Monday, December 17, 2012

Chronic Redional Pain Syndrome and Neuroligical Symptoms

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I've had RSD/CRPS for> 2 years CRPS2, stage 3. It is in both legs from my hips to toes and 5 mos ago started with symptoms in one of my arms. Since then, I have had more symptoms in my head that I am wondering if they can be due to the RSD. They are- ear pain, dizziness - like vertigo.  I went to an ENT MD, but she wasn't very acquainted with RSD. I am very accustomed to my meds, this is not from them. She indicated that I would have to come off all my meds to find out what was going on. I can't come off them - not with my pain. I do have a spinal cord stimulator which helps,but not enough to come off my meds. Thoughts?

Gender: Female
How tall are you (feet and inches)?: 5 ft 8 "
What is your weight in pounds?: 145
How old are you?: 54
How long has this been going on?: More than a month

Check all symptoms you are currently experiencing:
Palpitations
Ear/ Nose / Throat
Musculoskeletal Pain
Neurological

What have you done so far to remedy this condition? Please include tests and relevant studies here. Saw ENT. Cannot have MRI.

Please list any chronic medical problems and also list any prior surgery : RSD / CRPS 2 (damaged rt.  peroneal nerve from a bad pre-surgical block.

Menieres dsease
C5-6 fusion
Rt great toe surgery
Pelvic thrombophlebitis

Check all conditions present in your immediate family... :
Cancer
Cardiac Disease
History of Back Pain
Please list any medication allergies that you have : : None

Please list any medications you are currently taking (and dosage if known) :: Gabapentin 600 tid
Ultram 100mg tid
Cymbalta60mg
Dyazide

When was your last menstrual cycle?: 4 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: Within the next few days

Just want to get information.

__________________________________________

Wow. This is a very complicated question.  I am going to say right off the bat that in terms of RSD I wouldn't say that there were any doctors 'very acquainted with it' in that we do not understand it. We have treatments for it and research is ongoing, but it's a puzzle to us for the most part. 

Your ENT doctor may be more aware of RSD than you think. The current consensus seems to be that RSD can occur at the site of a prior trauma or surgery. There is nothing to suggest that it can affect the brain and produce the symptoms you are describing. 

I notice you have Meniere's disease. This was my first thought when I saw your question... that you might have Meniere's.

I think what your ENT is doing, or wanting to do, is to see if your many medicines could be causing side effects. I agree with you that stopping them may not be wise, but if you go to this website here (click on link), and add your medicines, you will see that the interactions alone could be causing some of your symptoms. This is quite apart from the side effect profile of each individual medicine you are on,

Here are the some side effects for your medicines....

Ultram, dizziness or spinning sensation
Cymbalta, headache, trouble concentrating, memory problems, weakness, feeling unsteady, loss of coordination, fainting, seizure
Gabapentin, dizziness, drowsiness, weakness, tired feeling, nausea, diarrhea, constipation, blurred vision, headache

And that is a very partial list of all known side effects. 

So, in summary, I can not tie RSD into the symptoms you mention. I can tie it to your medicines. I can also tie it to your Meniere's disease. I think the best thing for you to do is to get your RSD physician talking to your ENT physician. Right now it seems they may be working at cross purposes. 

Other than that I suspect this is likely related to your Meniere's disease than anything. Even though you may not be able to comply with your ENT physician's request to stop your medicines, I would continue to work with the ENT to find a solution, yours is a very complicated case.

Saturday, November 10, 2012

Liver Enlargement?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

This morning, while lying flat on my back in bed, I noticed that if I press around the area of my my solar plexus I can feel something rather firm and shelf-like. It doesn't hurt but was a little tender to pressure. It seems to be my liver, but why would it be firm? I have been overindulging in alcohol for the last month or so (I know, I will stop) so could that be a cause? Should I worry? I was recently laid off and do not have health insurance so am reluctant to visit a physician right now... Thank you for any input. 

Gender: Male
How tall are you (feet and inches)?: 6 feet, 0 inches
What is your weight in pounds?: 225
How old are you?: 44
How long has this been going on?: A few days

Describe associated symptoms not listed above: Odd firm structure, maybe my liver, in upper abdomen. Easily palpated.

What have you done so far to remedy this condition? Please include tests and relevant studies here. Nothing

Please list any chronic medical problems and also list any prior surgery: Cholecystectmoy (laproscopic) two years ago

Check all conditions present in your immediate family... Diabetes
Please list any medication allergies that you have : : None
Please list any medications you are currently taking (and dosage if known) :: Metformin ER 1,000mg/day

Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Daily


Is the structure I feel my liver?
Is it abnormal for it to feel firm/hard?
Is it abnormal for the liver to be easily palpated?
-----------------------------------------------------------------------


Very hard to say what this is. If you have been a regular drinker for many years you may indeed be feeling your liver, as a long drinking history WILL cause liver enlargement, and, in many, Cirrhosis. 


I understand your reluctance to see a doctor because of money issues, but you really need to get an ultrasound of your liver. This will tell if it is enlarged and if you have cirrhosis. If you do, you MUST change your alcohol habit and now. 


If this is not your liver or cirrhosis then the alcohol is not so important, at least right now. But it is hard to imagine, from the way you describe this, that this would be something OTHER than your liver. 


An ultrasound is not expensive. It is the test you need, along with a good exam by a good physician. 


Good luck, and if you have further questions please ask them in the comments section.

Thursday, October 25, 2012

Irritating Cough

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Ask your medical question here. : Two years ago I had a bad cold that turned into a chronic cough.  Eventually, I was diagnosed with asthma by an urgent care clinic doctor.  I took my meds faithfully, but they never really helped.  A year later, I got very sick with chest pain and breathing problems.  The same clinic diagnosed me with pneumonia; however, after their review of my x-rays, they said I did not have pneumonia.
Later, my GP said I did not have asthma, so I stopped taking my meds.

I now take Allegra only, and only occasionally (I forget to take them).  I have constant phlegm in my throat, but the cough only occurs after I eat or drink, even water.  It occurs every single time I swallow something, and lasts about an hour. I do not have (or don't notice) mucus in my sinuses.  I would like to know if it is possible to have tests show what is causing this symptom, and how it can be controlled.
Gender: Female
How tall are you (feet and inches)?: 5' 5"
What is your weight in pounds?: 128
How old are you?: 51
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing: Ear/ Nose / Throat
What have you done so far to remedy this condition? Please include tests and relevant studies here.
: x-ray of lungs
Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): whole body peripheral neuropathy - idopathic
Check all conditions present in your immediate family... :
Cancer
Hypertension
Stroke
Please list any medication allergies that you have : : penicillin, sulfonamide, tetracycline
Please list any medications you are currently taking (and dosage if known) :: Allegra - 4 or 5 a week
When was your last menstrual cycle?: I no longer have a menstrual cycle
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Weekly
I would like to know if this could be caused by a new allergy to food, and if I should get food allergy studies, or if it is possible that my neuropathy is causing my esophagus problems.
May we send you a satisfaction survey after your question is answered? It takes a minut to fill out.: Yes


__________________________________________________________

Sorry for your problem. It strikes me that you probably need to see an Ear Nose and Throat specialist. This problem could well be related to chronic sinus inflammation. Allergies are often associated with this. The sinuses drain to the back of the throat so this problem often causes a chronic cough which can be mistaken for asthma, though I must say that diagnosing you with Asthma without proper testing seems a bit off to me. Also consider the possiblity that you could have GERD (reflux) which can also cause a chronic cough and is also sometimes mistaken for asthma. My money would be on the first based on your symptoms.

I hope this helps. Please click on the links above for more information. Ask any follow up questions you may have in the comment section.

Be well.

Mononucleosis, Abdominal Pain, and Chocolate

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For the past 5 months or so ive hard sharp pains in the solar plexus area. Occassionally this pain has traveled to my lower back. This pain always shows up while im asleep keeping me awake from 30 mins to an hour or two which consists of me trying to find a comfortable podition to lie in. Ive recently just gone away to college a month and a half ago and the pains have gone from once a month to once a week or once every two weeks.

