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Muscle pain, jaw pain, vomiting, medication for fibromyalgia ineffective, taking insulin. Breakdown of muscles?

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General & Family Physician
Practicing since : 2004
Answered : 540 Questions
I had DKA and was in intensive care for 3 weeks. Been diabetic since age 12 due to physician boo boo. She gave me way too much cortisone, 2 injections a day for 8 days! killed off my islet cells. Took a while so finally at age 22 I went into DKA. Now I am on insulin, doing well, I had been doing well with my blood sugars, but got Pneumonia unaware! Now, My muscles aches so bad I can barely walk at times. My jaws even hurt to eat or brush my teeth, I have been given so many pain meds I could get XXXXXXX if I werent so honest!@! I want to get fixed, not have a band aid stuck on it all the time. I have a 4 year old son who needs me. I have to get better!! I need to get better not doped up. No insurance so it makes it difficult. I ask questions, they are quicker to send me home, I have to get better for my son, I just have to, Can you offer any suggestions? Are my muscles breaking down? Am I depressed? I was given meds for Fibromyalgia, been on them for over 2 month, closer to 3 months, not working. I dont know what to do and it is expensive to keep tying when it doesnt work! I hope you can help me. I am 22 years old, weigh 150, Newest symptom, started throwing up a lot, lost 15lbs in 2 weeks, Still throwing up, have lost about 7 more, This is miserable. I live in Roannoke va and I need help for folks with no insurance. Free clinic and ER does not help. Project Access sounds great but even with referral its taking me over a month to get in for paperwork, dont know when I can see dr. THanks so much for your help. Bless you!! I am just so tired because no one wants to listen or look for something this could be, They see me, with a couple of stupid tatoos and they think I am a druggie, nurses wasted over an hour drilling my roommates about what drugs I was on (which I am not) instesd of finding a way to save me. My blood work was back and showed my bloodsugar ws over 600 . I have a son, I am a single mom, and my mom is even sick so I need to be able to help her soon and I cant unless I am feeling better. So any answers I can get to help the drs I go to will be soooooo awesome, THanks so much!!you may call if need be at 000/000/0000
Fentanyl patches do not control pain so I usually do not wear them, they made me itch really bad, So I take excedrine more for pain so I do not itch so much, I take 5 to 7 orf more at a time just to take the edge off, My mom has to do the same for her pain, She has had bleeding ulcers, hope I dont get that.
Posted Wed, 11 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Sujeet N Charugulla 52 minutes later
Hello and thanks for your query.

I shall make an effort to provide you with good professional recommendations specific to your questions.

Well, let me sum up the issues at hand with you:
1. DM / Diabetic ketoacidosis
2. Pneumonia
3. Fibromyalgia
4. Depression
5. Presently on Insulin, serum glucose 600 mg%
6. On Acetaminophen, Duloxetine

Firstly, I do not know the issues of insurance and health cover in your country. But, if you are living now with a 600 sugar level, then that is the FIRST thing to set right. Which requires review of your Insulin dosage regimen with that same prescribing physician who put you on Insulin. High blood sugar has effects from head to toe and could cause any number of symptoms.

Simultaneously, the cause of your pneumonia pending, you would need preventive antibiotic cover for any possible infection on prescription. Pneumonia is an infection by bacteria in almost all cases.

Fibromyalgia is the answer for all the pains, groans and headaches you are currently facing. It has caused you depression, sleep difficulties, jaw pain, teeth pain, joint pain. And I am getting the feeling analgesia is not working for you. Because you have FENTANYL TOLERANCE. That itch and non-working shows just that.

I would not debate here with you if you say you were not on any drugs, but a doctor certainly knows why Fentanyl is not working for you.

Hence, I suggest you the following for now:
1. Medical advice compulsory for DKA management.
2. Support groups for Fibromyalgia.
3. Try acupuncture for pain, it works.
4. Cognitive behavioral therapy for your mental conditions - that would require a psychologist - if you cannot afford - try an NGO.
5. STOP taking that many excedrine pills at once. Yes, they are harmful if taken in that amounts. And can also cause bleeding ulcers for you too.

You have to remember:
1. Your muscles are fine, just that they are extremely tired.
2. Yes, you are depressed. Hence, on duloxetine.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Above answer was peer-reviewed by
Follow-up: Muscle pain, jaw pain, vomiting, medication for fibromyalgia ineffective, taking insulin. Breakdown of muscles? 7 hours later
I appreciate your answer! Thank you!! My DKA was in May 2011. I have since gotten my blood sugar under control. Am on insulin. Pneumonia has also been taken care of, I apologize for not clearing that up. All that is over and I am left with this pain. My spleen has been enlarged and painful. My Dr has tried me on Sevella and another med for Fibromyalgia but neither seemed to help the pain at all plus the Cymbalta for depression. I am wiling to try accupucture for pain but I am a single mom with limited income and I have spent my last dollar going to Drs for this! I have no insurance so I have to pay out of pocket. My husband left us when my son was only 2 months old. My son is 4 now. I am wondering if there could be another possiblilty besides Fibromyalgia? Mainly because of my huge weight loss, nausea and vomiting so much. I know it could be the pain but if that was the case I figure it would be all the time not just some of the time. Some days I can barely get through. The fatigue is just too much along with the pain. I work but my legs feel like they are going to fall out from under me at times. THank you for any other info you can find. I appreciate it so much!!
Answered by Dr. Sujeet N Charugulla 1 hour later

Thanks for writing again.

Well, then I duly note your present status both medically and economically.
And yes, I realize that Milnacipran (Sevella) on you has not shown any promise so far.

