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Suggest Treatment For Constant Body Pain With Swollen Hands And Rashes On Fingers
Question: I have had constant body pain for the last few months. All of the tests suggesting auto immune were negative except a positive ana tiger that was 1:40 speckled. My eosinophils also just came back at 8.8. I go to a military base clinic and they only tell me they don't know what's going on. My hands feel swollen and like they've been asleep and I get rashes on my fingers. I have a family history of RA. I also have vitamin D deficiency. But I take supplements for that. What else could it be?
Brief Answer:
Chronic Pain
Detailed Answer:
Thank you for writing on health care magic
I have gone through your history and would like to ask you a few more details to help me localize the origin of pain and the cause. Constant pains are a very difficult to diagnose. ANA positive at 1: 40 doesnt sound too significant. I would like to ask you a few more details before guiding you further:
1. Could you describe me the sites of the pain?? Which all location is it affecting you
2. Is it more on activity or at rest??
3. Do you have any early morning stiffness
4. Any history of backache or any other joint swellings?(Do your rings tighten in the morning)
5. do you experience dry mouth or dry eyes?
6. Any symptoms of constant fatigue/forgetfullness/irrtability??
Do let me know these queries. It will help me narrow down the possibility of inflammatory pain or non inflammatory one
Await your reply
Regards
Dr NAval
Chronic Pain
Detailed Answer:
Thank you for writing on health care magic
I have gone through your history and would like to ask you a few more details to help me localize the origin of pain and the cause. Constant pains are a very difficult to diagnose. ANA positive at 1: 40 doesnt sound too significant. I would like to ask you a few more details before guiding you further:
1. Could you describe me the sites of the pain?? Which all location is it affecting you
2. Is it more on activity or at rest??
3. Do you have any early morning stiffness
4. Any history of backache or any other joint swellings?(Do your rings tighten in the morning)
5. do you experience dry mouth or dry eyes?
6. Any symptoms of constant fatigue/forgetfullness/irrtability??
Do let me know these queries. It will help me narrow down the possibility of inflammatory pain or non inflammatory one
Await your reply
Regards
Dr NAval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1. The pain is in my legs, arms, back, neck and hands.
2. It's all of the time. At rest and with activity.
3. There is stiffness in the morning that is pretty bad. It's hard to move at all.
4. Not really any joint swelling. And no history of back pain
5. I have dry mouth but I also believe it's from Lisinopril. I take it for high blood pressure.
6. I'm always fatigued. It feels like I just can't make it through the day. Even after wAking in the morning I am tired and ready to go back to bed. My co workers have also noticed a mood change in Me. I'm more grumpy than usual. I forget stupid simple things more frequently now as well. Like where I put my keys down that I just had a minute ago. Sometimes even my friends names.
Thank you for your time.
here is a copy of my most recent labs:
Mrs XXXX;
your lab results are as follows:
C-Reactive Protein Site/Specimen 14 Sep 2015 0806 Units Ref Rng
C-Reactive Protein SERUM 0.2 < i> mg/dL (0-0.5)
Thyroid Stimulating Hormone Sensitive Site/Specimen 14 Sep 2015 0806 Units Ref Rng
Thyrotropin Sensitive SERUM 2.68 < i> mcIU/mL (0.27-4.32)
Vitamin D, 25-Hydroxy Site/Specimen 14 Sep 2015 0806 Units Ref Rng
Vitamin D, 25-Hydroxy SERUM 11 (L) < i> ng/mL (30-60)
CBC Site/Specimen 14 Sep 2015 0806 Units Ref Rng
RBC BLOOD 4.62 x10(6)/mcL (3.80-5.10)
Hemoglobin BLOOD 11.3 (L) g/dL (11.5-15.5)
Hematocrit BLOOD 36.7 % (34-45)
MCV BLOOD 79.5 (L) fL (80-98)
MCH BLOOD 24.4 (L) pg (26.7-33.7)
MCHC BLOOD 30.7 (L) g/dL (32.5-36)
RDW CV BLOOD 15.8 (H) % (11.6-15)
Platelets BLOOD 372 x10(3)/mcL (140-420)
MPV BLOOD 7.6 fL (7.0-10.0)
Lymphocytes BLOOD 24.7 % (14.0-46.0)
Monocytes BLOOD 6.3 % (3.0-13)
Neutrophils BLOOD 59.1 % (38.5-76.5)
Eosinophils BLOOD 8.8 (H) % (0-7.4)
Basophils BLOOD 1.1 % (0-2.6)
ABS Lymphocytes BLOOD 1.5 x10(3)/mcL (0.9-3.0)
ABS Monocytes BLOOD 0.4 x10(3)/mcL (0.2-0.9)
ABS Neutrophils BLOOD 3.6 x10(3)/mcL (1.3-6.3)
ABS Eosinophils BLOOD 0.5 (H) x10(3)/mcL (0-0.4)
ABS Basophils BLOOD 0.1 x10(3)/mcL (0-0.2)
WBC BLOOD 6.1 x10(3)/mcL (3.6-10.0)
ESR Site/Specimen 14 Sep 2015 0806 Units Ref Rng
ESR BLOOD 13 mm/hr (0-20)
