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A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 15857
Experience:  Board Certified NP, MS, RN. 25 years private practice & hospitalist
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22/f with high white blood cell count and

Customer Question

22/f with high white blood cell count and:                                   ;                                                                   Constant symptoms: L. Shoulder pain, neck pain and stiffness, jaw pain, tooth sensitivity, small round spot on chest, pain behind sternum, pinching under left arm, constant but varying in severity from day-to-day. Symptoms that come and go: muscle twitching, limbs falling asleep, sore throat, choking feeling, heartburn?, occasional traveling joint pain, muscle weekness, shortness of breath, higher than normal heart rate, sleep disturbances, headache. Frequent spells of "fluttering" heart, internal jitteriness, internal tremor, dizziness, loss of balance.
Submitted: 7 years ago.
Category: Health
Expert:  A. Schuyler, NP replied 7 years ago.



Welcome to Just Answer and thanks for your question. What evaluations have been done so far? What medications/drugs/supplements are taken regularly?

Customer: replied 7 years ago.
I have had an EKG which was normal and two blood tests, both revealing high white blood cell counts. I have had 3 courses of antibiotics. The first was Augmentin (which I developed a sensitivity to). After the Augmentin I had my first blood test revealing high white blood count. A course of azithromyacin was followed by another blood test revealing a high white blood count (slightly lower than the first. Most recently I had a course of doxycycline, which had to be stopped after a week and a half due to severe mental confusion.
Expert:  A. Schuyler, NP replied 7 years ago.

Do you have the numerical results of the high white count? I'm looking for how "high" is "high?" Do you have the differential results (basophils, eosinophils, neutrophils, etc.)?



Customer: replied 7 years ago.
I don't have the actual numbers, but I know that my doctor said "not too high" and that the count did lower after the z-pack. I don't have any other information other than that, sorry.
Expert:  A. Schuyler, NP replied 7 years ago.

White blood cell count is up in the face of any type of infection. Since your doctor said "not too high" I am assuming this was the reason. The rest of your symptoms are so diverse that it would prompt a provider to check to see if you might have a lot of stress and anxiety that is at the basis of your symptoms.


Customer: replied 7 years ago.
I am a person who has had a history of PTSD and have been in treatment for it in the past. That being said, I KNOW that what I am experiencing now is not anxiety because I have worked so much with a therapist in the past and am more than capable of recognizing the physical symptoms of anxiety.

I do spend a great deal of time in the woods and pull a lot of ticks off of myself. Could what I am experiencig be symptoms of Lyme disease?
Expert:  A. Schuyler, NP replied 7 years ago.

Your doctor could readily test for Lyme disease. About 80% develop a characteristic rash that can spread to be as much as a foot in diameter within the first month after a tick bite. There are many false positives in ELISA antibody tests, so if it were positive your doctor should order a Western Blot for confirmation.


You mention a therapist. Was this a psychologist or a psychiatrist and did you take/are you taking medication for PTSD?


Customer: replied 7 years ago.
LMFT, but I really have absolutely no symptoms of PTSD and have not for a long time, nor have I needed therapy. I am not on medication and never was to treat PTSD as cognitive behavior therapy was sufficient.
Expert:  A. Schuyler, NP replied 7 years ago.

I'm glad to hear that you are doing so well with the PTSD. It would still not hurt to talk to a physician (psychiatrist) about the possibility of an anxiety disorder. You really have nothing to lose at this point, unless your primary doctor can come up with some physical explanation for symptoms that affect the muscular, digestive, skeletal, respiratory, cardiac, and neurological systems all at the same or similar time frames. Your mention of "...Frequent spells of "fluttering" heart, internal jitteriness, internal tremor" are classic anxiety disorder.


Customer: replied 7 years ago.
I appreciate your trying to help me, but I can guarantee that what I am experiencing is NOT anxiety. I am also currently in school to become a therapist myself and am very, very aware of what symptoms of anxiety are. What I am experiencing is very real, and often very painful. My "frequent spells" do sound like a panic attack, but are very unlike in feeling to a panic attack, which I have had before. I also discussed the possibility of anxiety with my physician and we both concluded that to be an unlikely cause for a number of reasons, especially considering I am in such a wonderful place. Are there any other diseases or disorders that affect multiple body systems? I know that Lyme is one and was reffered to an infectious disease specialist by my own doctor, but won't be able to get in to see him for quite a while. I was just wondering if there were any other possibilities.
Expert:  A. Schuyler, NP replied 7 years ago.

There are few diseases that can affect all body systems at once. Lyme disease, lupus, and early MS are the big ones.


Congratulations on furthering your schooling. What they may not teach you in school is that not every panic attack is the same, and neither is every anxiety disorder, even in the same person. Just as two headaches or two pregnancies are not necessarily alike. So saying you've had panic attacks and anxiety before and would recognize either doesn't necessarily mean anything. I hope you will consider the psychiatrist if the ID doc finds nothing.


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