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Family Medicine (Expert Forum)
12 weeks tingling/burning extremities and more, Frustrated!!
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
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12 weeks tingling/burning extremities and more, Frustrated!!
by cjinhb, Oct 01, 2006 12:00AM
Hi 35 yo f
In mid july I started experiencing numbness/tingling/burning in my left hand that progressed over the next week to the right and both feet and was stumbling. Saw Md and he did full blood work up: ANA mono cbc cmp ra thyroid HIv syphilis, all norm except elevated wbc=10.5 and plt=90. Started taking neurontin and refered to neurologist.
Over the next week awaiting my neuro appt (6wk wait)muscle and joint pain started along with extreme fatigue, itching, stinging sensations and low grade fevers. Blood work repeated, wbc=11.8. Lightheadedness, HA's and lip & tongue numbness followed (wbc=13.5).
Finally saw neurologist, he did neuro exam and told me that because of muscle and joint pain I need to see hematologist, probably not neuro, prob systemic. Back to primary and he ordered MRI of c-spine and said I don't need to see hematologist because wbc's now back to 10. MRI done and there is a 2mm protrusion at C5-C6. MD says definately follow up with neuro and yes I definately need to see the hematologist (no explanation, what?). Neurontin no longer working at 1200mg/d so he DC'd that.
I am now seeing the hematologist this week and don't quite know why or what he would be looking for or what the neuro thinks is the problem? (see neuro next week) I am extremely anxious over this whole event and don't quite know where to go from here. I haven't been able to work since because of the pain in my hands and feet with use. Any suggestions on why hematology? Can the protrusion be causing all the problems on its own and whats the tx for that?
The muscle and joint pain has diminished but the numbness/burning has gotten worse and moves up the legs and arms. All other symptoms persist as well.
Any hints or foresight into what they may be seeing or looking for systemically would be helpful. Thank You!
In mid july I started experiencing numbness/tingling/burning in my left hand that progressed over the next week to the right and both feet and was stumbling. Saw Md and he did full blood work up: ANA mono cbc cmp ra thyroid HIv syphilis, all norm except elevated wbc=10.5 and plt=90. Started taking neurontin and refered to neurologist.
Over the next week awaiting my neuro appt (6wk wait)muscle and joint pain started along with extreme fatigue, itching, stinging sensations and low grade fevers. Blood work repeated, wbc=11.8. Lightheadedness, HA's and lip & tongue numbness followed (wbc=13.5).
Finally saw neurologist, he did neuro exam and told me that because of muscle and joint pain I need to see hematologist, probably not neuro, prob systemic. Back to primary and he ordered MRI of c-spine and said I don't need to see hematologist because wbc's now back to 10. MRI done and there is a 2mm protrusion at C5-C6. MD says definately follow up with neuro and yes I definately need to see the hematologist (no explanation, what?). Neurontin no longer working at 1200mg/d so he DC'd that.
I am now seeing the hematologist this week and don't quite know why or what he would be looking for or what the neuro thinks is the problem? (see neuro next week) I am extremely anxious over this whole event and don't quite know where to go from here. I haven't been able to work since because of the pain in my hands and feet with use. Any suggestions on why hematology? Can the protrusion be causing all the problems on its own and whats the tx for that?
The muscle and joint pain has diminished but the numbness/burning has gotten worse and moves up the legs and arms. All other symptoms persist as well.
Any hints or foresight into what they may be seeing or looking for systemically would be helpful. Thank You!
Doctor's Answer
by Kevin Pho, MD, Oct 02, 2006 12:00AM
, Oct 02, 2006 12:00AM
Abnormal elevation of the WBC as well as the low platelets are the reason for the hematology referral. There are various types of blood disorders or leukemias that can present that way. A bone marrow biopsy would be considered to further investigate this.
I agree with continued neurology f/u. MRI of the brain can evaluate for any type of stroke. I would also consider electrodiagnostic testing to evaluate the neuropathy.
These options can be discussed with your personal physician.
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.
kevinmd_
I agree with continued neurology f/u. MRI of the brain can evaluate for any type of stroke. I would also consider electrodiagnostic testing to evaluate the neuropathy.
These options can be discussed with your personal physician.
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.
kevinmd_
Thanks again!