Question: I have had symptom over past couple of years although same mild one over several years of bil lower leg edema L>.R( no cardiac problems-except hbp which is really worse over last several days -Maybe from hydro cortisone Ive been on a month(its cortef po). Im on disability for1. depression.2. pain management for back issues including spondolisthesis etc in every vertebrae cervical and lumbar spine, 3.chronic but I think well mged chronic hep c.4. did recently get 89,000 on platelet count( hasn’t been normal in sometime but usually over 120,000).5 seeing an endocrinologist for symptoms of fatigue, hyponatremia( hospitalized in July with---Na was 121-- neuro deficit. as I noted have had lots of oedema and am on fluid restriction and Lasix prn to manage, a.m.6. cortisol was less than 1 when ckd in july and 6. about a month ago I started taking a daily dose which helps me feel better although fatigue is still a predominant feature that continues now. I have a family practice, endo endocrinologist,7' and will see a liver specialist next week. also as noted,8 pain management and a 9.psychiatrist- have had more low mood.######Major question is that I feel like I need closer management like perhaps an internal medicine doctor. what do you think? there are so many days I feel like I am going to die. ive been researching but its so complex . I think I need an mri- but more importantly I need some guidance( my fam practice doc is great but hes having to get me out to specialists). I guess it may be a stupid question. I have had an mri some years ago which didnt show anything too bad I don't think. I do have a fairly ---10. large pineal cyst which the endo guy said may cause pressure and contribute to problems in pituitary but did not order one and said to come back in 3 months which is november. What is the best way to approach appropriate dx and management? thanks for any help you can give me.
on 8/5 8/29 9/24/14
am cortisol 4.68L rbc 3.66
alb 2.9L tot protein 6.1 hgb11.7 down 12.4
platlet 111,ooo hct 36.3 down 37.2
notfasting plt 89.000
? cortisol level
cmp albumin 2.9l
sgot 51h
platelets 125,000
cortisol testing inc level to 11.56