painful swollen ankles

[kyleknapp]

Last Sunday, I started feeling experiencing moderate aching in my neck, shoulders, back, hips, and knees, along with fatigue and mild headache, and thought I might be coming down with a flu.  By Monday night, all the joint pain had moved down into my feet and ankles.

By Tuesday night I could barely walk, the pain was so severe I could barely walk, when I went to bed, I started shaking with chills (although my temperature was normal, according to my thermometer).  My ankles felt hot and were sensitive to touch.  I got very little sleep, until 4am, when I took 800mg of ibuprofen.  Then I slept soundly for about 3 hours, then woke up and the pain was gone and I felt fine.  (Which was a huge relief, as I was planning to leave on vacation that morning.)

I felt fine most of the day (Wednesday while traveling to Florida), but by evening my ankles were starting to hurt again.  It was then I noticed they were swollen.  Ibuprofen and ice packs seem to have little affect.

It's now Thursday morning, ankles are still swollen and painful, but not as bad as Tuesday.   I am 55 years old, have  had chronic neck (stenosis) and back pain for years, and occasionally get aching joints after unusual physical activity, but have never experienced anything quite like this.

My questions:
What is this?  Could it be gout (does it come on this suddenly)?
Will I place myself at risk if I wait until next week, when I'm back at home, to see a doctor?

Thanks for any help you might give.


This discussion is related to Is this gout I am feeling.

[RDRDR]

Have you spoken w/a doctor about MRSA?

[RDRDR]

Have you spoken w/a doctor about MRSA?

[kyleknapp]

Well, it's been 4 months, my condition remains undiagnosed, and has not gone away.  The swelling comes and goes (never as severe as at first), the related stiffness and fatigue is pretty constant.

I have been tested for hepatitis, Lyme disease, autoimmune problems, all tests came back negative.  An infectious disease specialist said it was either a bacterial infection (pretty much ruled out by a month's worth of heavy antibiotics) or a virus (in which case I'll just have to wait it out).

Last Dr I saw (a rheumatologist, a couple weeks ago) switched me from Ibuprophen to Diclofenac Sodiun, and renewed my RX for Lortab, said to wait another month or so, and if I'm still not better he'll do a bone scan.

I haven't taken the Lortab for a couple days (it seems to cloud my mind), and taking plain Tylenol (1000mg 3 or 4 times/day) - seems to be about as effective.

[kyleknapp]

STILL SICK!

Okay, this has now been going on for over 2½ months.  The fever, chills and nausea stopped weeks ago, the diarrhea comes back from time to time, but is mild, and goes away quickly when I take Lomotil.

But my ankles are still sore.  Other joints (toes, knees, back, hips) hurt intermittently.  Very little swelling is evident in the morning, but becomes obvious by late afternoon (earlier, if I spend a lot of time on my feet), though not nearly as severe as that first couple weeks.

Several weeks ago I saw a rheumatologist, who pretty much looked me over and then said "come back in 2 months"  (in his defense, I was just coming off a round of prednisone at the time, and thought I was getting better).  I called him back a few days later, when my pain level increased, and he (reluctantly) re-prescribed Lortab-5/500 (acetominophen/hydrocodone) for pain.

Then I saw an infectious disease specialist, who didn't want to test me for anything ("if it's viral, there's nothing we can do, if it's bacterial, antibiotics will knock it out") - I insisted he test me for Lyme disease (which he said would be cured by the antibiotics as well).

So,
* I've been tested for Lyme disease (negative)
* Had 3 rounds of antibiotics, of increasing strength (against the presumption that I had some kind of infection), resulting in no change.
* I was on Predinsone for most of 2 months, which seemed to help some, but 3 or 4 days after I stopped the pain and swelling increased.
* Most recently, I was tested for autoimmune issues (they did a ANA & ESR) - both negative.

I called my GP yesterday to get the results of the ANA an ESR, the nurse said "Both came back negative, any questions?"  I said, "Yes, what do I do next?"  She said the doctor suggests I go back to the rheumatologist.

