Today Physically Verifiable (not much):
1)	Increase tint of skin – previous redness of face now “tanned”  along with hands and to a lesser extent the rest of my body
2)	Redness of fingers
3)	Weight loss 175 down to 155 in July up to 163 in August now down to 157
4)	High H2 Breath test in August -  treated by Dr. Briggs with Xiphaxin
Current Medication:
10 mg Celexa daily
20 mg Omeprazole daily
1-2 mg Klonopin nightly
Pretty Much every other test (all run in July/August) showed normal:
Chem 16 June 4 2012
Urinalysis June 4 2012
Liver Panel – July and August
Multiple tests on stool (Briggs) – August 2011
Upper Endoscopy – August 2011
Abdominal X_Ray – july 2011
Abdominal Ultrasound – July 2011 –
Chest Abdomen CT - August nodule on lung
Stress Echo - July
Colorflow Echo - October
Nerve Test of Hands/Arms – October
Immediate History:
July 1 I after some mild exertion at the pool, I felt the beginning of one of my previous episodes of confusion.   – more on this later
Took 250 mg of Fluconazole, followed by 2 days of 125.
Immediately had polyuria, fatigue and darkened urine.  Drinking only made me pee more.  I had nausea, but continued to eat normally.  I also had confusion/mind fog.  One morning, I near fell asleep many times on the drive to work.
Over the next 10 days I lost about 12-15 pounds. It was July and 115 outside and I did not sweat, in fact I couldn’t feel any temperature discomfort hot or cold…I could walk around my house with little on, or cover up with many blankets and I felt the same – bad.  I saw my doctor during this time, he did the Chem 16 and Urinalysis.  Everything was normal
Then the stomach cramps started.  One night it would be my lower abdomen – severe cramping after eating.  Then, the next night it would be higher.  During all this time I had increased urine volumes.  Finally, one night I had chest pains, I had been withholding urination, but decided to totally empty my bladder.  Within 15 minutes of that, I felt a relaxation within my body and the chest pains disappeared.  For a short time, it felt like I was walking on wet carpet.  As if there was extra fluid in the soles of my feet.  My nose also got very red during this time.  After this, my doctor ordered the abdominal and chest series and referred me eventually to a GI doc.  Strangely, I remember the exact moment the stomach pains stopped because within half an hour I had the first headache.
Then the headaches started, intense top of my head headaches with vision changes in my right eye.  These got progressively worse each day until one evening when I found myself to be agitated and angered by anything.  I just felt rage for some reason.  I would wake up in the morning with headaches and bloodshot eyes.  This is when I first noticed the red-faced appearance.  This is very noticeable when comparing old photos to photos of that time.  Laying down seems to aggravate the headaches but it is hard to sleep without laying down.
Let me add that I have had so many stomach related issues in the past that 1) I can eat a full meal with a nausea level of 10 on a scale of 1-10 and 2) Nausea never makes me throw up, anymore.
In August, I thought my Nausea and stomach issues might be due to blood sugar levels, so I measured them for few days.  They were always low  - 72-80, even an hour after a meal.  Drinking a sugared drink could get them to 150 briefly, but then back down.
Since July, I had some slight pain in my fingertips, but several weeks ago, it got much worse and my fingertips turned red and blue and the backs of my hands felt like they were on fire and  even my toes began to hurt.  So, I consulted my doctor, he said it was likely Reynauds, and ordered the colorflow echo and nerve test.  I took 2 days worth of 125 mg Fluconazole and the majority of the symptoms disappeared immediately, although I still have some pain and redness in my fingers.
One more odd note – I have terrible allergies every summer – last year I had nice dry nasal passages the whole time through early 2012.
This may be the longest history you have ever had prepared by a patient by the time I am finished, but I want to present everything, openly and without a filter.
1995
OK, now I want to go back to the start of my stomach/other issues.  Back in 1995, I was new to Tulsa, and new to a job where they supplied free drinks/water/candy.   I have always been someone that drank only as little as needed for two reasons, 1) in my youth I wet the bed.  As a result, I was also restricting my fluid intake in an effort to not wet the bed 2) when I was in college, I drank too much one night and attempted to “rehydrate” myself by drinking a lot of fluids and became confused and had to call a house brother who took me to a clinic where they processed my blood through something.  I was foggy the whole time and barely remember it, but I do remember the doctor saying that I might have a problem with liquids and to only drink when thirsty.
Anyway, so in 1995, I changed the amount I drank of pop and water – switching to caffeine-free things and lots of water.  I began to feel achy and seemed to be urinating all the time and scheduled a visit with my doctor (new doctor to me at the time).  He thought I might have a UTI, but couldn’t find any evidence of one but put me on an antibiotic anyway.  Soon, I started having loose bowel movements, so he put me on Donnatal.  (At this point I need to say that in 1983, I took one tablet of phenobarbital for recreational use, and had an emergency appendectomy less than 12 hours later.  I never told the docs about the pill, but I was in the hospital for 5 days, because they couldn’t figure out what was wrong with me.  During this time, the skin on certain areas of my body just dried up and peeled off.  The doctor reported my appendix was totally ulcerated – I felt fine before taking the pill.)
