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Pain In Limbs And Neck, Difficulty Walking, History Of Abortion, Infertility And High BP

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Posted on Tue, 2 Oct 2012
Question: I married with my cousin. After marriage,I came to know that I suffer from preejeculation.Anyway,my wife gave birth to a baby by major operation. soon after that, she got pregnant but unfortunately, due to little knowledge of ours, she was abortioned by an unqualified village lady health visitor. she got infection in her womb. her tubes were once washed by a doctor to get pregnant again but in vain. since that time(almost 15 yrs back), she didnt remain fit and now last yr , she had two or three times high blood pressure. she has got very fat as well. now she suffers from muscles pain in legs, arms,and the back of her neck. when she works, her back head muscles(neck and shoulder muslces ache). She is very pessimistic as well. Most medicines dont fall fit to her(i dont know whether she is alergic to medicine or cant bear them for anyother reason). please help us
most problem is that now she is always complains of pain in legs, arms and the back of the head and shoulder(neck muscles?)muscles,find difficult to walk but at the same time, succeeds in doing household chores. thanks
doctor
Answered by Dr. Jasvinder Singh (11 hours later)
Hello,

Thanks for posting your query.

From your wife’s symptoms few possibilities which need to be ruled out are:

1)     Hypothyroidism which can cause weight gain as well as muscle and joint pains in the body. For ruling it out thyroid function tests should be done.

2)     Secondly it can be due to polymyalgia rheumatica.It is an inflammatory disorder that causes widespread muscle aching and stiffness, primarily in your neck, shoulders, upper arms, thighs and hips.

It literally appears overnight, but the cause may be a problem with the immune system, perhaps involving both genetic and environmental factors. It can be diagnosed by ESR(Erthrocyte sedimentation rate) test, platelet count and Rheumatoid factor(to rule out Rheumatoid arthritis).

3)     Third possibility is of fibromyalgia (a disorder classified by the presence of chronic widespread pain and tactile allodynia(pain even on touching), polymyositis (means 'many muscle inflammation') and chronic fatigue syndrome(often manifests with widespread myalgia and arthralgia, cognitive difficulties, chronic mental and physical exhaustion).

Complete physical examination along with investigations like ESR blood, platelet count Rheumatoid factor, creatine kinase, MRI upper spine, electromyography and muscle biopsy may be needed to make a diagnosis.

You should get these investigations done for your wife after consulting a physician.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.






Above answer was peer-reviewed by : Dr. Radhika
doctor
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Follow up: Dr. Jasvinder Singh (9 hours later)
Respected Dr.
Doctors say there is infection in the womb(chornic? because abortion by uncertified village health lady since 14 yrs back and since that time, she couldnt get pregnant).She remained depressed,anxious and the main problem is that when she uses water or go to bathroom, pains starts inside womb and anus. once there was a very sudden hard pain on anus).
Another main problem is that her nerves are now very weak. She fear socialization. please suggest us tests which are obligatory and also some medicine.(she is alergic to medicine as well , i think)
Thanks for the reply and hope you will take personal interst in our case and help us.And Respected Dr sb: my wife lives in Pakistan ..if ESR is necessary,then please let us know how dangereous it is to have this test(its side effects) and where will you suggest to have this test please.? Another symptom : some five yrs back, my wife fell down on bed while tempring with ceiling fan, since that time, one of her upper thigh gets dead(senseless) while sleeping often. please let us know
Which tests are obligatory?
What are their side effects(esp ESR)
Where in Pakistan we can have a these test(some reliable place)?
Thanks again for taking your precious time
I will vote for No.2(personally, I am sure ,it is exactly No.2 which fully fits her history and problems( two of her brothers suffered nerveous problems) and she has infectional disorder inside the womb)
So, sir, can´t we avoid these complicated tests ? becuase it is me who knows well that Nº 2 is the reason of this all.
So sir, what will your suggest further after taking probabilty(it IS the reason sir, i know)
The reason we now know sir, I will be much obliged if you go ahead further and suggest medicines for this please(sir ,I am dead sure the cuase of this is only and only No 2).
Though I am doing an odd job here these days, but if you kindly give me your persoanl telephone number and we are able to communicate by phone,I will pay you extra if it is a must.
thanking you in anticipation and waiting for your sympethatic reply and response at the earliest, XXXXXXX the husband of the patient
XXXXXXX
doctor
Answered by Dr. Jasvinder Singh (14 hours later)
Hello XXXXXXX

Thanks for writing back.

I can understand your concern for these symptoms but these are all blood tests and are very simple to do and quite cheap in India and Pakistan. There is no risk associated with ESR. The technician will just collect the blood sample for these blood tests and you will get the reports in a few days. These are not complicated tests and there are no reported side effects of these tests.

Secondly, For the abdominal symptoms and rectal pain, three possibilities should be evaluated in your wife's case:

1)     Proctalgia fugax: It is episodic, anal pain that occurs due to contraction of the anal muscles.Treatment involves warm sitz baths,over the counter pain killers like Ibuprofen and botox shots in severe cases.

2)     Levator ani syndrome: Levator ani is group of muscles that surrounds and supports the anus. Spasms of these muscles are believed to cause rectal pain and can occur frequently in women.

3)     The presence of vascular deformities like Hemorrhoids or Inflammatory bowel disease like Crohn’s disease and any adhesion formation in the abdomen after C-section.

You can discuss these possibilities also when your wife visits a physician.

