Suggest treatment for pain in both wrists with tingling on fingers

Posted on Thu, 18 Jun 2015 in Bones, Muscles and Joints
Question: Pain in both wrists from forearm through thumbs. Occasional numbness/tingling of fingers. Bil. Trigger thumbs . Triggering of left wrist. Bil thick, painful joints at tips of fingers. Extreme fatigue, especially in the AM. Splitting Nails with black spots. Pernicious anemia. I am a train wreck !! Any help would appreciated.
Answered by Dr. Muhammad Hanif 2 hours later
Brief Answer:
You have Pernicious Anemia

Detailed Answer:
Dear XXXX!
I welcome you at my Virtual Clinic. I am Dr. Hanif. I understand your health issues and want to assure you that it will be alright soon. Prognosis of this disease is excellent and its readily treated.
You have Pernicious Anemia that is due to lack of a stomach protein "Intrinsic Factor"(IF). IF is needed for absorption of Vit. B12 and lack of B12 leads to damaged/decreased Red Blood Cells and neuron damage. Numbness and tingling sensations you feel, extreme fatigue, splitting nails are all due to anemia.
My Question is,Who diagnosed it is pernicious anemia, and who prescribed you B12?
If there is evidence for folic acid deficiency but pernicious anemia has not been ruled out, please take both Folic acid and Vit. B12 supplements until pernicious anemia is ruled out. Blood count will improve and you will also be saved from complication of nervous system damage due to B12 deficiency.
When a patient like you comes to my clinic I start her therapy with weekly Cobalamin (Vit. B12.) 1000microgram Intramuscular or subcutaneous injection for 6weeks. After that continuous monthly injections for lifelong mostly.
Please go for Lab Blood work for Complete Blood Count with peripheral Blood film analysis, and, LDH (lactate dehydrogenase levels) after 6 weeks and send me follow up Question for reports to see reticulocyte counts and hemoglobin levels.

Blood transfusion is needed as a last option if the above regimen doesn't work and/or you get neurological symptoms because Cobalamin is necessary for neurons to work properly.

And for wrist issues and thick painful joints of fingers, I normally suggest to take Celecoxib 200mg per oral once daily or divided q12hourly.

Advised Blood Work:-
1. Fasting blood sugar leves?
2. After 6 months some Blood work already written above in my explanation?
3.ANA antibodies?

Hope it helps you. I need you back improved much, with follow up Labs. Respected XXXX, you may contact me anytime you have a question/doubts regarding any health issue.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
Follow up: Dr. Muhammad Hanif 23 hours later
I was diagnosed by a MD for Pernicious Anemia with the Schilling 1 and2 tests. I was prescribed the B12 iM daily for 2 weeks then monthly for life with follow up lab 2x year. I have had this since about 1984. All this other stuff I described is new for the last year or so. I am in the dark about these other symptoms. I need better help for this
Answered by Dr. Muhammad Hanif 1 hour later
Brief Answer:
I need further details

Detailed Answer:
I welcome you back dear XXXXX!

I am more than happy to help you as you have genuine health concerns that needs to be addressed. That's why I need further investigation to better assist you. Please go for some Lab tests and come up with the reports:

*Complete metabolic profile
*Serum ferritin levels
*ANA antibodies
*serum uric acid levels
*fasting lipid profile
*Thyroid profile
*fasting blood sugar levels

I will wait for your reply and will try my best to promptly assist you. You may also ask me a direct question at my profile using "Ask me a question" tab; and, add reports of blood work there. Dear XXXX, please don't forget to high star rating this case, and write a feedback to better assist you in future too.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
Answered by
Dr. Muhammad Hanif

General & Family Physician

Practicing since :2009

Answered : 2369 Questions


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