5 months agoi was very physically active and did have slight back ains only when doing pushups.

Around 4 years ago i was hospitalized and diagnosed with mono. There was inflammation around my liver, my gallbladder, spleen and kidneys. I couldnt eat and had to work my way up from an all liquid diet. After getting released i was forbidden from doing exercise for at least 3 months and did not fully heal til at least 3 months after that.

The doctors said it would take 1 to 2 years for my body to fully recuperate and that i would carry the virus.

As of now my appetite is fine, the only thing bothering me being an itchy throat ive had for the past 4 months or so.
Ive been monitoring my diet and have seen that sometimes i may have worked out or eaten chocolate before sleeping.
My stomach has not reacted well with me eating chocolate since the mono sometimes causing stomach aches after eating it in the day.

And if its not too much to ask what could be causing this constant itchy throat?

My throat feels dry or itchy and it gets hard to try to cough. I try to always keep water near me to stop it. I end up coughing a couple of times. Hard enough that i end up tearing every time.
Gender: Female
How tall are you (feet and inches)?: 5'4
What is your weight in pounds?: 130
How old are you?: 20
How long has this been going on?: More than a month
Check all symptoms you are currently experiencing: Abdominal PainAbdominal Pain
Describe associated symptoms not listed above: Lower back pain
What have you done so far to remedy this condition? Watched my diet
I had thought that it was only when i ate chocolate before going to bed last two or three times but thats not the case this time. Ive also seen it may occur after working out.These are just guesses on my part.
Check all conditions present in your immediate family... :
Asthma / Lung Problems
Please list any medication allergies that you have : : None
Please list any medications you are currently taking (and dosage if known) :: None
When was your last menstrual cycle?: 3 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Never
Causes for pain
Any suggestion for treatment?

_____________________________________________________

Wow, these questions are very hard to answer without testing. My first thoughts are that you need a good pelvic exam by a qualified physician and that the most likely cause of your abdominal pain is going to be Gynecological. My money would be on ovarian cysts. These occur and reoccur.

Here is a helpful link for you.

This has, almost certainly, nothing to do with your recent bout with mononucleosis.

Getting to the bottom of female abdominal and lower back pain is complicated. I am simply giving you my best guesses. You definitely need a pelvic exam, and, based on that and other data, you might need an ultrasound or even a CT scan. An ultrasound would be optimal for finding ovarian cysts, a CT for most other problems in the abdomen. This does NOT sound like something bad lurking... It just doesn't sound that way.

You can certainly take Ibuprofen for this as long as you are not allergic. Tylenol would be my second choice until you get this properly diagnosed.

You may need to lay off chocolate for a bit if that seems to be a trigger. I would also suggest to you that your itchy throat may be due to allergies. It is the right season for them. Taking Loratadine over the counter might be a reasonable thing for you to try, but again, no substitute for having a doctor take a peek.

I hope this helps.


Friday, September 28, 2012

Bothersome Pelvic Pain

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I am a 69 year old very healthy woman - never had surgery.  I am post-menopausal for 15 - 18 years.  I take no hormones.  Have never had any post-menopausal bleeding.  I have been  celibate for the past 5 yr. About 2 weeks ago I noticed an uncomfortable, crampy feeling in my very low abdomen - like the menstrual cramps of years ago - and also low back discomfort.  No discharge or bleeding.  Bowels fine.  No stomach discomfort or nausea.  Eating normally.  I do not feel bloated.  My last Pap test was 2 yr. ago. What do you think?


Gender: Female
How tall are you (feet and inches)?: 5 ft 5 in.
What is your weight in pounds?: 169
How old are you?: 69
How long has this been going on?: A week or two

Check all symptoms you are currently experiencing:
Abdominal Pain

What have you done so far to remedy this condition? Please include tests and relevant studies here.

I have appt. with my GP tomorrow - plan to ask for referral to gynocologist.  I had my yearly physical 6 mo, ago and all labs were good.

Please list any chronic medical problems and also list any prior surgery  Hypertension (controlled)
Occasional atrial fib - none for 3 months (on med)
Check all conditions present in your immediate family... :
Asthma / Lung Problems
Cancer
Cardiac Disease
History of Back Pain
Hypertension
Stroke

Please list any medications you are currently taking (and dosage if known) Norvasc 5 mg qd
Amiodarone 100 mg qd
Prilosec 10 mg qd
Asa 61 mg qd

When was your last menstrual cycle?: I no longer have a menstrual cycle

Are you currently using or do you have a history of tobacco use?: No

Are you currently using or do you have a history of illegal drug use?: No

Please describe your alcohol consumption :: Weekly

I would like to know how I should proceed, after I see my GP tomorrow.  Should I request a CT, ultrasound, or MRI?

_____________________________________



Great question. The list of possible problems is great but abdominal pain such as you are experiencing and at your age needs to be taken seriously indeed. To get to you most important question at the bottom here, it's going to be your GP's call. But before you get to the CT v MRI v US it's time for another pelvic exam and pap smear. This may give your GP a good clue as to the best imaging test to order. As a rule the CT of the abdomen and pelvis is easy to get, quick, and very sensitive for most problems that occur in the abdomen up to and including various cancers. Deep breath, I am not suggesting this is the answer, I am merely pointing out that the CT is the best exam to get quickly to see everything between the diaphragms to the pelvic floor. An MRI is typically better for detail of soft tissue, but we are getting ahead of ourselves. An ultrasound is best to look at the ovaries and uterus but otherwise probably won't have much utility in your case. Expect your GP to do a pelvic exam and to check your stool for blood. Expect some labs to be drawn along with a urine sample. And then ask your doctor, who knows you well, what the top three things he is concerned about are. I will tell you that when you look at it this way, in terms of BAD diagnoses, that cancer does appear on the list. Cancer of the bowel, uterus, ovary, or bladder. But against these possibilities is the fact that these symptoms have been apparent for two weeks and happened rather acutely and seem to be accompanied by no other symptoms other than pain. Not a worrisome story for cancer, more likely pointing to a more benign cause. Constipation? Bladder infection? Hernia? I hope this has been helpful. Please feel free to comment or ask more questions below. Please check back in and let us know the result. God Bless.

Tuesday, September 25, 2012

Chest Pain? Palpitations? GI problem?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Ask your medical question here. : MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.
For the past year I have been having episodes of severe chest pressure that lasts 5-20 minutes it goes straight through between my shoulder blades. It leaves me feeling worn out for hours. It only occurs at rest, sometimes waking me from sleep. I have gone to the ER and had EKG, chest Xray, and stress test which all came back normal. I had 2 EKG's done in the ambulance during the pain and they both came back abnormal says possible inferior infarct of undetermined age. the ER staff acted like they were never made aware of this, even though I heard the EMT tell them twice. The pain is relieved with nitro, but I usually just ride it out med free. I have about 6-10 episodes a month now.  Should i see a cardiologist first or a gastroenterologist? My NP is clueless and not sure where to send me.
I have also recently starting getting these flip flop feelings in my chest. They are happening more often they take my breath away for a few seconds then they are gone.

