She wasn't so tired she couldn't ride the bike. The problem is she had trouble recovering. All the "obese" comments need to stop as they are just ignorant.
She wasn't so tired she couldn't ride the bike. The problem is she had trouble recovering. All the "obese" comments need to stop as they are just ignorant.
Try some research on tension myositis syndrome and Dr. Sarno (TMS). Nothing else has worked, so why not? Emotions can cause chemical reactions in the body that can cause real pain and suffering. And then the treatments don't work, which makes it even worse.
oh pleases wrote:
She wasn't so tired she couldn't ride the bike. The problem is she had trouble recovering. All the "obese" comments need to stop as they are just ignorant.
Yes, because when you look for medical diagnoses on a message board, it should be simple and straight forward.
A few observations:
Obviously the OP should not rely on online medical advice (likely mostly from non-physicians on a running board).
There is a saying in medicine that 90% of the time a doctor can diagnose the pt based only on the patient history and physical exam (actually the history is far more important). The history provided is only by the OP and from a doctor's standpoint is inadequate for a true intelligent medical discussion. Sitting across from someone and listening and observing goes a long way and cannot be underemphasized.
"Tests were negative." is also not adequate. There can sometimes be subtle clues in "normal" or near normal blood tests. We are not provided any true objective data.
The presumed doctors answering (one can tell by the response and style of the response that "doctor" probably is a doctor) are correct on several fronts - one that it is not a good idea to get medical advice on this forum except maybe for minor orthopedic running related injuries or for commiserating with others about more serious ones.
Now, judging from the limited history given - which btw was fragmented in the sense of "oh yeah, the wt gain was over 8 yrs" - - the pt's shortness of breath could easily be caused by wt gain and some component of aging and deconditioning.
The bone pain and exaggerated pain syndrome is unclear. Personally I think fibromyalgia is a garbage bag diagnosis given so pts have something to hang their hat on. I am not an expert in it. Generally treated with anti-depressants. It is probably a physical manifestation of depression much like irritable bowel syndrome may be.
Also, the pt's condition has been going on for 3-8 yrs (?). Thus, not likely a life threatening condition. Could it be Lyme? Sure.. CTD/Auto immune disease - maybe although I bet it has been tested for already. .
Most likely diagnosis - major depression, obesity... these are two diagnoses people often don't want to hear about or acknowledge. And again, if dissatisfied with current medical opinions of docs who actually saw the pt, you can always seek another.
My three cents with limited info...hope the pt gets better.
There are other tick-borne diseases besides Lyme's disease. My wife got ehrlichiosis, which is similar to Rocky Mountain Spotted Fever, but without the rash. It almost killed her.
Ehrlichiosis is so rare that doctors are unlikely to test for it, but there is a simple blood test that involves growing a culture. It takes about two weeks to get the results. Ehrlichiosis is resistant to some antibiotics, which could explain why there has been no relief to date, but it responds quickly to... (searching web)... doxycycline or tetracycline. My wife went from ICU to discharge in two days once they changed her antibiotic.
It's easy to get a small tick that attaches itself and then falls off in 24 hours without noticing it.
Since you're going to request some testing, ask doctors to include a test for ehrlichiosis and other tick-borne diseases, like Lymes and Rocky Mountain Spotted Fever.
I just did a search for the words ehrlichiosis prevalence California and found a high incidence in Northern California.
http://www.sciencedirect.com/science/article/pii/S0304401708005220
It's normally a dog disease, which makes sense because dogs are outdoors and around ticks a lot. Humans can definitely get it, too.
If the weight gain was over 8 years, it really does not seem like Lyme disease or anything of that sort. A low vitamin D isn't really anything and if all other tests were "normal" it really does seem more psychiatric in its sense and fits perfectly with major depression associated with fatigue.
When you have pain and think about it constantly or are stressed about it, the pain is made worse. This is probably causing things to worsen. Also deconditioning can make the recovery from exercise harder, it doesn't matter that she was OK doing the bike ride. And what does "could not recover" mean anyways? That she was sore and tired for a few days? That is to be expected.
When she was running and it was 8 years ago "portion control" was probably just fine to keep the weight off. Nearly 50 years old, simple portion control will not help to shed 70 pounds. Lifestyle changes related to food intake will. Chicken, egg whites, whole wheat, lots of fruits and veggies, less processed food, etc. Those are the things that make lasting changes along with portion control in those areas. A fad diet isn't the answer to drop the pounds quickly because it won't be sustainable (not saying that would have been her diet of choice anyways).
What does a typical day of food look like? Have her right in a journal everything she eats and drinks for a whole day and the calorie, fat, carbohydrate, and protein content for everything and you may be surprised at how much she is eating.
I highly doubt it is Lyme disease.
I had Lyme disease. I had a rash and no symptoms. Treatment made it go away with no complications. It is not a big deal.
Lymey wrote:
I highly doubt it is Lyme disease.
I had Lyme disease. I had a rash and no symptoms. Treatment made it go away with no complications. It is not a big deal.
Yeah, and yours was probably acute and never got the the chronic stage before it was diagnosed.
Nothing wrong with asking around a message board.
I was diagnosed with Eosinophilic esophagitis last year. Doc told me I'd be stuck with it for life, put me on steroids that I hated to keep it under control.
Got some second-hand advice on a message board that cleared it up within weeks (after months of suffering). Now trouble free. Surprise, surprise..
She doesnt think its depression. She was treated for that in her 20's. This is nothing like that.
The weight gain started post problems, not cause of problems. The fatigue she noticed after long runs (and now after bike/walk jogs) isnt that post long run fatigue we all know. Its days/weeks of exhausion accompanied by swollen glans and often fever.
We've kept food journals. 1500-2000 cal/day. For the past 2 months all the meat and chicken we eat comes from a local grass feed/free range farm. Resr mostly from Whole Foods.