Anyway, as it turns out, Donnatal has Phenobarbitol in it, albeit in small amounts, so you can imagine what happened next ( I didn’t put these two together until 1996 or 1997) – my stomach suddenly had ulcers.  An endoscopy at the time showed white lesions everywhere.  The GI doc (Dr. Cottril) said I had the stomach of a 60-yr old.  It felt like my stomach was on fire.  I found the only thing that made it better was – drinking cold water.  So, I stopped eating and just drank water for several days.  Then I started getting foggy, the area of my kidneys started hurting, and finally, I stopped being able to urinate even though I continued drinking.  This was all over a week or so.  Soon, I found that if I drank enough water, I could at least think, but I was super agitated and couldn’t sleep.   I didn’t realize I was putting my blood pressure through the roof.   From my readings, I think I was Hyponatremic. I remember at one point thinking how I just wanted to relax and sleep, saw that the donnatal could cause drowsiness and took 2.  Within 1 hour I had a white  bowel movement and my level of pain just increased.  At the ER, they gave me some mixture of different drugs for GI flareups – which once again contained Phenobarbitol – I threw up on the way home from the ER as the pain was increasing.  During this period of increased drinking, my wife would have to tell me something 2-3 times before I would recognize what she said.  I couldn’t think straight.
This is when I propose I developed some sort of systemic candidiasis infection.  I also had given up on doctors.  I was taking Potassium tablets to try to pee, but still drinking lots of water ( a 16 oz glass of ice water would take me 2-3 seconds to drink) – and not eating.  as I sat on the toilet one night about 2am trying to pee (as I had no hope of sleeping), the veins in my legs, scrotum and penis convulsed – I don’t recall what other pain I had as I was so freaked out.   First one leg had the veins bulge and my penis bent at a 60 angle to one side, then very shortly later the other leg did and my penis bent the other way.  I collapsed on the floor of the bathroom, unable to even call for help.  Over the next couple days, I was freezing cold, sweating profusely, and my sweat would leave a rash on my body.   I did not go to the Doctor or ER right away. This was the first time I could feel my heart pounding in my chest – it lasted the next 15 years or so until 2010.
Slowly, I began to feel more normal, and managed to eat something.  Right before leaving for Tulsa from Norman.  As I didn’t want to wreck, I drank a lot of water so I could concentrate, but now, I was urinating profuse amounts instead of not urinating at all.  I couldn’t even stop on the turnpike often enough and ended up filling a 1 liter bottle in my car.  When I got to Tulsa, I went straight to the ER at St. Francis.  My BP was 225/175 or something like that.  They said I was in strokesville – but that nothing was wrong with me –realize I had been to the ER 2-3 times already in the last month with stomach issues.  So, they sent me home saying it was extreme anxiety and my body was in fight or flight mode.
After a couple more days, I went back to Norman where my mom lived.  I tried to explain it all to her.  Finally I just wanted to die.  They knew I was at the end of my rope and hid everything dangerous.  I took a single Benadryl  thinking it might help me sleep.  Shortly after that, my mom made me eat a full meal of chunky soup and a coke.  I’m not sure if it was the Benadryl of the electrolytes and caffeine, but in the next hour I probably urinated 8 times and it was as if going made me need to go more – the stream of urine would increase in strength the longer I peed.
After that, I felt 100% normal for a short time.  My mind was not fogged, I could remember things and follow conversations.  But soon, I was foggy and started drinking water again.  Finally, I asked my Mom to take me to the Laureate.  It had been suggested previously when I went to the ER with the high blood pressure, and I figured I would try anything if I could just sleep – as it had now been 2 weeks or more without real sleep.  My pupils were 100% dilated which the staff found interesting.  
Upon checking in, I vowed to do whatever they said – I just wanted something to make me sleep.  So, the first meal, I just chowed down.  I ate everything I could.  Developing during the meal I had an intoxicated feeling and had to urinate  - again a lot and frequently.  After eating, I would return to my room, and first I would feel hot all over and then cold all over this would repeat several times very rapidly, say 30 seconds to a minute of cold then hot.  At the end of it, I would have a yellow waxy coating on my face, hands and feet.  My nose would also get bright red.
Then the psychiatrist said he thought I might be bi-polar so they started me on lithium.  That was just a salt as far as I was concerned so I was ok with it.  
The polyuria continued – I was not drinking excessive water during this time.  After those first three days, I felt like I was shriveling up.  I gave up on them figuring it out and asked to look through the diagnostic manual they had behind the counter.  It was indexed by symptoms, which made it easy to cross index polyuria with polydipsia and arrive at Diabetes and Diabetes Insipidus.  The second one sounded like what I had to me, but it didn’t account for all the other things going on.  However, at the end of each diagnosis was a “Rare” section.  Two after Diabetes insipidus were Terminal Onset Diabetes Insipidus with Candidiasis Majeure and Minor.  This is what I believe I have, however, I will warn you I can find nothing on it anywhere and I have searched over the years – I work at OU-Tulsa so have complete access to many online medical sources, but I have never been able to find anything.
Those two explained much more of what had been going on – the stomach issues, the inability to pee followed by polyuria and the euphoria. It also said it was Terminal due to changes in bloodflow somehow.  I don’t recall it exactly, but I think it had to do with hyponatremia, the heart or blood pressure and switching from using Sodium dilution to Potassium concentration to control urination.  There were two treatments, one which involved treating the infection and an ethanol drip or something like that and one where you put the patient into an accelerated state by giving a shot of adrenaline while they were dehydrated. This somehow caused a shift in brain chemistry allowing the pituitary to take over control of electrolyts. As I couldn’t do whatever the first option was, I decided to try the second one  - in the Laureate by myself.  I told them I was checking out ADA, unless they brought me 2 two liter bottles of diet coke and let me drink as much as I wanted without disturbing me.  They did.
I sat down and drank about a bottle and a half – holding back the urination the whole time.  Soon, I had what could only be described as the only migraine I’ve ever had in my life.  Every little sound was like thunder and eventually I couldn’t even wiggle a finger without causing myself pain in my head.  Then, it went away…and so did my need to urinate – most notably my bowels moved.
