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Nausea, fever, diarrhea, shortness of breath, headache, edema, nerve pain, asthma, hyperparathyroidism, pituitary microadenoma, BRAT diet, cardio, pilates, yoga

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General & Family Physician
Practicing since : 2004
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I'm a 33 year old female, dancer formerly 130 lbs and pharmacy tech. I had salominella poisioning in summer of '08. My symptoms were nausea, fever and diarrhea. I was placed on the BRAT diet and remained my diet for a full year. My weight in summer '09 was 142. I noticed I had swelling in my hands and feet and shortness of breath. I have asthma and that wasn't affected by this. I continued to gain weight and was diagnosed with hypertension. I went on a strict 1000 calorie diet and increased my cardio along with pilates and yoga. I bounced between 160 to 140 lbs. In Feb '10 after I did my yoga/pilate work-out I shoveled my parent's driveway and felt a dull ache by my right shoulder blade. I felt nausea, low grade fever, headache, cold sweat, hypertensive, rapid heart rate w/heart palpatations. I went to work and felt like that the entire day. I placed a call to my pcp. And her nurse said I would be fine. Two weeks after that my right hand began to "fall asleep". In the wks that followed it increased in it's intensity with numbness and tingling, burning pain and stabbing pain with pins and needles that radiated up the entire arm. To make a long story short at this point, every dr I saw felt my pain was coming from my neck since I've had chronic pain since my car accident. My sugery was May 14,2010, I had told my surgeon I was worried it may not be coming from my neck since the nerve pain was on my left side now and partially in my feet. C5-6,7 was fused with c5-6 discektomy. Before surgery I also had difficulty swallowing. Sadly to say but my health has drastically declined over this past year. I'm now 200 lbs, I can barely walk, I haven't danced or work in a year. The nerve pain is worse and I have great muscle weakness. My edema/inflammation in terrible and the person I see before me is a stranger to me. I've been to many drs; I have adrenal insuffiency, hyperparathyroidism and a pituitary microadenoma that they say is too small to be giving me these symptoms. It's 3.2mm x 3.2 mm. I don't believe my nerve pain was coming from my herniated discs. Do you have any thoughts that could bring me closer to the root cause of my ailments? I also have elevated crp and esr, slightly anemic, blood in my urine and once when I coughed. Not sure what info is relevant. Thanks for listening.
Mon, 21 May 2012 in General Health
Answered by Dr. Chakravarthy Mazumdar 6 hours later

I picked your query after 6 hours which is unusual. Generally queries are answered in couple of hours. When I read your entire query I understood that it is a complex problem and hence not picked up by other doctors.

I hope you appreciate my attempt to answer it.

At the outset you have a myriad of symptoms which should be evaluated and managed under one roof ( a multispecialty hospital) by NeuroSurgeon/Spine Surgeon, Endocrinologist, Physical therapist and Dietitian. Ofcourse few sessions by counsellor on how to tackle stress helps. They should co ordinate amongst themselves and closely follow your changing symptoms. If you have already done the above, consider referral to a Clinical Immunologist / Rheumatologist. The immediate goal is to improve the quality of life where you can walk and work, reduce the frequency and severity of symptoms.

Was an MRI of the cervical vertebra done, was muscle biopsy attempted? Can you type in the findings? I guess your doctors were relating the symptoms to herniated disc because of MRI findings. Your bothering symptoms may be consistent with this finding on MRI. Elevated ESR and CRP shows a pathological process. Certainly I would consider other causes including a Rheumatology profile.

The medication list is exhaustive. Did you check if some of them increase tingling and numbness?

Let me also think through this as one shop reply cannot help you in entirety.

Meanwhile if you have any other reports or lab values done recently please update them.

Have a Good Health.

Above answer was peer-reviewed by
Follow-up: Nausea, fever, diarrhea, shortness of breath, headache, edema, nerve pain, asthma, hyperparathyroidism, pituitary microadenoma, BRAT diet, cardio, pilates, yoga 2 hours later
I have had a follow-mri of the brain showing the pituitary tumor, mri of my shoulder showing arthritis around the bursa, and cervical mri showing mild disc protrusions of the remaining discs. My cta scan showed sclerotic lesions on t10 and t11 with dead bone infarcts. My meds are being tapered so my labs can be repeated with the least amount of confusion from their side effects. My nerve pain is in my entire right arm and shoulder blade. The edema might be exacerbated by the gabapentin and hydrocortisone. I appreciate the recommendation but I've seen five endocrinologists, two neurologists, two neurosurgeons, three pcp's etc...list goes on. After you have spinal surgery no one wants to touch you. Do you know of a good diagnostician or neurologist, endocrinologist to refer me to? I will travel if needed. Thanks for your time.
Answered by Dr. Chakravarthy Mazumdar 16 hours later
I understand your situation amidst the plethora of medical health problems you are facing.

With the sufficient evidence on MRI and arthritis of the shoulder any clinician would suspect and relate your symptoms. The arm pain and associated symptoms are of primary concern for you. You have infact seen many doctor, have you seen few who speak to each other and assist you allay the concerns. I still believe that if you can XXXXXXX that few on an outpatient basis in a multispecialty hospital rather than private clinics, the scope of speaking to one another is more if all of them stay under one roof. I also suggest to speak to your doctor about adding Methycobalamin in injection form for sometime.

I can name few docs in India but it would not make good sense to travel all here. I am sure you can find as good doctors there.

I think it is also the time to approach alternative therapies like physiotherapy and chiropractic which can increase the threshold of pain. You may find a response.

Though here I pray for your quick recovery. Any other ideas I shall share soon.

Wish you Good Health.
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