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Having Muscle Pain, Stiffness In Legs And Knee. Have Blood Pressure, Shoulder Pain And Carpal Tunnel Syndrome. Help?

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Posted on Sun, 4 Aug 2013
Question: Hi dr.Luchuo Engelbert Bain
I hope you still remember me you advice me ti go to reumatologist one monts or less we tolk regarding my health problems i wrote you my mri of spine and problem with shoulders to if you remember that is good i don' t nead to write my hystory back to you.
I went to reumatologist yesterday he read my oll papers and i told him also latly came more new things happening to me it is may pain in groving eria and capole days ago my mascule on both legs get so stiff i hardly wolk for few daysr naw i feeling some problem in may knee on right leg that is new things i told him i got sceard from mayself beacose of oll of hapening he did:
Check my blood pressure my neck may legs may hands exstention and streinth in may fingers and feast.He ask me if i have deppression i said yes if i have problem in may ancle in may feet i said no.He told me that may doctor should not sent me to him and he will write her later abaut same and that i have carpel tanel syndrom for shoure i said neurologist dont saing i have same i already call one wich did test bat he dont call back.he said i will give you to do some blood test if came negative i will not call back you if test show somthing i will call you back (he was for some rizon very apset and not pleasant tovard me).Beafore i left office he call me back and he said if i have my shoulder painful he will shoot me with injection right awey i said no thank you let wait for blood test (i alredy had my shoot in march and ortopeadic surgen told me nexst one no to take beafore past 6 months)like you said maby when you see test you wont have me anymore then i will give to do that sombady else.He said i have some adenophaty of shoulder and carpel t.syndrom i ask if i have artritis to that what my gp saing and i will have problems with joints to (osteoartratis)"ask hom if i have artritis"he said nothing (is that reumatologist speciality or not???) then i left office honestly dysapoitment in this doctor.
I will write on end of later blood test wich he gave me to do bat beafore to ask you what you think abaut this appoitment with reumatologist and what is this blood test for and what should i do ask her for other reumatologist orso????
Blood test was:ULA-B27 (frst later wos U or i couldnot read properbat if is not U then is H or N).My gp did alredy 6 months ago my hormone blood test wos ok is thissame test or no???
Thank you dr.Luchuo your's truly XXXXX
doctor
Answered by Dr. Luchuo Engelbert Bain (51 minutes later)
Hi and thanks for the query and trust.

I understand perfectly how distressing it could be leaving your physician's office being more stressed or unsatisfied.

HLA is the Human Leucococye Antigen Complex 27, specific markers that orientate us towards autoimmune and certain systemic diseases. It s negativity does NOT however imply rheumatological/inflammatory or systemic disease is absent.

The diagnosis of carpel tunnel syndrome is a possibility but not very probable with clinical scenario with which you do present with. I do respect very much his opinion. I shall be more comfortable and very calm when you consult a rheumatologist. His clinical review and blood tests shall give key guides towards a definitive diagnosis and management.

Rheumatologists do have a fairly flexible rheumatological package of tests which differs from case to case some how, depending on the signs and symptoms, past history and clinical review findings.Rheumatoid factor, erythrocyte sedimentation rate, C r P, XXXXXXX Anti Sm anti bodies, C3 and C4 levels (complement system measurements), complete blood count, Electrolyte panel, Blood Calcium and Vitamin D levels and appropriate joint X rays. Tests shall are generally expanded to include others or reduced depending n the case.

I would be honored getting a feedback after your consultation and results. Kind regards as I wish you good health.

Bain LE, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Luchuo Engelbert Bain (2 hours later)
Hi doctor
Since he told me to do jast test wich i wrote you it depend he will call me to came back or not haw came he think iam not case for him besaide osteoartritis i have this spreding issue with groving pain and naw legs?
After he sent his latter i will definitly write you back and i have to go on monday back to my famely doctor to do blaad test wich he request and tell her abaut what he told should i ask her abaut some exstra test to sent for him in case to do not look for new reumatologist(i now i should have extra neurologist or neurosrdzen bat so far she dont sending me to no one well se on monday i will ask her abaut these to ).
He told me (so far may gp always check never tell me there is cange in blood pressure)also may blood pressure wos 156/ i did not get rest bat wos high for his opinion i told may gp to do not give me any medicine wich can cause incressing b. p. beacouse may mother had 2 stroke it is very important for me so far i had jast once incrised b.p.after getting cortizone shoot bat jast for few days it came back on good one.Naw i have agein can you please tell me what to do regarding medicine it is very posibole i getting that from tyenol3 only that one i drinking latly on regular basis evry 6 haurs 2 all else medicine i dont beacose they dont do mach for me mirzapine and lorozepam do not regulary jast tayenol .
What should i do to ceep my b. p. good like always beafore to do not start to get medicine naw even for it iam tayerd of medication i did stress test 3 monts ago it wos negative it is i having good heart .
Thank you one more time your's XXXXX
doctor
Answered by Dr. Luchuo Engelbert Bain (53 minutes later)
Hi and thanks for the query,

