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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34294
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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MY LEGS HAVE BEEN FEELING HEAVY, ESPECIALLY MY RIGHT LEG, I

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MY LEGS HAVE BEEN FEELING HEAVY, ESPECIALLY MY RIGHT LEG, I HAVE BEEN FEELING LIGHT HEADED, AND A FEW TIMES FELT LIKE MY BODY WAS AS HARD AS A ROCK, LIKE I HIT A BRICK WALL, BEEN HAVING BLURED VISION, AND SOMETIMES SHORTNESS OF BREATH, STIFF NECK AND SHOULDERS, I RECENTLY HAD AN INJURY AT WORK WHERE I STRAINED THE WHOLE RIGHT SIDE OF MY BODY, I SOMETIMES HAVE SWELLING IN THE BACK OF MY ANKLES, TOP OF MY FEET, AND AROUND MY JOINTS, SOMETIMES I GET BURSIDIS IN MY HIPS AND CAN'T WALK, I HAD THERAPY BUT I DON'T FEEL THAT I WAS GETTING ENOUGH OR PROPER TREATMENT. DO YOU HAVE ANY IDEA WHAT MY SYMTOMS MEAN?
THANK YOU.

Greetings.

 

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?

 

Dr. Arun

Customer: replied 6 years ago.
I never had blood work done when i sustained the injury in feb. 2007 or any time following. I did have some blood work done with my own personal dr. She was a bit concerned about my blood sugar which was approx 195 at that time. I have not ben diagnosed as diabetic, i do not drink or smoke, i do crave sweets, i have suffered with endometrosis and extreme anemia because of heavy menstration, the only meds i take are omeprszole for acid reflux which i do have a hernia, also from the injury, and once in a while i take zanax for sleep or anxiety. my symptoms sometimes do precipitate and are aggravated by improper work station, i also have sharp pains on my joints, fingers, all over my body. i have never been tested for fibroalgia i do have osteoporosis in my spine, hip, and shoulders also due to long term stress aggravated by my injury, i cannot sleep flat, i cannot breath right.

Hello,

 

Thanks for the detailed information.

 

Your symptoms should be looked for the following;

 

1) Rheumatoid arthritis

2) Lupus

3) Polymyositis

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

RA factor

HLA B 27

CRP

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

Customer: replied 6 years ago.
I forgot to mention that i also have bloating in my stomach, and i believe to have irritable bowell syndrom, i also have fatigue and feel tired most of the time. I try to take iron but when i eat iron rich foods i fall asleep within 20 minutes, iron seems to tire me more than give me energy.

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 test
7) 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

Dr. Arun Phophalia and 2 other Health Specialists are ready to help you
Customer: replied 6 years ago.

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,

 

Dr. Arun