Unusual Symptom

The complete set of medical records is on the web at:
http://www.homestead.com/symptom
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Thank you,

Unusual Symptom
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Sex: Male, Age: 57

Unusual Symptoms:

1. Fatigue From Exercise
2. Fatigue From Bathing
3. Chest Pains and Muscle Vibration Or "Motor Sensation"
4. Red Lines On Skin After Bathing
5. Low Intracellular Magnesium
6. Muscular discomfort/pain

Bathing - Fatigue, Red Lines, Low Intracellular Magnesium

Until November 1997 bathing with a wash cloth at the sink just a part of me  such as my hair or my back, etc., caused increased fatigue and muscular discomfort or pain, rose colored lips, blue cast to the head of my penis, sometimes red lines on my body after bathing.  One facet of this appears to be is Intracellular Magnesium Deficiency.

In October 1997, I saw a doctor who's field of interest is Chronic Fatigue Syndrome and related issues.  I do not have the persistent low grade fever, swollen lymph glands, and over reactive immune system that is characteristic of CFS.  I do have some of the same but less definitive symptoms.  He ran some tests and found intracellular magnesium was far out of range.

In October of 1997 I began taking Magnesium Sulfate injections.  1 gm., 2 ml., (50%), IM per week.  The positive effect of the shots was immediate.  The improvement quickly plateaued and has remained steady.

I improved remarkably after taking one or two weekly shots of the magnesium sulfate.  A measure of improvement:

   Before the magnesium sulfate shots it took me three days to get over the fatigue and other bathing consequences from washing my hair.  Now I can wash 1/4-1/3 of my body and the fatigue lasts about 1 1/2 days.  I no longer experience discoloration of my lips or blue cast to the head of my penis from this bathing.

This fatigue from bathing symptom is extant before I took any antidepressants or other psychotropic medication.  I had previously taken allergy shots for dust, mold, feathers, and possibly pollen.  I have taken other medications for temporary disorders. (see my medical records)

The fatigue from bathing was not this severe when I first noticed it.  It has gotten steadily worse over the past 25 years and has not been meaningfully responsive to antidepressants, Cyclert, or anxiolytics.  It has not been meaningfully responsive to changes in my strength or endurance..

When I have increased fatigue from bathing or exorcise I sometimes experience tightness in a band around my head at the level of my forehead and eyes.  This can be very painful.  The degree of pain I feel is directly proportional to the amount of fatigue I am experiencing.  Antidepressants have helped with this.

Antidepressants have helped with this.  At one point I cut back on the antidepressants.  The increased pain I felt was unbearable.  I take the meds.  *smile*  My understanding is that this band around the forehead feeling is experienced by some people who experience migraine headaches.

In the late 1970's I was taking Parnate - 60 mg per day.  At this dosage I got enough lift so that exercise made me stronger.  I went from being house bound to walking 6 or 7 miles a day.   This often included climbing a steep hill.  There was no apparent change in the fatigue caused by bathing.  I was probably better able to handle it when I was stronger.

The effect on the "muscle motor sensation" caused by the bathing is coincident with the length of time it takes to recover from the fatigue from bathing.

Fatigue etc.  from bathing does not respond meaningfully to changes in water temperature from comfortable hot to cold out_of_the_tap temperature.

I normally wash my back using a warm wet towel.  I don't use soap when I do this.  It is just too much trouble.  I still have the fatigue etc.  from bathing this part of me.  Soap does not appear to be implicated as a source of the problem.

I can do the same physical motions of washing my hair but without the water and soap.  This does not appear to cause me any problem.

I can dampen my hair with a wet wash cloth to brush it.  This does not cause me any problems.

The period of fatigue etc. from bathing is accompanied by a slight but noticeable increase in respiration rate.  In bed I feel cold and require an extra blanket.  The fatigue ends abruptly.  Lip color returns to normal, increased muscular discomfort and pain goes back to the level before the bathing.  I take a deeper breath and my breathing returns to normal.  I stop feeling cold and I need remove the extra blanket because it is now making me too warm.  This pattern of ending an increased fatigue episode is the same whether it is caused by over exertion or bathing.

Red lines appear on my body.  I usually noticed them on my torso after I bathe.  Sometimes they appear as 3 or 4 parallel finger wide lines on the front sides of my rib cage under my breast just above the nipple line.

Other times they appear as one or more independent thin lines.  The thickness of one of these thin lines is about the thickness of the line drawn with a dull number two pencil.  I've noticed them usually on my chest and abdomen, my thighs, and around my knees.  These are the areas I can see easily.  The locations of the red lines are static from incident to incident although they only appear where I wash.

A dermatologist that I saw in January 1998 called them Dermatographia.  The CFS doctor agreed, but added "It is a red letter day when we find the cause in a particular case of Dermatographia."

He prescribed magnesium sulfate shots supplemented with Slow-Mag tablets.  I took as many as eight tablets a day.  Currently I am taking six per day.  I took the inter muscular magnesium sulfate shots from October 1997 to April 1999.

In November 1998, after fourteen months, I again tested for intracellular magnesium.  The level was at the low end of the expected range.  (see lab report).  I continued the magnesium sulfate shots for another 4 months.  I still take 6 Slow-Mag tablets per day and an additional 500 mg per day in the form of magnesium oxide and magnesium aspartate.  This is the value of this nutrient in six TwinLab Allergy Multi Caps.  I take six per day.

