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Suffering from headache, fatigue, sore neck and sweating. What treatment should be done?

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General & Family Physician
Practicing since : 2005
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I've been ill for 2 months now. I had a uti which was resolved but have continued to be ill.
Female 36 Ht 5ft 4 wt 161(recent weight gain)

Headache constant goes from mild to severe
Abdominal cramping, mostly upper but upper and lower
Neck is sore but I'm normally sore there, just more now
Occasional chest pain
Occasional sweats
Low to normal temp- I usually am a little higher than normal 98.6, since this I'm going anywhere from 97-98.4, I do feel like I should have a fever if that makes sense- temp wise I feel like I'm hot and fluish but not
Fluctuating blood pressure low to normal
Feel at times like I'm going to pass out, even while just sitting.
Primarily began with pain in lower back to right side in addition to headache of severe nature.
Finally went to er had ct scan and results were the uti and a ruptured ovarian cyst.
I was given macrobid and sent on my way. I began to feel better and then started to get worse, which is indicative of my symptoms this whole time, things seems to come and go in the intensity, but still there in general. I went to the clinic, had a pap and tested for std's and uti- all clear and fine.
Still sick. Begin getting gallbladder pains of a severe nature. Go to er again. Ultrasound shows no stones or abnormalities with gallbladder or liver. A wet prep was done and showed that I had high wbc there. Nobody knows what it could be. So I continue on, tryign all I can to feel better-vitamins etc, which help but don't resolve and I feel i'm getting worse and worse. I have the cbc from er-
Abnormal values listed below
Low BUN 5
Low Sgot/AST 14
Urine Squamous epi cell 2-5 (abnormal)
Low RBC 4.08
Low Hematocrit 36.5
High Mean corpuscular HGB 31.7
High mean Platelet Volume 11

I have gone to another dr. who couldn't figure it out, and went to the dentist thinking perhaps my impacted wisdom tooth had something to do with it, although they don't seem particularly inflamed or painful at the moment. Nonetheless they prescribed amoxicillin and I'm taking that. Still feel sick. Seriously sick. Please help.
Posted Thu, 26 Jul 2012 in Headache and Migraines
Answered by Dr. Prasad 5 hours later

Thanks for the query

I have read the details submitted by you with diligence. I will try to provide you with useful information pertaining to your concern.

It looks like you are suffering with multiple symptoms. In such cases where the symptoms are spread across multiple systems, it is difficult to predict a close possibility without clinical examination and investigations. I see you been investigated widely in these 2 months and I have noted the results of the test. Accordingly, the following are the close possibilities which I feel could be the cause:

1. Post infection / inflammation some residual symptoms can remain for few weeks to months. It is possible that your current symptoms are direct relation to the recent cyst. Adequate rest and proper hydration is essential in the recovery of such post inflammation syndrome. Vitamin supplements give added benefits.
2. Thyroid disturbances especially hypothyroidism can explain symptoms of recent weight gain, easy tiredness, low body temperature, fluctuating vital signs, feeling low and so on. In addition you may also have period disturbances, mood fluctuations and reduced appetite. Getting a simple blood test known as thyroid profile will confirm the thyroid hormone status.
3. Other metabolic disturbances such as diabetes, water and electrolyte disturbances need to be ruled out too.
4. It would have been good if you had mentioned the units of measurement with the reference range in the complete haemoglobin count report (as different labs have different standards of reference). But presuming you indeed have low hematocrit with high mean corpuscular volume, possibilities of anemia cannot be ruled out. Anemia can also be associated with your symptoms
5. Nutritional deficiency especially vitamin and mineral are associated with myriad of symptoms, some of which can mimic your symptoms.
6. In addition to these if you are also depressed, psychological conditions also need to be ruled out.

I apologize if my answers are very gross and not specific. However due to the ambiguous nature of the symptoms and with restricted clinical details, I am unable to provide you with an unique specific cause. It is possible that there could be more than 1 possibility also. So a careful examination by an internist (general physician) is warranted. That being said, I do not think we are dealing with something very concerning or cancerous. With the help of step wise evaluation that should begin with review of blood counts, vitamin B12 levels, blood sugar and thyroid profile and scans your physician should be able to derive clues towards proper treatment.

Hope this is informative enough to guide you to a proper treatment. Let me know if you I have missed out any other concerns.

I wish you good future

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