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What Causes Fatigue, Eye Pain, Blurred Vision And Muscle Twitching?

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Posted on Thu, 9 Apr 2015
Question: I'm a 37 year old man. After about a year of fatigue, malaise, right eye pain, sole of the foot pain, and blurred vision symptoms, I've now been having very pale bowel movements and muscle twitching for several months. If I eat the RDA of fat, my stool becomes loose or floats. The change in color and consistency came on in December at a time when the other members of my family had a stomach bug. I assumed for a while I just had a bad version of that. Prior to December my stool color size and shape were perfectly normal. My liver enzymes have been tested and are normal. My pancreas enzymes have been tested and are normal. I had an abdominal CT scan which showed no abnormality. My thyroid tests are normal as well. I do have gallstones, but very rarely experience any dicomfort in my upper right abdomin or central abdomin. I had several tick bites in a short span immediately before my initial symptoms. I've tested negative for lyme and several coinfections, but am currently being treated empirically. Could the CT and all the blood tests be wrong? What should I do?
doctor
Answered by Dr. Chakravarthy Mazumdar (5 hours later)
Brief Answer:
Neurological spectrum

Detailed Answer:
Hi,

With the symptoms described it looks like you should head towards a neurologist consultation. Get yourself examined first with him/her. Lyme's disease can present this way. When there is a history of tick bite though the labs are on contrary I would still treat it as Lyme's disease first with appropriate course of antibiotics for a month. Were you treated?

Do not worry this is not a mystery that can never be solved. It is just you did not find the right doctor who is patient enough to treat you successfully till the end.

Tell your neurologist about tick bite and get his opinion on the nerves.
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Chakravarthy Mazumdar (3 hours later)
I recently switched primary care doctors and really liked the new doctor. I'm being treated now for lyme for the first time since this began. I have a 30 day prescription of Clarythromycin and also 30 days of hydroxychloroquine. I've been taking them a little under a week with not much of a change so far. I have pretty extreme fatigue an hour to 3 hours after meals, bouts of emotional difficulty if I'm late for a meal, and very disturbed sleep. I have sesnsations of hotness at night if I've eaten fatty food as well. Some result in minor sweating but they never show up as a measureable temperature. If anything, my body temperature has been lower than it used to be. My concern is that the digestion challenges, pale stool, floating stool/fat indigestion, and night symptoms could add up to serious liver, pancreas, or gallbladder problem. Do the labs and the CT put me in the clear for those problems?
doctor
Answered by Dr. Chakravarthy Mazumdar (51 minutes later)
Brief Answer:
Yes labs are clear against serious organ damage

Detailed Answer:
Hi,

I think your treatment was delayed against Lyme. Lyme disease sufferers complain of extreme fatigue, hotness, disturbed sleep. You just started it and I suppose you are on track now. You should complete the course of treatment irrespective of whether the symptoms respite or not.

Your labs do not show any serious liver, pancreas or gall bladder problem and I do not expect this in a Lyme disease suffering just over three months. You should believe in them.

Your primary care doctor is doing great judgement now. You should continue to be with him.
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Chakravarthy Mazumdar (54 minutes later)
Unfortunately, my tick exposure was much earlier. I had 4 deer tick bites in a one month span in April of last year and 2 more the November before that. My GI issues began in December, but digestion related hotness, fatigue, etc have been with me since last April. I was just hoping for reassurance that the floating/paleness of stool/fat indigestion/GI issues can't be the result of a bile obstruction or tumor that was not found in the CT or the labs. Is that a pretty safe assumption?
doctor
Answered by Dr. Chakravarthy Mazumdar (18 minutes later)
Brief Answer:
Cannot rule out Bile duct obstruction

Detailed Answer:
Hi,

Floaty stools could be bile duct obstruction as bile is secreted into the digestive tract and is not able to assist the micelle formation and there forming bulky and floating stools. The pale stool is bile not being secreted there by loss of color. The fact is you have gall stones and that obstructs the bile duct and tumor was not present. Gall Bladder tumors are not common at this age.

After the complete course of this (probable) Lyme's treatment you should also check for size of gall stones and may want to take an opinion from GI specialist.

Did you get the answer now.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Aparna Kohli
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Answered by
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Dr. Chakravarthy Mazumdar

General & Family Physician

Practicing since :2004

Answered : 2242 Questions

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What Causes Fatigue, Eye Pain, Blurred Vision And Muscle Twitching?

Brief Answer: Neurological spectrum Detailed Answer: Hi, With the symptoms described it looks like you should head towards a neurologist consultation. Get yourself examined first with him/her. Lyme's disease can present this way. When there is a history of tick bite though the labs are on contrary I would still treat it as Lyme's disease first with appropriate course of antibiotics for a month. Were you treated? Do not worry this is not a mystery that can never be solved. It is just you did not find the right doctor who is patient enough to treat you successfully till the end. Tell your neurologist about tick bite and get his opinion on the nerves.