Gender: Female
How tall are you (feet and inches)?: 5'9"
What is your weight in pounds?: 219
How old are you?: 34
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Chest Pain
What have you done so far to remedy this condition? Please include tests and relevant studies here.
Chest Xray, abdominal ultrasound, chest CT to rule out aneurysm, stress test, EKG, cardiac enzymes
Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): tubal ligation, gall bladder removal, tendon repair in foot

Check all conditions present in your immediate family... :
Cancer
Cardiac Disease
Diabetes
Hypertension
Stroke

Please list any medication allergies that you have : : none
Please list any medications you are currently taking (and dosage if known) :: lisinopril 5 mg
When was your last menstrual cycle?: 1 week ago
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely


Which type of doctor should I see first?
Can i go to a cardio and request an event monitor or a cath?
May we send you a satisfaction survey after your question is answered? It takes a minut to fill out.: Yes

_________________________________________________________________

GREAT QUESTION. I THINK YOU SHOULD SEE BOTH A CARDIOLOGIST AND A GASTROENTEROLOGIST. INSIDE THE CHEST WE DO NOT FEEL PAIN LIKE WE DO ON OUR SKIN. IN OTHER WORDS, PAIN FROM THE STOMACH OR ESOPHAGUS CAN BE EXPERIENCED AS CHEST PAIN, AND, PAIN FROM THE HEART CAN BE FELT IN THE ARMS, JAW, OR THE STOMACH. ALSO, NITROGLYCERIN RELIEVES PAIN FROM THE HEART AND ALSO, OFTEN, PAIN FROM THE GI TRACT. IF YOU WERE MY PATIENT I WOULD HAVE YOU ON A HOLTER OR EVENT MONITOR TO CAPTURE THESE PALPITATION EPISODES ON A COMPUTER DEVICE SO A DOCTOR CAN REVIEW IT AND SEE IF YOUR HEART RHYTHM IS CHANGING WHEN YOU HAVE THESE EPISODES. YOU ALSO NEED AN ECHOCARDIOGRAM (ULTRASOUND OF THE HEART) AND YOU NEED AN UPPER ENDOSCOPY BY A GI DOC. THE REASON YOU NEED THE ECHO IS TO SEE IF YOUR HEART AND IT'S VALVES ARE ALL NORMAL. IF YOU HAVE HAD AN OLD INFERIOR INFACT THIS WILL SHOW IT, THOUGH THE EKG IS NOT THE WAY WE DIGANOSE AN OLD INFARCT (HEART ATTACK). THE FACT YOU HAVE PASSED A STRESS TEST POINTS AWAY FROM YOUR HEART AS A CASUE BUT DOES NOT RULE IT OUT. ALSO, THE TYPE OF SYMPTOMS YOU DESCRIBE ALSO SUGGEST YOU MAY HAVE ESOPHAGEAL SPASM AND THIS IS WHY YOU NEED THE GI DOCTOR TO LOOK AT YOU AS WELL. I THINK WITH THESE SYMPTOMS I WOULD START WITH THE CARDIOLOGIST, AND, IT WOULD BE GOOD TO HAVE THE HOLTER OR EVENT MONITOR DATA BEFORE YOU GO AND SEE HIM. SECONDLY, I WOULD SEE THE GASTROENTEROLOGIST. I HOPE THIS HELPS!

BEST

DOC1

Tuesday, September 18, 2012

Pain Two Years after Motorcycle Accident

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Ask your medical question here. : I had a motorcycle accident 2 years ago (Aug 2010) Had broken neck. I now have two titanium rods in neck and 10 screws. Still having pain in neck and back. More severe the past 3 weeks. Hurts to take a deep breath and cough. I have been seeing a massage therapist for over a year. There is no sensation on dermis of skin area between the shoilder blades. Pain is more severe when turning body to left than right.

Gender: Male
How tall are you (feet and inches)?: 5-08
What is your weight in pounds?: 180
How old are you?: 62
How long has this been going on?: A few days
Check all symptoms you are currently experiencing:
Difficulty Breathing
Vomiting
Musculoskeletal Pain

What have you done so far to remedy this condition? Please include tests and relevant studies here.

Heat therapy and Stim. Aleve at night.

Check all conditions present in your immediate family... :
Cancer
History of Back Pain
Please list any medication allergies that you have : : CIPRO
Please list any medications you are currently taking (and dosage if known) :: Sertraline (100mg)
Flomax
When was your last menstrual cycle?: I'm a man, baby!
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely
HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible
Why is the pain still there after two years.

Low Potassium after Gastric Bypass

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I would like to know how fast my potassium level can drop below a 3.0? I had blood work done 2 Weeks ago and my NP sent me to see my Dr that did my gastric bypass and he told me to go back to my NP and have her deal with it. I'm so frustrated with the round about... I don't feel well and do not have an appetite. Body hurts and some times my chest. But I also get shortness of breath or feel like I'm dizzy when I bend over and come back up. I'm not sure if I should wait to make another app with my NP or go to the ER. I have read up on this issue and am now afraid. Please help... Thank u. Btw this was just found because I asked for blood work to be done since I did not feel well and it's beena long time since I had my blood work done I had gastric bypass 1 year and 9 months ago. But have been feeling bad for 3 to 4 months so asked for the blood work.

Gender: Female
How tall are you (feet and inches)?: 5.4
What is your weight in pounds?: 180
How old are you?: 32
How long has this been going on?: A week or two
Check all symptoms you are currently experiencing:
Difficulty Breathing
Chest Pain
Diarrhea
Nausea
Musculoskeletal Pain
Respiratory
Weight Loss

What have you done so far to remedy this condition? Please include tests and relevant studies here.
 I am on a prenatal vit (not pg) I take iorn, vit d, b12, b1 and potassium

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Had my gullbladder out had an instrumentation fusation of my L5 to S1 and gastric bypass also had a nerve cord stimulator implanted in my back. I have  spinolisosis,degenerative disc disease, bipolar 1, ptsd, anxiety, sleep issues ADD that's all I want to list

Check all conditions present in your immediate family... :
Asthma / Lung Problems
Cancer
Cardiac Disease
History of Back Pain
Psychiatric Disorders
Stroke

Please list any medication allergies that you have : : Penicillin, morphine
Please list any medications you are currently taking (and dosage if known) :: Saphris 10mg sublingual at night, xanax 2mg twice a day as needed, lunesta 3mg every night, vyvanse 40 mg once a day and aderall 15mg once a day and all the vitamins I listed above
When was your last menstrual cycle?: 4 weeks ago
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Never

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible
How fast potassium can drop. And should I wait to make yet another app with my Doc or go to ER

Sunday, September 16, 2012

Abdominal Pain? Back Pain?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.


Gender: Female
How tall are you (feet and inches)?: 5'6"
What is your weight in pounds?: 171
How old are you?: 65
How long has this been going on?: More than a year


Describe associated symptoms not listed above: Quite a few years ago I began to have a slight twinge in the area of my solar plexis.  Went through all kinds of tests by a gastroenterologist and finally it was chalked up to IBF.  It has gotten progressively worse but the next time I went back he came up come up with the same diagnosis because he couldn't find anything else.  But that was still quite a few years ago.  Now it's really pronounced and the twinge radiates down my legs and I can feel it in my ankles.  Some sort of nerve thing????  It happens at night in bed mostly.  Any idea what this might be?

Please include tests and relevant studies here. Endoscopy, colonoscopy, MRI (or catscan) of my abdomen.  Again all quite a few years ago.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Used to have chronic fatigue - but it has been under control for quite awhile.

Complete hysterectomy, hip replacement, carpel tunnel, many trigger fingers, orthoscopic knee ( 2 surgeries), stent for May Thurner syndrome in iliac vein.

Check all conditions present in your immediate family... : Stroke

Please list any medication allergies that you have : : MRI Contrast - hives

Please list any medications you are currently taking (and dosage if known) :: levothyroxine .088 mg 1/daily
imitrex 5mg as needed for migraine

When was your last menstrual cycle?: I no longer have a menstrual cycle
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible
 
I'd like to know what this is since it's getting progressively more intense.  Or what type of physician I should see and what to tell them.  When I try to describe it no one seems to have any idea what it might be and tests don't find anything.  But the feeling is like the fright/flight internal shock.
May we send you a satisfaction survey after your question is answered? It takes a minut to fill out.: Yes

Friday, August 10, 2012

Abdominal Complaints in a Healthy Young Male

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I am a 24 year old male smoker with a clean bill of health, no known allergies, and no family history of cancer or illness.