After that, I felt much more normal, and was able to play along well enough that we all agreed to let me go home.  I couldn’t follow a TV show, or a conversation, but I was out and feeling better.  From there, I went to a Doctor in Norman that treated people for systemic candidiasis.  I realize in most cases, that is probably a quack diagnosis, but for me, it worked perfectly.  He put me on digestive enzymes and Fluconazole.  After the first Fluzonazole, within 15-30 minutes I felt so different I was scared.  My heart was racing was the main difference.  I started getting headaches, and had some polyuria – mostly during meals, but I attempted to control that by just not completely emptying my bladder, and drinking a lot of water. Interestingly, I would still get a euphoric, relaxed feeling when I would have this polyuria.  I had my first headache centered at the top of my head back then.  I would get them whenever I exerted myself for a while.  

At one point, my polyuria was bad enough that I was very dehydrated.  I couldn’t keep the water in, but I noticed that when I showered, my body literally absorbed water.  This sounds ridiculous I know, but since I had given up on doctors believing me, I just took it head on.  I got into the pool at my gym – and felt like I was having a heart attack within just a few minutes.  I got out and just laid on the floor for several minutes.  Then I did it again.  Over the next few weeks, I went from getting in, to wading to swimming 40 laps.  My whole body changed as it took on fluids.  I went up a size in pants and underwear, I had a butt for the first time in my life (always had a flat butt before then).
Over the next 15 years, and had several episodes where things started to get out of hand, usually starting with nausea and palpitations.  Each time, I resolved those with Fluconazole – inevitably with polyuria – and would end with a shot of caffeine.  Each time, I would get the same immediate relief and noticeable a bowel movement immediately after the caffeine.    My stools during this 15 years time were always light brown and almost dry – except when I would go on Fluconazole during which they would get dark.  I think the last bad spell was about 2005 or 2004, after that I had 5 or 6 years of perfect health such that I convinced myself nothing was wrong or if it was, I definitely didn’t have the Terminal Onset Diabetes Insipidus.  That would prove wrong later.
2009-2010
During the intervening years, I kept in excellent shape – eventually running various 5ks and the Tulsa 15k three times.  In 2009, when I ran the tulsa run 15k, I did not hydrate afterwards – long story but I was walking to meet my wife and we missed each other so I went home and forgot to drink anything.  By midafternoon I was vomiting profusely.  I ended up at Southcrest ER where they pumped a bag of saline into me and sent me home.  After that, I never felt very good.  I think I lost a lot of salts here which really threw off my fluid balances.  Then a week later, I had my 5 year follow up colonoscopy which didn’t help the electrolyte situation.  So, that was November.  Over the next month or so, I would literally fall asleep whenever my head hit the pillow – quite a change for someone that usually had a hard time sleeping.  Then in late December, my wife woke me because I was snoring too loudly.  At that moment it felt to me like my body temperature was like something straight out of the refrigerator.  I could barely stand, and did not feel better until I got some fruit juice down.  
In January 2010, I started feeling nauseated and unable to concentrate – and I began losing weight very quickly.  I have a few photos of myself during this time, and my face was flush.   It was like all my hard earned muscle just melted off in a few weeks.  I had a butt, then I didn’t.  I also had thrown away my fluconazole, finally buying into the “it must be in my head” theory and thinking I’m 100% healthy as nothing could take more than 10years to kick in.  Anyway, I switched my PCP to OU IM and they put me in St. johns for 4 days.  At this point I thought I did have addison’s disease or something similar or the original Terminal Onset Diabetes Insipidus.  
The first two days they measured my urine output, and took a lot of blood samples.  On the first day I refused the Heparin shot – but they convinced me I had to on the second day.  After that shot,  it felt like my body fell apart.  They also gave me a head CT with Iodine. I stopped urinating on day 2.5 – but they had stopped measuring at that point.  My knee joint got totally loose and I was limping when I walked.  At that point, with me not urinating, having severe stomach cramps whenever I ate, I truthfully thought I would die any day.  My whole body felt 10x worse than before I entered, but I could think much more clearly and the nausea was lessened.  I decided I would say whatever they wanted me to so I could go home.  
The only abnormal finding they had was an increase in new (young) blood cells.
  I had my first dark stool while still in the hospital these continued until July 2011.  The difference in stool color from say 2005 to after this visit was dramatic, they were also greasy.  After I left, I didn’t pee for almost a full week.  I would pee just a few drops of dark urine whenever I tried.  I thought it might be from the Iodine contrast, but now I think it was my kidneys returning to a “normal” working order.   I started peeing again after about a week.  A subsequent visit to the doctor showed everything kidney related was fine.  When I got out, I started on fluconazole and took it for a week or more at low dosage (125mg/day or less).  My stomach cramped every time I ate, but eventually that went away. 

Currently
  My legs ache evenly and deeply in all the muscles (calves, quads, glutes).  It is still occurring.  He wanted me to get my nerves tested for back issues.  I declined.   I think I can explain it, but that is later.  
Since then I have felt good,  except for the leg pains – overall weak, but I have paced myself.  Good appetite, sleeping well, etc.  As of two weeks ago, my therapist and I both thought I was doing great.   Now, however, things are changing rapidly.  I awake feeling ok, then by 9am I am very nauseated, this lasts until evening when I feel ok.  During the nausea, I also feel “foggy” but I can still concentrate I just feel strange, mentally like I am intoxicated but not in a nice feeling way in a dizzy way – this also abates in the evening.  I will say that I had these symptoms last fall for a period, but they were not as prolonged.  I found that they would be gone by about 1pm.  I also found that drinking just part of one of those energy shots type drinks (the small ones with caffeine, B Vitamins, Taurine, etc) would help me through the worst of the morning.  I am trying that again now, but it isn’t working this time.  
