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I've had medical things going on that I just can't seem to…

I've had medical things going...
I've had medical things going on that I just can't seem to pinpoint a problem. This all started probably around February or March of 2017. I would wake up with stiff feeling and aching around my knees. Either surrounding the knee itself or just above them, always both never just one. Throughout the day the stiffness would get better, the aching would not. The stiffness would also return after long periods of standing. I feel like the problem has gotten a little worse since then. In august it was really bothering me, I had a fever and was feeling really fatigued, so I went to the doctors. They ran a CBC and my WBC was 11.7 so I was given a 3 week course of doxycycline. I had a another CBC about a week and half in and the WBC was 8.8. It was determined I had an infection since the WBC decreased. About 3 or 4 days into the antibiotic course, I started to get a numbness/heavy/cold feeling in my right foot around the toes, which still now persists on and off. The top part of the foot where it meets the ankle is what feels stiff when I move it. Also in August I had a negative ANA, negative ANCA, SED rate of 1 mm/hr, negative RA, negative Cirtulline AB, Lyme, HIV, Hep C all diseases ruled out. I would say the period in August was the worst I felt, prompting the doctor visit and all these tests. The feelings have since persisted with my legs and my foot, some days are worse than others and some days are totally fine. I especially feel better when moving around a lot. Vigorous exercise isn't necessarily the answer but moving defineitely is a help. My questions are:
1. Does having the WBC count decrease on antibiotic rule out anything not infection related that causes a high WBC count? Or would an antibiotic always lower WBC regardless?
2. Were my autoimmune test results (ANA, RA, ANCA, etc.) reliable at the time taken? They were at least 5-6 months after symptoms started? Also taken at a time when the feelings were worst.
3. What could cause this with my foot? I saw a potential side effect of doxycycline is this problem, is it possible mine just never went away?Also just a little more information, I had a sinus and neck CT in July 2016 all normal andchest x ray in October 2016, also normal. As was a echocardiogram in November 2016. Is there any other medical issue I should be considering? Thank you.
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Answered in 6 minutes by:
1/17/2018
drphophalia
Category: Neurology
Satisfied Customers: 39,062
Experience: Regularly deal with musculoskeletal neurology, spinal issues, bowel and bladder dysfunctions etc.
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Customer reply replied 7 months ago
39;ve also had a lymph node you can feel in my neck since July 2016 at least, its a cervical lymph node, that the doctors have told me is about 1.5 cm so not too big, but I feel like anything lymphoma or leukemia related would have gotten much worse by now. I've also had a full eye exam in August of 2017, which I was told would see things like MS. Just really not sure what could be causing these things. I have no family history of anything at all
Customer reply replied 7 months ago
I guess it'll probably be a question, but not really having any issues with fatigue. I'm getting only 3-4 hours of sleep per night for the last 1 or 2 months maybe 6-7 hours a night on weekends, and if that's not making me tired, I wouldn't say I'm having an issue with fatigue

A solitary lymph node, which has not changed is likely to be benign. An ultrasound can further substantiate that.

Now your specific questions;

1) A decreased WBC count by antibiotic usually is indicative of infection.

2) The autoimmune panel results were reliable. Autoimmune panel may need repetition and many times an investigation which was negative before may become positive later.

3) There is a cause and effect relationship, that when doxycycline was started the foot felt cold/heavy/numb. Neuropathy though is not a common adverse effect of Doxycycline. You may get a nerve conduction velocity study (NCV) for the evaluation.

You may also need;

Thyroid function tests

Thyroid autoantibodies

Repeat of autoimmune panel.