Note: The intracellular magnesium is different than the magnesium level in the blood.  The test is different than a serum level test.

The CFS specialist requested the following laboratory tests.
   a.  WBC Magnesium
   b.  Immunology: Anti Candida Albicans Antibodies, Giardia Lamblia Antibodies.
   c.  Parasites
   d.  Bacteria: Lactobacillus, Bifidobacter, E. Coli, Gamma strep, Serratia marcascans.
   e.  Yeast Organisms Cultured, Trichosporon species.

The tests detected GI parasite antibodies.  For a month in late 1997 I took Nystatin for the parasites.  It had no effect on how I felt.

In January 1998 the CFS doctor tried a basic food elimination diet: There was no change in my condition as a result of this test.

Muscle Vibration or "Motor Sensation"

This is the "I was diagnosed with Clinical Depression not Psychosis" section.  It starts out simple enough.

In 1968 and again in 1969 I experienced "crunching" chest pains.  I was in a high stress job.  During this period I became increasingly fatigued.  I left the job at the end of 1969.  With in days the "muscle motor sensation" began.  An EKG showed nothing unusual.

I ended up in a psychiatrists office in 1975.  I began antidepressants.  In 1981 I began "Interpersonal Psychotherapy."  This therapy was completed years ago.  The fatigue and muscle motor sensation continue.

Background muscle vibration sensation. The vibration is not of the whole muscle, but it feels like a single fiber. (I didn't study anatomy.  This is just how it feels.)

An Electromyographic test in July 1999 did not show anything unusual.

There are eight major body sections affected:

(1)  Upper chest/neck/face/around eyes.
(2)  Top of thighs.
(3)  Sides from armpit to waist.
(4)  Abdomen.
(5)  Inner thigh ending lower abdomen just above the hip bone. I feel this inside my abdomen.
(6)  Inner thighs, across pelvis, ending over kidneys (below rib cage to the sides, sometimes as far as the backbone in my lower back.
(7)  Backs of my legs, buttocks, behind scrotum, back, back of neck.
(8)  Upper back, neck.

The "muscle motor sensation" feeling moves in intensity from one area to the next in regular defined rotation. (The above list reflects the order of the rotation cycle.) The most noticeable cycle is 24 hours (8 groups of 3 hours). Within the three hour groups there are divisions of 22 1/2 minutes.  If I am very still and my location is very quiet, I can detect a cycle within the 22 1/2 minute period.  Also there is an eight day cycle and a 64 day cycle (8 days times 8 areas).

The 8 cycle periods that I have observed are:
8  8 day periods
8  1 day periods
8  3 hour periods
8  22 1/2 minutes periods
8  2.8125 minutes periods

A curious phenomenon is that the change from standard time to daylight time does not change the beginning time of the cycles. i.e. a 24 hour cycle starts at 6:35 a.m. Standard Time, it starts at 5:35 a.m. Daylight Savings Time. (or the other way around). The timing has never varied a minute during the 10 years I payed close attention to it. I was not aware of the cycles when I was in NYC. I don't know what happened in this 3 hour differential. I expect the cycle timing was not affected.

A psychiatrist I consulted told me that while he had never run across this "Muscle Motor Sensation" (the phrase is his) on this scale, he told me it can be a symptom of anxiety.

This sensation has not been responsive to antidepressants or anxiolytics.  I've taken BuSpar and Librium.  It has not been responsive to the Magnesium Sulfate injections.

The cyclic nature of the vibration has not been apparent to me since I've been on Wellbutrin, possibly since Prozac.  I don't remember.  The cyclic nature of this sensation seems to occur when I am on a therapeutic level of antidepressants.  Enough emotional lift to make me feel buoyant or have a feeling of well being.

I am not on a therapeutic level of antidepressants at present and have not been on one for about 3 years.  I am currently searching for the right combinations of psychotropic medications that will put me back on a therapeutic level.

I am suspicion that there is something going on other than the consequences of Clinical Depression.

Remember, I have been treated for Clinical Depression not Psychosis.  Your opinion my vary, but I am reporting my experience as I know it.

Thank you for reading this.

Unusual Symptom

Complete medical records at:
     http://www.homestead.com/symptom
e-mail:
     mailto://***@****
---------------------------end

[HFHS MD-JM]

Anon,

    You report several different somatic symptoms which have partially responded to treatment with medications.  Other than hypomagnesemia and dermatographia there has been no further evidence of a physical etiology.  Somatization, manifesting/expressing psychological(anxiety,depression) issues via somatic(body) complaints may be the primary process you are dealing with now.
    The mood disorders, somataform disorders and anxiety disorder should all be considered by your treatment team of physicians.  The good news is that you have had some success/improvement which is generally the case in this type of problem. Good luck. Remember this information is intended for general educational purposes only.  Please see your personal physician for specific health concerns.

Sincerely,

HFHS MD-JM

Keyword: Somatization,depression,anxiety

[Another Anon]

I have recently experienced a vibrating sensation in the area of my left breast.  It could be in the heart area.  I have recently had an upper respiratory cold and last year I had pneumonia.  I do not have any cough now and the cold is gone, but once about 3 years ago after an EKG a doctor said I had mitral valve prolapse.  Then in a subsequent EKG the same doctor said I didn't have mvp after all. Could a vibrating sensation every few seconds be a symptom of mitral valve prolapse that I have developed, or is this vibrating sensation something to be concerned about at all? It seems to be getting more noticeable lately.