I am a 41 year old female who had onset of R arm and R foot pain. I literally went to sleep on Friday and woke up on Saturday morning with the pain the next morning. The pain/soreness felt as though I had a tough workout. The pain got worse in my arms by Monday and it was hard to grip and pinch anything for 2-3 days. The leg soreness ended up in both my legs by Monday, but, I remembered doing 20 squats, which may have caused the leg pain. Tuesday morning I also had a sore throat. I went to see the PA on Tuesday morning and they did some tests. He started me on Doxcycline, in case it was Lyme Disease (I live in CT). He also ran some other tests, one was a CPK test in which he said my number was high, 198. He referred me to a rheumatologist who I will see this Thursday. I feel better on the antibiotic, however, my arms still are not 100%. I am tired, not as tired as I had been but, I am always tired, I do not sleep well in general and I have a 2 year old. I did not work on Tuesday, Wed and and 5 hours on Thur, Fri and Saturday. It was hard to work, I still had pain and my muscles were tired. I worked about 50 hours that week and about 43 the week before and 45 the week before that. I have been under enormous stress, especially the day before the symptoms occured. I am a bit nervous about the CPK level and everything that is going on. Any advice would be appreciated. LAB TESTS: CBC- Auto = Auto Diff- all WNL Comprehensive Metabolic Panel=WNL CPK= 198 Ehrilichia Chaffeensis ABS Panel: normal ESR: WNL Lyme Titer w.Reflex- Western Blot- normal Rheumatoid Factor + CCP- WNL Strep, GP A Direct DNA: neg TSH, ULTRASENSITIVE: WNL West Nile ABS IGG/IGM, blood: negative/no reaction Awaiting Lyme C6 Peptide results
Do you think this episode could have just been the result of too much work. I work in an outpatient setting, using my hands all day.
I feel about 75 % better but, I have not worked since Saturday.
I am afraid that when I work tomorrow I will be fatigued and in some pain/discomfort in my arms. I dread it!
I am looking into the anti-inflammatory diet. Maybe something like this will help? I have a ton of environmental allergies and a touch of autoimmune disorder to my thyroid..that is under control and levels are normal. But, maybe with all the stress I am causing some type of autoimmune reaction/inflammatory reaction within my body. Can this happen?
Both Lyme tests were both negative. The doc told me to continue taking the antibiotic until I see the rheumatologist. I will ask the rheum. to take the CPK level again and ask about the ANA test. My arms are a bit sore from working (I am still here..a long day unfortunately).
My thyroid levels were normal on Friday so, I don't think it could be that.
Hmmmm... I guess I will just wait and see after I talk to the rheum.
Also, you don't think that just overworking could cause an increase in CPK. I know it can happen with strenous exercise...I guess overworking could be a form of strenuous exercise. But, I guess it should have gone down after working?
thanks for your help!
HI Lynette, You are most welcome! I am pleased I can be of help. I am so happy your Lyme's test was negative. Second stage Lyme's with its joint pains was not a thing you needed. Strenuous exercise can cause inflammatory changes that can raise those markers that measure inflammation like CPK because the work out is itself a source of inflammation. I do not know what you do but I think you are in health care in some way given that you wrote you work in an "out patient setting". I cant see any health care profession's tasks being so constantly strenuous to the extent that they raises ones CPK.Since Lyme's is out of the question, maybe this is something a bit more unusual. An outside thought that occurred to me was wondering if for some reason...maybe due to the exercise, maybe due to something else, you had a condition where the muscle fibers themselves break down. This is called rhabdomyolysis, and while some cases can be mild some can be rather severe. Symptoms are joint pain, fevers, fatigue, muscle aches. People with this can also report abnormal colored urine because of the breakdown of muscle. The confounder here is that rhabdomyolysis will raise some liver enzymes, and you write that all your tests in the Comprehensive Metabolic Panel (They'd be SGOT/ SGGT or written as ALT and AST) were normal. There are quite a few different causes of rhabdomyolysis, strenuous exercise is one. Here is more information on it, and you will see that many of its most common causes seem to have nothing to do with you at all. http://www.nlm.nih.gov/medlineplus/ency/article/000473.htm and http://www.medicinenet.com/rhabdomyolysis/article.htm (this article has a more comprehensive list of causes)It really is a shot in the dark, but it is worth asking the rheumatologist about, and his or her response may well be that the online nurse is nuts. I hope that helped, and please keep me informed about what the rheumatologist had to say. Sincerely,Susan
I did read about the rhabdomyolosis and bizarrely enough, I did have some darker urine. I remember asking myself if I took any extra supplements! I know that is probably not what it is.
I did some light and deeper massage and a lot of joint work/stretching for people (I am an occupational therapist) that week. I usually don't sleep well anyway and like I said, I was under an enormous amount of stress.
But, I will see tomorrow. My arms are not 100% but they are a lot better than one week ago.
I will see the MD tomorrow so, I will let you know. Maybe he will just repeat the CPK and do the ANA test.
Hi Lynette, Thank you so much for the Accept and the lovely bonus. And Occupational Therapists do work quite hard....but I cant see that as enough to raise the CPK like that. Please do let me know what the MD has to say...and good luck at the appointment! I hope you continue to feel better.Sincerely,Susan
Just following up with you. The rheumatologist thinks that I had a virus. He said that my CPK level was not really significant. Usually a value of 500 is significant. He wants me to check my value again and follow-up with him in 8 weeks if I do not feel 100%. Thankfully I am feeling normal again.
Thank you again for your assistance!