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I am 39 yr old female, 16 yr hx of ulcerative colitis (total

 
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I am 39 yr old female, 16 yr hx of ulcerative colitis (total colectomy completeted by 2009; atypical post colectomy patient-dehydration frequent but improving,rapid transit time). RA or arthropathy dx 2003, remission with colectomy. 4mm pituitary microademoma no secretory; however, 0.00 endog cortisol produced (really); mineralcorticoids fine (adrenals "fried"). Shingles of ALL things(!) in two dermatomes -cervical, lumbar;3/2012. QUESTION: have had at least 5 episodes of waking up wih profound diffuse tingling:facial, including intense even @ tip of nose, as well as arms to fingertips, legs to feet & toes, not as pronounced as arms and face below the knee. Oh, have had migraines since I was 9, still have them ~q20-30 days, they have not changed. Had full(7 films) of cervical spine taken 5/2012.

 

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Person's Gender: Female
Person's Age: 39

Already Tried:
Denial. Cervical films which were NORMAL. And previous window would not let me insert onset of symptoms--late April 2012. In all of the "fun" I have had with chronic disease, I have never experienced anything like thus, which is a sensation, therefore seems like nerves are involved potentially (electrolytes, BP,etc, OK; vit D & vit B deficient most of the time)I also frequently feel lightheaded versus dizzy (NO spinning). Too many docs already! (& I'm just a veterinarian!)

Submitted: 279 days and 7 hours ago.
Category: Medical
Value: $59
Status: CLOSED
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Expert:  DrThomasMd replied 279 days and 7 hours ago.

Hello from JA

Thank you for the very interesting question.

Let me ask you what you mean by cervical films?

x rays?

Customer replied 279 days and 6 hours ago.

Sorry-yes, radiographs or x-rays of neck positioned every which way. All completely normal per radiologist.

Thanks,
jen

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Expert:  DrThomasMd replied 279 days and 6 hours ago.

OK
That says nothing about discs, nerve roots, ligaments and other subtle findings.

Your symptoms are of neuropathy or paresthesia.

And there can be many causes.

unknown cause
Disc disease in the spine..being over weight makes this more likely, an MRI would reveal this
Diabetes
B vitamin deficiencies
Certain autoimmune diseases and neurologic disease such as poly neuropathy
Liver or kidney disease
Hidden infections
Heavy metal toxicity
hidden malignancy
Alcohol or other poisons
Polycythemia vera
Iron deficiency


Hyperventilation can cause these symptoms as well.

I would go over this carefully with your doctors.

And I would have all B levels..B1,2,3,5,6,12 and folate checked with blood testing.

Let me know if you have further questions.

Please select a 4 or 5 rating as this is how we are paid. Great service is my goal and if you are not yet satisfied please reply to me via the REPLY TO EXPERT button. I will be happy to continue further and do everything I can to provide you with the service you seek.

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Customer replied 279 days and 5 hours ago.

Yes, given the extensive information that I already have, I appreciate the list and that there is no client patient relationship, but the following I do NOT have (blood gets drawn A LOT): diabetes; all renal & hepatic enzymes are normal; exposure to poison-no-i treat those cases in animals, do not live in old home, entire family of five is not affected. NO polycythemia Vera, not even close. I do not drink alcohol. I am not overweight-no large intestine, don't like food much. I don't hyperventilate, but I may be idiopathic. As of 3/2012, chest & abdomen had CT's, w/ cont.,gi scope end-end. Vit def, as I told you, B&D,are chronic past 4 yrs.Neoplasia or infec in head but just found that mass.mom,sister,all have autoimmune dz. Anything else w/ that info?

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Expert:  DrThomasMd replied 279 days and 5 hours ago.

Chronic B deficiency can ultimately lead to this...D...maybe.

I would also do a hair analysis for heavy metals as a screen..it is missed all of the time.

If it comes and goes completely, it certainly is not well defined.

I would also have an intracellular magnesium level run.
Regular serum is not accurate, and even a medium to low could mean...low...deficient.

Also have a gliadin and celiac panel run [gluten sensitivity, which you would want to know about.]


Please select a 4 or 5 rating as this is how we are paid. Great service is my goal and if you are not yet satisfied please reply to me via the REPLY TO EXPERT button. I will be happy to continue further and do everything I can to provide you with the service you seek.

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Customer replied 279 days and 5 hours ago.

I think we are getting off the beaten path a bit. Granted, I'm a train wreck, and am I satisfied yet,no, but I think you can. The progress I perceive is the exchange and moving things to the BOTTOM of the list or eliminating them. For example, I wish gluten or celiac was it. Celiac tested negative, I avoid gluten any way. Remember, a g.i tract without large intestine is not a happy place. My serum magnesium alone is problematic when I get dehydrated, so it's always replaced wit the potassium. I eat a lot of avocados to stay out of the hospital. Seriously. I just need to refill my injectable Vit B to r/o. But my life has been filled w/severe immune-med& all other probs seem to start there. I need to go attend to family for a bit;can we "put this on hold"-is that possible? This is my 1st post.

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Expert:  DrThomasMd replied 279 days and 5 hours ago.

I think have given you the list of possibilities , including idiopathic.

You won't get a diagnosis with out further testing..and in fact this is not a site where we diagnose, for obvous reasons, we simply present information.

It sounds like the magnesium has not been tested correctly.
Not all of the B vitamins might have been tested.
And heavy metals have not been tests.
Then there is idiopathic.
A sed rate and ANA panel should be done if not done recently.
In very rare cases, MS can present like this..but it is not at all typical. That requires an MRI of the brain to define.
Please select a 4 or 5 rating as this is how we are paid. Great service is my goal and if you are not yet satisfied please reply to me via the REPLY TO EXPERT button. I will be happy to continue further and do everything I can to provide you with the service you seek.

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Future questions? Ask for DrThomas in the question title or see my profile to request me. Save my profile to your browser favorites http://www.justanswer.com/medical/expert-dr-thomas

Customer replied 279 days and 4 hours ago.

We shall finish up then. I think you hit on the one that I need to rule out. Sed rates and ANA were elevated earlier this year and nobody chased it as we didn't know what to chase. I also thought an MRI would be more complete on the neck, but just can't get over the intense nose tingling (pins &needles) & didn't know in humans if that was often related to disk dz, which is what I was concerned about due to previous years of steroids and weight from that in past. Waking up with pins and needles out of blue in past 3 months-really?!? The problem with my train wreck hx is that I seem to fall into the 1% category. Let's hope Vit B complex is a cure-all. If you will just respond so it generates the row of faces, I'll finish up. Oh, FYI, my mom has immune mediated vasculitis, sister ulc. Colitis. Thank you for your patience and excellent service-jen

Accepted Answer

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Expert:  DrThomasMd replied 279 days and 4 hours ago.

ANA panel then, not just ana.

Good luck


Please select a 4 or 5 rating as this is how we are paid. Great service is my goal and if you are not yet satisfied please reply to me via the REPLY TO EXPERT button. I will be happy to continue further and do everything I can to provide you with the service you seek.

Otherwise, a high positive rating is very much appreciated, bonuses are great, and find me anytime for follow up.

Future questions? Ask for DrThomas in the question title or see my profile to request me. Save my profile to your browser favorites http://www.justanswer.com/medical/expert-dr-thomas

Expert TypeBoard Certified Physician
Category: Medical
Pos. Feedback: 97.4 %
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Answered: 7/1/2012

Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc

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