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What did your blood work, x-rays, show?
Were you investigated for different arthritis?
Did you consult any specialist?
Are you diabetic?
Any significant past medical illness?
What are your present medications?
Did your symptoms precipitate due to injury at work or were aggravated by it?
Thanks for the detailed information.
Your symptoms should be looked for the following;
1) Rheumatoid arthritis
4) Ankylosing spondylitis
Following blood work would be warranted, if not yet done (these tests tell about the immune mediated arthritis): ANA Anti-dsDNA Anti-Sm Anti-SSA (Ro) or Anti-SSB (La) Anti-ribosomal P Anti-RNP Anticardiolipin Lupus anticoagulant Coombs test Anti-histone
HLA B 27
ESR Thyroid function tests
Your blood sugar was elevated and should be further investigated by;
1) Glycosylated hemoglobin; this tells about the average blood sugar of last three months.
2) Glucose tolerance test
Diabetes and immune mediated arthritis cause nerve affections, which is called as NEUROPATHY. Your symptoms aggravation especially after the injury can be due to the primary disease process as well as due to neuropathy. The specialist to consult would be rheumatologist. Your primary care physician should meanwhile get a blood estimation of vitamin B12 which also causes neuropathy and a DEXA scan. DEXA is a very specific test for osteoporosis and tells about it's extent, so depending on the severity, aggressive treatment can be done. Osteoporosis can again be an aggravating factor in your case, for all these symptoms. Please feel free for your follow up questions.Dr. Arun
Hello,People who have episodes of fatigue or tiredness (or persistent symptoms) need to be classified in;1) chronic fatigue syndrome; unexplained, persistent or relapsing fatigue with unrefreshing sleep, muscle pain, concentration problems, headache, sore throat etc.2) idiopathic fatigue; it does not meet the above criteria.Fibromyalgia, lupus, sleep disorders are the other disorders which should be looked for your symptoms.Following investigations are essential (most of these are common which we get for the immune mediated arthritis);1) Complete blood count, 2) Erythrocyte sedimentation rate (ESR), 3) Thyroid function tests, 4) Muscle enzymes; 5) Anti-nuclear antibodies (ANA)6) Adrenal function test7) Anti-dsDNA 8) Anti-Sm 9) Anti-SSA (Ro) or Anti-SSB (La) 10) Coombs test 11) Anti-histone
So fatigue basically is an overlapping symptoms for the immune mediated arthritis, fibromyalgia and chronic fatigue syndrome. Many of the immune mediated arthritis affect the other organ systems of the body, including the gastrointestinal tract and affect the movements of the stomach and intestines. Thus they can be responsible for the bloating and constipation or diarrhea. If you have a documented iron deficiency anemia, this point to spondyloarthropathy, rheumatoid, lupus which are classically associated with it. So crux is thorough investigation and an appropriate specialist consultation.
If an ultrasound of the abdomen has not been done, should be done to rule out gall bladder stones with symptoms of bloating.It is pleasure and privilege assisting you.Dr. Arun
Thank you, XXXXX XXXXX take this information to my doctor who i have been trying to explain my symptoms to for the past two years. I thik it's time to get a new Doctor.
You are very welcome. A second opinion helps many times, I agree.
Best wishes and kindest regards,