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Family Medicine  (Expert Forum)
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Where to go next????
Answered by
J.M. Keyes, MD - Family Medicine
Gainesville - FL
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.

Where to go next????

by angierenee, Apr 28, 2008 02:42PM
I have several things going on and have no clue whats related if anything. Please help
I started having foot pain this morning when I woke up and a sore on my stomach that resembled a large ant bite.I know two totally different thigs but you never know what could be linked together. The foot pain was much like the pain that you would feel from walking barefoot on hot pavement. I have not stood on my feet for long periods, i work inside, nothing has changed in my daily activities lately. I will try to shorten up my history as much as possible but give you enough to go on.I am a 30 yr old female with a history of health problems.
I recently underwent gallbladder surgery for sludge,had a hysterectomy about a year ago for endometriosis and cysts, have a history of kidney stones and diabetis both found during pregnancy but both hereditary also. I also recently found out that I have high cholesterol which is like 220 and triglycerides were 385.Again another problem in my family. My Liver enzymes are 78- all liver function tests good.My doctor started me on fish oil pills for cholesterol giving it three months to lower with help of diet and exercise before starting cholesterol meds. He seemed to think that that was not too bad. I just dont feel normal lately and hoped you could tell me if this is because of whats been going or possibly something different is happening.Other symptoms I have been experiencing are fatigue, difficulty understanding concentrating.Remembering things or even forgeting things in mid sentence.
Loss of intrest in daily activites or work due to fatigue. I have had blood work and many other tests ran all are fine. I have also seen a cardiologist for chest pain. Only thing found was MVP and I was told that would not cause pain so they started me on Cymbalta for stress/anxiety. I feel like I am going crazy and just ant someone to find out what is going on. Any advise you can give will be greatly appreciated.

by J.M. Keyes, MD, Apr 28, 2008 03:15PM
To: angierenee
Hi there.
Sorry to hear you are feeling so unwell all around.

It certainly sounds with all of your symptoms that depression/anxiety could be playing a major role.  Many of the symptoms you describe (fatige, loss of concentration, memory loss, loss of interest in activites) are all classic depressive symptoms.  Depression and anxiety also commonly cause physical symptoms too, such as pain, palpitations, along with many others.  You  may find that getting this under control will make a huge improvement in your feeling of overall wellbeing.  Generally, if one medication isn't doing anything to help after a month to six weeks, it is time to either increase the dose, or try another medication.  I would make sure you follow up with your doctor about this as needed, and really be agressive with getting successful treatment, because, like I say, many of your symptoms may totally resolve.  That being said, sometimes symptoms can be brushed off as being due to depression, so if something comes up that really concerns you, make sure that other things are ruled out.

Obviously, there are separate things that are going on that aren't related to depression or anxiety- like your cholesterol.  I agree that a trial of lifestyle modification is a good idea, because you are so young- you really don't want to end up on a lifetime of meds for this if you can make a few changes and avoid it.  The changes you have to make for this are changes that will really benefit your whole health anyway- the cholesterol may just give you the motivation you needed to watch your diet and get a regualr exercise routine.  With your family history of diabetes, you really need to take the bull by the horns with this- it's nothing to fool around with, and something that you have a lot of control over depending on he lifestyle choices you make.

I'm not sure about the sore on your stomach, and the foot pain- it's hard to know without examining you.  They don't really go together.  If they aren't resolving, or are getting worse, I'd them looked at.

Good luck- I hope that things turn around for you soon.

JMK MD
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