Still Sick years after returning from Africa

[uk1978]

Hi

In 1998 I visited Nigeria.  Two months after returning, i took a leave of absence from school due to the following syptoms:

--unrelenting fatigue
--nausea, loss of appetite
---low grade fever
----night sweats
-----chills
-----severe joint and muscle pain

At the time, i saw a few American doctors at my college who told me i was fine.   Since that time, my health has deteriorated.  Five years ago, i left my job due to intense recurrence of these symptoms that left me incapacitated.

I've seen a few docs, and some say i'm fine.  Others don't know what to say, and i feel i haven't received adequate care.  Is it possible i picked something up there?

I was born there, but left as a young child.   I've been so sick on and off since 1998, and i really want to get my life back.  Any ideas?

I haven't been able to see an infectious specialist yet because doctor's are resistant to refer me because they think it's nothing.

thank you

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Hello again,

Thanks for the additional information.

Of the many tests that you have had, are any of the tests abnormal in addition to the CMV and EBV?

Is your white blood cell count still low and what is it?

Is chronic fatigue the only medical diagnosis that medical providers have mentioned? Have medical providers mentioned "myofascial pain syndrome" or fibromyalgia?

What specific chemicals cause the "allergic reactions"? What symptoms do you experience when you have this "severe allergic reaction"?

Based on what you have shared with me, it is difficult for me to attribute your current symptoms to an illness that you may have acquired in Nigeria in 1998.

I would also encourage you to "stay positive", try to be as physically active as you can, and continue to have frequent contact with a medical provider who you trust and get along with.

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

[uk1978]

i forgot to also say that another major symptom is severe allergic like reaction to chemicals.  

[uk1978]

Thank you for your response Dr. Parks.  I'll try to answer your questions here.


Can you bring me up to speed on what testing that you have had and what your daily (or weekly) symptoms are at this time?

Rheumatoid Factor
ANA
STD Testing(incl HIV)
Vitamin b12
Complete Blood Count
Celiac Blood Test
Tropical Sprue Blood Test
EBV
CMV
HHV-6
Candida
Creatinine  Ur 24-hr
Creatinine Clearance
Complete Metab Panel

Upcoming Tests:
MRI
EEG(hospital stay)
Sleep Study

Daily Symptoms:
Tingling sensation in legs and arms
throbbing pain in legs and arms
nausea
loss of appetite
i wake up in pain and go to bed in pain
severe headaches
facial tingling and numbness(feeling of)
sensitive stomach(prone to soft stools and stomach pain)
severe insomnia( i've slept 3 nights during the month of march.)
severe night sweats
pain in legs and arms

What do you mean when you say that you have "been sick on and off since 1998"? Have you been hospitalized? Unable to work (and why)?

During the summer of 98 i visited Nigeria.  Two months later, i couldn't get out of bed due to severe fatigue, fevers, night sweats and many of the above symptoms.  At that time, i slept all the time and sleep came easily and frequently.  You could day i over slept.  I barely got through the semester and decided to  withdraw for the Spring 99 semester.  I spent the whole year feeling "ill."   At the time, i went to see a hematologist who expressed concern about my low white counts.   The following year i felt "better" and started school again, but i wasn't quite back to normal.  I started working out again(running) but had less stamina but i could attend classes and get through school.   In the summer of 2002, i started to go through the same symptoms again.  I had finished college and was teaching high school.  This time i experienced insomnia instead of sleeping all the time.  In the fall, i spent the month of September awake at night.  A year later(Oct 2003) i left my teaching position because i couldn't muster the energy to teach, and i the fact that i wasn't sleeping made things worse.

I haven't worked since then, and my health keeps getting worse.  I haven't slept much in the last 4 years.  A year ago, i went to the emergency room where they said i was having a seizure.  I've also ended up there with fevers, diarrhea and dehydration. I used to be a long distance runner, and can no longer do that or run a mile.I've spent the majority of my twenties being ill, and i'd like to figure out what's going on.

Do you have other chronic medical conditions? High blood pressure, diabetes, depression, anxiety, connective tissue disease, rheumatoid arthritis, etc.

As of now, i've been told many things.  Some doctors say they don't know and others say i have chronic fatigue, but they don't know why.  I'm unsure of what to make of it because i went to a CFS specialist who said that he didn't think i had cfs and wanted me to get an HIV test.  That test was negative.  This has been a challenging process because many doctors have told me to "think positive" and want to give me antidepressants without a diagnosis, and others don't want to give me certain tests.  It took years before i was given any autoimmune disease tests.

Have you had malaria or any other tropical disease/illness before?
No

Here are my questions:
1.  Is it possible that positive tests for CMV and EBV could be causing my problems?
2. Do you think there's any relationship between these symptoms and my trip to nigeria.  I'd feel different about the whole thing if i just fell sick one day and hadn't traveled back home.

I hope all this writing answers your questions.

thanks again!

[Philip D Parks, MD, MPH, MOccH, FACOEM]

Hello,

Can you bring me up to speed on what testing that you have had and what your daily (or weekly) symptoms are at this time?

What do you mean when you say that you have "been sick on and off since 1998"? Have you been hospitalized? Unable to work (and why)?

What kind of "incapacitation" are you referring to?

Do you have other chronic medical conditions? High blood pressure, diabetes, depression, anxiety, connective tissue disease, rheumatoid arthritis, etc.

Have you had malaria or any other tropical disease/illness before?

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

[sarikate]

Hi there,
Just a fellow traveler who returned from Africa a few years ago with a lot of "issues" myself...it might be helpful for the doctor here if you briefly review any kind of testing you've had done (blood work would probably be helpful) so he can see what has already been done.  I personally would push for a consult with an infectious disease or tropical medicine specialist at a major academic medical center, if you could...they might have more insight into some of this.  I know some of my doctors wouldn't touch my case with a 10-foot pole once they found out my travel history, just because they aren't uniquely trained to deal with the bizarre things we can pick up when we're on these journeys.  I wish you the best of luck, and I'm sure Dr. Parks will help point you in the right direction!