Vitamin B 12.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Customer reply replied 7 months ago
I did have an ultrasound in conjunction with the CT scan when I first noted the lymph node, no abnormalities seen. That was July 2016, and no changes to the feel of this lymph node. Thyroid also viewed in this study, no abnormalities. Also had a thyroid cascade last December in annual physical no issues. I have not had B12 checked.
With my foot, it is not always there and seems better when I am not wearing shoes or tie my shoes loosely. Does that indicate less likely to be nerve related? Blood circulation maybe? But weirdly the ankle feels stiffer when I lie down. And its not weak at all like ive seen through google searches for drop foot.
The doctor was betting if it was autoimmune it would be Lupus or Vasculitis. But you said the autoimmune testing was reliable. Also the sed rate was so low. Does the low sed rate also help prove that its not autoimmune because there is no actual inflation?
With no actual inflammation, could this be more of a perceived thing rather than actually having something wrong? Like stress related or depression? Not that I feel like I have either of those things, but weirdly all this started at the end of a Middle East deployment.
Customer reply replied 7 months ago
The whole low sed rate situation boggles my mind because if there is no inflammation what could actually cause these things
Customer reply replied 7 months ago
Wanted to clarify the feeling in my foot, its not numb like tingly pins and needles. More so feels stiff/heavy in the top of the foot by the ankle joint and a long the base of the toes. I still have full feeling and movement, ive tried poking at it and pinching it to make sure it feels

Low sedimentation indicates that chance of autoimmune phenomenon was less, especially the autoimmune panel too being normal.

Pain decreasing on opening shoes is difficult to explain though. Blood vessel or circulation issues do not explain the phenomenon.

A neuropathy is the best explanation at this point. And a NCV may be the investigations of choice with B 12 estimation.

It is privilege assisting you.

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Customer reply replied 7 months ago
What are some examples of a neuropathy? Do they tend to be more serious? And would they cause all other issues? Can B12 definiciency alone cause these feelings?Is there also a chance this is just all perceived? WIth so much testing normal, could it just be that simple?
Customer reply replied 7 months ago
Sorry, just wasn't sure what you mean by neuropathy?
Customer reply replied 7 months ago
This foot thing has been going on just about 5 months now, with no changes for the better or worse and no neurological symptoms showing up anywhere else in the body, does that decrease the chances?

I can assure your it is nothing serious.

This can be just perceived thing. Anxiety can cause any or all symptoms.

Neuropathy can be caused by;

Diabetes

Vitamin deficiencies

Thyroid diseases (usually hypothyroidism)

Autoimmune connective tissue disorders

Heavy metal toxicity.

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Customer reply replied 7 months ago
Ok thanks, ***** ***** what you mean by neuropathy now. Since all this started, so about a year or so, I've never had any, not even once, an upper body symptom. Anything at all above about 2 inches above the knees. Is that weird?Is there any vitamins you recommend I try? Only thing I take is Vitamin C. Should I get a B 12 Vitamin? Anything else you recommend I do? Daily or at least every other day workouts seem to provide some if but a relief, but anything else based on what you think it could be?
Customer reply replied 7 months ago
I just googled foods high in B12. BEst I can say from that list is I eat maybe 5 eggs per week and maybe 1 fish and 1 beef meal per week. Sometimes not even. I'm guessing that's not enough?
Customer reply replied 7 months ago
I'm also pretty confident I do not drink enough water, could dehydration cause these symptoms? It's pretty much every night I wake up in the middle of the night needing to chug water.

Dehydration does not cause these symptoms.

You may take an over the counter multivitamin and a B 12 supplement.

And please do not get anxious.

There is nothing serious going on.

It is privilege assisting you.

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Customer reply replied 6 months ago
My apologies for not responding yesterday, got caught up in work and couldn't get back to it. I just have one last question. I have a friend who is a PA and she gave me some strength tests to do to test foot and I can do them all, along with having a numb feeling and a coming and going kind of thing points away from serious things like ALS. Basically agreeing with what you said and that it sounds like a neuropathy. My question is when a neuropathy occurs in the foot like this is it reversible or is it kind of a permanent damage thing?

Neuropathy can recover completely.

Physical therapy may play a definite role.

drphophalia
Category: Neurology
Satisfied Customers: 39,062
Experience: Regularly deal with musculoskeletal neurology, spinal issues, bowel and bladder dysfunctions etc.
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drphophalia and 87 other Neurology Specialists are ready to help you
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Customer reply replied 6 months ago
Thanks for all the information and help. Guess its time to make an appointment.

You are most welcome.

Wishing you the speedy resolution of your symptoms.

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