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What Causes Uncontrolled Hypertension, Headache And Joint Pains?

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Posted on Tue, 20 Jan 2015
Question: ok, here goes-I have been suffering for several years now with various symptoms that I am beginning to think have a systemic cause. I will give you as much info as I can. I am 35 yo F, I have uncontrolled hypertension, have been on 11 different meds to no avail. BP usually runs 160ish /110ish. I have been to a nephrologist that ran tons of tests, found nothing conclusive, have had stress tests, multiple EKGs, MRIs, again nothing conclusive. I have chest pains and dizzy spells. I have had several abdominal surgeries-Gall bladder, hernia repair, tubal pregnancy that resulted in emergency surgery to remove the fallopian tube and ovary, removal of most of the other ovary due to cysts, hysterectomy that left me with the partial ovary only. After the hysterectomy, which was a little over 3 years ago, was when the problems really began. First thing was recovery from the hysterectomy was not so smooth. I woke up feeling like my guts were being dug out with a knife. I was on very, very high doses of hydro, morphine, ativan, diazepam but they had very little effect on the pain. What was supposed to be a 48 hour stay turned into 8 days, simply from lack of pain control. I was even scanned to be certain there were no foreign bodies left behind. Cue the other strange stuff-I have traveling joint pain. Somedays my knee will hurt, then my ankle, then my shoulder etc, without any injury or strain and seemingly no reason. I go to Dr and get diagnosed with tendonitis, pulled or strained muscle, something like that. Then they give me percocets, depomedrol and pt. After a while it will get better. I have vicious headaches that last for days-sometimes up to week or more. Nothing helps. Nothing OTC, not Imitrex, not the diazepam nothing. They are almost always in the same place-right side of my head just behind my temple. I am very, very stiff in the morning or after periods of inactivity, like long car rides. I simply cannot straighten out. I walk like I'm 90 years old, and have even gotten out of bed and fallen down because my body just says no. Most mornings when I wake up my hands are completely numb or tingling. And I am just in pain, like all the time. Even the weight of my clothes on my skin will hurt sometimes. Right now I have a spot on my foot that is just horrible! Just behind the arch of my left foot medial aspect. There is nothing visible on the outside, but I will feel pain all the way up my leg, sometimes like a burning in my bones kinda feeling, other times like a deep muscle soreness in my calf and/or thigh. I was also just in the hospital for a week for bi lateral pneumonia and sepsis. I was on IV antibiotics, loads of steroids, breathing treatments, and again tons of pain meds from my ribs just aching from the coughing. Was even sent home on hydromorphone, percocets, and tramadol. But again the meds don't help that much, takes the edge off, but after all that I should be pretty numb! While there I had blood work and lots of it. I have a very high WBC count (even after all the abx) was way under for protein, and calcium (no, I'm not vegetarian or vegan)and tested low % for Lyme. I have been exposed to mycoplasma through my work at an animal shelter, but they said people can't get it, I'm not 100% convinced. Cats tested positive on a PCR for hemobart. I also have insomnia, I take 20mgs of valium, about 5 or 6 25mg benadryl and sometimes a couple nyquils every night, or I just won't sleep. While sleeping my husband says I often whimper, make sobbing noises, have even screamed in my sleep, and am extremely restless. I wake feeling like I was hit by a truck. My short term memory is also shot. I am at my wits end. I just feel that all of these issues have a common denominator. I'm not that old that I should be having all of these problems, I stay active, I work, I take a multi-vitamin, fish oil, and eat healthy. Please help give me some insight
doctor
Answered by Dr. Drkaushal85 (27 minutes later)
Brief Answer:
you may have connective tissue disease.

Detailed Answer:
Hello dear, thanks for your question on HCM.
And thanks for the detailed history.
I want to ask few questions first.
1. Are you obese?
2. Are you smoker?
3. Have you tested for diabetes and connective tissue diseases (CTD)?
Connective tissue diseases are commonly seen in females between 30-40 years.
They all typically having multi organ involvement.
And all your symptoms like uncontrolled hypertension, headache, joint pains, skin lesion are seen in CTD.
So let me know answers of above mentioned question s. So that I can guide you further.
I will be happy to help you further.
Wish you good health.
Thanks.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Drkaushal85 (9 hours later)
1. No (but I have begun gaining weight in the last few years, even though my diet has stayed the same and my activity level has actually gone up)
2. No ( I also do not drink, or use recreational drugs)
3. Yes to diabetes, no to CTD (diabetes runs in my family, so I am very aware of the dangers of that)
I do not have skin lesions, no where in my description did I say that.
I also do not have a sedentary job. Actually I have 2. I am a veterinary technician at an animal hospital and I work in a cat shelter. Both jobs are physically demanding, and I am on my feet 10 hours a day, 14 days straight, with only 2 days off a month. I am including this information just in case it was assumed that I am sedentary and therefor having pain from any unusual exertion.
After re-reading what I wrote before I can also add a few things. GI issues-I have loose to diarrhea stools all the time. I have been scoped, found nothing, given sucralfate, famotidine, and told to take immodium to control symptoms, which I do every other day or so. I have a low immune response-I catch everything! If someone is sick with in a 5 mile radius I get it. And I will stay sick for several weeks while the rest of my family will get better within a few days. I also have muscle spasms, sometimes they are weak small pulses, sometimes they are agonizing cramps. They will occur anywhere, but I seem more prone in my neck, back and cranio facial muscles. (I do not grind my teeth, this is an assumption other Drs have made, so just clearing that up) I also do that restless leg thing, I tap my foot constantly if I am sitting, and especially when I am trying to get to sleep. I hope this additional information helps.
Thank you for your response.
doctor
Answered by Dr. Drkaushal85 (1 hour later)
Brief Answer:
get done S.ANA level.

