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Medical Forum / General / General / June 2005Nasal Glucose
Hi, A few weeks ago I made a post about hitting my head. I've been using a glucometer to test the clear drop of fluid that comes from the nose sometimes. It is usually around 25-50mg/dL. Is there any other reason why there would be glucose in nasal fluid besides CSF leak? The top of my neck at the base of the skull is sore sometimes, but I'm not sure if it is just from stress. I haven't made an appointment with a doctor because the waits are usually a long time and I'm not sure what to tell them or what they can do anyways. Thanks for any info > Hi, > [quoted text clipped - 7 lines] > a doctor because the waits are usually a long time and I'm not sure > what to tell them or what they can do anyways. I can't think of any. Glucose level in CSF is usually about 2/3 that blood. Usually, glucose in nasal mucus isn't measurable. HMc I saw a doctor. He said he doesn't think it's anything, but I have Head and Sinus CT Scans scheduled for tomorrow, "just in case". :( I don't have the money for unnecessary CT Scans... but they give you the alternative of possibly dying if you don't. Talk about a perfect business model. "You don't really need this fully equipped car you can't afford... but if you don't buy it you might die." Oh well. >I saw a doctor. He said he doesn't think it's anything, but I have Head > and Sinus CT Scans scheduled for tomorrow, "just in case". :( I don't > have the money for unnecessary CT Scans... but they give you the > alternative of possibly dying if you don't. Talk about a perfect > business model. "You don't really need this fully equipped car you > can't afford... but if you don't buy it you might die." Oh well. The difference between buying a car, and dealing with your health, I suppose. The other difference is that you can't sue the car dealer that sells you more car than you need. HMc http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 4647890&dopt=Abstract http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 4678009&dopt=Abstract http://jama.ama-assn.org/cgi/content/abstract/234/10/1052 Some interesting links > Hi, > [quoted text clipped - 7 lines] > a doctor because the waits are usually a long time and I'm not sure > what to tell them or what they can do anyways. I looked into this. The test of choice to rule out CSF rhinorrhea is to determine the presence of beta2 transferrin in the drainage. It is always present in CSF, never present in other secretions. Your local lab would need at least 0.5 cc of nasal fluid as well as a couple of CCs of blood. It would be cheaper than a CT scan or MRI, and probably more specific. HMc >> looked into this. The test of choice to rule out CSF rhinorrhea is to determine the presence of beta2 transferrin in the drainage. It is always present in CSF, never present in other secretions. Your local lab would need at least 0.5 cc of nasal fluid as well as a couple of CCs of blood. It would be cheaper than a CT scan or MRI, and probably more specific. << COMMENT: Agree! There are all kinds of ways you can have a small crack enough to leak CSF, and never even be able to see it on CT. So they'll end up doing chemistries on the fluid even if the CT is negative. Duh. Which means why not do the chemistry first to save the money of a CT (if it IS negative)? Answer: because nobody advising about the CT decision is PAYING FOR THE THING. If it was the *doctor's* money he had to pay out of pocket, he'd have done the same 5 min medline search Dr. McCollister just did, methinks. But it's not. Advice to patient: if you really are going to pay out of pocket for the radiology, demand the definitive chemistry first. That being said, I can't think of any way you're going to have glucose that high if it's not CSF. But who knows? These test strips aren't perfect, and aren't made to measure glucoses at levels this low. SBH Ya, looking at the images from the CT Scan, there's no way a tiny leak would show up. Not only that, but statistically (according to info found on the net) most mild cases of fractures and CSF leaks heal on their own with time. The glucometer is pretty accurate, I believe it goes down to around 20mg/dl and anything below that is 0. That's why I did repetitive testing over the course of a week. In the last instance I performed 3 readings one right after the other, and got 45, 50, 50. Chemistry looks like the way to go. Why then do I read of these tests where they insert dye into the CSF through the spine, and you keep cotton stuffed up your nose for a long time? Anyways, part of my reason for doing the CT Scan was to see that I had a brain. It turns out, while the images show a brain, I have none since I went through with the test rather than being smart about it. The physician didn't even know that nasal secretions don't have glucose or what the normal CSF levels are. >>Anyways, part of my reason for doing the CT Scan was to see that I had a brain. It turns out, while the images show a brain, I have none since I went through with the test rather than being smart about it. The physician didn't even know that nasal secretions don't have glucose or what the normal CSF levels are. << COMMENT: LOL. Don't feel bad about it. Why, anybody can have a brain. That's a very mediocre commodity. Every pusillanimous creature that crawls on the Earth or slinks through slimy seas has a brain. Back where I come from, we have universities, seats of great learning, where men go to become great thinkers. And when they come out, they think deep thoughts and with no more brains than you have. But they have one thing you haven't got: a diploma. -- The Man Behind the Curtain Thanks but too late, I already went. It wasn't an enjoyable experience and I have buyers remorse. I imagine when the report comes in the doc will want another appointment just to tell me they found nothing. P.S. - Physician was interested in hearing what your advice was. I said it was to go to the ER and get a CT Scan. Maybe that is why mine was scheduled. ;) |
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