A Break in Clouds or a Can of Worms?

We’re going to not say too much about last week. Except this: I ended up seeing an endocrinologist, because I drink a lot but pee a lot more. A lot more. And the bladder started it, your honor. I was convinced of that, my doctors — not so much. (While I understand their logic, but seriously, I have nothing but time to sit and work out the chronology here, folks. My bladder started this water fight.)  The endocrinologist on Friday, however, was pretty confident… Actually, a little too confident for my comfort, but hey. He is pretty sure I’ve got some sort of diabetes insipidus going on — either neurological or nephrological (not dipsogenic…). He’s unclear on partial versus complete. I don’t know what partial versus complete means, really.

So today I had a water deprivation test. Usually they do these inpatient, and he said it might work out that way.  Here’s the issue, I’m a stubborn girl, and I figured I’d do it outpatient as he felt it would pretty safe, and that I wouldn’t cheat (yeah, evidently, people cheat. Why?) I’d stop drinking anything at midnight and at eight this morning I’d have a blood draw and pee in a cup. Then I’d get a shot of an antidiuretic hormone, wait an hour, and then pee again. The idea is that we get a look at how things are baseline when I don’t drink.

Believe me, eight or nine hours with no fluid is its own hell for me. I did okay-ish till seven. Then the muscle twitches, the head pain, the back pain, the horror, the horror.  I thought I was going to die, and I wasn’t going to stop the test because I was an hour out from starting the wrap up. I was not going through this again.

The interesting bit was the ADH hormone (this was DDAVP) worked. I mean, okay, I don’t know if my blood osmolality was high or my urine osmolality was low and didn’t hit the golden (heh!) norm after the eight dry hours (I’m guessing both were somewhere in the high low spectrum). I don’t know what the change in urine osmolality value was before DDAVP compared to after. I do know that I was allowed a small amount of water after the DDAVP shot. And where that small amount of water would’ve been less than a drop in the ocean of my dessication previously, those few sips while I waited for the second test were enough. And since then,  I’ve only had to go every two or three hours (as opposed to two or three minutes — no lie). And I drank as much water today, sum total, as I would normally in any random hour and fifteen minute time frame. I do not want this stuff to wear off. It will, of course.

So I see the endocrinologist for the results next week. I am guessing that it’s the neurological type. That means an MRI where they actually consider my pituitary and hypothalamic regions (they don’t normally spend too much time reviewing that area, I guess… since, you know, I’ve had a lot of my problems seeming to originate there.) I know this is recent, I know I haven’t had any head trauma, surgery, or radiation. I don’t think I have any tumors. I mean, I really don’t. I am fairly sure there is a lesion somewhere there, honestly, in my gimpy hypothalamus but I don’t know why, or if it’s actually even visible on imaging.

So where will it get me? Off the toilet, for one thing. That’d be awesome. Because I can’t drink enough to keep feeling okay, actually, but I can get close. But this is the biggest pain in the arse, ever. It’s in some ways the least of my worries, and doing a great job at holding me back. (The idea was that I was ramping my “thermostat” up by drinking too much, and that would mess up any autonomic tests. But it would seem that’s not the case, I guess… And I’m drinking a lot. So treated effectively, it’s either less of an issue, or something they’re just gonna have to deal with and wrap their heads around when figuring future autonomic tests.)

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