2. It's all of the time. At rest and with activity.
3. There is stiffness in the morning that is pretty bad. It's hard to move at all.
4. Not really any joint swelling. And no history of back pain
5. I have dry mouth but I also believe it's from Lisinopril. I take it for high blood pressure.
6. I'm always fatigued. It feels like I just can't make it through the day. Even after wAking in the morning I am tired and ready to go back to bed. My co workers have also noticed a mood change in Me. I'm more grumpy than usual. I forget stupid simple things more frequently now as well. Like where I put my keys down that I just had a minute ago. Sometimes even my friends names.
Thank you for your time.
here is a copy of my most recent labs:
Mrs XXXX;
your lab results are as follows:
C-Reactive Protein Site/Specimen 14 Sep 2015 0806 Units Ref Rng
C-Reactive Protein SERUM 0.2 < i> mg/dL (0-0.5)
Thyroid Stimulating Hormone Sensitive Site/Specimen 14 Sep 2015 0806 Units Ref Rng
Thyrotropin Sensitive SERUM 2.68 < i> mcIU/mL (0.27-4.32)
Vitamin D, 25-Hydroxy Site/Specimen 14 Sep 2015 0806 Units Ref Rng
Vitamin D, 25-Hydroxy SERUM 11 (L) < i> ng/mL (30-60)
CBC Site/Specimen 14 Sep 2015 0806 Units Ref Rng
RBC BLOOD 4.62 x10(6)/mcL (3.80-5.10)
Hemoglobin BLOOD 11.3 (L) g/dL (11.5-15.5)
Hematocrit BLOOD 36.7 % (34-45)
MCV BLOOD 79.5 (L) fL (80-98)
MCH BLOOD 24.4 (L) pg (26.7-33.7)
MCHC BLOOD 30.7 (L) g/dL (32.5-36)
RDW CV BLOOD 15.8 (H) % (11.6-15)
Platelets BLOOD 372 x10(3)/mcL (140-420)
MPV BLOOD 7.6 fL (7.0-10.0)
Lymphocytes BLOOD 24.7 % (14.0-46.0)
Monocytes BLOOD 6.3 % (3.0-13)
Neutrophils BLOOD 59.1 % (38.5-76.5)
Eosinophils BLOOD 8.8 (H) % (0-7.4)
Basophils BLOOD 1.1 % (0-2.6)
ABS Lymphocytes BLOOD 1.5 x10(3)/mcL (0.9-3.0)
ABS Monocytes BLOOD 0.4 x10(3)/mcL (0.2-0.9)
ABS Neutrophils BLOOD 3.6 x10(3)/mcL (1.3-6.3)
ABS Eosinophils BLOOD 0.5 (H) x10(3)/mcL (0-0.4)
ABS Basophils BLOOD 0.1 x10(3)/mcL (0-0.2)
WBC BLOOD 6.1 x10(3)/mcL (3.6-10.0)
ESR Site/Specimen 14 Sep 2015 0806 Units Ref Rng
ESR BLOOD 13 mm/hr (0-20)
Brief Answer:
Chronic Pain Syndrome
Detailed Answer:
Good evening
Sorry for the late reply. Was caught up at work
Well, I have gone through your reply and the blood reports.