For last 6 months I have had general weakness and ongoing discomfort in my lower/middle left abdomen area: sometimes its enough to wake me up; I feel better after a bowel movement and or urination.


I also have...

-joint pain
-slight numbness in my left leg, left testicle and lower back.
-when I urinate I have a burning sensation on the tip of my penis that comes and goes
- when I push hard on certain area on my lower left abdomen I have a quick sharp pain that I can feel in my anus
- frequent loose stools
- frequent diarrhea
- I've also lost ten pounds recently but I have had a more active life style and I've been going to the gym

My GP can't seem to figure out what is wrong. I've already had...

-full blood and urine work
-an MRI of my spine
-a three day stool study
-an ultrasound of my left testicle and lower left abdomen

I forced them to schedule me for a colonoscopy next week..


Everyone tells me its just stress/anxiety but I just don't feel like myself anymore and I think something is wrong.

Can all of these symptoms be explained by something benign... ie gas, ibs, stress, pinched nerve, etc

All these tests are depleting my savings...

What should I do? Whats wrong with me? Are there any other tests you would recommend.


Gender: Male
How tall are you (feet and inches)?: 6'1''
What is your weight in pounds?: 172
How old are you?: 24
How long has this been going on?: More than a month

Check all symptoms you are currently experiencing:
Abdominal Pain
Palpitations
Diarrhea
Musculoskeletal Pain

Please list any medication allergies that you have : : none

When was your last menstrual cycle?: I'm a man, baby!
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Daily

Can all of these symptoms be explained by something benign... ie gas, ibs, stress, pinched nerve, etc?

what should I do?
______________________________________________________
 
Wow, tough one. First of all, when you get your colonoscopy, which I'm glad you are getting. Ask the GI physician if he would recommend anything further. The one miss that I see is that you have not had a CT of your abdomen and pelvis, but, honestly, your symptoms wouldn't prompt me to order that test right away. Certainly this could be something benign and it most probably is. The worrisome symptoms you mention is the abdominal pain which is produced with pressure on your left lower quadrant of your abdomen. Make sure the GI doc knows about this. So far I think your GP has done a great job ruling out the bad things that can happen to a 24 year old who is otherwise healthy. Testicular cancer, lower spine issues like nerve impingement from a mass or tumor, and there's other things, no doubt that have been ruled out. I do wonder if stool studies have been sent, not just looking for blood, but looking for infection like Giardia Lamblia... a pretty common parasitic infection of the colon that is picked up by drinking stream or creek or lake water in many parts of the US. Make sure to ask the GI doc about this as well. I think you are being well taken care of. I know this is late in coming, so please do write and tell us what is going on. You can do this in the comment section. Thank you for the question and sorry for the delay.

Wednesday, July 25, 2012

Supraventricular Tachycardia

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.
Seriously.. please take me seriously!

For over ten years I have had 'attacks' of SVT. Throughout my childhood and teen years, I would experience periods of arrhythmia, had pneumonia several times and was often sickly. No one ever took me seriously about my heart. I'm now 29 and my SVT lasts about 3 hours at 250-300 bmp. I have been informed that I am "Too young..." and a hypochondriac.


An episode was at last caught on an EKG after ten years of being dismissed. AV Nodal re entrant SVT.


More tests ensued, MRI, MRA, Echo, Doppler. Told I have a common carotid malformation, no neck rubbing. Shipped out of the ED with a rx for Metroprolol and no idea what to do. I just stated a new job, in a new area. No benefits until October. More than slightly worried.


History of illegal drug use in teen years. Cocaine overdose at 17. No drug abuse since.
Gender: Female
How tall are you (feet and inches)?: 5'6"
What is your weight in pounds?: 180
How old are you?: 29
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Bruising or Bleeding
Describe associated symptoms not listed above: Bruise ridiculously easy. Iron and potassium always deficient on blood work.
What have you done so far to remedy this condition? Please include tests and relevant studies here.

I have not begun the beta blocker. I take fluxetine and xanax for severe anxiety and read there could be an interaction.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Anxiety, ADHD, Psoriatic Arthritis, Migraines
Two C-Sections
Cholecystectomy

Check all conditions present in your immediate family... :
Asthma / Lung Problems
Cancer
History of Back Pain
Please list any medication allergies that you have : : Latex

Please list any medications you are currently taking (and dosage if known) :: fluxetine 60mg po in a.m.
Xanax 1mg - 5x a day
When was your last menstrual cycle?: 2 weeks ago
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: Yes
Please describe your alcohol consumption :: Rarely

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible

This is something that has been getting more severe over time.  Can it wait a few more months?
__________________________________________


I'm confused by your question ma'am. It seems that you have problems with anxiety that can mimick an attack of SVT, but now you have an EKG which proves that you do have it. 

From the ER you would have been advised to seek the care of a cardiologist. In particular, you need to see an electrophysiologist. They can, usually, cure, permanently, your SVT with something called a 'cardiac ablation procedure'.

I have no idea what to make of the comments that you are 'too young' and 'a hypochondriac'. 

As to the metoprolol I do not understand why you are not taking it. The interaction is that while being on the other medicine you are on the dose you need may be lower than that for most, but metoprolol can prevent the episodes of SVT. Smoking, of course, is a risk factor for heart attack and you should stop.

It is time, now, to call and make an appointment with a cardiologist. While your SVT is likely okay to follow over time, a one time capture of the rhythm in the ER is lucky, but is also crying out for expert intervention at this time, namely that of a cardiologist. And one very important thing, when you go see the cardiologist, take a copy of the EKG. Scan it, make ten copies, don't ever lose that EKG... it is very important indeed.

That is where you should turn. Can you wait? Sure, Will anything bad happen? Probably not, especially if you take your metoprolol, but you absolutely need a physician to supervise your medicines and get to the bottom of this. The ER is the worst possible place to go in a case like yours, because while SVT is something we see routinely, we can not fix it. And now that we know what you have it's time to get to the doctor that can fix it.

Friday, July 20, 2012

Chronic Abdominal Pain

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

My wife has been suffering from pain in the solar plexus and accompanying pain to the center right on the her back.  All treatment and medication has not achieved any relief.  This all started with a glad bladder removal and maybe other procedures to find the cause. Dr's have prescribed medication which only has temporary relief.  She had had CT scans, X-rays, endoscopy and more.  Most all test come back negative, but pain is daily and persist even through medication.  We now have Tylenol 3 codine and Celebrex, still minimal relief.


Any type of prolonged Sitting and wearing a bra's cause daily discomfort.

What should be our next course of action?
What / who should we see next?
Any help or direction would be appreciated.

Gender: Female
How tall are you (feet and inches)?: 5' 6"
What is your weight in pounds?: 155
How old are you?: 46
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Abdominal Pain
Chest Pain
Musculoskeletal Pain
Weight Loss
Please list any chronic medical problems and also list any prior surgery : None
Please list any medication allergies that you have : : None
Please list any medications you are currently taking (and dosage if known) :: Tylenol 3 codine
Celebrex
Diovan
When was your last menstrual cycle?: 3 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely

What should we do nextWhat type of Dr should we go see
_______________________________________________

This is a really hard question for an online discussion. It is possible that your wife has a post cholecystectomy syndrome. This is a very difficult diagnosis and somewhat controversial. She needs to be seen by a very good GI doc and her surgeon should also know that she is having these problems. The thing is, it seems from what you are saying that she has had a VERY thorough workup since this started. The problem here is that her pain is so suggestive of pain originating in the area of the gall bladder that it's hard to think of another cause, especially with the tests she has had and the results obtained. I wish I had a 'magic bullet' solution for you but I simply do not. You said the tests have been 'mostly normal'... can you tell me what tests have not been normal? Please respond in the comment section.

