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Hi Dr, I'm 65 Year Old And Generally Well. My
Question: Hi Dr,
I'm 65 year old and generally well. My question is about a tingling sensation in all 4 of my extremities at once. It feels like the beginning sensation of your foot "going to sleep." I have been experiencing this for the last couple of days. It's an odd feeling that I have not had before and I'm wondering if it is anything of concern.
I have been diagnosed with fibromyalgia and I take wellbutrin and prozac for depression. I am stable and high functioning. I have persistent sleep issues and take 1 mg lorazipam and hydroxizine to sleep. These were recently reviewed by my psychiatrist. The only other thing is that I have been very sick for the last 2 and a half months with a mean sinus infection which seems to finally be passing with the help of Chinese Medicine. I have been taking mucinex for discomfort but not exceeding the limit.
I'm 65 year old and generally well. My question is about a tingling sensation in all 4 of my extremities at once. It feels like the beginning sensation of your foot "going to sleep." I have been experiencing this for the last couple of days. It's an odd feeling that I have not had before and I'm wondering if it is anything of concern.
I have been diagnosed with fibromyalgia and I take wellbutrin and prozac for depression. I am stable and high functioning. I have persistent sleep issues and take 1 mg lorazipam and hydroxizine to sleep. These were recently reviewed by my psychiatrist. The only other thing is that I have been very sick for the last 2 and a half months with a mean sinus infection which seems to finally be passing with the help of Chinese Medicine. I have been taking mucinex for discomfort but not exceeding the limit.
Brief Answer:
First (as always a solid NEUROLOGICAL HISTORY AND EXAMINATION)
Detailed Answer:
Good evening. Many thanks for your question on this platform and I see a number of patients that have similar complaints.
The first that should be done is a SOLID NEUROLOGICAL HISTORY AND EXAMINATION in order to determine if there are any other sensory or possibly MOTOR abnormalities in any of your limbs that may be inapparent to you....you'd be surprised how much can fly under a person's radar once they get focused on one particular symptom or set of symptoms.
I would make sure that in addition to a neurological survey of both MOTOR/STRENGTH and SENSORY INTEGRITY of the extremities that I checked out the deep tendon reflexes (DTR's) since if there were possibly some type of compression or large osteophyte complex at the level of the cervicothoracic cord or the cervicomedullary junction then, the reflexes would tend to be unusually brisk including whether or not you might be exhibiting a hyper-reflexic response in the ankles (i.e. the foot bounces up and down for a few beats when it forcefully bent upward).
I'd also look carefully at eye movements as cervicomedullary junction lesions that could cause 4 limb paresthesias would also likely cause some type of eye movement abnormality.
AT the same time if you were my patient I'd send you for the following blood work right after we were done with your consultation:
1. Thyroid Hormone levels (FT4, TSH)
2. Vitamin B12 (minimum 450), folate (usually always normal)
3. Vitamin D (sweet spot 60-80)
4. Inflammatory markers such as ESR, C-reactive protein, ANA quantitative and qualitative
Fibromyalgia is almost not going to be a consideration in this case with the symptoms you're complaining about and I'd be much more interested these labs at least to start.
I would also check into the details of the Chinese herb you're using as many of those types of organic compounds contain chemical elements in them that can be NEUROTOXIC....remember, just because it's ORGANIC (or some quasi-like state) doesn't mean it doesn't react with important biochemical reactions in the body. Make sense?
Slow down on the Mucinex is also my recommendation since you may be experiencing some type of rebound phenomenon where the Mucinex is being used so frequently (and in such quantities) that it is causing what APPEARS to be a sinus blockage and may very well be instead a headache syndrome. Remember, just because you don't exceed the "limit" doesn't mean you're not using excess chemicals that are of no practical value.
If I've provided useful or helpful information could you do me a HUGE favor by CLOSING THE QUERY and taking a moment to provide a few kind words of feedback, perhaps even stamping the consult with a 5 STAR rating if you feel so inclined?
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.
This query has utilized a total of 21 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
First (as always a solid NEUROLOGICAL HISTORY AND EXAMINATION)
Detailed Answer:
Good evening. Many thanks for your question on this platform and I see a number of patients that have similar complaints.
The first that should be done is a SOLID NEUROLOGICAL HISTORY AND EXAMINATION in order to determine if there are any other sensory or possibly MOTOR abnormalities in any of your limbs that may be inapparent to you....you'd be surprised how much can fly under a person's radar once they get focused on one particular symptom or set of symptoms.
I would make sure that in addition to a neurological survey of both MOTOR/STRENGTH and SENSORY INTEGRITY of the extremities that I checked out the deep tendon reflexes (DTR's) since if there were possibly some type of compression or large osteophyte complex at the level of the cervicothoracic cord or the cervicomedullary junction then, the reflexes would tend to be unusually brisk including whether or not you might be exhibiting a hyper-reflexic response in the ankles (i.e. the foot bounces up and down for a few beats when it forcefully bent upward).
I'd also look carefully at eye movements as cervicomedullary junction lesions that could cause 4 limb paresthesias would also likely cause some type of eye movement abnormality.
AT the same time if you were my patient I'd send you for the following blood work right after we were done with your consultation:
1. Thyroid Hormone levels (FT4, TSH)
2. Vitamin B12 (minimum 450), folate (usually always normal)
3. Vitamin D (sweet spot 60-80)
4. Inflammatory markers such as ESR, C-reactive protein, ANA quantitative and qualitative
Fibromyalgia is almost not going to be a consideration in this case with the symptoms you're complaining about and I'd be much more interested these labs at least to start.
I would also check into the details of the Chinese herb you're using as many of those types of organic compounds contain chemical elements in them that can be NEUROTOXIC....remember, just because it's ORGANIC (or some quasi-like state) doesn't mean it doesn't react with important biochemical reactions in the body. Make sense?
Slow down on the Mucinex is also my recommendation since you may be experiencing some type of rebound phenomenon where the Mucinex is being used so frequently (and in such quantities) that it is causing what APPEARS to be a sinus blockage and may very well be instead a headache syndrome. Remember, just because you don't exceed the "limit" doesn't mean you're not using excess chemicals that are of no practical value.
If I've provided useful or helpful information could you do me a HUGE favor by CLOSING THE QUERY and taking a moment to provide a few kind words of feedback, perhaps even stamping the consult with a 5 STAR rating if you feel so inclined?
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.
This query has utilized a total of 21 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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