When in 1995, I read the description of the condition I believe I have, it talked about all the phases and changes the body goes through.  I think I misremembered some of it, and left out other parts.  But, if you will recall, I said my pituitary was in charge of my system completely at this point.  For the last 8 months or so, my blood sugar has been 75-85 even after meals.  Now, it is starting to rise – it is still within normal ranges but the shift from the low numbers I experienced for those months is over.  This is because the pituitary is giving out.  I remember the article basically started with it is “all about ATP”, and that is part of it.  The nausea cycle I am experience is due to the natural circadian rhythm of the endocrine system.  The article said that that patient would reach a point at which you would stuff them with food in the morning and then try to keep the food down until evening when the natural rhythm of the endocrine system would be peaking and the patient would feel more normal.   In this disease, food helps increase blood pressure, the article stated, which was supposedly the reverse of normal.  It was something to do with reduced blood flow to the intestines and the food being actual support via pressure.    I believe this is about where I am.  I was sleepy last night and slept from about 10:45 to 1am after which I awoke and felt hyper-alert and not in the least nauseated but was unable to sleep.
On most recent mornings when I slept the whole night, I awoke each day with blood shot eyes.  These go away after a half hour or so, but can return later in the day sometimes, but usually not to the extent they are in the morning.  
My weight is now 162 on my scale which is basically my average over the last 15 years and has been a constant value for the last several months – at times (1995-2010) when I was running I got down to 152lbs or so and when not I hit 175lbs. Body-wise, I am thinner than just about any other time and my legs are much thinner than in any other times.    My bowel movements are the consistency of thick oatmeal, brown, very greasy and smelly.  Let me edit this line to say I’ve lost 3 pounds since I began writing this email a few days ago.  Yes, something like this takes several days to compose.
Phase I, II, III and IV
Now, I want to try to explain, as best as I can, the syndrome, or whatever you want to call it.  This isn’t a disease, as it is not naturally occurring, but only happens as a result of specific series of events – basically iatrogenic.
The article I read in 1995 listed a specific body type of person likely to experience this.  It also said they were generally naturally inclined to candida infections as a host.  It even said they were likely to have been raised fairly dehydrated, which I definitely was, as I wet the bed until I was 11 or so, and I did everything I could to stop it – which mostly meant not drinking much.  Somehow this combination of things allows the body to host the fungus without any outward signs.  Which is usually harmless, but under the right/wrong conditions is very bad.
The first thing that happens is exhaustion of the kidneys due to dipsomania for whatever reason – I believe I had an intestinal fungal infection that I attempted to solve by drinking as much water as I could because it was the only thing that helped the burning.  I drank so much that I stopped being able to urinate.  Soon, I was brain fogged all the time, and the only thing that would make it better was drinking more water.  I had severe lower back pain.  Then, at some point due to pressures and electrolytes the blood pressure gradient across the kidney’s reverses.  I don’t know exactly how this happens, but it involves the heart and it hurts.  This happened in 1995.  Essentially, venous pressure exceeds arterial pressure in a portion of the body.  This  happens somehow by a little blood backflow slightly in one of the heart valves and another one squeezing harder than normal.  As a person, what you experience during the shift is two, distinctly different, briefly separated episodes of bulging veins and pain in the groin and back and abdomen.  I know that starting that night, I could feel my heartbeat distinctly.  Early on (for weeks/months), I could even feel it in my fingers and toes at every moment.  Each beat.  It was very disturbing.  I could only sleep on my right side because sleeping on my left side made it feel like someone was poking me in the chest every second.
At some point after that shift, urination is again possible.  However, personally, I can say I sweated profusely for a couple days and the sweat would cause a rash on my body wherever something touched me like a sheet.  My BP was 225/175 or something like several days later as measured at the St. Francis ER, so it was not an uneventful occurrence.
After that, the endocrine system is using potassium molarity to regulate fluid levels – I’m going to call this Phase I.  However, this doesn’t work, because the body tries to decrease the concentration by urinating and in this reversed pressure model, potassium doesn’t pass through the kidneys somehow.  So, urinating just causes more urinating and the body quickly dehydrates ending in a stroke if nothing is done.  The article had two solutions to this, one I do not recall except for that it required serious medical intervention involving medications and surgery (I think it mentioned removal of the pituitary but that seems rather drastic if even possible)  which I didn’t have access to from the isolation of The Laureate, and the second was a large dose of adrenaline to put the brain into an accelerated state by inducing a stroke-like event and kicking the pituitary into overdrive – I’m going to call this Phase II somehow this normalized things.  It stated that the second solution would grant years to the lifespan of the patient – but that it was not a true fix.  Eventually, there would be a “rapid test run” of what the patient would go through at the end of the condition.  This would occur when the accelerated state collapsed.  This would lead to the inability to maintain the abnormal pressure differential.  This was me in Jan-Feb 2010, when I first experienced a night of extreme coldness and shortly thereafter began losing weight, experiencing nausea and fogginess.  I’m going to call this Phase III.  In my original writings, I think I referred to this Phase II was Pseudo-Addisonian, but now that I have researched what Pseudo-Addisonian is, I think that term was being used to describe the eventual stage IV.  That fits much better, as Phase IV is the exhaustion of the adrenal-cortex.