Wednesday, July 18, 2012

Hypokalemia of Unclear Cause

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I am a 32 year old female and have never had a problem with my potassium until the last three months. I was put in the hospital once because my potassium was 2.3, I got potassium by iv and it was painful! They sent me home taking 80 MEQ a day then when my blood work came back normal they told me I didn't have to take the potassium anymore

Then a month and a half later my legs started hurting really bad so I went to have blood work in the morning and the doctor called that evening and told me to go to the er because my potassium was 2.3 again. When I got there the doctor told me he though they made a mistake because he didn't think it could be that low so he checked my blood again and it had already dropped down to 1.6 So they admitted me and three bags of potassium and  A LOT of potassium pills later they finally got it up to 3.1 The doctor in the hospital said that I was losing blood (my count was going down) but couldn't find a reason for it other than a mild anemia. My co2 levels are also so low they said it was dangerous for me to go home with them that low.


I was told to go to my doctor every other day for blood work but I never could get any answers from the doctor on how to treat it so that I am not in the hospital every other month not to mention the pain in my legs when it gets so low I can barely walk.

Gender: Female
How tall are you (feet and inches)?: 5'6
What is your weight in pounds?: 175
How old are you?: 32
How long has this been going on?: More than a month
Check all symptoms you are currently experiencing:
Difficulty Breathing
Describe associated symptoms not listed above: Major leg pain, hurts so bad I can barely walk
What have you done so far to remedy this condition? Please include tests and relevant studies here.
: So far all that has been done is treating me in the hospital with potassium by iv and a lot of potassium pills. This last visit they added a daily vitamin. Once my potassium goes up they take me off the potassium.
I had blood work where my co2 and potassium were extremely low.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): As far as medical problems I have only really been sick once about 3 years ago. I got up with a sore back and the next day I had to call 911 because I couldn't walk. I had meningitis, endocarditis, and internal MRSA. As I was being treated for those my blood stopped producing hemoglobins so they had to give me a blood transfusion. I was in the hospital for a little over a month and had a PICC line to keep taking medicine for another two months after I got out of the hospital.

Check all conditions present in your immediate family... : none
Please list any medication allergies that you have : : none
Please list any medications you are currently taking (and dosage if known) :: potassium 30 MEQ, daily vitamin
When was your last menstrual cycle?: 4 weeks ago
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally

I want to know what is wrong with me and why would it come on suddenly?
Is the medicine I am what i need to get my body on the right track or do I need to look for another doctor?
_____________________________________________

Ma'am, you have a complex medical problem. You have had diseases and conditions that would have killed most people. It is possible that after your bacterial endocarditis that your kidneys are permanently damaged. As to why you can't keep your postassium levels up, if your current doctor can not tell you, then you need to see a nephrologist. 


To be frank, you have a life threatening condition that has not been fully explained, or, if it has, it has not been fully explained to you. Please do contact or see a Nephrologist (kidney specialist) as soon as possible and do not hesitate to go to the ER if you have worsening symptoms. 

To summarize from the above link....

"

Causes

Low potassium (hypokalemia) has many causes. The most common cause of low potassium is excessive potassium loss in urine or from the digestive tract. Only rarely is low potassium due to not getting enough potassium in your diet.
The most common cause of excessive potassium loss is the use of prescription diuretics — water or fluid pills. Causes of potassium loss leading to low potassium include:

When to see a doctor

In most cases, low potassium is more commonly found by a blood test, before it gets so low that it causes symptoms.
Low potassium symptoms may include:
  • Weakness
  • Fatigue
  • Muscle cramps
  • Constipation
Abnormal heart rhythms (arrhythmias) are the most worrisome complication of very low potassium levels, particularly in patients with underlying heart disease.
Talk to your doctor about what your results mean. You may need to change a medication that's affecting your potassium level, or you may need to treat another medical condition that's causing your low potassium level. Treatment of low potassium is directed at the underlying cause and may include potassium supplements. Don't start taking potassium supplements without talking to your doctor first. 
"

Causes

Low potassium (hypokalemia) has many causes. The most common cause of low potassium is excessive potassium loss in urine or from the digestive tract. Only rarely is low potassium due to not getting enough potassium in your diet.
The most common cause of excessive potassium loss is the use of prescription diuretics — water or fluid pills. Causes of potassium loss leading to low potassium include:

When to see a doctor

In most cases, low potassium is more commonly found by a blood test, before it gets so low that it causes symptoms.
Low potassium symptoms may include:
  • Weakness
  • Fatigue
  • Muscle cramps
  • Constipation
Abnormal heart rhythms (arrhythmias) are the most worrisome complication of very low potassium levels, particularly in patients with underlying heart disease.
Talk to your doctor about what your results mean. You may need to change a medication that's affecting your potassium level, or you may need to treat another medical condition that's causing your low potassium level. Treatment of low potassium is directed at the underlying cause and may include potassium supplements. Don't start taking potassium supplements without talking to your doctor first. "

If you have questions please ask them in the comment section.

Monday, July 9, 2012

Chronic Abdominal Pain

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I am having a continued dull pain at my solar plexus area. It is also somewhat tender or is a little painful when i press this area. I do not know if my breathing i related to this but sometimes it seems i can not draw a satisfying deep breath. This started to be a constant dull pain just a few weeks ago. I was hoping that it would simply go away but it has not.  Is there any suggestions about this?

Gender: Male
How tall are you (feet and inches)?: 5' 8.5"
What is your weight in pounds?: 194
How old are you?: 65
How long has this been going on?: A week or two
Check all symptoms you are currently experiencing:
Difficulty Breathing
Chest Pain
Palpitations
Respiratory

What have you done so far to remedy this condition?
 I have just taken pain relievers ( otc ) for the pain.

Please list any chronic medical problems and also list any prior surgery: In 2004 i had two stints put in after a heart attack.

Please list any medication allergies that you have : : none that i know of
Please list any medications you are currently taking (and dosage if known) :: sotolol 80mg twice daily
lisinopril 20mg once a day
asprin once a day
When was your last menstrual cycle?: Now
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Never

Top three questions?
The pain, the cause, the seriousness. The reason for the tenderness when i press there, the shortness of breath
______________________________________

Sir, 
I hate to tell you this but with your age and your prior heart problems this could be anything from a simple stomach irritation or ulcer to an aortic aneurysm in your abdomen. The first is of little concern except for the pain it is causing you, but an abdominal aneurysm if not diagnosed can rupture and kill you. There is simply no other option for you but to see your doctor and get an exam and some tests run. You might try some over the counter antacids to see if that helps, but even if it does this does nothing to tell us that we have solved the riddle. Abdominal pain complaints are very difficult to figure out in general and that is why, if you go tot he ER with a complaint of abdominal pain, you are very likely to get a CT Scan.... there are simply to many possible causes, some dangerous, to make a diagnosis based on story alone, and even story and exam is rarely enough to make a diagnosis. I am sorry but you need to get with your doctor as soon as possible. Today would be best. If you do not have a doctor then you will need to go to the ER. I hope you get better soon and please do tell us what this ends up being, but this needs professional evaluation as soon as possible.

Saturday, June 30, 2012

Recurent Solar Plexus pain

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I have a recurring solar plexus pain right, almost like I received a punch in the solar plexus. I have tried to be aware of what I eat or if I'm particularly stressed, but have found no pattern yet. The pain usually lasts for a few minutes, growing in intensity, until if quickly wears off and completely disappears. Sometimes it lasts longer though, up to an hour or two. I have stones in my gall bladder, but don't know if that is in any way related to this pain. What should I do?