Detailed Answer:
Hello dear,Thanks for your follow up question on HCM.

Since you have not done work up for CTD, I advice you to get done
1. S.ANA (Anti Neutrophilic Antibodies)
2. If this comes positive thdn get done full ANA profile.
You have mentioned that something horrible is developing in your foot just beneath skin.This can be cutaneous nodule. And Cutaneous nodules can be seen in CTD. So better to rule out this.

And thanks for the extra information.
You may have low immunity due to conditions like congenital immune deficiency syndrome. This is genetically determined . In this production of protective antibodies like IgG and IgM are deficient. So these patients tend to have recurrent gastro intestinal tract infection.

If all these are normal, then you may have anxiety or stress related problem.

Hope I have solved your query.
I will be happy to help you further.
Wish you good health.
Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Drkaushal85 (7 hours later)
This is the blood and urinalysis results from my hospital stay, Sorry I did not include this in my earlier statements, I couldn't find the paper work. Does this information help you any in your thought process for potential diagnosis?

WBC------High-----22.3---4.4-11.0
Neutrophils (%) (auto)------High-----76.4%---40.0-70.0
Lymphocytes(%) (auto)----Low--------18.0%---25.0-40.0
Absolute neutrophil--------High--------13.66 k/ul---1.4-6.50
Potassium-------Low-------2.5 mmol/L---3.5-5.0
Chloride--------Low-------89 mmol/L---99-111
Glucose------High-------112 mg/dl---70-100
Calcium--------Low----------7.9 mg/dl---9.5-10.7
Albumin-------Low---------3.1 g/dl---3.1-4.4
Total Protein----------Low-----------4.2g/dl---6.8-8.4
Total bilirubin----------Low/WNL---------0.2mg/dl---0.2-1.2
Prothrombin time)---------Low/WNL------11.9 seconds---11.9-13.9
Prothrombin time international ratio--------Low---------0.96 INR---0.97-1.26
Activated Partial Thromboplast time--------High--------34.3 seconds---23-34

Urine analysis
Blood-trace
RBC-High-5
WBC-High-5
Specific Gravity----1.020
pH------6.0
Appearance----Hazy
squamous epithelial cells present
mucus-present

Cholesterol
HDL Choleserol-Low-33mg/dl---40-92
Cholesterol/ HD L Ratio-High-5.3---0.0-5.0
Non HDL Cholesterol-High-141 mg/dl---0-130
doctor
Answered by Dr. Drkaushal85 (6 hours later)
Brief Answer:
Get done S.ANA

Detailed Answer:
Hello dear, thanks for your follow up question on HCM and reports.
I have gone through reports.
I think this blood reports are of your pneumonia admission. And if yes than due to infection your counts are high.
So let me one thing, this high counts are at the time of admission or at the time of discharge.
So, you have not tested for CTD till date.
Better to get done S.ANA level. If this comes positive then get done full ANA profile to rule out CTD.
And due to low protein, your immunity is low.
Causes for low protien s are
1. Deceased intake
2. Decreased absorption
3. Protien loosing enteropathy
4. Urinary loss.
Chances of urinary loss due to renal damage are high. Because your urine report suggest presence of RBC and pus cells. These are markers of renal damage.
And renal damage can be seen in CTD.
Have you ever undergone renal biopsy?

I will be happy to help you further.
Wish you good health.
Thanks.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
Dr.
Dr. Drkaushal85

Pulmonologist

Practicing since :2008

Answered : 15005 Questions

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What Causes Uncontrolled Hypertension, Headache And Joint Pains?

Brief Answer: you may have connective tissue disease. Detailed Answer: Hello dear, thanks for your question on HCM. And thanks for the detailed history. I want to ask few questions first. 1. Are you obese? 2. Are you smoker? 3. Have you tested for diabetes and connective tissue diseases (CTD)? Connective tissue diseases are commonly seen in females between 30-40 years. They all typically having multi organ involvement. And all your symptoms like uncontrolled hypertension, headache, joint pains, skin lesion are seen in CTD. So let me know answers of above mentioned question s. So that I can guide you further. I will be happy to help you further. Wish you good health. Thanks.