Question: I have many ailments going on with my body and can't seem to get any answers. Seems living in a small town is a disadvantage because there aren't really any good dr's. here that will thoroughly check you our or really listen. I am a 54 year of female, non smoker, 127 lbs. and 5 ft 6 inches. I have a history of SVT and Mitral Valve Prolapse, PVC's and PAC's. I take the generic for Tenormin and have since age 23. I have a yearly echo. I try to go walking when I feel like it, which lately seems to not be very often. I did go last night and tonight, but didn't really feel like it. I don't sleep very well, and haven't for some time. I go to bed and turn and toss, and finally go to sleep about 4am and then wake up about 7am. That is about all the sleep I have been getting for over six months. I stay so very short of breath and it feels like I need to draw a deep breath and it doesn't go all they way. I stay so tired feeling it is scary and I feel as though I could lay down and die. It isn't a tired like sleepy, it is like I am so tired I can't sleep and could almost drop to the ground. The bottom of my feet throb and hurt so bad and my calves of my legs stay swollen and also ache. When I get up of a morning the swelling seems to be gone, but when my feet hit the floor, they are so sore it hurts to walk and my heels at the back are so sore to the touch. I also have been having pain in every joint in every finger and they seem swollen and tight and also the bone on both sides of my elbows are so sore to touch and shoulders ache. Also after getting done walking I smell a strong smell of ammonia and it only happens after walking. My heart seems to be skipping a lot more lately or double beating or it even feels like it is just quivering at times. I have told the dr. all of these things, but not much gets done. I did go to the nurse practioner today. She has order some blood work. CBC, CMP, Ammonia Level, TSH, CRP, Sedrate (ESR), ANA, RF, Lymes, Ehrlichia, RMSF. I was wanting to see if you could tell me what these blood tests will show? I wonder if I could have Lupus and if these would show it up or maybe rule it out or require more tests. Also, if I had blockage in my legs, would that cause them to throb and ache so bad and swell? What tests would you suggest for me to have to find out why my legs hurt so bad and swell and the bottom of my feet to throb and feel like they are going to blow off? Also the swelling of my legs and ankles? If you could please help to suggest some tests I would greatly appreciate it.

Your answer helped some, but you still didn't answer all my questions I asked. What is autoimmune etiology and Ehrilchiosis? Would this be the autoimmune inflammatory disease you speak of, or is it something else? Also would these test show up anything to do with Lupus? As far as my heart, wouldn't the yearly echo I have show up something with my heart if I had it, or if not, what tests would I need to rule out my heart causing any of these? When you say early complications of pre-existing heart disease, what kind of heart disease are you referring to and what kinds of tests would I need? Also, what kinds of infections are you referring to and what kind of tests would I need for this? I was reading on the internet last night about what kinds of tests show up blockage and it says that the MR angiography has replaced the other tests where they go up thru with a catherization because of the complications and risks associated.I didn't have the last three blood pressures and pulse rates to give you, they never tell me my pulse rate. I do know they couldn't find the blood pressure in my left arm yesterday, but could my right one. The one in my right one was 90/65. I took it when I got home on my machine and it was 90/65 and heart rate was 56.

I also noticed where my knees are puffy beside them. Appears to be fluid. What was it you thought to make my legs throbbing and swelling and the bottom of my feet?

Sorry to keep asking questions, but also the hair on my legs has completely stopped growing. I don't have any now. Do you think the tests she ordered will be enough except for the thyroid one you mentioned to show up the things you mentioned could be wrong?

Also, what do you mean when you say with some auto immune disease the blockages co exist? Does that mean exist because of the immune disease and is it the same kind of blockage as it would be if it were heart related and can it be cleared out like with the angioplasty?

Fluid accumulation is a bad sign. We need to investigate if it is transudate or exudates by drawing this fluid and testing it. Inflammatory exudates is probable in your case.
Where would they draw the fluid from? Would it be from my legs and would this procedure hurt? Would this be to see if it is an autoimmune disease or something else? Also the ammonia smell I get after I walk, do you find this to be something that is important? The dr said she had NO idea what would cause this. This has been happening ever since last summer when I would walk.

Fluid should be drawn from the joint. It is just like an injection that they insert in the joint and draw the fluid. Your doctor / NP should order Urine analysis and serum protein, albumin and globulin as well. I forgot about Xray of the lungs to see if there is fluid there as well. Would they do this at the hospital, or would a dr do this in the office? Also what kind of dr do I need to go to for all this being I seen a nurse practioner the other day for this blood work?If there is generalized body swelling as it appears to me then the hair follicles are damaged and the hair would not grow. This says that the disease is long standing and a proper diagnosis is imminent for proper management. When you say the disease is long standing, are you speaking of the autoimmune disease? Also, if this blood work doesn't show up anything, what next do you suggest?

Your doctor / NP should order Urine analysis and serum protein, albumin and globulin as well. I forgot about Xray of the lungs to see if there is fluid there as well.
What will these tests you mention show up? I would like to print off what all you have sent me and go to a dr and let them read this and hope they are not offended that I went to the internet for help. Do you think that would be ok, or would they be offended in your opinion? I just want to get to the bottom of all this and get to feeling better. You have been very helpful.