I can understand from your post that she is having mild depression also, maybe it is due to the abortion she had. You should talk to a psychiatrist about depression and get antidepressants prescribed for her. Psychotherapy will also help a lot in your wife's case. Apart from that, she should try doing regular physical exercise by joining a gym.

For the senseless feeling in thigh after the fall, it looks like a nerve injury and compression of the nerve. To confirm the diagnosis you need to get a MRI spine and NCV (nerve conduction velocity) test done from a physician. She can take some vitamin B 12 in the meanwhile which will help in strengthening the nerves.

For Polymyalgia rheumatica, corticosteroids and calcium and vitamin D supplements are prescribed only after confirming a diagnosis by a physician.

You can consult me through this forum and send me any additional queries that you have.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Jasvinder Singh (8 hours later)
Respected Dr.Esq., just almost last question please: keeping in view all what is described(pragnancy by a major operation, abortion by an untrained village lady,anxiety,infection in uterus since long time(chronic?),fatness, and NOW pain in legs, pain in arms , highly sensitive female breast part(inside and pain if even touched), and last but not the least, pain in the neck,shoulders , strain in muscles, sometimes difficult to walk in the coutryard now...pain in the whole body...sir, what tests do you prescribe(which are obligatory) and if diagnosed correctly, is it curable? and how long can it take to get well please.(.once or twice she has suffered high blood pressure,and she is very alergic to the medicine as well)? life for her is a living hell , although so far ,she is able to do her daily domestic chores. Thanks if you will briefly guide us to the practical course of action please.
Prayers for you
XXXXXXX
doctor
Answered by Dr. Jasvinder Singh (25 hours later)
Hello,
Thanks for writing back.

The obligatory test which your wife requires are ESR blood, platelet count Rheumatoid factor, creatine kinase, MRI upper spine, hormonal studies of female hormones, electromyography and muscle biopsy.

Treatment and further management depends on the confirmation of diagnosis. If it is hypothyroidism and polymyalgia rheumatica then specific treatment is required and if there is any hormonal imbalance then hormonal therapy may need to be initiated.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Jasvinder Singh (4 hours later)
Sir, I know I am taking much of your precious time but as you konw how much it is necessary for us to ask quesitons from you. We have visited many times physicians but to no avail. Two of them told us that it is hormonal imbalance but without having proper tests. Sir I will try to have these tests soon if it these are possible in lahore. Would you like to guid us as:
How much difficult it is to tackle harmonal imbalance? Can it be got rid of easily and permanantly? how much time this therapy will be needed ?
How much will these tests cost us?
Bundle of thanks for cooperating and guiding us properly. Should I send you back the reports of the tests or is it better to consult some well knowm local family physician here in pakistan sir?
If you could kinldy eleborate what I requested above, I will be much obliged.
Thanks again
XXXXXXX
doctor
Answered by Dr. Jasvinder Singh (8 hours later)
Hello XXXXXXX

Thanks for writing back. I appreciate your concern for your wife and you can have your doubts cleared through this forum.

These tests which I have mentioned above are done all around the world and can be done in a good hospital in Lahore.

Hormones are basically chemical released in the body that help in growth, cell repair, appetite, metabolism, fertility, reproduction, and regulation of pain. In most cases, the imbalance can be verified by testing hormone levels in the blood, saliva, or urine depending on the hormone, usually by immunoassay (as described in Symptoms). Hormone imbalances are typically treated through synthetic hormones or drugs designed to mimic other parts of hormone pathways and curb symptoms.

The treatment depends on the hormonal imbalance that your wife is having (like estrogen/ progesterone/ thyroid hormones). Treatment is long (may take months or years) and the hormonal tablets have to be taken for long period of time till the levels come to normal.

These tests should cost a few thousand rupees (approximately less that 20,000 rupees).

Get your wife evaluated from a good physician in Lahore and these investigations done. You can send us the reports attached along with your query at our forum. I will be happy to review them and it will be helpful for me in understanding your wife's condition better.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Kind regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Radhika
doctor
Answered by
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Dr. Jasvinder Singh

Internal Medicine Specialist

Practicing since :1998

Answered : 1578 Questions

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Pain In Limbs And Neck, Difficulty Walking, History Of Abortion, Infertility And High BP

Hello,

Thanks for posting your query.

From your wife’s symptoms few possibilities which need to be ruled out are:

1)     Hypothyroidism which can cause weight gain as well as muscle and joint pains in the body. For ruling it out thyroid function tests should be done.

2)     Secondly it can be due to polymyalgia rheumatica.It is an inflammatory disorder that causes widespread muscle aching and stiffness, primarily in your neck, shoulders, upper arms, thighs and hips.

It literally appears overnight, but the cause may be a problem with the immune system, perhaps involving both genetic and environmental factors. It can be diagnosed by ESR(Erthrocyte sedimentation rate) test, platelet count and Rheumatoid factor(to rule out Rheumatoid arthritis).

3)     Third possibility is of fibromyalgia (a disorder classified by the presence of chronic widespread pain and tactile allodynia(pain even on touching), polymyositis (means 'many muscle inflammation') and chronic fatigue syndrome(often manifests with widespread myalgia and arthralgia, cognitive difficulties, chronic mental and physical exhaustion).

Complete physical examination along with investigations like ESR blood, platelet count Rheumatoid factor, creatine kinase, MRI upper spine, electromyography and muscle biopsy may be needed to make a diagnosis.

You should get these investigations done for your wife after consulting a physician.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.