Saturday, June 12, 2010

Its official: the bone pain is on its way out!

Yes, finally! I am so relieved! The bone pain which perplexed the doctors, from India, the US and Australia is finally on its way out. I honestly had given up hope if it ever being resolved. I thought I would have to live with this forever. And you can't really blame for thinking that way. I did all the tests suggested by everyone. Nothing of significance came in any of them. We tried so many things. Nothing was working.

Eventually, my nephrologist, Dr. Girish Narayen sent me to meet with an endocrinologist, Dr. Rakesh Sahay who is a professor of endocrinology at Osmania Medical College. Dr. Sahay worked on first principles. He noted that my PTH was not normal but it was responding to Calcium like it should. So, we don't really need to worry about PTH suppression on giving Calcitriol. I was not convinced. The nephrologists I discussed this with were also skeptical. But we decided to try it for a week. Calcitriol and calcirol would both help with the bin pain, he felt. We tried it for a week and there was no suppression of PTH.

We continued the Calcitriol - 0.25 mcg twice a day and Calcirol granules - 1 sachet every week. Calcitriol is the active form of Vitamin D3 - 1 alpha 25 dihydroxy cholecalciferol - the form that the body directly uses, the form that the Vitamin D obtained by the body from the food and sunlight is converted to by the kidneys. Calcirol is the inactive form of Vitamin D3 - 25 hydroxy cholecalciferol - the one that the body obtains from sunlight and food.

It's been about six weeks since I have been taking this and my PTH is stable - around 150 pg/ml and my bone pain has reduced significantly.

These are times when you appreciate the knowledge, experience and the thinking of doctors like Dr. Girish Narayen for sending me to the right doctor and of course, the brilliant Dr. Rakesh Sahay for nailing down the problem and relying on simple reasoning to arrive at the correct diagnosis. I was quite profuse in my thanking when I met with Dr. Sahay a few days back to report the successful treatment. He said, "We didn't do anything great!" Hallmark of genius? Whatever!

3 comments:

geetika said...

I am taking 1000 IU of Cholecalciferol every day - I have pain in keen which my doc attributes to weak cartilage cover - he suggests a blood test to check Vit D in blood - what has been your experience - can you share it please

Your write up was very informative

Thanks
Geetika

KT said...

Go ahead and get your Vitamin D test done right away. It is most likely that your reading will be below 30 ng/ml which is the minimum normal level. 1000 IU of Cholecalciferol will not help if you have low D3 and you may need to take booster dose of Cacirol Sachet for a few weeks.

So get your Vitamin D test (25-Hydroxy) done right away

Regards,
Kiran

Anonymous said...

My vitamin D in blood is tested to be 13.5. My doctor advised to take Calcirol Sachet for 12 weeks once a week and later on once a month for six months. I had no symptoms as such just found our in routine blood tests