Exhaustion

Posted by Sara on July 14, 1999 at 15:49:42
Hi.  I don't know if I'm in the right place but I thought I'd give this a shot.  I will try to keep this short and to the point but there is quite a bit of history.
I am 22, female, 29 weeks pregnant.  About 3 years ago I had a case of food poisoning.  Following that I had frequent (at least once a month) flu-like illness with low-grade fevers (99, 100F), swollen tender lymph nodes in my neck and under my arms, nausea, vomiting, diahrrea, body aches, headache, and occasionally sore throat and/or congestion.  I also had exhaustion severe enough to compromise my college work.  The clinic at the college said it was just stress, and I should excercise and eat right and get enough rest, and I would be fine.  I did these things, but the symptoms slowly continued to worsen until I was unable to continue school.  I worked for a time but was eventually unable to continue that either (I was calling in sick at least once a week); fortunately my husband has been most understanding and is willing to have a one-income family.  The symptoms continued to worsen, and new ones appeared:  migraine headaches (diagnosed with a CT scan); sebhorric dermatitis (diagnosed by a dermatologist); allergic reactions to some soaps, perfumes, cleansers, etc.; and agoraphobia-like symptoms.  Instead of classic panic attacks (chest pain, trouble breathing, etc) I would begin to vomit uncontrollably, have a fever (101-102 F), and have diahrrea.  The "panic attack" would subside shortly after I went to my bed - fever included.  This got to the point that I could not leave the house.  I sought therapy and was placed on antidepresants (tried various types & dosages) and though they helped with my energy levels they left me feeling manic and out of control emotionally, even in the lowest doses.  The therapist suggested I take a sedative in addition to the antidepressant, but I elected to go off the medication instead.  My energy levels slowly fell over the next few months until I was back where I started.  I tried St. John's Wort with no apparent effects.  I did not find the therapy helpful and eventually stopped going.  Through a support group on the internet I was able to deal with the "agoraphobia" and slowly resumed a relatively normal life.  I was still not able to work or go to school, but I could take care of normal day-to-day things and have something of a social life.
I became pregnant in January of this year, and symptoms suddenly disappeared.  I still have the flu-like illness but only once every 6-8 weeks instead of once every 1-4 weeks.  My energy levels are down but I am usually able to do the normal day-to-day things.  There seems to be a link between what I do and how I feel; i.e. if I get ample rest and do only my normal activities, I do well, but if I "push" and do extra things, I quickly become exhausted and it takes me a few days to recover.
I have been repeatedly told this is all in my head, there is nothing wrong with me, this is just normal exhaustion that everybody feels, and I should just learn to deal with it.  It doesn't seem to me that this is so.  Am I crazy?  Are these symptoms all psychological?  Or could there be something physically wrong with me?  Thyroid problems run in my family but I don't seem to have those symptoms, other than the exhaustion.  Are there tests I should ask my doctor to run?  Can they be done during pregnancy or do I have to wait until after the baby is born?
I know you can't make a diagnosis, and I plan to see my family doctor as soon as possible.  (He has been out of town and I am not comfortable talking about this with his replacement.)  It wasn't until the sudden alleviation of symptoms with the pregnancy that I realized how bad things had gotten.  Thanks for any input or suggestions you can give.
-Sara.

Posted by HFHS M.D - HG on July 21, 1999 at 19:07:39
Dear Sara,
                Congratulations. I am glad that you are feeling better. Your physical symptoms, particularly fever, swollen lymph nodes, sore throat, vomiting, diarrhea need to be evaluated thoroughly. You may need to undergo certain tests to rule out any organic causes for your symptoms. Exhaustion can be due to several reasons- medical causes, depression, pregnancy etc.
                I would recommend that you follow up with your family physician as soon as possible. Once the diagnosis is clear, you may consider a consultation with a Mental Health  Professional to assess the anxiety. For an appointment at Henry Ford Hospital Behavioral Services Clinic, you may call (248)-689-7476.
               This information is provided for general educational purposes only and should not replace evaluation by a physician.
Key Words : Anxiety