During the Phase II the infection has to be dealt with.  I got anti-fungal meds at the time from a doctor into treating such things.  I can tell you I was brain foggy after discharge right up until I started the medicine.  Phase II, which was the primary phase and lasted years, the patient’s body would go through many changes.   Initially, insulin secretion is triggered during urination.  I know that sounds weird, but it said something about portions of the pituitary switching roles and that somehow in this state urinating cause the release of insulin.  This included something to do with pleasure, too.   I remember that just the act of urinating felt weirdly good.  I could also urinate almost endlessly, initially, and controlled my urination by just peeing as much as I thought I should pee.  It wasn’t like I had a full bladder, more like the act of urination caused urination.  Similarly, eating caused the need to urinate – almost immediately.   To me, I see this as a system out of steady-state reaching a steady state.  It took a while, but eventually these things lessened and then stopped.  Various other changes would manifest in symptoms from psychological at times to physical pain, but nothing clinical evident.  Part of this process results in blood flow changes, as you would expect with a change in differential pressure.  Somehow, this involved losing some flow in the digestive tract.  I don’t know if that was venous or arterial.  However, I do know that 3-4 times during the 15 years after 1995, I felt nausea and fogginess and treated it with anti-fungals and fluid restriction – which always seemed to bring on excessive urination of dark urine.  Then, I would boost my system with very concentrated black tea and focus and suddenly (within a few minutes) my bowels would move and I would feel much better.  I believe this was the gradual collapse of some blood vessels for my gut – which in turn would make it easier for my heart to pump (less area requiring supply).  Normally, this would cause severe issues, but the whole reverse pressure thing makes it silent.  The reduction in flow made it easier for my heart to keep up the pressure differential.
It is important to note that at no time does the candida infection become obvious externally.  That is part of the pressure differential and something to do with pH, somehow when it does return or worsen it is only in extracellular or intracellular space.  One way I know this, besides the article, is that after treating myself with antifungals each time I would be very chilled for many days or weeks.  Eventually, in one evening – and always while I was in bed lying down, I would feel a sudden bloom of warmth over my back and shoulders usually in the middle of the night.  At that point, the chill ALWAYS went away.  So, the infection is present even when not obvious or causing symptoms.  The last time I had that feeling was in December of last year.  I had been chilled for a while and I remember the warmth.  Looking back over the years, I distinctly the return of the warmth as a pleasant thing.  I knew it meant I would feel better.  Even though, I guess it meant the infection had returned or increased.
When Phase III occurs – this is right when I got out of the 4 day observation in 2010, the body has to try to begin doing things the normal way again.  However, it can’t keep it up forever.  The transition is marked with a period of non-urination (I went 6 days or so) while pressure shifts in the body – at the same time bowel movements sped up  - I was having 3 or 4 per day that week.  Meanwhile blood starts trying to flow places and ways it hasn’t in a long time.  This hurts like hell.  After every meal my stomach would cramp like I have never experienced.  The limit to the time the body can do this is somehow based on the concentration of a specific electrolyte I don’t recall exactly.  Essentially, you start at one end of the spectrum at the beginning and slowly move towards the other.  The problem being that these are intracellular/extracellular concentrations – so it isn’t something you can measure.  Somehow, the kidneys work during this phase by increasing the concentration in these spaces instead of just decreasing concentrations in the circulatory system.  In a partial effort to compensate for the now missing pressure differential, the body builds up fluids in circulatory system. Once the limit is hit, you get Phase IV, which is what I hit last July.  Then your body immediately sheds the excess fluids which is how I lost over ten pounds in a week while having dark (brown) urine.  This is real hard on the already damaged kidneys.  I will say that the article talked about being acidic in some of these phases and then basic, and that the final shift was to acidic, but that due to the “brief” basic phase the formerly acidic heart turned soft when the acidity returned.  It talked about how small parts of valve flaps could literally tear off during exertion at that point.  I think that is late Phase IV stuff.  
During Phase IV is when the pituitary takes complete control and insulin is no longer involved with blood sugar control this is because levels are held below that at which insulin would normally be released.  This is a fast transition marked by severe headaches, blurred vision and other physical and psychological symptoms.  Essentially, you hit a point where the pituitary can no longer force the pancreas to excrete insulin.  Blood sugar spikes and the pituitary immediately begins trying to control it through other means.  This results in concentrated bloodpressure to the pituitary until some limit is hit which somehow enables it to take control, after which the pressure subside but it remains in control. Basically, somehow part of the circulatory system – from the heart to the head, has a higher pressure than the rest of the body – which has lower than normal.   This is done somehow with hormones causing constriction of vessels and strong pumping of the heart.  This was the first week of July for me last year.  Somehow, blood sugar levels are then maintained via other hormones such as adrenaline and others.  This results in an slightly lower than usual blood sugar level – and great ability to concentrate as I have had for the last 10 months or so except during just a couple short periods – I’ve read probably 2 books a week during this time.  
Prior to phase IV (1995-2011),  my blood sugar always around 100 mg/dL, the last 10 months have had me at 75-80.  The article I read stated the pituitary would work to keep the blood sugar levels low in order to reduce the spread of the candida.   As it is exhausted, sugar levels rise, giving rise to the infection.  During this time, the body focuses on maintaining hormone levels in whatever way it can.  As the additional electrolyte are pushed into the cells including the heart muscle, the heart becomes less capable of doing its job, however, the typical heart failure symptoms are not seen.  Instead, this type of heart failure is evidenced by loss of fluid volume.  Blood flow through the body changes, causing more pain during these shifts.  The article mentioned specifically that fluid would not accumulate due the weakened heart in the final phase – but would during phase III when it was trying to maintain the pressure differential.  
