At my appointment with No Name this afternoon, I mentioned my increasing fatigue and exhaustion, increasing water retention, breathlessness upon exertion and increasing joint and muscle pain.  He realized that I was not prepared to leave until I had an indication that a resolution would be found.  We discussed adrenal insufficiency but he is not convinced that this is my problem.  I asked him if he was not concerned about my high ACTH levels.  No Name assured me that he was concerned and mentioned a carcinoid tumor and MEN 1.  We went through some of my symptoms which include flushing, abdominal cramps, occasional diarrhea, high blood pressure, wheezing and breathlessness.  Apparently these can all be symptoms of a carcinoid tumor.  A carcinoid tumor can also increase epinephrine levels which could be an explanation for the adrenaline jolts that wake me up at night.   As I expected No Name did not know what tests to order for a carcinoid tumor.  He assured me he would find out.

My blood pressure today was 169/102 which is really too high.

No Name gave me a prescription for some sleeping pills today.  They ended with “pam”.  I finally consented to give the pills a try to see if I could get some sleep.  I wonder if anyone has ever croaked from lack of sleep?

Before I left No Name gave me a requisition for a Renal Profile including NA, K, Creatinine, and Urea.  He also included TSH and Free T4.

I will spend this weekend researching carcinoid tumors and the testing involved.  On Monday I will hand deliver all pertinent information to No Name at his office.   For all the research I have to do on my own behalf, I should be getting a cut of the doctor’s fees.   By now this would probably amount to a nice monthly income.