get in to see that specialist and schedule some of those other scans, if indicated.

[Anonymous]

Any updates , OP?

[Anonymous]

Anonymous wrote:OP with an update - I got the prelim report and A1C does not show diabetic. Liver enzymes normal range. Vit D is lowest end of normal, magnesium is also lowest end of normal. CBC normal. CMP normal. LDL High. Waiting on Celiac Panel. B12 normal.

LabCorp screwed up and forgot to put in the order for fasting glucose, TSH, T4 and T3 and CA19-9

I guess its another waiting game after I go back tomorrow.

I asked chatgpt if I need the fasting glucose too and it said yes because a1c monitors 3 month trend but fasting glucose shows current.

My doctor has also ordered an MRI Enterography.

It sucks that all the MRI dates available are in January for the JH network. I'm not sure whether to just go to another center since my records are at JH. And since I have appointments at Sibley I cannot get on any wait list for the other JH locations since the other 5 centers are independent of Sibley

I called and my follow up MRCP earlier this year was with a 1.5T scanner while my first MRI was a 3T. Not sure if that made a difference in the measurements of my IPMN.

OP, I just wanted to say that Sibley can’t put you on the waitlist for other JHU centers, but you can call yourself and ask for earlier appointments or waitlist. I had to do this to get a scan - there are 2 separate numbers for different groups of facilities in Baltimore. What you do at any JHU facility will show up accessible in your chart to all JHU facilities. I think there is also a way to make an appointment online - but they will only allow you to do it a week out because they have to run the insurance. If, when you call you tell them you already have an appointment at Sibley and the insurance already ran and approved the scan, the scheduling people may be able to look for appointments inside a week because it is easy to transfer the insurance approval between facilities.

[Anonymous]

Anonymous wrote:Any updates , OP?

OP here. Not really. Gave my pending bloodwork today that's it. The CA19-9 and TSH, T3, T4 are in this one.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP with an update - I got the prelim report and A1C does not show diabetic. Liver enzymes normal range. Vit D is lowest end of normal, magnesium is also lowest end of normal. CBC normal. CMP normal. LDL High. Waiting on Celiac Panel. B12 normal.

LabCorp screwed up and forgot to put in the order for fasting glucose, TSH, T4 and T3 and CA19-9

I guess its another waiting game after I go back tomorrow.

I asked chatgpt if I need the fasting glucose too and it said yes because a1c monitors 3 month trend but fasting glucose shows current.

My doctor has also ordered an MRI Enterography.

It sucks that all the MRI dates available are in January for the JH network. I'm not sure whether to just go to another center since my records are at JH. And since I have appointments at Sibley I cannot get on any wait list for the other JH locations since the other 5 centers are independent of Sibley

I called and my follow up MRCP earlier this year was with a 1.5T scanner while my first MRI was a 3T. Not sure if that made a difference in the measurements of my IPMN.

OP, I just wanted to say that Sibley can’t put you on the waitlist for other JHU centers, but you can call yourself and ask for earlier appointments or waitlist. I had to do this to get a scan - there are 2 separate numbers for different groups of facilities in Baltimore. What you do at any JHU facility will show up accessible in your chart to all JHU facilities. I think there is also a way to make an appointment online - but they will only allow you to do it a week out because they have to run the insurance. If, when you call you tell them you already have an appointment at Sibley and the insurance already ran and approved the scan, the scheduling people may be able to look for appointments inside a week because it is easy to transfer the insurance approval between facilities.

Thank you! I called Sibley again and no change to date - doctor ordered both an MRI abdomen/pelvis and MRCP and scheduler insisted that it was just MRCP when the order says otherwise, and she asked me to call the doc office again and said that when she called them they wanted just MRCP. With all my issues I'm pretty sure my doctor wanted the full sequence of tests and not just the focus on pancreas.

All the other JHU locations have January dates.

When you say - tell them that Sibley already has approval of scan - do they do that for an appointment 3 weeks out? How would I know they have approval? I don't think I need approval for MRI, not sure about MRE. Sibley has me for MRCP.

[Anonymous]

Sorry you are going through this OP

Hoping for a resolution for you

[Anonymous]

Anonymous wrote:

Anonymous wrote:Any updates , OP?

OP here. Not really. Gave my pending bloodwork today that's it. The CA19-9 and TSH, T3, T4 are in this one.

And they were all normal? That's reassuring at least?

[Anonymous]

If CMP is normal, that has glucose in it. If that is normal and A1C is normal, no concern about diabetes.

Radiology locations will not do 3 tests at a time. You can’t have MRI abdomen and pelvis and MRCP. You can have MRI abdomen and MRCP.

You mentioned MRE. That is looking for inflammation in your small intestine.

Great news that everything is normal so far!

[Anonymous]

Anonymous wrote:If CMP is normal, that has glucose in it. If that is normal and A1C is normal, no concern about diabetes.

Radiology locations will not do 3 tests at a time. You can’t have MRI abdomen and pelvis and MRCP. You can have MRI abdomen and MRCP.

You mentioned MRE. That is looking for inflammation in your small intestine.

Great news that everything is normal so far!

Just gave my TSH and cancer marker bloodwork today. Crossing my fingers.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Any updates , OP?

OP here. Not really. Gave my pending bloodwork today that's it. The CA19-9 and TSH, T3, T4 are in this one.

And they were all normal? That's reassuring at least?

Just gave them today. Hoping to get the results in the next couple of days.

[Anonymous]

Anonymous wrote:

Anonymous wrote:If CMP is normal, that has glucose in it. If that is normal and A1C is normal, no concern about diabetes.

Radiology locations will not do 3 tests at a time. You can’t have MRI abdomen and pelvis and MRCP. You can have MRI abdomen and MRCP.

You mentioned MRE. That is looking for inflammation in your small intestine.

Great news that everything is normal so far!

Just gave my TSH and cancer marker bloodwork today. Crossing my fingers.

What? I thought you said they took them all the same day and was waiting on those to come back?!