Additionally, I believe it said that somehow even the skin and muscles are used to generate ATP but that this results in cell death eventually in those areas which is why skin doesn’t sag during weight loss and in fact gets tighter as the underlying layers die off.  If you will remember, I told you in October of last year I had swollen/painful red fingers and the pads of my feet.  This was resolved quickly with 2 small doses of self-administered Fluconazole – my doctor thought it was Reynauds when he saw it, after which I immediately took the medicine because I knew that wasn’t it – the pain was radiating up my arms and it was on my feet too; however, I believe what basically happened was that the candida consumed the fat pads on my fingers and feet.   Pressing on my fingerpad now leaves an indention for a minute or more.  I think that the leg pain I have been experiencing is either due to this or reduced blood flow or to my legs. The article actually had had drawn pictures of a person and how their body changed in each phase.  For example in Phase III, fluid is retained so the waistline expands, while in phase 4 the body shrinks due to reduced volume and actual cell death.  In phase III, I basically had boobs, despite not being much heavier than I am now.  I also went up to a 34-inch waist and they got tight.  When phase IV hit, I went from 34’s to 32 in ten days.  I threw out my back twice in phase III due to all the extra-fluid around my spine – this is the only time I’ve ever had back issues, both times it was a minor effort that threw it out (one was just bending over, the second was just lifting one leg). You can consult the EMR to see the change in my height between 2010 and when I last saw you.  I would say I’ve shrunk another half inch since then.   As a former runner, I can tell you there should be no way my weight has remained relatively steady, but my favorite running shoes are too big.  All my shoes are too big.  Even the running shoes I mail ordered once and tried running in and immediately knew they were too small are actually too big.  Those are my default shoes these days as they fit the best.  For my work shoes, I added thick insoles and they are still loose on my feet. It also doesn’t make since that I can have my average body weight and lose inches in circumference around my waist and legs.  The other thing is that my feet grew during phase II.  I remember having to go up a size in running shoes and my feet widening – I always had skinny feet before that (and now do again).
The reduced heart function causes the reduction in pressure to the pituitary which then causes the body to further reduce volumes in order to maintain pressure.  The pressure to the brain is maintained at the cost of other areas and one section of the heart keeps getting smaller and smaller to keep the pressure up.  I definitely remember that from the article.   The article said that the patient could “power through” multiple heart attacks due to the extra hormone it was receiving via the more direct blood supply and the efforts of the pituitary. It also said that during some one or more of these changes, that high pressure blood would literally rip the vessels in the gut causing pain and reduced absorption.  Additionally, it said that at some point, blood would be released via the normal route of bile.  I know I have had those bowel movements.  I’ve probably had about 6 since last july.  Times when my bowel movement was pure black/green and rubbery.  I have not had one for a few months at this point, so I think I have passed whatever that phase was.  I did have one in early January which was right before a set of tests performed by Dr. Chalmers which had a BUN reading in the 99th percentile and elevated blood proteins.  A subsequent followup test a couple weeks later came back in the normal range.
The nausea I had last fall  - which would be in phase IV – was followed by severe pain over my liver and pain in the area of my right kidney.  Scans at the time showed nothing special. 
During phase IV you also get the flushing of skin.  I think this is because the underlying layers of the epidermis are dying as explained above.  The exposed skin is actually much “newer” than would be typical and much closer to the blood flow as well as much easier to sunburn as well as staining due to the electrolytes being loaded in.  Additionally, the maximization of blood flow to the head is a contributor. As an experiment, I’ve been wearing spf 30 face lotion on half my face since march or so, without any difference.  I am tanner now than in most years past.  I now have zero crow’s feet around my eyes at basically 43 years old.  At 40, I had them.  This is also due to the skin tightening aspect.

The article also mentioned that during phase IV, the shrinking would disguise muscle weakness by increasing reflex conductivity and would also increase spinal strength by reducing the excess fluid.  
Additionally there were pictures of the fingernails.  They looked exactly like mine.  Essentially, the shrinking causes the tips of the fingers to lose blood flow and you get these lines behind the ends of your fingertips under the fingernails.  It actually hurts intermittently as the quick of the nail essentially separates from the finger.  But then, the line will disappear as the separated nail growth can be cut off.  It said something about how nail color was normal, but that pressing on the underside of the finger would show something either the inelasticity of the finger pad (my finger pads now hold an indention if pressed) or the nail color darkening, I don’t remember honestly.  
Another thing is my blood pressure, while during Stage II my average pressure was generally 135/87 or so, during phase IV it has been 110/75 or so.   Great to have the lower blood pressure as a rule, but something worth mentioning.  If I truly am experiencing anxiety or stress instead of having an illness, I would expect higher than normal blood pressure. 
Physical exertion of any significant amount (even a 20 minute scrimmage in soccer against my 5 year old), causes me to get a head ache right in the top of my head.  I’ve had this type of headache during three periods – 1) in 1995 when I first when on the antifungal and would exert myself – I will say it was wonderful then though, as the fog always lifted and I got really hungry, 2) Last July which was actually much worse due to the vision changes, and other issue, and 3) Now when I exert myself.  Over the last month or so, I have gained about an inch in the stomach without changing weight or diet.   I know you the tests you performed should indicate that if it was present, however, this condition is insidious in how it works.  I don’t know if the tests would be any different today – in fact I don’t think the tests would be the same at one time of the day as they are at another given how my days are cycling.  I’m not asking for tests, I’m just frankly venting.  
I do remember it did discuss measuring blood pressure standing versus sitting and with a leg cuff during phase IV as a diagnostic screen.   I’m not sure what would be the abnormal values, but it is something I remember.  pH testing wasn’t a good tool due to how it is done. Somehow, actual pH differs from what you would expect given the normal electrolytes used to calculate it.  Perhaps a simple pH strip or something less advanced would be better. Essentially, the body is in multiple metabolic conditions that all cancel each other out and make those tests less relevant.  Hormonal values obviously weren’t helpful at least as of January when you tested.   I know this resembles the end stages of Addison’s disease as I have all of the symptoms (exhaustion, weakness, tanning, changes in mental acuity, changes in blood sugar levels) just none of the significant clinical findings like electrolyte imbalances (at least as of January).  That is why I feel I misspoke by referring to an earlier stage as pseudo-addisonian before. It is, in fact, this later stage that is such.