Gender: Male
How tall are you (feet and inches)?: 6 feet 2.5 inches
What is your weight in pounds?: 243 pounds
How old are you?: 36
How long has this been going on?: More than a month

Check all symptoms you are currently experiencing:
Abdominal Pain

Check all conditions present in your immediate family... :
Cardiac Disease

Please list any medication allergies that you have : : None
When was your last menstrual cycle?: I'm a man, baby!
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally


What can cause the pain?
Should I be alarmed?
How can it be treated?
___________________________________________

The most obvious answer is that this IS related to your stones in the gall bladder. Curious that you know this, as I wouldn't think to actually look for gallstones unless someone came to see me with a good history and exam for gall bladder pain. My point is that some doctor in the recent past was concerned about your gall bladder and got an ultrasound and found the stoned. Could it be something else? Sure, just not likely, especially at your age. Hard to think of another cause which would produce similar symptoms. Generally, once stones are discovered people are scheduled for a cholecystectomy... a gall bladder removal. My suggestion is that you get with a surgeon and get an opinion on whether your pain is from your gall bladder and, if so, when you can get it removed. The danger of ignoring this is that you could develop CHOLECYTITIS, an infection of the gall bladder, and this is a true medical emergency requiring emergency surgery. Best to get the gall bladder out on an elective basis. It's a much easier and safer surgery.

If you have questions please ask them in the comment section.

Be well.

MDSTAT ER Doc 1


Monday, June 25, 2012

Recurrent Abdominal Pain (absent gall bladder)

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

I have been having horrible pain 4-5 inches above my belly button midline of my abdomen.  The pain is always an achey pain, but then I get attacks of horrible pain that are severe and are similar to previous gallbladder attacks that I had when I had my gallstones years ago. I  had my gallbladder removed in 1995. The pain starts suddenly and intense and lasts from 4 or more hours. The severe pain goes through to my back and up into my chest to the point where I can't take a deep breath because of the pain. I feel like my heart is fast. I have had nausea and occasional vomiting during this time.

I also have been having some floating stools that don't hold their form and are grainy and fat floating in toilet. No light colored stools though. No fevers which I usually don't run a fever due to my hypothyroidism.  I feel full after small amounts of food and the severe attacks usually occur after eating. The first attack occurred while in a restaurant.   I felt immediate abdominal pain, nausea, became very hot and my face appeared flush.  I felt like I was going to die.

I didn't say anything to my husband but he asked me if I was ok and I told him how I was feeling.  I felt better the next day, but it happened again the next month so I went to the ER.  I had another severe attack while there and they admitted me.

They ruled out a heart attack and all other serious problems. I take 24 hour prevacid for stomach pain, levothyroxine, prednisone 10mg a day for back pain (have been taking this for 6 months), hydrocodone 10/660 3x a day prn for back pain, soma 4x a day prn for back pain.   I have had bloodwork, CT scans, and ultrasounds. One of my previous scans showed a dilated bile duct and mild fatty liver.  I have only drank 10 alcoholic beverage in my life and I don' t drink or do drugs. I am scheduled for an ultrasound on Monday to try to find out why I hurt so bad.  Any help would be greatly appreciated!  Thanks!

Gender: Female
How tall are you (feet and inches)?: 5'7"
What is your weight in pounds?: 250lbs
How old are you?: 40
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Vomiting
Nausea
Describe associated symptoms not listed above:  Pain radiating into chest and back. Floating Stools not formed with floating fat. So painful that I can't take a deep breath. Fast heart rate. The pain is a achey pain with  some throbbing pain also. When the severe attacks start it is a severe ache that doesn't let up. I  get full after eating small amounts of food. The severe attacks usually occur after eating.

What have you done so far to remedy this condition? Please include tests and relevant studies here.
I have had CT scans, ultrasound and bloodwork. I will have another ultrasound on monday. One test showed dilated bile duct and fatty liver.
Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): medical problems: hypothyroidism, possible gastritis or ulcer, previous tracheal stenosis of unknown cause, and Degenerative disc disease and arthritis.

Surgeries: Tubal ligation, gallbladder removal, tracheal resection/anastomosis surgery.

Check all conditions present in your immediate family... :
Cardiac Disease
Hypertension
Please list any medication allergies that you have : : N/A

Please list any medications you are currently taking (and dosage if known) :: Levothyroxine 137mcg 1x a day
24 hour prevacid 1x a day
Soma 350mg 4 x a day as needed
hydrocodone 10/ 660 3 x a day as needed
Prednisone 10mg 1x a day
When was your last menstrual cycle?: 3 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible

What conditions could cause the symptoms that I am experiencing?
Could it be pancreatitis?
Can gallstones form after gallbladder has been removed?

__________________________________________

Well, you certainly are having a rough go of it. I am only now able to post your question after a couple of days on the road. Your ultrasound was today. I hope it is diagnostic. This is unlikely to have anything to do with your gall bladder unless you have a reatained ductal stone, and the only way to find that is with a procedure called ERCP (an upper endoscopy).

You are young for intestinal ischemia.... pain in the abdomen due to lack of blood flow to the abdominal organs, usually triggered by eating, though it should be on the list. 

The striking thing to me is the pain's relation to eating.

A couple of things you said triggered something though, and I do not wish to scare you, but there is a rare condition called 'Cardinoid Syndrome' that is associated with some cancers and a rare tumor of the GI tract (intestines). If everyone is drawing a blank you might suggest this. 


Given its rarity I wouldn't mention it at all as it will, no doubt, make you worry, but it does seem that your doctors are trying to knock out all the usual suspects and simply haven't solved this one yet. I would mention this at your next appointment and see if they have already checked for it (they probably have). 



Monday, June 18, 2012

Biliary Colic?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.


Hello,
I would truly appreciate your help. I have had persistent throbbing pain at a point specifically between the umbilicus and xiphoid process. The frequency of pain began as once every 6 months, and over the course of two years has increased in frequency to once or twice a week. When the pain comes on, it always starts in the evening and lasts for 3 to 5 hours (it's important to note that it comes on while I am sitting up or standing - in other words, not when I'm lying down). Last month I adopted a vegetable + fruit + dairy diet, but then eating wheat bread triggered it. I believe the density of certain foods can trigger it, as may sugary foods (such as apple pie). I have been able to eat creamy foods and not feel pain. I began blending fruits and vegetables and this helped. Sometimes I also have an achy anterio-lateral right sided pain (like at the far edge of my body), which is where my liver is (wouldn't gallbladder pain be between the midline and lateral side?). I was a veg etarian (but ate salmon and shrimp) between the ages 14 and 32. At 32 I began to eat poultry. I'm 39 now.

I had an ultrasound done that showed 7 gallstones. I had an endoscopic exam of the esophagus, stomach, and intestines that came back negative for h.pylori, gluten intolerance, but positive for mild acid reflux on the esophagus. I had a functional CT scan of my upper and lower abdominal quadrants that was negative (stones could not be seen on this scan - I was told because they were not calcified). EKG was negative. Liver enzymes were normal.

Last night I had an attack after eating a piece of pie, and felt feverish, throbbing pain, and vomited for a few hours (did not vomit bile - only pie). I've only had vomiting with the pain once before. Usually I do not feel feverish or vomit with the pain. Thanks so much!!!

Gender: Female
How tall are you (feet and inches)?: 5 foot 6 inches
What is your weight in pounds?: 120
How old are you?: 39
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing: Abdominal Pain
Please list any medication allergies that you have : : None.
When was your last menstrual cycle?: Now
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible

Top three questions...
1. Could this throbbing pain be my pancreas?
2. Could the achy pain be my liver?
3. What could be wrong? What tests would you recommend for a differential diagnosis?

The doctors suggested I have my gall-bladder removed, but I've read that sometimes it's not the gall-bladder. I don't want to have something removed and then still have pain and now even more issues (like having to take digestive enzymes for the remainder of my life).

________________________________________________-

Okay, a quick answer from me. This is, in all likelihood, your gall bladder. It is not your pancreas, as pancreatitis is typically of acute onset and not recurrent with meals. It is true that pancreatitis can be caused by gallstones, but the way you describe your pain and with the testing that has been done you most certainly have BILIARY COLIC. If you click on the blue lettered link you will be taken to a pretty thorough explanation of why you almost certainly have pain from your gall bladder. 

