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Rash on the penis, over weight, hyperventilation - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2580 Questions
User :   hello
Doctor :   Hi
Doctor :  
How can I help you?
User :   I have a long problem sorry
User :   can I post it in bits for you to read, not sure how many characters I can post at a time
Doctor :  
You can post it at a time
User :   First symtom ever was a rash on my penis (I honestly dont know if this was the first symptom as I cant remember when this started) - but it went away - I got tested for every std possible - all clear, waited another 3 months and got tested again - still all clear. Next symptom was in early 2006, sore joints in feet, came and went and each attack got worse - I was trying to lose weight at the time so wasnt eating a lot and was still having a few drinks so doctors assumed gout and gave me gout treatments like colgout which never really worked but most times it cleared up within 4 or 5 days. Went OS to Thailand - Germany, Prague and Ireland - feet were sore there but not all that bad - put it down to gout etc due to having drinks while away.
Doctor :  
I shall take time to read by the end I shall reply
User :   excellent
User :   Shortly after getting back (I think - cant remember) I got vascalitis (spelling) in my legs, spots looking like busted blood vesels traveling up my leg, I went to hospital, they said it was mild vascilitis and not to worry too much about it. They tried treating my rashs with anti fungal creams, whih did little more than change the color of the rash, it still existed - they then put me onto Hydrosol (steroid with anti fungal) this cleared it up for a few days and then it would return. Feet continually got worse, just more often, so completely changed diet - only vegies - only had drinks on weekends - doctors tried me on a bunch of different gout remedies (none preventive at this stage) none really seemed to do anyhting, but feet took about 4 or 5 days to clear up again each time - was also prescribed basic anti inflamatories - I was gaining weight while only eating vegies and salads - no alcohol- doctors didn't believe me so we did a test - I only ate vegies for 2 weeks and had no alcohol, I gained 3kgs - doctor got my thyroid tested and tested for growth hormone - tests were fine they put me on a weight loss drug - that was similar to speed called Duramine.
User :   Duramine had speed like affects on me so I stopped taking it - feet were getting a lot worse now, every attack now lasted 1 x week and then I would get 1 x day break and then they would hurt again - not just in the toes now - was also in the heel, the middle of the foot and the ankle and occasionally the hands. Hands and feet would swell up each night so much so that skin would split on the feet - small postules (blisters) would form on the bottom of my feet - they werent itchy just painful (not too bad) they were small and clear - skin around my toenails started to peel away and the skin on my hands would flake and peel like it was shedding skin - It became impossible to clench a fist as it hurt like carpel tunnels - this still happens quite frequently at night - it hurts around where the rod is inserted in my schaphoid. This cycle lasted for a very long time - the skin issue seemed to worsen and be more frequent - the rash spread to become perianal and I also got something on the back of my scalp that was similar. Feet got very bad, fluid was building at the ankle - different ankle each time (large amounts of fluid), I was trying to excercise but could not do it without aggrivating the issue, was placing feet in ice regularly, never reduced the swelling but stopped the pain for around 15 mins each time - anti inflamatories did not work nor did any of the gout medicines.
Doctor :   Let me read

