Which Autoimmune Disease Could it Be?!


Question: Which Autoimmune Disease Could it Be?
I am a thirty-four year old mother of three. I do not work out or do anything that would be considered physical other than chase my 2 year old around the house.

A couple of months ago, I started having some interesting symptoms. The first thing I notice was a burning sensation running down my right arm from my elbow to my wrist. Then, the same burning sensation appeared in my legs (running along my femur from my knees to my ankles). Then, my ankles and tops of my feet began to burn. The burning is/was an excruciating pain.

At this point (a couple of days into the pain) I went to the Vanderbilt Walk-In clinic. They ran blood work. The results were as follows:

RA - Negative, ANA - Negative, CRP - Elevated, ESR - Elevated, Red and White Blood Count - Normal, Potassium - Low

They asked me to make an appointment with my primary for a follow up and sent me on my way.

A week later, I was still in pain. My ankles and feet were tender to touch and mornings are/were unbearable. Many times, I would crawl to the bathtub. One morning, I couldn't take the pain anymore so I made a trip to the ER. They did an ultrasound on my legs (looking for bloodclots). It was normal so they prescribed Naproxen and Hydrocodone and sent me on my way.

I finally saw my primary a couple of weeks later. By this point, my feet and ankles were so swollen that they appear broken (all the while I've been trying to continue to work). Also, they have/had new and old bruises of different color and variation (red, purple, and blue). My primary didn't do any additional testing but, rather, made an appointment for me with a rheumatologist. But, the appointment with the rheumatologist was so far out that I couldn't wait. I ran out of Naproxen and Hydrocodone (it really wasn't working anyway).

So, I went back to the Vanderbilt walk-in. This time, they sent me over to an orthopedic. The orthopedic ran more blood tests and some of the same old ones. The results were as follows:

ANA - Negative, RA - Negative, Lyme - Negative, B12 - Normal, Rocky Mountain Spotted Fever - Negative, ESR - Elevated (but lower than before), & CPR - Elevated (MUCH MORE ELEVATED)

The orthopedic gave me a Tuardol (?) shot and put me on a prednisone pack. Within hours of the shot, I was feeling some relief from the pain. And, for the first couple of days of the prednisone pack I felt GREAT. I even worked out. But, as the steroids tapered off... the pain and swelling returned and, now, I am back where I started (in pain). Today, I haven't gotten out of bed.

I have googled these symptoms and the condition that seems to match my description the most is Mixed Connective Tissue Disease. But, what baffles me is the negative ANA and RA. I'm pretty sure that they've ruled out infection due to the normal blood count. What could we be missing here?

Answers:

Best Answer - Chosen by Voters

You need to be obnoxious and call the Rheumatologist every day, get your appointment moved up.

ANA normal; rules out Lupus RA normal...I'd look into more specific RA testing "Anti-CCP". ESR and CRP are general markers for inflammation and or infection, none tell you the source. With swollen ankles and feet, it's pretty much a given they will be elevated. CBC normal; no infectious process. Lime Disease from infected tick can cause joint inflammation, even chronic arthritis and many other symptoms you did not appear to have per your narration. Rocky Mountain Spotted Fever, unsure of why they tested you, symptoms are not suggestive of this disease; both test negative. Vit B12 deficiency's might cause some nerve damage, but not swelling. A normal CBC would probably lead you to believe that a Vit B12 def would not be suspect. Potassium low; I hope they replaced this or instructed you to eat foods high in potassium if it was just marginally low.
Potassium affects the way neuromuscular cells discharge energy (depolarize) and then regenerate (repolarize) that energy to be able to fire again. When potassium levels are low, the cells cannot repolarize and are unable to fire repeatedly, as is needed for the function of muscles and nerves. It is understandable then that the effects of low potassium include: muscle weakness, muscle aches, and muscle cramps.
Since the heart is also a muscle, there can be some changes in the electrocardiogram (EKG or ECG) that are associated with hypokalemia, especially in the repolarization section of the EKG tracing. Palpitations (irregular heartbeats) may be perceived by the patient. In severe cases, hypokalemia can lead to dangerous disturbances in heart rhythm (arrhythmias). Google for foods high in potassium and avoid diurectic diet aids and abuse of laxatives that leach potassium from you.

The medications they have given you help with pain and swelling. Naproxen is a non-steriodal anti-inflammatory, Hydrocodone is a narcotic pain reliever with Tylenol and a synthetic codeine, Toradol is a anti-inflammatory pain reliever, non-narcotic; similar to an injectable form of Motrin or Advil.
Prednisone is a steroid and inhibits the body's immune function and in simple terms stops the body from reacting to a stimulus that it perceives as a threat. That stimulus can be external (allergic reaction) or internal (auto-immune diseases).

I think this has gone on long enough, center your communication between your Primary MD and the consulted Rheumatologist. Get to the top, to the one that can diagnose the problem.

I would encourage you to stay active despite pain (swimming warm heated pools) and reduce stress (Yoga). Exercise and stress reduction is favorable to arthritis (chronic or acute) and all autoimmune diseases.



I would run to see an LLMD (lyme literate medical doctor)

lyme test being negative means nothing

find an LLMD Here
http://www.symptomsforlymedisease.com/ly…



check your house for mold



The Lyme screening test that's typically given in actually unreliable. Often says you don't have it when you actually do. Recommend you read up at the following websites:

Good sources of info about Lyme disease:
http://www.lymedisease.org
http://www.ilads.org
http://www.canlyme.com
http://www.lymeinfo.net
http://www.lymediseaseassociation.org
http://www.lymenet.org
http://www.igenex.com
http://www.lymedoctor.com
http://www.touchedbylyme.org
http://www.facebook.com/lymedisease.org




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