I am a 31 year old female. I have had 6 outbreaks of shingles in the last 3 years in the same place on the upper right side of my back. I've been dx'd with Postherpetic Neuralgia as a result. I now have developed the following symptoms: Tremors in arms and legs (my hands shake when I hold something, my my legs are most noticable going down stairs), I have mod-severe fatigue 3-5 days a wk, I have memory problems(cant remember words, names, and how to spell at times), I have swollen and tender glands under both arms, I generally run a low grade fever (98.9-100), in the last 6 months I've started having loss of use in my right arm (it started out only when my PHN was acting up now its more frequent - at times I cant turn a door knob and I have a numb pain almost like a heavy feeling but it seems like I can actually feel my bones in the arm), I've had Addies pupil since '95, I've had respiratory problems in the last 6 months (reoccuring bronchitis, short of breath, chest pain when breathing hard). I've been to a neuro, she did an MRI in May with nothing significant and I am scheduled for another one in Sept. My Gen Doc cant find anything specifically wrong. I'm on Ultram and Hydrocone as needed for the PHN, I'm on Neurontin at 1200 mg per day for the PHN, I have propranolol as needed for tremors. I've started making nutritional changes. I'm not sure what I should look at to try to find a reason or dx for this. I am looking for direction to see if I should ask for specific blood tests, if it may be a neurological condition, MS. Any direction would be greatly appreciated
For a woman your age (relatively young) to have so many outbreaks of shingles, low grade fevers, resp problems and swollen glands (lymph nodes?) I am concerned about an underlying problem with your immune system. The medical term is "immunocompromised state." This occurs in the elderly, people who have cancer, HIV+ patients,and steroid-dependent patients (taken for a number of disorders) among other diseases that would affect your immune system. Autoimmune or collagen vascular diseases such as lupus could also be a possiblity. MS is also a thought but it is not high on my list (though keep in mind I have not personally examined you or looked at your MRI). Your doc can start by checking a routine blood count (CBC) and then possibly an autoimmune panel like an ANA - anti nuclear antibody test, a sed rate, and maybe a C reactive protein. (These are markers of inflammation. If you have risk factors for HIV, perhaps you should get tested.
As for your symptoms, you could try capsaicin cream which burns initially, but some patients say it does help with the pain as well as antidepressants that have analgesic properties like amytryptilline (elavil). Also, the propanolol you're taking for the tremors could be exacerbating your respiratory problems, especially if you have underlying asthma or lung disease. Sit down with your doctors and let them know about your concerns. You may consider a rheumatologist if your doctors agree that there may be an autoimmune process going on after a complete physical examination and lab work has been done. Good luck to you.
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