User :   Doctors started to track my uric acid levels they were high, but previous tests also showed them as high - diagnosis - definately Gout - perscribed Alluporinol (gout preventative) - this didnt make any difference - Uric acid levels didnt drop very much ..swelling was very prevelant and attacks were constant, also got sore fingers - my arms had always "gone to sleep" (pins and needles) when I was laying down but now that started to happen when I sat down and raised an arm or didnt use it for long. Attacks became so bad that I had to crawl around the house - could no longer drive, or go to work, had to carry ice with me any time I did leave the house, muscles got sore but think this may have been from crawling along the ground on hands and kness. Doctors were concerned about swelling in the ankle - they sent me for untrasound and drained liquid to test for urate crystals - they didnt drain the ankle but drained around joints in my feet using an ultrasound - felt much better after this MUCH better - they found a small amount of urate crystals in the fluid. I see my mothers doctor he perscribes me Prednisone (steroid) in mild doses increasing - this INSTANTLY fixes the issue, I can walk properly for the first time in 6 months - flare ups are controlled with the predinisone. sorry - let me know when your ready for more -
User :   More?
Doctor :  
User :   Ok sorry
Doctor :  
for a min
Doctor :  
Go ahead
User :   ok 2 secs
User :   I cant send anything
User :   it wont let me cut and paste anymore..hang on
User :   It is suggested to see a rhumotologist - I see a rhuemo who again diagnoses gout but just to be sure decides to do MRI of ankle - MRI findings were as follows. Ankle joint effusion with prominent synovial enhancement, Mild synovial enhancement subtalar joint, preronial tenosynoviotis - ATFL is chronically deficiant - no cartilage or arthritic problems. Doctor notes rash but wont view it - says it may be more than gout - could be Psoriatic Arthritus - prescribus sulphasalazine (I dont take this) high dose allupurinal (much stronger) and the strongest allowed steroid amount for prednisone - I gain a lot of weight always hungry...rash persists but is controlled with hydosole cream.
Doctor :  
Why did you not take a sulphasalazine?
User :   want sure it was psoriatic arthirituys and has bad side effects
User :   sorry for the long essay but being trying to to work this out for years..more to come it gets quite bad..currently having toruble breathing
Doctor :  
I mostly feel that this is to be worked out with multidiscipline
Doctor :  
Dermatology, Rheumatology and Internal Medicine Physician
Doctor :  
Yes not too complicated but has to be tackled by all the above specialist in a mutually complementary manner
User :   I know..i really want to get to the end of this, i know its long..can you bear with me please
User :   this was just the start, ti gets a lot owrse..need to know if they are related
Doctor :  
Doctor :  
Please go ahead
User :   thnak you...I dont want to seem like a hypochondriact (spelling) but its taken years to get this far and its pretty bad
User :   Whenever steroid is weened off feet start to play up again - I eventually ween of the steroids and the feet do not get bad, I can actually walk and play sport - still taking the allipurinal - occasional flare up of feet issue is cured by taking 1 x pill of the steroid (I know this is wrong but very concerned about weight gain). I decide to see a new doctor, he notices the lumps in my chest - some in my chest wall and says they do not move so they could be lymphomas - he extracts one from my back to find it is only fat, however ones in my chest are getting much larger - the back gets infected slightly - antibiotics seemed to clear it a little. - was also perscribed another weight loss pill that was designed to reduce hunger - retinol or something - didnt take it for long - also deep xray of upper spine to see if extra rib may be there causing arms to go to sleep - it wasnt.
User :   While cleanng the house on my knees, my knee gets sore - it continually gets worse very rapidly until it has blown up in size a lot - I go to hospital as it is very painful, they drain a LOT of fluid from it - the colour of the fluid is yellow so they assume possibly infected - they put me on drip of antibiotics - i tell them I am allergic to penacilan - they ignore this and say probably as a child - they put in a penacillan derivative - no effect, they test the fluid for urate crystals and find some - they diagnose gout - knee eventually recovers - strong anti inflamatories are given and I go home. All this time my Girlfriend says I keep stopping breathing at night and I do wake up from biting my tongue or chocking - but she says it pretty bad and happens a lot more now. I find myself closing my mouth a lot during the day and biting down - noticed it sometimes is harder to breathe but opening my mouth fixes it, this gets slowly worse to the point where breathing appears to have very little effect when sitting down but this only happens when relaxed and watching tv or not doing something physical or mentally active or talking - I ask my doctor and he sends me to sleep specialist for apnoa study, sleep study reveals very low O2 levels down below 80% and lower - tells me I must see my specialist immediately
User :   see specialist (who would much rather be playing golf) he tests my lungs on basic machine - then tests again after ventalin - there is an improvement but possibly just becasue i am better at the machine second time around, he tests my O2 saturation and asks "are you sure your feeling ok, you had better lie down" I felt fine - he then retests my O2 levels lying down and tries to use a ecg measuring machine but it does not work - he refers me for full lung function test and ECG and CT with dye in my veins to test for clot in lungs..this is all clear - prescibes symbicort this does not help. Sends me for sleep study with apnoa mask this time My breathng is fine when I excercise - no issues there so I play soccer the Sunday before the test - note - my feet have been fine for 5 months or more been able to excercise 3 x times a week with no issue even kicking footballs- after excercise I tend to be ok for at least another 24 hrs or so - the day of lung fuction test I was fine, so no surprise that the tests were ok, just a small issue with lower part of lung, under 30% increase with ventalin.
User :   I see specialist with results from ECG and Lung Function - he can barely remember me, he reads his notes then suggests I simply hyperventalate - he gets upset when I say I do not think this is happening - he suggests tests for virus which can be picked up in Thailand - i am not too happy as it scares me not being able to breathe - he suggest i am just hyperventalating but says he will send me for a full heart stress test anyhow just to be sure - suggests stopping alluprinal as it may be casuing the rash. Apnoa test with mask improves O2 levels to 93% at worst point which is big improvement - nurse says i need to ENSURE I get an auto machine as I need 12.5 in Rem sleep but very little when dozing - script is written wrong and I end up with non automatic machine - very hard to use as cant sleep well with such a strong 12.5 blowing - worries me that breathing is getting much worse, now hard to breathe when standing and walking at times but running seems fine - poking tongue out helps - sitting down O2 levels are around 94% to 92% but with cpap machine it is around 98 to 99% when awake and using it.
Doctor :   o2 levels of 94% are fine while sitting