You gall bladder sits with in the liver which is on the right side of your abdomen and just under the ribs. The fact that you have had attacks that now seem to be associated with meals makes this more certain. 

And as to what you have heard about problems after gall bladder removal I am amazed at all the bad information that is out there. The fact is that with the ability to remove the gall bladder laparascopically (without an open incision) that the recovery time and the results of ROUTINE gall bladder surgery today are almost always excellent.

There does seem to be, in a small number of patients, problems with post gall balder pain. Mostly these patients have small stones retained in the bile ducts and a simple endoscopic procedure fixes this problem. In an even smaller group of patients some persistent symptoms of gall bladder pain can occur for months after the procedure. 

However, consider this, since we know you have stones in your gall bladder you would be well advised to have removed at a time of your choosing for two main reasons.....

1. your pain attacks will keep happening and become more frequent and you will find yourself in the ER eventually, and maybe many times. A few ER visits and you have already spent more money than you would in an elective surgery. 

and 

2. If you keep waiting the chances of your gall bladder becoming infected become higher and higher, and when this happens 'acute cholecystitis' it is called, the surgery no longer is elective, it is an emergency surgery and it is life saving surgery. In this way the gall bladder with stones is much like the appendix. In short, you run a much greater health risk by waiting than by having this done as soon as you can and on an elective baasis. 

So, in summary, I would bring your concerns to your surgeon and ask about post-cholecystectomy syndrome and how frequent it is. Your concerns are valid, your surgeon will answer your questions and will be happy to hear them. If he is not then you may have the wrong surgeon.

Please feel free to ask questions in the comment section below. Good luck and thanks for your question.

Monday, June 11, 2012

Achilles Rupture?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.
MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.
Gender: Female
How tall are you (feet and inches)?: 64
What is your weight in pounds?: 160
How old are you?: 75
How long has this been going on?: A few days
Check all symptoms you are currently experiencing:
None of these

Describe associated symptoms not listed above: Left ankle and lower leg swelling. Had successful Achilles surgery in 1991. Experiencing pain in the Achilles area and there is a knot the size of a larger pea in the lower Achilles area.

What have you done so far to remedy this condition? Please include tests and relevant studies here.
: Raised leg and iced.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): Achilles surgery 1991
Check all conditions present in your immediate family... :
None of these
Please list any medication allergies that you have : : n/a
Please list any medications you are currently taking (and dosage if known) :: n/a
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely
HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible
Chances of re-rupture?
_______________________________
Obviously this diagnosis is one that can only be made by a physician doing a good exam, and this will likely require an MRI. However, there is a simple test you can do at home to assess the integrity of the Achilles tendon. It is usually called the "Thompson test". Simply lie on your stomach and have a friend or family member gently squeeze your calf muscle. If your foot moves, then you have not ruptured your Achilles tendon. If it doesn't not move, like in this video, then there is likely a rupture. Please see your doctor asap to have this properly evaluated.

Friday, June 1, 2012

Sciatica?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.

Gender: Female
How tall are you (feet and inches)?: 5'6
What is your weight in pounds?: 155lbs
How old are you?: 31

How long has this been going on?: More than a month
Check all symptoms you are currently experiencing:
Abdominal Pain
Diarrhea
Bruising or Bleeding


What have you done so far to remedy this condition? Please include tests and relevant studies here. i have been to the hospital and they have said it could possibly be sciatic nerve pain or restless leg syndrome. so far i try to stretch but it hurts more. it hurts when i walk and when i use the restroom.i had have couple surgeries that might cause some symptoms like a partial bowell removel, gall bladder removel,appendix removel.and also i am fixed from having kids so i had a tubal.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): i have anxiety and depression and a little bit of arthritis in my lower back.  i have had a partial bowell removel,appendix removel, gallbladder removel.

Check all conditions present in your immediate family... :
History of Back Pain
Stroke
Please list any medication allergies that you have : : n/a

Please list any medications you are currently taking (and dosage if known) :: gabinpentin, klonapin, prozac,
loxapine

When was your last menstrual cycle?: 2 weeks ago
Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible

what should i do? i have no insurance and no income just got out of a 8 year marriage have 3 kids. been to hospital last week and they gave me a muscle relaxer shot and a steriod shot in butt cheeks.  should i return to the same hospital with the paperwork they gave me and tell them the problems im having again and that no doctors will see me? whats ur opinion on what i might have wrong with my legs.
 
_______________________________________
 
I think we may be missing your main question here.... it did not come through in the form. Can you clarify the question or be more specific in the comment section? To start with, the WORST place for you to get a chronic, non-emergency condition diagnosed and treated is the hospital. The ER is set up for emergencies. If you do not have one they will send you on your way with instructions to follow up with your doctor. If you do not have a doctor this IS a problem as, and again, I think your main question is not asked above, but it sounds very much like you need to be evaluated for low back pain, possibly a herniated disk. An orthopedic surgeon or a good Family Practice doctor is a good place to start. We are standing by for clarification or restatement of your question.

Monday, May 21, 2012

Near Syncope?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Hello Docs

I am a female, 16 years old, 5"3, and 112lbs. I exercise often, and I am in good health.


I believe I have episodes of orthostatic hypotension. When I stand up, I sometimes get very lightheaded-more of a headrush, really. My vision fades to black, and I lose my sense of balance/control of my body, and often have to grip onto things or sit down to prevent falling. In more severe "episodes," I can feel my heartbeat in my head, chest and neck, I have slight chest pressure (but not pain), and I have slight difficulty breathing for a short amount of time. Ocassionaly I have a slight numb-feeling in my head and fingertips. Metaphorically, it feels like somoeone has turned off my "power button," waited a few seconds, then turned it back on. I feel fine after the episodes, but during the episodes it can feel like I'm going to pass out, and it's not pleasant.


I have had numerous near-syncope episodes, but those only happen maybe 2-4 times a week. Regular episodes occur around 2-3 times a day, and usually after long periods of time sitting or lying down and then standing up. I have fainted, but only 2 or 3 times. Once, more than a year ago in the morning, and again a few months ago. The second time I fainted, I hit the back of my head on my mom's metal exercise bike. There were no problems due to the injury, other than a bump on the back of my head that was painful to touch. And I might have fainted a third time about a month ago, but I'm not positive if I actually lost conciousness or not.


My question is this: Do you think it's necessary to see doctor? I personally would like to, but my problem is my mom. My mom doesn't want me to "label" myself with a problem and make things like getting a driver's liscence more difficult if the doctors can't even do anything about it (which based on internet research, they can't). So, should I urge my mom to take me to the doctor's? Do you personally think my symptoms are serious?


With Thankful Regards,

Emily


Gender: Female
How tall are you (feet and inches)?: 5ft3
What is your weight in pounds?: 112lbs
How old are you?: 16
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing: None of these

Describe associated symptoms not listed above: I am not CURRENTLY experiencing any of these symptoms, but lightheadedness, vision that fades to black, chest pressure (but not pain), slight difficulty breathing for a few moments (like a catch in my breath), and loss of balance occur in my "episodes," when I sometimes stand up from sitting or lying down after a period of time, and lasts from 15-30 seconds. The episodes have gotten more frequent and slightly more severe in the last few weeks.

What have you done so far to remedy this condition? Please include tests and relevant studies here.

I haven't been to a doctor about this specific problem. But when I went to an urgent care for a sinus problem (which is now gone), I experienced a very severe "episode," and possibly fainted. The nurse was pricking my finger for blood for a mono test (as I felt like I had no energy), and he asked me stand up and walk over to the near-by table. By when I stood up, I got extemely light-headed and mumbled that to the nurse before trying to catch myself on the table (because I had lost my vision and balance). The nurse caught me and had me lie down on those bed/chair-things in the room that patients sit on. The main doctor didn't think anything of it, other than getting more blood for a more detailed bloodtest (which come back normal), and telling me that some people just faint more than others. (By the way- I am not squeemish at blood).