We do eat out to often, but make healthy choices when we do. Lots of salad and veggies.
Doctor's appointment scheduled for next Monday.
A full check up by a doctor is best, but I would want to know a bit about menopause. Has she entered that stage of her life yet.
So we went to the primary care today and expressed the concerns and frustrations. We reviewed the previous test results:
- Connective Tissue Disorder - Negative
- Lupus - Negative ANA normal.
- Auto Immune Disorder - Negative
- RA - Negative
- Thyroid - nope
- Cancer - none that he is seeing
- Gluten: He didn't think enough stomach problems
- Chest Xray: nothing appears to be wrong.
- Mono - Took blood to do a differencial test
- Lymes - Took blood for test, but thinks pretty rare in Nor Cal.
He believes the Fibromyalgia is a disease of exclusion. He wants to see what the mono and Lymes Disease tests come back with and wants her to have a pelvic exam, breast exam.
Based on all of that, we'll go from there.
She should be checked for lymphoma due to swollen glands and fever. I'd have an MRI of her body done to visualize her lymph nodes, especially the swollen ones.
Doctor in the house? wrote:
We've been dealing with three years of crazy physical aliments. Most doctors giving her the run around. One says Fibromyalgia.
She is suffering from mal prescriptions, overdiagnosis, and excessive toxicity. The only cure is to get away from the doctors, cleanse her body of all the toxic medications, and regain her health.
The mono test might prove to be interesting. Mono is one of the diseases caused by the Epstein Barr Virus (EBV). EBV can manifest some of the symptoms she's having and there is a very wide range of reactions to the virus ranging from mild flu-like symptoms to Chronic Fatigue Syndrome. It can be chronic... lasting for years. I have Epstein Barr, but it didn't really bother me until after age 60. There are some alternative medicine treatments for EBV.
misdiagnosis abundance wrote:
Doctor in the house? wrote:We've been dealing with three years of crazy physical aliments. Most doctors giving her the run around. One says Fibromyalgia.
She is suffering from mal prescriptions, overdiagnosis, and excessive toxicity. The only cure is to get away from the doctors, cleanse her body of all the toxic medications, and regain her health.
Don't think that's it... We're only food shopping at Whole Foods and get meat/chicken from a farm that does grass feed, free range. She drinks little alcohol. One coffee a day.
Only meds are a sleeping pill based on the Fibromyalgia diagnosis and Vit. B pill.
I think we got the doctors attention today and perhaps he was thinking Lymphoma as well.
I googled "Lyme disease map" and one of the hits was a
map that shows the areas of reported Lyme disease in the US from the early 2000s to 2010.
While the vast majority of cases are in Minnesota, Wisconsin, and the NE coast, especially New Jersey and Connecticut, if you click each year from 2003 to 2010 you see a growth of Lyme disease in Northern California.
I know you don't want to be a jerk and start questioning the doctor when in his/her office, but c'mon, if a dumb running message board can ask some important questions, what is s/he doing?
too much waiting wrote:
I googled "Lyme disease map" and one of the hits was a
http://www.cdc.govmap that shows the areas of reported Lyme disease in the US from the early 2000s to 2010.
While the vast majority of cases are in Minnesota, Wisconsin, and the NE coast, especially New Jersey and Connecticut, if you click each year from 2003 to 2010 you see a growth of Lyme disease in Northern California.
I know you don't want to be a jerk and start questioning the doctor when in his/her office, but c'mon, if a dumb running message board can ask some important questions, what is s/he doing?
I actually did challenge him on that. We're way past the deferencial conversations. He considers that to be over diagnosed as well. But... he is checking for it. He seemed as stumped at this point as we are.
webby wrote:
Another vote for Lyme Disease. Not uncommon to get it without the rash. Here's a good recent paper on long-term symptoms by a former colleague of mine:
http://jama.ama-assn.org/content/283/5/609.full.pdfGood luck getting this figured out. Awful story.
So you throw me under the bus for chronic gloom and doom syndrome when it comes to Myalgic Encephalomyelitis (CFS), which has many organic biomarkers, neurological, immune and gastrointestinal dysfunction among them, but give a full diagnosis of Lyme? Nice. What a guy. You do realize that if you drew a Venn diagram, chronic Lyme and ME overlap big time because you're an expert?
OP, post-exertional malaise is a HALLMARK of ME/CFS. Patients are often misdiagnosed with pericarditis and eventually develop postural orthostatic hypotension, though generally not tachycardia. Diastolic dysfunction is very common in the illness, though cardiologists are only used to seeing it in the old and generally don't have the top-of-the-line echo equipment to diagnose it anyway. Intestinal disturbances are common, as are swollen/tender glands, pain, unremitting headaches of a new origin, etc. Have her doctor run IgG and IgA tests for EBV, CMV, and HHV6. Also a sed rate and a tilt table test.
If the antibody titers are elevated to any of the three viruses mentioned above and the sed. rate is low, dig deeper. They could do a short cytokine panel and look at IL-8 and IL-12. IL-8 tends to be elevated. Also check C4a and TGFb1 for excessive inflammation. Check NK, CD4, and CD8 status, as these can be depleted, and maybe get an MRI to check for lesions on the brain. While rather esoteric, α-N-acetylgalactosaminidase tends to be elevated in this illness, as well as cancer and HIV.
Good luck. I hope she doesn't have this. It sucks, but it's better to diagnose it early. By the way, shortly before I succumbed, I tripped while running on the sidewalk twice. I also felt like I had lead in my legs. That had never happened before in eight years of running. I had had mono in my early 20s that came back on me. Three years later, I had the "mono" that would never go away. It was very common in No. Cal and Nevada back in the mid-late 80s.