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Suggest Treatment For Extreme Fatigue, Muscle Pain, Headache And Diarrhea

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Posted on Wed, 18 Sep 2019
Question: Hello. I am a 58 year old female and returned last night from a weeklong vacation in XXXXXXX visiting my son and several days. I had a wonderful,amazing time until Friday morning about 7am. I woke up absolutely freezing, my entire body trembling, a severe “squeezing type headache, dizziness, nauseous and watery, consistent diarrhea. I felt horrendous and took a 30 minute extremely hot shower but it did not warm me up. I took my morning meds and my friend turned the heat up in the house which did not help. I also had bad muscle aches and pains. I shook for 2 hours and that finally stopped. My friend wondered if I was having a panic attack or was completely dehydrated. I did not know. I do have a lot of anxiety and take several medications for this but have never experienced a panic attack. I was finally not shaking and warming up some, I took 2 Alene and ate a banana. Did some meditation and deep breathing exercise and began to feel a little better. A few hours later I ate a yogurt to get some protein and had been pounding water all morning. I felt a little better by afternoon and left for the 5 hour drive back to XXXXXXX I made it, but barely. My son was on a road trip with his baseball team, and once I got in I started feeling like a XXXXXXX Truck hit me. I looked up the nearest Urgent Careand drove their immediately. I arrived 5 minutes after they closed. They recommended I go to the nearest ER. Which I did. They took me back to triage and my blood pressure was 97/55 and then 88/49. They sent me back to ER and the dr asked me a ton of questions and then did “orlistat” testing and my blood pressure slowly began to rise. He said I was probably dehydrated but since I was holding down liquids well to continue with as much water as possible and that was better for me than IV fluids. He put in a small IV and gave me Benadryl and Reglan for the headache and nauseousness. He also sent me with a prescription for Metoclopramide 10mg for the headache. My future daughter in law came to pick me since I could not drive. I spent the night in XXXXXXX and woke up yesterday morning at 4:45am. I got ready and waited to wake my son up at 7:45am. He drove me to get my car at the hospital and I stopped on my way out of town to fill the Rx. Got on the road home, another 5 hour drive. Only made it 2hours with several stops along the way with diarrhea and severe sleepiness. Finally stoped at a Holiday Inn along the highway and rented a room for the night. I got in my pjs and over as many blankets I could find. Took 2 Aleve and 2Tylenol thru the day. My husband was very worried and concerned so he found a good friend to drive him3 hours south and pick me up. We got home about 12:30pm. I drank more water took my meds and went to bed. Slept about 7hours and got up struggling to pull my body out of bed and went to the kitchen to drink 2full glasses of water and take my morning meds. Went back to bed and slept another 2 1/2 hours. Got up and have been drinking as much water as possible and finally ate a bowl of fruit with yogurt on it. Am laying on the couch since and feel so tired, lots of muscle pain and achiness, still a headache but better and one bout of diarrhea today. Can you please give me some advice on what I am experiencing and what I should do next? Thank you very much. XXXX.
YYYY@YYYY
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Answered by Dr. Dr. Muhammad Sareer Khalil (3 hours later)
Brief Answer:
Infectious diarrhea/ hypokalemia

Detailed Answer:
Hello and Welcome

I appreciate your concern

Diarrhea can lead to potassium loss, resulting in hypokalemia , which can cause severe fatigue, weakness and muscle cramping even. In severe hypokalemia, arrhythmia can occur, too. Electrolytes levels should be checked and replaced accordingly.

Infectious diarrhea if present should be treated with antibiotics especially if there is associated abdominal pain, tenesmus, a high white cell count or blood in stool.

Instead of free water replacement alone as the fluid replacement therapy, I would advise an isotonic solution like gastrolyte or ORS to replenish the electrolytes in addition to the water loss.

Fever should be documented and focus of infection should be looked for on the physical examination. Septic screen including CBC, ESR, chest x ray and cultures (urine + blood) should be sent.

Metoclopramide is a gastro kinetic agent. It doesn't treat the headache directly. Gut motility is reduced during headaches and drugs like metoclopramide can resolve the headache if given in addition to NSAIDs.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

Dr. M.S. Khalil
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2906 Questions

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Suggest Treatment For Extreme Fatigue, Muscle Pain, Headache And Diarrhea

Brief Answer: Infectious diarrhea/ hypokalemia Detailed Answer: Hello and Welcome I appreciate your concern Diarrhea can lead to potassium loss, resulting in hypokalemia , which can cause severe fatigue, weakness and muscle cramping even. In severe hypokalemia, arrhythmia can occur, too. Electrolytes levels should be checked and replaced accordingly. Infectious diarrhea if present should be treated with antibiotics especially if there is associated abdominal pain, tenesmus, a high white cell count or blood in stool. Instead of free water replacement alone as the fluid replacement therapy, I would advise an isotonic solution like gastrolyte or ORS to replenish the electrolytes in addition to the water loss. Fever should be documented and focus of infection should be looked for on the physical examination. Septic screen including CBC, ESR, chest x ray and cultures (urine + blood) should be sent. Metoclopramide is a gastro kinetic agent. It doesn't treat the headache directly. Gut motility is reduced during headaches and drugs like metoclopramide can resolve the headache if given in addition to NSAIDs. Wishing you best of health Thanks Let me know if you have any query Please consult your doctor before deciding on any further course of action. Dr. M.S. Khalil