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Family Medicine (Expert Forum)
Bruises, muscle pain, diarrhea, shooting pain, overheating and now fatigue
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
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Bruises, muscle pain, diarrhea, shooting pain, overheating and now fatigue
by Will76, Aug 28, 2004 12:00AM
I have had lots of test run and they all came up with me having normal health. I have had Stool samples taken the type that go into tubes of liquid and the type that are smeared on a card. I had multiple blood tests which lead to the last one that was an "ana panel" they all came up normal except one. The doctor did not elaborate enough for me to understand what was wrong except that the "ana panel" was ordered because of it and the "ana panel" came back fine so it was nothing.
Symptom history from oldest symptom on.
Overheating to the point that I lay on top of the covers even when it's mid sixties in room every night - going on 18months
Muscle pain that I can only describe as being like growing pains. This is not every day but once or more a month real bad Scolding hot bath takes it away after half hour - going on 18 month
Diarrhea that’s so physically painful I ache all over right down to my bones throbbing in an ache like pain. I will experience the previous symptoms with in 24 hours of this diarrhea. This happens once a month - going on 12months
Shooting pain that goes from one point in body to another. Ex. Pain starts in knee shoots up thigh and lingers in hip for 10 secs. This is very random and happens when doing non physically demanding things. ex. driving, laying in bed, doing paper work etc. - about 8 months
Bruises are forming with out a recollection of incident. I have got them every where at one point of time except on hands, torso, feet, head, or genitals and at least 2 a week. - Started 6-8 months ago
Loss of concentration. Forget where I place things and can look for stuff for 15 min before finding at least 3 times a day. - 6 months or more
Muscle pain and weakness. The pain is a sharp pain like one would experience after weight lifting. The weakness is more of a perception ex. I find stuff like jar lids over tightened by me and I have to loosen them for people. This pain doesn't go away any more weather I work hard physically or not - 4 month maybe more ?
Fatigue is now common and getting in way of job to the point that I am thinking of urging boss to start looking for replacement. I constantly need to sit and sweat over small activities. - This has gone on for 2 weeks or maybe 3
Tough to keep track when you feel like an old person struggling to cross a street before the light turns red.
I am 28years old my doctor is not interested in running more test and I feel my self worsen day by day and not sure how to get help or how to request a second opinion while not sounding like a hypochondriac? Or if I need to ask for a specialist and if so what type? Where do i turn for help before the emergency room? What might it be?
Quick note that might be relevant but told it wasn't. I had to spots of skin cancer one was Basal cell and the other was stated as "pre melanoma” the doctor said it was all contained and removed. Smoked from age 20 - 25.
Symptom history from oldest symptom on.
Overheating to the point that I lay on top of the covers even when it's mid sixties in room every night - going on 18months
Muscle pain that I can only describe as being like growing pains. This is not every day but once or more a month real bad Scolding hot bath takes it away after half hour - going on 18 month
Diarrhea that’s so physically painful I ache all over right down to my bones throbbing in an ache like pain. I will experience the previous symptoms with in 24 hours of this diarrhea. This happens once a month - going on 12months
Shooting pain that goes from one point in body to another. Ex. Pain starts in knee shoots up thigh and lingers in hip for 10 secs. This is very random and happens when doing non physically demanding things. ex. driving, laying in bed, doing paper work etc. - about 8 months
Bruises are forming with out a recollection of incident. I have got them every where at one point of time except on hands, torso, feet, head, or genitals and at least 2 a week. - Started 6-8 months ago
Loss of concentration. Forget where I place things and can look for stuff for 15 min before finding at least 3 times a day. - 6 months or more
Muscle pain and weakness. The pain is a sharp pain like one would experience after weight lifting. The weakness is more of a perception ex. I find stuff like jar lids over tightened by me and I have to loosen them for people. This pain doesn't go away any more weather I work hard physically or not - 4 month maybe more ?
Fatigue is now common and getting in way of job to the point that I am thinking of urging boss to start looking for replacement. I constantly need to sit and sweat over small activities. - This has gone on for 2 weeks or maybe 3
Tough to keep track when you feel like an old person struggling to cross a street before the light turns red.
I am 28years old my doctor is not interested in running more test and I feel my self worsen day by day and not sure how to get help or how to request a second opinion while not sounding like a hypochondriac? Or if I need to ask for a specialist and if so what type? Where do i turn for help before the emergency room? What might it be?
Quick note that might be relevant but told it wasn't. I had to spots of skin cancer one was Basal cell and the other was stated as "pre melanoma” the doctor said it was all contained and removed. Smoked from age 20 - 25.
Doctor's Answer
by Kevin Pho, MD, Aug 29, 2004 12:00AM
, Aug 29, 2004 12:00AM
With the ANA panel drawn, it seems like your physician was suspicious about some sort of rheumatological disorder. I would agree with this approach. In addition, I would also test for various muscle enzymes, including CK levels, ALT/AST, and LDH levels. If there continues to be muscle pain, you can consider a muscle biopsy in the area of concern for further evaluation.
Thyroid tests as well as tests for inflammation - ESR and C-reactive protein - can also be considered.
Regarding the diarrhea, a colonoscopy or flexible sigmoidoscopy can be considered to evaluate for inflammatory bowel disease - which can also manifest with joint and muscle complaints. Tests for malabsorption (via stool tests) and celiac disease (via blood tests) can also be considered.
I would consider a referral to a rheumatologist for further evaluation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Thyroid tests as well as tests for inflammation - ESR and C-reactive protein - can also be considered.
Regarding the diarrhea, a colonoscopy or flexible sigmoidoscopy can be considered to evaluate for inflammatory bowel disease - which can also manifest with joint and muscle complaints. Tests for malabsorption (via stool tests) and celiac disease (via blood tests) can also be considered.
I would consider a referral to a rheumatologist for further evaluation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Hi You might want to also consider asking for a "Prothrombin time" blood test. Your symptoms of bruising for no reason and fleeting pains in various areas of the body could indicate a problem with one of the various clotting factors of the blood. Malabsorption could be involved as well, and that can cause the prothrombin time to increase thus causing the bruising , muscle pain, and fatigue.