What I am supposed to experience next is a continued worsening of this cycle.  Blood flow changes will eventually shut off all flow to the kidneys.  If treated, the treatment is pretty horrible and the result is just a prolonging of the process.  If I can keep eating, eventually my pituitary will be unable to keep blood sugar levels down, this will lead to a resurgence in the candida infection which will cause more mental confusion and just snowballs the whole thing as it digests the sugars further straining the liver.  There were pictures of people with rotted appendages  in the article – from the fungus. I think without treatment the outcome is the collapse of one of the veins coming from your leg which is evidently fatal – or if you begin vomiting at any point (trust me, as of this week, I want to just about every moment but I have so much experience with nausea and there is so little bloodflow to my gut that I have yet to vomit once) if you begin vomiting it quickly spirals out of control and ends with a stroke.  With treatment – which involves keeping blood sugars “as low as possible” first via insulin and later with direct injections of glucose (because the gut has shut down and cannot absorb/process foods) followed by adrenaline (and a subsequent ice bath due to body temperature rise), the eventual outcome is death via stroke but you get to go blind first due to the surges in blood pressure during the treatments.  Antifungals don’t help as most suppress the adrenal cortex, which is basically driving the bus at this point.  And the infection will return anyway, as the body uses it to supply ATP to cells.  Sleep is out for all that, as the pressures are too high and sleeping itself would allow sugars to rise too much.   Insulin injections cause the creation of water during the reaction with sugars which causes too much pressure as at this point the kidneys have all but quit.  Additionally, I remember it said almost word for word “you would think that diuretics would be the solution but most diuretics cause narrowing of the blood vessels in the kidneys” and somehow that made it worse.  It mentioned the recent advent of some potassium or sodium sparing diuretics, but I don’t remember what it said about that. So, of the options, I think I am better off with no treatment.  The article did say something strange about the very end, that the person would be extremely clear minded right at the end.  I don’t remember if that was treated or untreated, but I found it interesting.  It makes sense, though, given what I am going through daily right now.  I can see where it would be at the peak of the circadian rhythm when the end came.  The article said that once the patient stops eating, the fungus has a natural affinity for the hormones supplied by the pituitary and will eventually attack there resulting in a stroke.  There were pictures of people eating cooked liver and spitting it out because they couldn’t process it – saying that making it that far had trained them to eat no matter what and that as their mouth was the only part of the body that could still absorb anything this was the best they could do.  I will say that throughout the various episodes of nausea starting with the bad periods of phase II, eating was the only thing that cleared my head.
Other possible treatments were discussed in the article and ruled out.  Hormone replacement wouldn’t solve the other problems and wouldn’t supply the high levels of hormones needed due to the adjustment of the body to the higher pressures to the head.  Heart transplant wouldn’t work because at this point regular pressure to the brain wouldn’t be enough, dialysis wouldn’t work to prevent the onset of phase IV due to the pH of the blood being different than the normal pH of someone that needs dialysis and the fact that the level needed to be maintained was well outside the ranged usually done. I know my pH tested normal, but it said something about the actual pH versus the calculated value based on CO3, I don’t remember what.  

I’ve said before that the patients were kept in a position such that their head was above their heart and their feet were  below their heart.  Essentially in a reclining chair.  I think I mis-spoke before.  This was something to do with keeping some amount of blood flowing through the kidneys as well as being the best position for their heart.  It said normally, in heart failure a different position was ideal but it was different in this case due to the blood pressure issues.  It also said the chair had a lever on them that the patients could flip that would cause their feet to be elevated.  This was essentially giving up, as it would cause them to enter a “hypoglycemic coma”.
I will tell you this, when I was in the Laureate, the physical symptoms I was undergoing were so severe, I read that article and said to myself I would do whatever was needed to get those extra years, rather than die of a stroke that day or week, and let me tell you it was probably close, as I was so dehydrated my whole inside arm bruised when they drew blood, I could barely lift my legs, and my veins were literally having spasms…I could put my finger on one and watch it wiggle.  So, I held my urine and drank a lot of caffeine and whatever I did was close enough to the shot of adrenaline that the book had said was the former treatment.   My outcome was a migraine like headache that started slowly, lasted an hour or two and at the peak of it, I felt like I could hear a pin drop and every sound hurt.  Additionally, just wiggling a finger caused intense pain in my head.  
I get up every day even back then, force myself to do what has to be done and given that phase II is pretty uneventful, comparatively, I’ve had a good life.  It was good enough that I made myself believe that I didn’t have what I knew I had.  There is no way I should’ve ever doubted myself given the severity of what I had been through and the several times I had to take the antifungals and dehydrate myself to get back on track.  It was just such a long gap since the last time and 2010 that I had convinced myself otherwise.  I won’t be giving up.  I’m not that guy.  But, it is getting harder and my hope is that eventually there will at least BE a clinical diagnosis.  What I don’t understand is how medical knowledge like this is “lost”.  The article was so detailed, even though it stated it was rare, but there were pictures with many people with the same condition – all in the reclining chairs.  I understand that medicine progresses, and perhaps there was something that used to be done that is not anymore so the study of the result is no longer required, but it just seems strange to me.
Anyway, I believe I am in the more final stages of this where there will be no more stable periods.  If I am correct, then it should become evident in the near future.  I have had just about every test one could want at one point or another during all of this.  I do see a therapist every two weeks.   The last few months I’ve felt weak, but pretty much normal otherwise – very clear minded, it has been great.  Things are changing now.  I will face it head on.
To understand my theory you would have to believe the following assumptions:
1)	Over the previous decade and a half, the blood supply to my intestines had changed such that most of the arterial flow bypassed the gut and most of the flow through that area was actually veinous.  Thus, the nutrients and sugars first would go through my heart and then to the rest of my body.
