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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7818
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I am a 43 year-old female, 54", 250 lbs living in Fort Knox,

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I am a 43 year-old female, 5'4", 250 lbs living in Fort Knox, KY. For the past year, I have been experiencing a swollen tongue, pain and tingling in my tongue and inner lips and throat. Allergy and asthma tests were done and came back negative for all. Bloodwork showed nothing unusual except for one kidney function being "off". (PA gave no further explanation.) Chest X-ray and EKG normal. Yesterday, I went to the ER after waking up with one eye swollen slightly and the other eye swollen shut completely. I have slight chest pain - more like a heaviness or pressure on my sternum and lungs. No cough. Upon waking today, both bicep areas of my arms are hot to the touch. When I use a touch-thermometer on my arms, the temperature reads 99.9F. My forehead temperature reads 99.3F. The skin of my arms and face are bright red. I feel like something is just bothering my whole system. I've been having these symptoms for over a year with no clear diagnosis or treatment from the military hospital where my husband is stationed.

Current medications: Toprol, 100mg 2x a day; HCTZ, 25 mg; Micardis, 80mg; Nexium, 40mg; Levothyroxine, 25mcg; Welchol, 625mg; Seroquel, 100mg; Effexor, 150mg, 2 caplets per day; Buspar, 15mg 2x a day. Last 3 meds are for treatment of severe Emetophobia with anxiety-related symptoms.
Submitted: 11 months ago.
Category: Eye
Expert:  Dr. Rick replied 11 months ago.
Hi. I'm Dr. Rick and I have two decades of ophthalmology experience. I'm online and happy to answer your question today.

As an Air Force brat myself (my father retired as an O6) I completely understand what you are going through with the military medical system.

It sounds like you have spent quite some time trying to get to the bottom of what is going on. I am sure that your previous doctors have thought of, and ruled out, all of the common and easily treatable conditions that could be causing your issues. Would you say this is a correct statement?

Well I think it might be time for you to take a very difficult, and bold, step to see if you can get some relief, although it means you will have enter the civilian medical system....


It sounds like you have been receiving good care from very qualified physicians without any significant lasting improvement in your condition. At this point I think the best thing for you to do would be to gather up copies of all your medical records and travel to a large University Teaching hospital. At an institution like that you could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.

The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this. That being said there are many excellent teaching hospitals all across the country and I am sure that there is one near you.

I know that this is going to take significant effort on your part but I believe that going to one of the "Medical Mecca's" is your best chance to, finally, get to the bottom of what is going on.

Does this make sense to you?


I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 11 months ago.


Thank you for your suggestions - I agree that a teaching hospital/university would be a great thing to try. That being said, with the difficulties in getting referral approval from the military, I'm not sure it will be possible.


 


Just for some further information, I was told by the allergy specialist that he suspects Amyloidosis. Do my symptoms fit that diagnosis?


 


Also - looking at the medications that I am currently taking, is it possible that there is some sort of reaction taking place due to the mix? Could taking NSAIDS or Tylenol along with these medications cause a reaction like mine?


 


Finally, and I know this is a pretty "out there" question, but is it possible that I could have some form of cancer without any big red flags showing up in the tests I have had done so far? As time goes by with no cessation in symptoms, I am becoming increasingly concerned that I could have some strange, rare condition and it is increasing my anxiety levels - which I know is not a good mix to add to this already confusing pile!


 


Thank you for any other advice you may offer.


 


Kristin

Expert:  Dr. Rick replied 11 months ago.
Kristin,

First of all, you need to dump the PA and get into see a MD -- and I agree: An allergist is the place to start.

Let me go over your questions in order:

1. That is a possibility...but further testing is needed by a specialist.

2. It is very unlikely that your symptoms are due to NSAIDS or a reaction to your current medications. Taking Tylenol along with your meds should not cause your symptoms.

3. Anything is possible in the world of medicine. That being said, I very, very, very much doubt that you have some form of cancer.

Could you have some rare or unique condition? Yes. That is why I suggested going to a teaching hospital for a cutting-edge workup. After spending 19 years of my life getting all my care in the Military medical system I really don't have a lot of faith in them figuring out what is going on in any but the most basic and routine of cases.....

Do your best to control your anxiety because, you are correct, marked anxiety will just make things worse. :(

So. What is the take home message? If you can not get the care you deserve with the medical staff available to you on base, do your best to seek care in the civilian sector, preferably at a place like The Mayo Clinic.

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7818
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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