Your blood reports are quite ok except 25 hydroxyvitamin D3 which is very low. Its defieciency can cause lot of fatigue and generalized muscle ache. We will need to supplement you with it till you reach the normal limit
But I still feel, there is another problem going on which needs to be looked into. The symptoms you have mentioned about and normal lab reports, go more in favor of a disease called Fibromyalgia. It is a disturbance of the pain center , that is more of a central cause than the peripheral one( Joint/muscle/nerve).
I am gonna give you a link. Do go through it and let me know if your symptoms match it( Do avoid google as it can give a lot of mismatch information with worst case scenarios). The treatment part is easy once when we have the diagnosis. Since noone is able to figure it out for you, we can give it a try
XXXX---> Patient education---> Fibromyalgia
Await your reply
REgards
Dr naval
Chronic Pain Syndrome
Detailed Answer:
Good evening
Sorry for the late reply. Was caught up at work
Well, I have gone through your reply and the blood reports.
Your blood reports are quite ok except 25 hydroxyvitamin D3 which is very low. Its defieciency can cause lot of fatigue and generalized muscle ache. We will need to supplement you with it till you reach the normal limit
But I still feel, there is another problem going on which needs to be looked into. The symptoms you have mentioned about and normal lab reports, go more in favor of a disease called Fibromyalgia. It is a disturbance of the pain center , that is more of a central cause than the peripheral one( Joint/muscle/nerve).
I am gonna give you a link. Do go through it and let me know if your symptoms match it( Do avoid google as it can give a lot of mismatch information with worst case scenarios). The treatment part is easy once when we have the diagnosis. Since noone is able to figure it out for you, we can give it a try
XXXX---> Patient education---> Fibromyalgia
Await your reply
REgards
Dr naval
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr. Naval. Thank you for taking time for me. I looked at the website and information. The symptoms match mine almost exactly. Including the IBS. I didn't realize they could be related. I do get migraines more often now than before. I've had migraines my whole life but they are more frequent. I do not have tmj though. I'm always tired. It never ends. I'm extremely forgetful which is not a good thing in my career. Also sometimes I have issues with an overactive bladder. I just don't make it in time to the restroom. I wasn't aware that all of these things were related and my current dr. Never asked about them. Thank you again.
Brief Answer:
Fibromyalgia
Detailed Answer:
Good evening XXXX
Well, yes most of your symptoms do fit into the disease and as long as you are convinced about the diagnosis the treatment part should not be difficult.
The medicines you have to ask your GP to prescribe... I personally favor duloxetine/amitryptilline.
But along with medications, there has to be changes in the life style as well. If we practise both of them together, the results are better and you can go off medications after a while. But minimum 6 months is needed.
As for the life style changes:
1. I would suggest you learn some meditation. 10 minutes in the morning is helpful.
2. Get proper sleeping hours( 6 hours minimum required by your body in the day)
3. Do regular exercises. Initially they may pain but overtime , if you are persistent it will get better
4. Indulge in a hobby. Whatever you always wanted to do.
We have to try combining both and get you out of the disease as it can hamper the quality of your life.
Do visit your GP as you do have a diagnosis and get started on the medications
PS: Dont forget to supplement with Vitamin D as well
Do let me know for more queries. Would be happy to help out
Regards
Dr Naval
Fibromyalgia
Detailed Answer:
Good evening XXXX
Well, yes most of your symptoms do fit into the disease and as long as you are convinced about the diagnosis the treatment part should not be difficult.
The medicines you have to ask your GP to prescribe... I personally favor duloxetine/amitryptilline.
But along with medications, there has to be changes in the life style as well. If we practise both of them together, the results are better and you can go off medications after a while. But minimum 6 months is needed.
As for the life style changes:
1. I would suggest you learn some meditation. 10 minutes in the morning is helpful.
2. Get proper sleeping hours( 6 hours minimum required by your body in the day)
3. Do regular exercises. Initially they may pain but overtime , if you are persistent it will get better
4. Indulge in a hobby. Whatever you always wanted to do.
We have to try combining both and get you out of the disease as it can hamper the quality of your life.
Do visit your GP as you do have a diagnosis and get started on the medications
PS: Dont forget to supplement with Vitamin D as well
Do let me know for more queries. Would be happy to help out
Regards
Dr Naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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