So, long story short, I have done nothing other than drink more water and consume more salt, but my symptoms have gotten worse in the last few weeks.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): none
Check all conditions present in your immediate family... : Cancer, History of Back Pain
Please list any medication allergies that you have : : None
Please list any medications you are currently taking (and dosage if known) :: None
When was your last menstrual cycle?: 2 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Never

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible

1. Do you personally think my symptoms are serious? Should I be worried?
2. Is it necessary to go to a doctor for my symptoms?
3. Is this just orthostatic hypotension, or could it be neurocardiogenic syncope (which one of my cousins has)?

Friday, May 18, 2012

Is it Lymphoma?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree. Hi doctors, I  have asked a question before (hypokalemia mystery). I have no problems with my potassium now,  no potassium supplements! I have a new problem that I am worried about. I am concerned about cancer, lymphoma. The past 1.5 years I have had siginificant weight loss in Oct 2010 I weighed 210 pounds, in September 2011 I weighed 150 I now weigh 130.  At first I enjoyed the weight loss, but people have started to make comments about how I've lost too much too fast since I am doing nothing at all to make me lose the weight. I looked up causes of unintentional weight loss and a majority of them I have been tested for recently. One that stood out was lymphoma, now I'm a bit scared because some symptoms I've had match lymphoma, I itch all over, allergy meds don't work and my skin isn't dry but I scratch so much at night I make myself bleed. I have always been fatigued and have generalized weakness. 2 months ago I got the flu and did prednisone for a week and a sinus infection so amoxcillin for 10 days, since then I have been running fevers on and off every 3-4 days & the fever usually ranges from 101-103. 2 months ago I found a firm painless lumundemanding my left jaw. I saw my doctor 2 days ago and she wasn't concerned. She felt the lymph node under my jaw and found one enlarged in my neck, armpit & groin. She said it was a cold virus and that we should just recheck my weight in 1-2 months. The same day I saw my neuro-opthamologist (see her b/c of different pupil sizes). When I told her about my symptoms she was concerned and kept asking if my doctor was ordering imaging studies. She thought my pupil problem may be horner's syndrome and that a mass in my chect was causing my pupil differences but the test she did was negative. I just have this gut feeling that this may be cancer. I'm concerned because it seems like at least for lymphoma it doesn't show up in the blood unless it's greatly progressed because it orignates in the lymph system. Gender: Female How tall are you (feet and inches)?: 5'3'' What is your weight in pounds?: 130 How old are you?: 23 How long has this been going on?: More than a year Check all symptoms you are currently experiencing: Fever Weight Loss Describe associated symptoms not listed above: all over itching, fatigue, weakness, swollen painless lymph nodes fever is always between 101-103 I only take tylenol for if it I get really uncomfortable. When I get them I usually notice it because I've been really uncomfortable all day and hot, even though everyone else is around me is not hot at all or someone touches me and the comment on how hot my skin feels. I haven't had any night sweats, but I have had some changes in my night time sleeping habits, I used to always need to have at least four blankets on my bed because I would get so cold at night and I can't sleep unless I'm warm but now even one blanket on my at night can been to warm and I find myself kicking it off too hot with it. Also with the weight loss I've really never been below 150 at least ever since high school I've always been a bit overweight with my lowest weight being around 150 pounds, so even though I'm still at a normal weight for my height it's concerening to be because this has never been a normal weight for me. The weight loss is concerning, but I can't say that I am not pleased with it as well, really I think anyone would be. What have you done so far to remedy this condition? Please include tests and relevant studies here. : CBC with differential (normal) My docotr said if it was cancer it would show up here, but I'm not completly conviced because lymphoma at least originates in the lymph system. Comprehensive metabolic panel (normal) Thyroid normal not diabetic The only 'abmornal' results were barely out of range, BUN was 6 mg/dL, Anion Gap was 6mEq/L but those are always just a bit low like that for me, have been for years. I eat normally, nothing has changed in my diet, I really don't exercise. Please list any chronic medical problems and also list any prior surgery: Hemicrania Continua: treated with occipital nerve stimulator implant Neurocardiogenic Syncope: Loop recorder implant and explant surgeries. Inappropriate Sinus Tachycardia 3 EP studies Check all conditions present in your immediate family... : Asthma / Lung Problems Cardiac Disease Diabetes Hypertension Stroke Please list any medication allergies that you have : : nkda Please list any medications you are currently taking (and dosage if known) : Bisoprolol 10mg 1x a day (for inappropriate sinus tachycardia) Zoloft 100mg 1z a day (for neurocardiogenic syncope) Multi-vitamin 1x a day Nasacort AQ 55mcg Clatrin 10mg 1x daily Ambien CR 12.5mg 1x day When was your last menstrual cycle?: 3 weeks ago Are you currently using or do you have a history of tobacco use?: No Are you currently using or do you have a history of illegal drug use?: No Please describe your alcohol consumption :: Occasionally HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible What are the chances of this being lymphoma or another form of cancer? Am crazy for fearing that I may have cancer? Should I seek a second opinion, if so how is the best way to go about doing this? My health history is abit extensive and can make starting over difficult. Can I just wait it out with my current doctor or ask for more testing now? If more testing, what kind?

Friday, May 11, 2012

Lyme Relapse?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.


My daughter was diagnosed with Lymes a year ago and was treated.  Now she is having symptoms again.  Low temp, bad headaches, dizziness, fatigue.  She is just seeing her regular doctor who has her  on doxycycline for 2 weeks, and the symptoms are not getting better.  In fact she feels worse like she is in a fog?, and now she has a swollen lymp node under her chin.  I think she should go to a specialist, as from what I am reading she needs someone with more knowledge about lymes.  Her doctor says to wait a few more days and if she's not feeling better they are going to do an mri?

The remaining info completed is about my daughter as best as I know
Gender: Female
How tall are you (feet and inches)?: 5 feet
What is your weight in pounds?: 140
How old are you?: 31
How long has this been going on?: More than a month
Check all symptoms you are currently experiencing: Nausea
Check all conditions present in your immediate family... : Diabetes
Please list any medication allergies that you have : : allergic to penicllin
When was your last menstrual cycle?: Now
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Rarely

HOW QUICKLY DO YOU NEED THIS TO BE ANSWERED?: As soon as possible

whether or not my daughter should see a specialist, or continue with her doctor
 
______________________________________________
 
This may surprise you to hear but I do not think your daughter needs a specialist in Lyme disease. The reason is that it is not at all clear to me that this is Lyme at all. Much has been made of 'chronic Lyme disease', but the best evidence we have is that there really is not such thing and that, if the organism that causes Lyme disease is not demonstrated by positive lab testing, that further treatment with antibiotics is unlikely to do anything but cloud the picture. And this is not just me talking, I am merely quoting the New England Journal of Medicine.

Here is a good quote from the linked article above....
 
" 
Conclusions
Chronic Lyme disease is the latest in a series of syndromes that have been postulated in an attempt to attribute medically unexplained symptoms to particular infections. Other examples that have now lost credibility are “chronic candida syndrome” and “chronic Epstein–Barr virus infection.” The assumption that chronic, subjective symptoms are caused by persistent infection with B. burgdorferi is not supported by carefully conducted laboratory studies or by controlled treatment trials. Chronic Lyme disease, which is equated with chronic B. burgdorferi infection, is a misnomer, and the use of prolonged, dangerous, and expensive antibiotic treatments for it is not warranted.
"




Stick with her current doctor. Look for other explanations. Print the New England Journal article out and take it with you. One thing is sure, the PUBLIC believes in chronic Lyme or recurrent Lyme. It is certainly possible to be infected with Borrelia burgodorferi more than one time, but if the tests for acute infection are negative and there is no telltale rash then I might kindly suggest that the diagnosis of Lyme is likely to be incorrect and that other possible causes need to be sought. I will stand by for my colleagues to weigh in. Thanks for your question.