HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

What Causes Severe Leg Pain Despite Being Negative For Lyme Disease?

default
Posted on Wed, 19 Aug 2015
Question: I am a 63 year old man with severe leg pain, hospitalized a few times with pneumonia, chf and leg pain. Treated with diuretics, heart meds, etc, givin Lyrica for leg pain, small dose worked then stopped, larger dose seemed to increase CHF related symptoms, but stopped working for pain... tried dyxcillin for lyme, which didn't work, tested negitive for Lyme, told by many people and doctors both that antibiotic used was wrong, or not taken long enough and that it can still be lyme even though I tested negitive. I could sure use an honest answer or opinion....
doctor
Answered by Dr. Suresh Heijebu (3 hours later)
Brief Answer:
Possible Vascular disease of lower limb?Need confirmation.

Detailed Answer:
Hi Sir.

I understand your concern.

You possibly seem to have Chronic thrombotic venous disease/dvt of the lower limbs.

This can bring frequent pain both during rest as well as exercise.

This form of DVT is of high suspicion considering your age and frequent hospitalizations and history of CHF.

Lyme is extremely unlikely in presence of negative screen.

Lyrica is of no use in the current scenario.

I advise you to get an Duplex Colour Doppler study of both lower limbs,if any thrombus is detected,further action can be taken.

Further management with drugs like Low mol wt Heparin is based on test results.
Post your further queries if any.
Thank you.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Suresh Heijebu (28 minutes later)
I was sent for various Vein tests of my legs. Opinion of doctors remains that there is some mild verigus veins not capable of causing my kind of pain. Neurology testing showed mild to very mild abnormalities, doctors prescribed some form of nonsteriodal anti-inflamatory cream, ZERO results, My insurance has bounced me around from doc to doc, most will not deal with my issues and resend me to the same specialists, who basically run when they see me now. A urologist claimed this had to be Lyme. My current primary care doc keeps pushing blood thinners on me, despite test results, as if she cannot read??? I'm currently on a 15mg time release morphine, 10mg oxecodone and 200mg celibrix, which barely takes the edge off the pain. I came up with a retry of antibiotic at larger dose. I was recently sent for back X-Rays the hospital refused to preform, Neurologist who checked me out first said it was definanetly not muscular and I might have a bit of nerve neuopathy, she does not believe could cause this kind of problem... Sorry for all this info, but my goals are to be able to walk a bit without pain and to stop being my own doctor, since at this point they are asking me for ideas... I'm an Ex- semi pro bodybuilder, my legs were always very strong and still are. My legs feel like they are on fire...
doctor
Answered by Dr. Suresh Heijebu (25 hours later)
Brief Answer:
Get B12 levels checked

Detailed Answer:
Hi Sir,

I understand your concern.

In case if many vein tests are negative,it usually points to neuropathic cause.

For this I advise you to get a Vit B12 and Vit D levels.

Low B12 levels will cause neuropathic symptoms.

A trial of Inj B12 1000 mcg once everyday for 7 days followed by Tab Methylcobalamin 500 mcg one tab orally daily for 3 months will help to improve the symptoms to a large extent.

Simultaneously tapering the dose of tab Morphine or Oxycodeine will help to reduce the restlessness or uneasiness which is a predominant side effect with their use.

Post your further queries if any.

Thank you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Suresh Heijebu (17 hours later)
There is so much info to give you, I try to write only what I feel is important. Blood tests have shown my red blood cell count to be slightly elevated, perhaps due to breathing restriction? I had a truck I was repairing fall on me in 1987 and have had some shortness of breath since. There were no blood abnormalities out of test ranges, except to say some were toward the upper end of scale and some at the lower half of scale. That blood test was given me about 6 month ago. Aside of that, I live in New Hampshire, USA for the last 6 years, prior in New York City. Even people with bad diets here may suffer from obesity and a weight loss of 15-20 pounds may make me a sexier old man, but I would rule out vitimen defecieny for most peo-ple in my area, faster then Lyme diesase. I do not want to wear out my welcome, but please tell me I'm annoying you, instead of just not answering my responce to your question. I do understand. Oddly, what "They" are calling CHF, seems inapropraite to me, since my heart is actually pumping strong and no artry blockages were found in Echo. I was duped into a catherization in 1999, which showed no problem with blockages and have refused wishes to give me another one, since they said it was an insurance requirement before giving me viagra. I tried small dose viagra on my own for 3 weeks. Possible improvement in breathing, but very tiny and my complaint about leg pain severe enough to destroy my life, for the last 6 years were being ignored while they were giving me the viagra speech, as I'm talking to them, whille holding on to a chair in the office and wincing in pain???
doctor
Answered by Dr. Suresh Heijebu (29 hours later)
Brief Answer:
HRCT lungs will throw additional light

Detailed Answer:
Hi Sir,

I understand you concern.

Chest related breathing symptoms can be thoroughly evaluated if you have HRCT scan of your lungs.

This can assess the degree of any restrictive lung disease.

CHF cannot be determined by angiogram alone.

You need FFR study and thallium scan of the heart to document accurate functional status .

B12 levels cannot be correlated based on community findings.