A blood pressure at 156 for the systolic is definitely high. This however deserves confirmation. Excluding stress as a possible cause of an increase in your blood pressure is very vital. In this case, I will advice you to get your family physician redo the appropriate taking of the blood pressures again. This should be done under stress free conditions. 5 minutes of appropriate rest and repeated at least twice to obtain repeatedly high values before concluding you are hypertensive.

In case this has been done or hypertension has been diagnosed already, management involves aspects where you are to take drugs and key life style changes or approaches. Exercise, maintaining a good weight, low salt diet, XXXXXXX fruit and vegetable diet and low consumption of saturated fats are key aspects that if considered and practiced carefully, could on thier own, maintain the blood pressure at normal levels. After three months generally, if these measures fail, you are to be put certainly on medication. The choice of the medication is at the discretion of your family physician, based on the clinical findings, blood pressure levels and your medical history.

For now, I advice confirmation of hypertension formally by your doctor, and being put on life style change regimens or medication, in case the blood pressure values are too high, and I belief not. Do not bother so much. Feel good, do exercise, discuss with loved ones, and belief in your self. I think things will be better. Be good as you wait to see your family physician and rheumatologist.

Kind regards as I wish you good health.

Bain LE, MD.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Luchuo Engelbert Bain (3 hours later)
Hi doctor what should i do if when i do my HLA-27 blood test if came ok and reumatologist dont call me back (he said he wont call me back) should i ask my gp to sent me to different reumatologist or not and what to ask her to do seacund opinion?
Thank you and i will get back to you after his latter to may doctor.
Your's E.I.
What else of blood work i should do exept HLA-27 wich will be usefull for my reumatology test to be better presented at may problems at reumatologist then he may call me back?
doctor
Answered by Dr. Luchuo Engelbert Bain (54 minutes later)
Hi and thanks for the query,

Irrespective of the results of the HLA-27 test, you need to see the rheumatologist. A positive HLA only increases the likelihood that you have a given set of inflammatory rheumatological or autoimmune disease. Even if it is negative, it in no way tell us anything about the absence of the disease. It guides us to orient the thinking and reasoning if the physician, in his further testing and diagnostic possibility/decision making process.

I am afraid I strongly suggest you do see a rhuematologist. It s better we get an in depth opinion from a rheumatological point of view before continuing. Like that, I honestly think its better.

Thanks once again and hope this helps. Feel free asking any questions or worries if need be. Waiting. Kind regards as I wish you good health.

Bain LE, MD.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Luchuo Engelbert Bain

General & Family Physician

Practicing since :2009

Answered : 3092 Questions

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Having Muscle Pain, Stiffness In Legs And Knee. Have Blood Pressure, Shoulder Pain And Carpal Tunnel Syndrome. Help?

Hi and thanks for the query and trust.

I understand perfectly how distressing it could be leaving your physician's office being more stressed or unsatisfied.

HLA is the Human Leucococye Antigen Complex 27, specific markers that orientate us towards autoimmune and certain systemic diseases. It s negativity does NOT however imply rheumatological/inflammatory or systemic disease is absent.

The diagnosis of carpel tunnel syndrome is a possibility but not very probable with clinical scenario with which you do present with. I do respect very much his opinion. I shall be more comfortable and very calm when you consult a rheumatologist. His clinical review and blood tests shall give key guides towards a definitive diagnosis and management.

Rheumatologists do have a fairly flexible rheumatological package of tests which differs from case to case some how, depending on the signs and symptoms, past history and clinical review findings.Rheumatoid factor, erythrocyte sedimentation rate, C r P, XXXXXXX Anti Sm anti bodies, C3 and C4 levels (complement system measurements), complete blood count, Electrolyte panel, Blood Calcium and Vitamin D levels and appropriate joint X rays. Tests shall are generally expanded to include others or reduced depending n the case.

I would be honored getting a feedback after your consultation and results. Kind regards as I wish you good health.

Bain LE, MD.