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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for severe fatigue and muscle pain

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Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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Posted on Thu, 30 Mar 2017 in Lupus
Question: I have multiple joint and muscle pain, I have a sed rate of 42, WBC of 12.6, all other blood work negative including RA factor and ANA. Also have periodic symptom of finger tips and toes turning completely white and feeling cold and "tingly"...... only other symptom is frequent headaches (which I also have migraines) and pitting edema in lower legs from knees to ankles.
and EXTREME fatigue!!!
Doctor just called and said everything was fine according to labs....have also had CT of shoulders and neck due to pain but all was negative.
so so desperate for help.
doctor
Answered by Dr. Shruti Rijhwani 13 minutes later
Brief Answer:
What is your ENA profile .

Detailed Answer:
Dear Madam,

Thank you for posting your query on HCM.

Well I have gone through your complaints and agree that you may be suffering from underlying connective tissue disease . I would like to know whether your ENA profile was done or not . Sometimes all these markers can be negative despite the presence of disease so we need to see the patient clinically for these diseases .

Take care

Dr. Shruti

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Shruti Rijhwani 2 hours later
I have not had ENA, MD said not indicated due to negative ANA.
I have been given Rx for Naproxen which did help minimally, but had to discontinue due to developing malignant hypertension with diastolic BP ranging 128-134.....and still more steroids after that....now on 4 BP meds and continue to have moderate pain in shoulders, hips, knees, and ankles. Doctor has now rolled his eyes at me and dismissed me leaving me to feel like a hypochondriac. I was given Ultram which does help, but refuse to take due to addicts being in my immediate family....(simply not going there!) Doc did tell me if I hurt I would be taking the med....I want a fix not a cover up.
Am I justified in seeking another opinion or should I do as my doctor instructed and "stop focusing on the pain"? (however you do that) I work full time as a Home Visitor Social Worker for indigent high risk, drug addicted moms in the projects of XXXXXXX Alabama. I have continued my work, but need to be able to run when things get scary.....I barely have the stamina to keep going but don't feel that I am only focused on the pain. I do weigh 197 lbs and have been told that pain could be due to 65 lb weight gain over the last 18 months. UGHHH
doctor
Answered by Dr. Shruti Rijhwani 14 hours later
Brief Answer:
Follows.

Detailed Answer:
Dear Madam,

Thank you for reverting back.

Well it would be difficult to say that dismiss this notion because we havent ruled out everything . Since you have muscle pain CPK , LDH are indicated . I think you should go for 2 nd opinion . Weight gain may contribute to pains and aches but it may not be the sole reason for your complaints . So better to go for other opinion .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Nagamani Ng
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