You need to have a blood screen for this vitamin in context of your leg symptoms to rule out this deficiency.

Thank you.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Suresh Heijebu (7 hours later)
Sooooo, most important is that the operation is a sucess, but the patient died...
You take your chances every time you get out of bed in the morning. You could lesson those chances by preforming all kinds of tests, but then you'll be late for work??? They have done that already, been kicking it around for 6 years... But then, we don't measure time the same way, do we??? I'd like to see you converse with anyone, if you were sitting on my mushroom.... Ha
doctor
Answered by Dr. Suresh Heijebu (29 hours later)
Brief Answer:
Tests are ordered to assess the stage of the pathology rather than time.

Detailed Answer:
Hi Sir,

I understand your concern.

Elevated red blood cell count in your case indicates secondary polycythemia.

This indicates chronic lung pathology usually.

Pathological process vary with time,hence its important for an appropriate and timely set of investigations.

In your case,possibility of cor pulmonale is high hence a repeat of investigations is logical.

Therauptic principles vary with both time and stage of disease.

Management protocols doesn't always solely depend on clinical picture of the patient.

Hence it is prudent to undergo the set of investigations I mentioned.

Post your further queries if any,

Thank you.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
default
Follow up: Dr. Suresh Heijebu (23 hours later)
If you look up a flies you know what, guess what you will find??? Explained previously: Most tests done on my gumpy old ass, with a time fram of 1988 - 90 days since I mad you aquaintence, have been within the tests range with one or two past my plumber's scope and concern for medical things being less then 2% of test range, have remained virtually unchanged, since I was released from a hospital in 1988. I was taken there in a coma by ambulance, with a slim chance given for my survival. I'll cut to the chase, I saw no "White Light", during the estimated 12 minutes before some medic shot a load of adrelin into my heart, to get me going again. during follow up check ups, after being released from the hospital, medical students told me I was an "Act of God", and I bcame a favorite study in the ritualistic tourment the poor bastards had to endure, during many an internship. So Yes, looking where, you will find some miniscule of you know what. I deeply thank you for all of you input and I seriously mean that. Between 1996- 1998, I had some doctor who administered massive injections of "B" complex and oral tablets of same, though not as massive as what you said here, even though I had none of the symptoms I'm experiencing now. I guess in some ways I have an advantage over you, in that I live inside the body with this problem. If I didn't I'd say I have to agree with you... In the real world however, it makes sense that I allow them to do all tests again and start me on an antibiotic, in the true sprit of desperation, because I simply know nothing tried on me in the last 4 years has worked at all and better men then I couldn't figure out what the Hell was wrong with me since three days after my accident a doctor told my then living parents, "We don't even know how he's alive... Sooo how about a handshake and a thank you from me???? :-)
doctor
Answered by Dr. Suresh Heijebu (26 hours later)
Brief Answer:
You are a brave man.

Detailed Answer:
Hi Sir,

Gone through your response.

Extremely disheartening to see that you have gone through this chronic rough patch in your life.

At the same time I would like to appreciate your courage in handling these issues.

You have been an awesome character and source of inspiration for many.

It is my honour to have a hand shake with you.

Thankyou
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Suresh Heijebu (1 hour later)
Your very welcome. I see you have a sense of humor too... Brave might be over-stuffiing the envelope a tad??? In reality, I'm some sort of eccentric, who currently lives in a cabin, on a miniature mountain up here... The ultimate Fool on the Hill. shhhh, just don't tell anybody... Happy Trails to You!!!
:-)
doctor
Answered by Dr. Suresh Heijebu (24 hours later)
Brief Answer:
You are welcome Sir.

Detailed Answer:
Hi Sir,

Good to have you back.

Ultimate fools are the real tough ones to crack.

You are the Mountain Man.

Your philosophy towards life is unmatchable.

Take care Sir,
Have a Nice day.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Suresh Heijebu (1 hour later)
hummm??? I don't know what to say??? Nothing to worry about really... Either your already there, or it looks to me like you'll be here, or maybe on an adjacent mountian in china, eventually???... And for that, sometimes I feel I owe you an apology??? :-)
doctor
Answered by Dr. Suresh Heijebu (27 hours later)
Brief Answer:
Wishing you a great health.

Detailed Answer:
Hi Sir.

Good to have you back.

Yes obviously I and this entire team of HCM are at your health service.

I personally wish you a great health ahead without any limitations.

We are friends.

No apologies.

Thank you.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Suresh Heijebu

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
What Causes Severe Leg Pain Despite Being Negative For Lyme Disease?

Brief Answer: Possible Vascular disease of lower limb?Need confirmation. Detailed Answer: Hi Sir. I understand your concern. You possibly seem to have Chronic thrombotic venous disease/dvt of the lower limbs. This can bring frequent pain both during rest as well as exercise. This form of DVT is of high suspicion considering your age and frequent hospitalizations and history of CHF. Lyme is extremely unlikely in presence of negative screen. Lyrica is of no use in the current scenario. I advise you to get an Duplex Colour Doppler study of both lower limbs,if any thrombus is detected,further action can be taken. Further management with drugs like Low mol wt Heparin is based on test results. Post your further queries if any. Thank you.