2)	Candida can exist at the cellular level in a symbiotic fashion without obvious clinical symptoms

So, the theory is that Candida was in my body and the energy it supplied by processed sugars at the cellular level (ATP) allowed my body to sustain the phase III time during which intracellular electrolyte levels were slowly moving towards a level at which the pituitary could no longer make the pancreas excrete insulin.  This was manifested by an increase in the fluid levels of the body in Phase III.  The sudden die off of Candida caused by the Fluconazole caused the electrolyte levels to quickly shift as the body threw off much more fluid than usual but was unable to excrete whichever electrolyte is the one that the kidneys no longer can due to the early kidney damage in stage I onset – I will add that during stage II, the long healthy stage, the kidney damage is bypassed  by excreting the electrolyte through the feces due to the unusual pressure differential where veinous pressure exceeded arterial in the intestinal areas.  Also, I exercised a lot running 5ks and the Tulsa Run etc, sweating profusely with regularity as well as donated blood fairly regularly because both made my head clearer – until my doctor told me I was anemic and I stopped the donations.   At some point, the intracellular electrolyte level is reached where insulin can no longer be caused to be secreted as the concentration cannot be increased further for some reason, so blood sugar levels rise quickly.  This causes a large new supply of energy to the pituitary.  This in turn causes it to go into overdrive and take over sugar levels completely.  This was manifested first by nausea and then headaches and blurred vision.
Several times since then I have briefly taken Fluconazole.  I would do this because the nausea had returned.  My theory there is that the candida would return enough to cause nausea, the dose of Fluconazole would kill it off, and the sugar levels would rise until the pituitary was able to work even harder to keep down levels.  This explains my post-prandial sugar levels of August – fairly recently being sub – 100 more like 75-80.  Now however, the pituitary or the heart or both are unable to work as hard.  So, my sugar levels have been rising.  Four weeks ago when I wrote you, I had experienced the nausea and fogginess again – my post prandial blood sugar was 115   - normal I know, but not what I had been having for the previous 10 months.  So, I took Fluconazole not because of the sugar level, but because of the nausea and fogginess.  This had a rather dramatic effect within 36 hours.  I first had the stomach cramping, then my head cleared up and the nausea mostly went away.  Over the next week, I had more energy than I have had over the last year, with some headaches and less severe stomach cramping.  The initial cramping, however, was severe and extended into my chest and the back of my neck.  My theory here is that the sugar spiked as the candida was killed off, and the pituitary used the new energy to reduce volumes in order to be able to control the level.  This resulted in some flow to my intestinal/organs being cut off – the veinous flow.  This made it easier for my heart to pump blood and helped reduce sugar levels some.  This is because basically the heart is sucking (literally not figuratively) and sucks so hard it closes off some of the flow – the reason it is sucking so forcefully is the pituitary is causing it to through the manipulation of endorphins combined with vaso-dilaters and constrictors.  
So, that all sounds pretty elaborate, I know.  But there are other things that happen when I take the pill and the weird thing is that dosage I take is small.  My palms turn red and blotchy for one.
Anyway, I think from here it is going to get worse and more frequent, as while I have had a stable couple weeks, last week the nausea and fogginess returned – this time my post prandial blood sugar was 129 (trend fairly established at this point from mid 70s to almost 130 all of which are documented in my glucometer).  So, I did the only thing I could do and took Fluconazole again on Friday/Saturday June 15th and 16th.  It worked somewhat, but not as well, but I did not take as much as I did 4 weeks ago (100mg total over 2 days about half the previous amount which was over 4 days).  I have the headaches again though, and have been able to think more clearly and the nausea mostly went away, but already I am foggy, so I’m not sure what I will do next.  I know if the nausea returns I will take it again.
I anticipate that the cycle will worsen and eventually, I will have diabetic blood sugar levels.  I think this is what the article meant by the return to an acidic level for the cells of the body.  I’m assuming such high sugar levels will bring along higher acidity levels.  The article talked about how muscles would begin tearing as they were broken down by the changes…This is another reason the people were confined to the chairs, as the muscles couldn’t take normal exertions. 
This is all why the article had the patient treated by keeping the blood sugar as low as possible because essentially each blood sugar peak is a one way step to the next higher level and each step results in reduced blood volume and other changes.  All the while, the electrolytes are kept in the normal range, as it is using molarity to control things and ignoring volume.  That is the most significant part of the clinical equation – and because of it everything appears fine in basic medical tests.  I can imagine some clinical things that might be different – the blood pressure in the legs should show lower than expected, perhaps a fMRI of the brain, I don’t know.  
However, I can only imagine how the patient does during these times.  The inability to concentrate is extraordinary.  They wouldn’t be in pain, but they would be pretty mindless.  I’ve already been there and I know I hate it.
So, in my theory the path forward is a continued worsening with peaks that are only resolved by further reduction of flow to the bodies organs.  This is why it said one path was the collapse of the major vein coming from a leg.  With treatment, you end up confined, with pressures escalating with blindness, death of the intestinal tract, inability to think, etc until the candida either attacks the heart muscle or the pituitary directly.
I know my body.  I’ve lived with it a long time.  The things I’ve described to you really happened and more, from the profuse urination in 1995, to the resolution of symptoms at times with a simple anti-fungal.    But, I also can tell that things are not what they used to be.  I know with 100% certainty the seriousness of what is going on.  It will become clinically evident at some point, I think.  I just want that to occur such that my family can know.  
For what it’s worth, I went to my doctor to report the stomach pains on June 4th.  He did a CBC, Chem14 and TSH and said all were normal (I haven’t seen the results, but I’m sure he is right).  He wanted to do a CT with and w/o contrast of my chest due to a nodule that has shown in the past, but I turned that down due to the iodine and the fact that the last time I had iodine in 2010 I went about 5 or 6 days without significant urination.