Fibromyalgia is a diagnosis based on the criteria of several weaknesses over time, and the diagnosis review I think is not worth. And even if your weakness is not fibromyalgia, your symptomatic treatment would remain the same. So, do not focus on the diagnosis.

Spleen enlargement is due to the infections, and will subside slowly.
Weight loss is due to Insulin (nothing to worry) and nausea, vomiting I suspect to be due to the effects of your polytherapy of so many medicines in your history, and not because of the pain as you think. Fatigue is due to the weakness and would get better if you control the pain.

If these symptoms are more than your pain, then get reviewed by the doctor - sorry no alternative here.

Else if your pain is more than those symptoms - a acupuncture consultation should not be that expensive. Try contacting the Fibromyalgia support group as I said before. WWW.WWWW.WW
I advised two of my patients before to shift to ayurveda therapy by a standard company in India.
You can perhaps give a try. Not very expensive. And promising results.

That way you will get back your health gradually, and remember you will have to resolve to get better for the sake of your son who would need a decent childhood soon.

I wish you best of health.

Write back for further queries.

Above answer was peer-reviewed by
Follow-up: Muscle pain, jaw pain, vomiting, medication for fibromyalgia ineffective, taking insulin. Breakdown of muscles? 5 hours later
I will certainly give accupuncture a try asap! Thanks. I do want to mention another symptom that may or may not be related. I have not had a period since May of this year. I am not pregnant either! I had pregnancy test done even though I have not had sex. None of the Drs I am seeing seem to think this is odd but I do. In August I had slight bleeding for only about an hour, not even enough to say it was a period. Just wondering if this has anything to do with my other symptoms since it started about the same time? Just after my DKA episode. And I think it is so odd too that I have never needed insulin until now either. I had my son 4 years ago and my blood sugar was perfect! No problems at all and no insulin. All the sudden, Pneumonia, DKA, insulin, no periods, my hair is falling out (forgot about this one), and generally I feel like crap! Pardon my expression. I was tested for Lyme disease and Lupus. All negative. I hope the accupucture helps. If you think something else could be causing my periods to stop and my hair to fall out, please let me know. And thank yu soo very much!! XXXXXXX XXXXXXX
Answered by Dr. Sujeet N Charugulla 7 hours later

Thanks for the additional reply.

Loss of periods and falling of hair may have to be correlated with your present status if I do not have reports of the current status of your ovaries, uterus or the pitutary - which would be required only if things cannot be explained straightly.

I would blame the fibromyalgia to have caused both. As the symptoms are many as a part of this syndrome depending on the individual.

Get your acupuncture done as soon as you can.

Let me know in case you have further doubts.

I would appreciate if you leave your feedback for me on this site as you have meant in your words in here.

Take care.

Above answer was peer-reviewed by
Follow-up: Muscle pain, jaw pain, vomiting, medication for fibromyalgia ineffective, taking insulin. Breakdown of muscles? 3 days later
I went for accupuncture. The Dr there said he was amazed that other drs were not interested in the fact that I have had NO period for almost 5 months, Ive lost over 20 pounds, most of it was in less than 2 weeks and I am throwing up for no reason. I get hot then cold, my hair is falling out, My muscles and joints hurt so bad I can barely move and I am only 22. He is wondering if I am going through premature menopause for some reason. He has suggested I have my hormone levels tested. He did some accupuncture and the best massage I ahve ever had. I do not feel much better yet but I have hope. I know I may need hormones if that is what is going on but at least someone has finally given me hope! THat alone makes me feel better. I have no idea what would make this happen to me. Can DKA some how throw me into Menopause because it was so severe? I just do not understand! It was very sudden, yes I was diabetic but never had to take any meds at all for it till May when I went into DKA so it was very abrupt to my body. Just so not understanding all this and it upsets me because with out understanding, I cant cope well. What are your thoughts on this. His only other thought was if not menopause it could possibly be something like ovarian cancer. My back pain and leg pain have been constant. So I am still not sure of anything. I have to keep working and take care of my son. My muscles are not what they used to be. I am not what I used to be. I need your help so much. THank you soooo much! I am so Blessed and thankyou. PLease take your time and Prayerfully consider your answer. THank you!!
Answered by Dr. Sujeet N Charugulla 7 hours later
Hello and thanks for your response again.

I am glad you have started on a positive note, keep tracking acupuncture till you utilize its full potential.

Yes, regarding your - loss of periods, loss of weight, throwing up, pains - I did mention in the previous response about the need for a review with a gynecologist already, to elaborate on the status of your uterus, ovary and abdomen etc.

DKA does not have a direct relation to causing premature menopause, though in studies there are many other related effects mentioned.

And your symptoms although may resemble premature menopause - until the exact diagnosis is made, you should work towards getting a consultation and investigations first. It could also be due to hormonal disturbances which needs to be confirmed by Hormonal Assay.

I understand that a lot of worry comes to you - when you do not have good authentic information about your condition. For this, I would advise you to keep off internet discussion forums, non medical websites.

Cancers are a possible complication of long standing diabetes or as separate entity, but ovarian cancer speculation should be reserved until you get the reports.

The bone pains caused by your lower hormone levels couple with the muscular fatigue compounded by your fibromyalgia and long standing diabetes is the main reason for your overall lack of initiative in life.

So, invest in the right doctor and specialist and investigations for the right returns of your quality of life for you and your son. All your comforts come later, so make a good decision and make arrangements for this as soon as you can.

Hope I have answered your query.

Wish you good health soon.

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