I called the rheumatologist to schedule another appointment, but he has no openings until Aug 29th (more than a month from now).

I don't like taking the Lortab - it DOES help with the pain, but my wife says it makes me chatty and sarcastic, plus I "crash" in the middle of the afternoon - I can't work a full day, and I'm falling badly behind.

At one point one of my doctors suggested Aleve (naproxen sodium), but even taking 2 tables (440mg) had zero effect.  I see now that much larger doses are sometimes prescribed - would it be safe for me to try 3 tablets (660mg) and see if it helps?

[kyleknapp]

I completed the course of Prednisone, but still not 100% so I went back to the doctor.  She spent awhile examining my legs for blood clots, but found nothing.  We discussed a variety of possibilities (cellulitis, Lyme disease, hepatitis, gout) none of which appears to fit.  She said Hepatitis fits some of my symptoms (but not the swelling), so she did a blood test to eliminate that (haven't gotten the results yet).

She flat-out told me she was stumped.  She suspects it's some kind of infection, and will probably just run its course, but since she can't identify, she has no way of predicting whether I'll be sick for a few more days, weeks, months, whatever.  She referred me to an infectious disease specialist - I have an appointment for a week from today.

Now that I've been off prednisone for a couple days, the pain and swelling are getting worse.  Just trying to get out of bed this morning to use the restroom was excrutiating - I took 2 pain pills (acetaminophen/hydrocodone 500/5mg) right off the bat, just to be able to function.  (This makes me a little nervous too, as I have a history of drug abuse, though it was a long time ago).

Just to recap, my symptoms are:
- Swelling and pain in my ankles (swelling is not as severe now as it was a week ago, but seems to be getting worse, and since I finished the prednisone, pain is extending to my knees, hips, hamstrings)
- Intermittent fever, chills, nausea, diarrhea, headache, lethargy
- This has been going on now for 17 days

If anyone recognizes this combination of symptoms, I'd be most grateful to hear about it.

[kyleknapp]

swelling continues to go down, but has not gone away,  Had intense diarrhea for about 24 hours, but that seems to have mostly passed.

Saw my primary care doctor yesterday.  She dismissed the Erythema Nosodum diagnosis out of hand, but had nothing definitive to replace it with.  They've done blood and urine tests and an ultrasound of my heart, and found nothing wrong there.

My doc thinks its a virus (and that the nausea, vomiting, fever, and diarrhea were all part of the same illness) and that I'll be fine once it's run its course.

[kyleknapp]

Well, the problem seemed to get better, then got worse again.  There's no doctors within a couple hundred miles in my insurance network, so going anywhere around here was likely to be expensive.  Nevertheless, by Sunday I was in so much pain I found and went to an "Urgent Care" clinic about 25 miles away.

They drew blood, took a urine sample and chest X-Ray.  The PA 'tentatively' diagnosed me with Erythema Nosodum (so I guess this question doesn't really belong in the arthritis forum after all, sorry), and suspected Sarcoidosis as the cause (though I've had no chest pain).  They gave me some printouts (Chemistry, Hematology, Urinalysis) and said other lab results wouldn't be available until Wednesday.  

They prescribed Prednisone (60/40/20mg for 3 days each) and Lortab-5 (1-2 every 6hrs as needed), and recommended I see a doctor soon after I get home (I have an appointment for Wednesday.)

A day later it seems to be helping, the swelling is going down (slowly) and the pain is greatly diminished.  

BUT, a few hours after I take the pills, I experience a kind of 'crash', fatigue, gravelly voice/sore eyes/headache as if I'm up past my bedtime, followed by nausea (and yesterday, vomiting).  I'm thinking it's the Lortab that's giving me the side effects, as the nausea got worse (and led to vomiting) after I took the next dose.  We have a dinner date tonight (last night of our vacation) so I'm going now to pick up some Pepto Bismol and hope for the best.

[Dee1956]

Hi whatever you are experiencing sounds really bad, have you thought of going to an emergency room?  Just a thought
I always thought that gout happened in one place like the big toe, did not know it could happen all over the body, have you tried to look it up on line?
Good luck
D