Undiagnosed problem

[fritz281]

Hi,

I would greatly appreciate help from your members in identifying a cause for some unusual and alarming symptoms I have been experiencing over the last 12 months or so. Firstly a bit about myself. I am a 42 year old male (gave up smoking 3 years ago). I am overweight (250lbs, 6ft tall) but I am otherwise active. I have been diagnosed with angina (3 years ago, angioplasty performed about 2 years ago and, according to the hospital, sucessful). I have also duodenal ulcers (diagnosed about 10 years ago and treated with zoton). My job has involved working with highly toxic chemicals such as organophosphates (about 2 years ago) but recently the only chemical I regularly come in contact with in any significant quantity is methanol.

Over the last 12 months I have started to suffer from some worrying symptoms. Initially I had episodes of breathlessness each lasting only a few seconds which have continued at a similar frequency (4 or 5 times a month). These episodes come on rapidly and unexpectantly with no warning whether I am exercising or not (in fact when one occurs while I am sleeping it is even more alarming). A cardiac investigation by the hospital proved negative and I was given a clean bill of health regarding my heart.

I have also been passing a sticky and smelly stool (moth-ball type odour) and this has increased in frequency until it is the norm rather than the exception. I bought a faecal blood test kit about a month ago and it was positive (my GP hasn't been informed). I also have become more fatigued over the last few months together with a spinning feeling of dizziness. This fatigue/dizziness is periodic however I notice that it is becoming more common. Furthermore I have had a problem with my sight over the 12 month period. I developed a dark spot in my right eye vision (eye hospital diagnosed a floater which may or may not disappear on its own). Recently however my sight sporadically blurs in both eyes and sometimes I get foggy vision (like looking through a net curtain). I also sometimes have vision like looking through a heat haze (similar to migraine symptoms I used to get as a teenager). These episodes of visual disturbance seem act in unison with feeling dizzy/fatigued and lately are accompanied with ringing in my ears.

Additionally over the past few months I have developed limb pain (worse in the arms but also occurring in the legs). These started with cramp-like sensations in the hands and feet with a stinging pain in my big toes. I have periodic spasms in my fingers and toes (claw-like contractions) and get sporadic pain in my kness, elbows, ankles and wrists (which are exceptionally painful). These pains are positional and most painful when the joint is flexed (for example when the hands are bent back). My arms fell heavy and ache after being in raised positions for very short times (even supported, e.g. hanging onto a overhead strap in an underground train). I sometimes also get shooting pains in my arms.

I have been to my GP several times but since the onset of the symptoms has been quite gradual I've been fobbed of with excuses like writer's cramp, tennis elbow, plantar fasciitis, arthritis, eye floater, stress etc (I haven't mentioned the stool issues through embarassment). I did get a test result that caused the doctor concern where high enzyme values were obtained for a series of liver function tests. These tests were requested by my doctor after I was given antibiotics for a toe infection after having my ingrown toenails treated (which I initially thought gave rise to the stinging sensations in my big toes). These antibiotics did not agree with me and since I was on such a high medication dose for my angina the doctor requested the tests. These tests remained high for about 2 months before she was happy with the results.

Quite frankly I am now at the stage where I have lost faith with my GP and I am resolved to go on until I drop. I also fear for my job which is sometimes physical and involves driving. Any more trips to the GP will worry my boss and vision problems may restrict/stop me driving and jeapodise my job. I would therefore be extremely grateful for any suggestions where I could take something more concrete (such as a diagnosis) to my doctor and possibly get effective treatment.

[fritz281]

Hi Caregiver222,

Many thanks for replying. The cardiac investigation I referred to did indeed involve a stress/rest test after ingestion of a radioactive tracer followed by imaging. I was also wired up to an ECG recording device for 24 hours. The cardiac department seemed happy that there were no issues with my heart.

No one has mentioned that I maybe suffering from a lung disease but I am not wheezy or got a persistent cough. However, at my work where I was dealing with very toxic chemicals we were strictly monitored and this included six-monthly lung function tests (I also worked with lung damaging compounds) as well as acetylcholinesterase determination. Interestingly just before I was diagnosed with angina the site nurse referred me to the work doctor as I had a low lung function test result. The doctor suggested that I lose weight first and try to give up smoking. As I was diagnosed with angina soon afterward I assumed this lung function result was down to the developing angina. With respect to the organophosphates I worked with I was monitored weekly for acetylcholinesterase levels and no issues were flagged. I certainly had no cause to use a combopen during my career there (I moved from this job due to the angina and the hazardous nature of the job).

I have had a fasting glucose test recently (last eight months or so) and the doctor said I had a very slight glucose intolerance although she did not appear overly concerned with the result. As a consequence I’ve been monitoring myself regularly with ketostix/diastix and have yet to get a positive result. I do this monitoring myself without the doctor's knowledge as I'm trying to minimise visits to my GP as my boss has being laying people off recently and a sick employee would be in the firing line. With reference to my blood pressure I've never had a reading that has caused concern.

Many thanks for the advice about taking quinine for the cramps. I'll try and get some (will tonic water suffice?). However, although cramps were and still are an issue, the spasms and joint pain (and possibly bone pain) are now more of an issue with regard to limb symptoms.

I should mention that during my career as well as the highly toxic chemicals alluded to above I have handled many solvents including benzene and carbon tetrachloride. I mention these in particular as google-searching my symptoms almost invariably leads to the suggestion of some sort of cancer although lupus presents itself as a candidate. I have also prepared novel compounds where no toxicological data are known.

Hope this info helps. Many thanks for getting back to me as whatever is wrong with me appears to be progressive and not stable. Unfortunately in today’s economic climate it doesn’t pay to be sick. Thanks once again,

Fritz281

[caregiver222]

You have a complex array of symptoms, and I wouldn't be able to hazard a guess, however breathlessness such as you describe is ocasionally associated with right heart failure, and known as cor pulmonale. The general scenario is long standing lung disease (poor lung function) coupled with high blood pressure. But there are other symptoms, such as waking suddenly in the night.

You say you had a "cardiac investigation", but what did that entail? Were you given a stress test while being imaged with radioactive dye? There is some hazard in this protovol, but it is definitive.

I assume you have had a fasting glucose test. If not, get one.

The cramps may be relieved by drinking a glass of milk or two or taking magnesium glycinate supplements. You don't have "writer's cramp". You have a calcium channel issue. Quinine pills are no longer approved, unfortunately. If you can talk your local health food store into selling you a few (they now have them hidden) do so.

I assume you have had an acetacholinesterase level test. And I assume the base levels were established at the plant where you were working. I am also sure you are familiar with PAM-2 if you have handled these substances.