Would a heart dr be a good dr to go to for all these things or what kind of dr would you recommend?

Would this ultrasound of the legs and MR angiogram be able to tell if I have bad veins that are not visible? I can't see varicose veins, but can sometimes see like a little bulge place on my leg like there is a vein underneath but not really at times.

If the blood word doesn't show up anything alarming to suggest the autoimmune disease, do you still think I should have the fluid drawn off the joint like you mentioned where my lower legs swell and ankles?If all these test come back ok that she ordered, and I have the MR angiogram and the color Doppler done and they are ok too, what then would I need to do, or where do you think I should go to see what is making my lower limps swell and the ache so badly and the bottom of my feet and ankles that swell? My legs have been hurting for years and swelling, but seem to be worse this year and the bottom of my feet, especially the left one feels like it could blow off with the throbbing and burning.

Most likely a surgeon will take up the issue and investigate in terms of lymphodema. Similarly if the heart function and size is fine then surgeon is the next person to contact.

Long standing swelling and pain should be related to vessels and lymphatic system. Compressing the nerves.
What is lymphedema, and how is it diagnosed? To find out if the heart function is find, what kind of test would show that? Would an echo show this? Also what kind of tests would show the vessels and lymphatic system and compressing the nerves?

Do you think I need a test for RA or would any of the test she ordered show this up? I wish you were close by so I could come to you, you seem thorough. What state is your practice located?

I also wanted to say today I have tingling in my left hand especially, like it has been asleep and this is just with me sitting and not having it in a weird position like it would cut off the circulation, and the index finger on my rt hand hurts so bad in the first bend and the second one and feels tight. I just feel like my body is being attacked by something with all of these things going on. It is so discouraging.

Systemic diseases. These include kidney disorders, liver disease, vascular damage and blood diseases, amyloidosis, connective tissue disorders and chronic inflammation, hormonal imbalances (including hypothyroidism), and cancers and benign tumors that impinge on nerves.

Vitamin deficiencies. Vitamins E, B1, B6, B12, and niacin are essential for healthy nerve function. A B12 deficiency, for example, can lead to pernicious anemia, an important cause of peripheral neuropathy. But too much B6 also can cause tingling in the hands and feet.Systemic diseases. These include kidney disorders, liver disease, vascular damage and blood diseases, amyloidosis, connective tissue disorders and chronic inflammation, hormonal imbalances (including hypothyroidism), and cancers and benign tumors that impinge on nerves.

Vitamin deficiencies. Vitamins E, B1, B6, B12, and niacin are essential for healthy nerve function. A B12 deficiency, for example, can lead to pernicious anemia, an important cause of peripheral neuropathy. But too much B6 also can cause tingling in the hands and feet.Systemic diseases. These include kidney disorders, liver disease, vascular damage and blood diseases, amyloidosis, connective tissue disorders and chronic inflammation, hormonal imbalances (including hypothyroidism), and cancers and benign tumors that impinge on nerves.

Vitamin deficiencies. Vitamins E, B1, B6, B12, and niacin are essential for healthy nerve function. A B12 deficiency, for example, can lead to pernicious anemia, an important cause of peripheral neuropathy. But too much B6 also can cause tingling in the hands and feet.Systemic diseases. These include kidney disorders, liver disease, vascular damage and blood diseases, amyloidosis, connective tissue disorders and chronic inflammation, hormonal imbalances (including hypothyroidism), and cancers and benign tumors that impinge on nerves.

Vitamin deficiencies. Vitamins E, B1, B6, B12, and niacin are essential for healthy nerve function. A B12 deficiency, for example, can lead to pernicious anemia, an important cause of peripheral neuropathy. But too much B6 also can cause tingling in the hands and feet.Blood tests. These can include tests to detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, and signs of abnormal immune system activity.
An examination of cerebrospinal fluid. This can identify antibodies associated with peripheral neuropathy.
An electromyogram (EMG), a test of the electrical activity of muscle
Nerve conduction velocity (NCV)
Other tests may include:

Computed tomography (CT)
Magnetic resonance imaging (MRI)
Nerve biopsy
Skin biopsy to look at nerve fiber endings
Edit Delete Posted By : Gailnightowl199
I ran across this article and wondered if you thought any of these things might apply to me and I would need any of these tests. Sorry for it printing three times, only meant for it to come across once.

I keep forgetting to let you know everything. My toes also on my rt foot are tingling. Is so strange my fingers and toes doing this.

Got a call from the dr's office and they said all the blood work was ok. Does that mean autoimmune is pretty much ruled out with the tests she ordered?

At the same time I wish a Psychiatrist screen for anxiety neurosis, depression parallel. You think I need to see a Psychiatrist just because I have so many issues going on with my body and have asked so many questions. I am not crazy and these things are really going on with my body. I find it insulting you think the things are not real I have mentioned. I think this is why so many people with real issues going on get dismissed because dr's want to push them off on a psychiatrist and don't believe them. They just assume they are crazy. I can't help it that I have so many things going on at the same time, but it doesn't mean I am crazy or that they are not real.