User :   I know
User :   since being off the alluporinal my feet ache again..but that could be poor circulation?
User :   my biggest issue is feels hard to breathe all the time and only when sitting down - not talking or concentrating on anyhting?
Doctor :  
What is your age
User :   38
User :   but I have aged a lot in last year or falling out and gone grey very quickly
User :   could the rash be related to all of this?
User :   ?
Doctor :  
The cause of rash is very tricky to say after everything you described here
Doctor :  
Is it autoimmune or because of the drugs
Doctor :  
is not clear
User :   interesting thing is that I have not evn had a cold in 3-4 yrs not even 1 x sore throuat
Doctor :   What did the Dermatologist say
Doctor :  
or suggestion for biopsy or scrapping?
User :   cant get in to se one..they are all booked out......need to stop the hydrosol in order for it to come back...
User :   semen seems to affect it..which is weird
Doctor :  
The first chance could have been to a Dermatologist
Doctor :  
which is missed on
User :   IE if I have sex and then go to sleep and semen leaks out the next day its really bad - might be the friction though?
User :   originally had some weird stuff on my legs, they biopsied that years ago...came back as numular exma
Doctor :   ok
User :   hydrosol fixes it very quickly but it just comes back?
User :   my tonsils are rather lose and sometmes make me want to gag...could they be clocking my airways?
Doctor :   Yes a good possibility

User :   The only symptom that i currently have is the inability to make a fist, hurts where carpel tunnels are
User :   so do you think any of this could b erelated...i hate sounding like a weirdo...just trying to piece it all together the breathing is getting worse every week or so..scares me
Doctor :  
I see a lot of relevance of expert opinion of Dermatologist, a Clinical Immunologist ( Rheumatologist)
Doctor :  
to find out the cause
User :   ok...any thoughts
Doctor :  
If needed you will be benefitted with some immunomodulators
User :   I will see a dermatologist asap..
Doctor :  
Did the Doctor say a restrictive type of Lung function when he done the spirometry
User :   but the foot pain hasnt been around for over 6 months until today and i assume thats only becasue i stopped taking alluporinol
User :   lower lungs were a little restricted but other than that they were fine...but on the day of the test i ahd no breathing problems
User :   why havent I caught so much as a cold in so many my immune system too active
Doctor :  
I guess you personal hygiene is too good to catch a virus or another germ
User :   could my immunes system be too active and be attacking me?
Doctor :   and your diet and life style is pretty decent

User :   I gave up smoking 3 months not so perfect...weird though bretahubng would be better after that...was lite smoker
Doctor :  
I guess you do not have impact on your general health
Doctor :  
Good that you gave up smoking
Doctor :  
other wise things would have been worse
Doctor :  
I now relate somethings to your smoking too
User :   so what lung doctor thinks i am hyperventalaiting, how can I prove I am not?
Doctor :  
Since you are not able to breathe properly you tend to increase the number of breaths per minute
User :   only smoked about 4 cigs a day
Doctor :  
un knowingly
Doctor :  
Any amount of smoke is dangerous to health
Doctor :  
So you cannot really prove it
User :   really ...doesnt seem like that - seems like my breath is slower and weaker
Doctor :   just try to count the number of times your chest moves up and down in a minute
User :   so what do I do..breathing is getting worse..cant ignore that ...but lung guy says that its just not sure what to do now....bit concerned
User :   how many should it be?
Doctor :  
Relaxing reduces the number of breaths
User :   a doctor friend suggested sarcoidosis..buit wouldnt hat have shown up on the Ct scan..even if it was looking at veins in the chest
User :   the brething issue only happens when im relaxed...sitting back watching tv or somehting
Doctor :  
Try to engage yourself in some thing where you do not notice about the breathing
User :   I seem fine when that happens..but largely becasue I am talking or walking
Doctor :   Do you have cough?
User :   no cough..not much anyhow..little phlem - sticky and white but not a major cough no
Doctor :  
Was the sputum analysis done?
User :   no..
User :   should I suggest this?
Doctor :  
User :   with whom..pulmologist
Doctor :   Yes
Doctor :  
How is the weight now?
Doctor :  
How is your hunger, sleep and stools?
User :   ok will there any diseases that could link all these symptoms together..and lastly is it possible a fungal thing could be in my lungs?
Doctor :  
What is your occupation?
Doctor :  
Sputum analysis says about the fungal thing
User :   weight is fairly constant...rather overweight..whole family is...I am 110kg 6ft 2in...ex full time athlete so not as overweight as you might think
Doctor :  
I know you may fail to accept the fact that 110 kg is Obese
Doctor :  
and it can cause hyperventilation
User :   no I know its obese......but until 6 months ago I couldnt really exercise..I have dropped a few kg...and will lose the weight now - trust me on that
Doctor :   Good

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