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Suggest Treatment For Severe Fatigue, Chest Pain, Oily Skin And Periorbital Dark Circles

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Posted on Fri, 20 Jan 2017
Question: I WAS IN THE ICU IN LATE OCTOBER FOR A SERIOUS COLON INFECTION ALMOST GONE SEPTIC. WHEN THEY DID THE COLONOSCOPY SOME OF THE CELLS WERE LYMPHOMA. I HAD TO MOVE FROM ARIZONA TO XXXXXXX THE NEXT WEEK TO TAKE CARE OF MY 91 YEAR OLD HUSBAND WHO IS GETTING WORSE WITH ALZHEIMERS. I AM NOT HUNGRY, I AM BEYOND FATIGUED, I GET CHEST PAINS, MY SKIN IS OLIVE BUT IN THE LAST MONTH MY FACE IS SHEET WHITE WITH HUGE BLACK OR RED CIRCLES UNDER MY EYES. MY EYES ARE ALSO SINKING INTO MY SKULL. I HAVE NOT HAD TIME TO FIND A DOCTOR HERE. ARE THESE SYMPTOMS OF CANCER AND/OR HEART PROBLEMS? ALSO, WHAT TYPE OF DIAGNOSTIC DOCTOR WOULD BE BEST FOR ME? WHAT TYPE OF BLOOD WORK IS NEEDED? I NEED SOMEONE TO HELP ME ASAP. THANK YOU.

are you currently working on my problem right now?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (57 minutes later)
Brief Answer:
Questions so that I can help:

Detailed Answer:
Hello XXXXXXX

Here are my thoughts after reading over the history you provided:

When lymphoma cells were found during the colonoscopy, did the gastroenterologist indicate in his/her report that it was visible and isolated and that all were removed? What were the recommendations for follow up on the report? If you did not get the gastroenterologist's full report, contact where it was done and ask for a copy of it. They will likely have you sign some HIPAA forms, but then they should release it to you.

How much weight have you lost?

Are your stools black and tarry appearing?

Do you have a history of heart problems? Is your chest pain pressure like or sharp or gnawing? How long does it last?

Are you depressed or anxious (I'm sure there is plenty of stress!) and do you have any respite help for your husband or social support for yourself?

More information to follow after you write back.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (9 minutes later)
Thank you Dr. Berger-Durnbaugh,

The gastro doctor sent the pathology report from Arizona to Mayo in XXXXXXX and they confirmed lymphoma...but I was moving to XXXXXXX the next week, so when I called her for follow-up she told me to do it in XXXXXXX But as I told you, I have not had the time for myself. I am now getting scared by how I feel and how badly I look...my cheeks are even sinking in.

I do have intra-atrial septal aneurysm with a slightly positive bubble study.

I have had various cancers - vulvar, cervical, right eye. All surgically treated. never any chemo or radiation.

I would like to know what blood tests I could have my ex-doctor in Arizona order for me here..... to rule out heart problems, and more importantly anemia, lymphoma, any other cancer. I am willing to pay for a Petscan if I could get someone to order one. I had a heart doctor in Arizona...but he gave up on me too when I had to move.

I have no one to help me with my husband and have no friends in XXXXXXX I am pretty much drowning in everything..... and even if I sleep 14 hours I am still very pale and exhausted.

Any ideas? there MUST be blood work or tests that can be done to figure this out?

Thank you so much.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (12 minutes later)
Brief Answer:
Information

Detailed Answer:
Thanks for the additional information.

I'll assume you are not having bleeding per rectum or black, tarry stools.

I know you don't have time for yourself but some of the tests to sort this out will take time. I don't know if your doctor in Arizona will have privileges to order tests in XXXXXXX Different medical sites have different policies. If he is able to order tests, I recommend:

1. CBC with manual differential: This can show what your blood lymphocyte count is as well as if you are anemic.

2. TSH and free thyroxine: To check your thyroid function.

3. ESR (erythrocyte sedimentation rate): To check for inflammation in the body. It is a nonspecific test and is elevated from any cause of inflammation - it will not tell where - but can help with giving an overall picture of what is going on.

4. Liver panel for liver function.

5. Vitamin B12 level.

These are all blood tests. If you don't have a doctor where you live, who will take a look at these to interpret them? The responsibility will be on the ordering physician to address the results. That's why I think even though it might take a bit of extra time, you should see an internist in your area to start with. And provide that internist with the colonoscopy report too.

Further, I would recommend and EKG, and possibly an Echocardiogram for your heart function.

The internist can order all of these things, and depending on what is found, refer you to cardiology and gastroenterology.

I also think you must find someone to help with respite care before you run yourself down completely. If you get very sick, you will be no good for either you nor your husband who depends on you. Contact the local hospital and ask to talk with their social worker on the phone. Tell him or her that you are looking for respite care for your husband so that you can address your health issues. While the hospital social worker can't help directly, they very likely know what services are available in the community for these purposes.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (9 minutes later)
You are so helpful with these detailed suggestions. I will get on it after New Years. Thank you so much for your help. I am so grateful that someone hears me.

Do you know an excellent internist in XXXXXXX Colorado?

Please have a beautiful New Year's Eve and New Year.
XXXXXXX
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (12 minutes later)
Brief Answer:
Information

Detailed Answer:
Hi XXXXXXX

I'm sorry I don't know any of the doctors in XXXXXXX Sometimes you can get information by googling the doctors' names and looking them up on "Healthgrades" or other rate-the-doctor sites. While I don't put a lot of stock in whether a doctor has high marks (because their friends and family can rate them too), be cautious of ones with negative reviews. Usually you can get all the information you need without having to pay those sites - just the information that they have available for free on their page. The other thing you can try is sometimes, if you call a clinic with multiple doctors, you can ask the receptionist for a doctor who has been in practice for awhile and one that patients seem to like a lot. While they usually can't recommend a doctor outright, they likely have heard comments from patients over the years, and can recommend one that patients seem quite satisfied with.

Best wishes to you, and if the question hasn't been closed by HCM, I invite you to let me know how you are doing.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3133 Questions

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Suggest Treatment For Severe Fatigue, Chest Pain, Oily Skin And Periorbital Dark Circles

Brief Answer: Questions so that I can help: Detailed Answer: Hello XXXXXXX Here are my thoughts after reading over the history you provided: When lymphoma cells were found during the colonoscopy, did the gastroenterologist indicate in his/her report that it was visible and isolated and that all were removed? What were the recommendations for follow up on the report? If you did not get the gastroenterologist's full report, contact where it was done and ask for a copy of it. They will likely have you sign some HIPAA forms, but then they should release it to you. How much weight have you lost? Are your stools black and tarry appearing? Do you have a history of heart problems? Is your chest pain pressure like or sharp or gnawing? How long does it last? Are you depressed or anxious (I'm sure there is plenty of stress!) and do you have any respite help for your husband or social support for yourself? More information to follow after you write back.