Joint pain, rash, reoccuring fever, fatigue, headaches (long post)

[Preschoolmom]

First, I am a 30 yr old female, my height is 5’3”, I weigh 126 lbs, and I am a fairly active person. I don’t run marathons; however, I am a pre-school teacher for eleven 3-4 yr olds. Under normal circumstances I am usually jumping around the room while singing songs, playing duck-duck goose, and we even do 15 minutes of daily stretches and breathing. I am also the single mom of a two yr old, so I do plenty of chasing around the house as well. I am not on any medications and I rarely take any over the counter medication. I have eaten healthier in the last year or so than I have ever before in my life.
I woke up from a brief nap on Dec 25th and my right wrist hurt as though it could have been out of place. Within an hour my left ankle was hurting as well. A few hours later both my ankles, both wrists, and my right shoulder were hurting. The next day I woke up with only minor pain in my right shoulder, both ankles, right wrist, and both elbows. As the day went on the pain level increased and by that evening I could barely hold my purse. By the 27th, the pain had moved into my knees as well, but my right shoulder felt fine. The pain seems to move from joint to joint, it does not feel like a sore muscle, and there is no apparent swelling. It almost feels as though the joint has been over-extended. If I lay still and all my joints are well supported the pain goes away; however, even standing and my arm dangling from my shoulder causes pain. I have tried taking 800 milligrams of ibuprofen and it does not seem to affect the level of pain at all, which I find unusual.
I went to my regular doctor on the 29th and upon exam; he noticed a very fine rash on my back, stomach, and thighs. This rash looks like light red blotches and has a feel like fine sandpaper. This rash was not something that I had noticed in the days before, and did not seem to itch. The nurse stated that I did not have a fever, and the doctor ordered quite a few blood tests. He also went ahead and prescribed me “Indomethacin”. I took the Indomethacin that evening at my parents while having dinner, and fell asleep on their couch within 45 minutes. My mom tried to wake me up a couple of times, but she said I was just “too out of it”. I woke up the next morning, and my pain was gone. However, I could not continue to take this medicine because I cannot be “knocked out” when caring for a 2 yr old. I called the doctor the next day and he told me to try 400 milligrams of naproxen until my lab results came back.
The naproxen did not seem to help either as the pain in my knees came back later that night. I could not fully extend my knees and had to walk like an 80 yr old who normally uses a wheelchair. On the 31st I woke up and my knees were slightly sore along with one of my ankles, but the pain was gone by that afternoon. However, it was replaced by a headache and shooting pains in my head. I took my temperature and noticed that I had a low grade fever 99.9F. My joints were still somewhat stiff, but not unusable.
On the 1st, my joints were still slightly stiff, but my shin bones ached, and I'm now feeling tired, weak, and rundown. I took my temperature that morning and it was normal; however, by that evening the shooting pains in my head had returned along with my low grade fever. I have had a headache with fever before, but this does not feel the same. These symptoms continued until about the 3rd when I also started feeling some muscle stiffness mostly in my shoulder blades and lower neck region along with a feeling of heaviness and chest pressure. The low grade fever seems to come and go and is usually accompanied by strong sharp pains in my head.
On the 5th my doctor finally got my test results back he had ran the following labs: CBC, CMP, SED rate, Lyme titer, RA, TSH, uric acid(DH). He said that everything looked quite normal that the only concern was that my iron and HDL (good cholesterol) were very slightly under what they should be. Since my rash is still present, along with the low grade fever, and my various other symptoms he is referring me to a Rheumatologist. He also prescribed generic “Mobic”. The mobic seemed to help, but the rash spread to my arms overnight and I am not sure if this is a side effect of the drug. I looked up mobic on the internet and noticed that its less serious side effects are what I currently have as symptoms. So if I keep taking it how do I to know if I am getting better or just having side effects??? So for now I have stopped taking it, and hope to see the rheumatologist soon.
Upon thinking back, some other things that I have noticed recently about a month ago I began having dandruff which I have never had before. The past few showers I have lost enough hair to stop the shower from draining correctly. It is not noticeable to me when looking in the mirror, and I do not know if it is related.
It’s now the 8th, and the 14th day of this stuff. I need my life back, and my daughter needs her mom back to normal! If you have any suggestions or ideas I would appreciate them.

[taniaaust1]

post back if you go and see the rhemy doc and he's at a loss too or you develop more symptoms... im currently thinking that you may find he's going to be at a loss too.

it kind of sounds virally. (or i've heard of lyme people getting similar weird pains)

[aquila]

It not bacterial (Lyme etc.), or a virus, ask them to look for celiac disease. Try here:

http://digestive.niddk.nih.gov/ddise...liac/index.htm

The other possibilities in a young person are called spondylarthropathies. You can read more here:

http://my.clevelandclinic.org/disord..._overview.aspx

[stillhere]

preschoolmom,
I am new here but I had to post in response to you. Have any of the children at your school had symptoms of mild cold/flu followed by a rash? When my nightmare started, my daughter was in daycare and I think it was fifth disease that presented like this. Did you ever have any strange stomach issues? We dealt with a few different viruses that were diagnosed only after the main symptoms and contagious period were gone and the rash appeared.
One of the older teachers said she was sure she had contracted one of the viruses the kids had (which was said adults don't get) and her symptoms were very similar to yours. She quit working there after 9+ years. She was very concerned about me and my symptoms which were similar but .....I had joint pain which moved also. I remember my wrists hurting and like a more topical pain such as bruising.
I had rushed my daughter around this time to the doctor with an undiagnosed rash which two doctors looked at and made us come through a back door as she was coverred with it. It only lasted 24 hours and then lightened and went away. She also got the 'slapped cheek' rash from another virus which I think was the fifths disease. My blood work came back fine also.
Hopefully for you, it will go away and not be reoccurring.
I don't know if any of the above will help but I thought it may be worth mentioning.

[Preschoolmom]

I have recently had a couple of dizzy spells and the dizziness isn’t occurring when Im moving around. Once I was just standing and talking to a friend and the other I was sitting and teaching. Yesterday morning on my way to work I felt some pain in the left side of my chest. I pulled off the road and the pain subsided after about a minute or so. I decided then to go ahead and drive to the doctor rather than to work. The doctor was not in yet, but the nurse took my blood pressure and it was 102/60. She said that she would notify the doctor when he arrived. The doctor called me shortly after I got to work and told me that he was still in the process of getting me an appointment with a rheumatologist (as there is only 3 within a 100 miles of me); however, he would do everything possible to get in touch with one on Monday and get me an appointment scheduled as soon as possible. He said that if over the weekend my dizzy spells got any worse or more frequent or if I had chest pains again to immediately go to the ER. I am beginning to not like my doctor as much as before. I have gotten some great recommendations for a general doctor at another hospital; however, he is about an hour away.
Also, I do not know if this is a related symptom, but I have been having some heart burn. I do not normally have heart burn and the last time I remember having it I was pregnant (nearly 3 yrs ago). The heart burn has been present even when I haven’t eaten anything that would normally give me heart burn (like salad with ranch dressing).
Today (01/10/09) and yesterday my I have felt about the same (usually my symptoms have differed from day to day). My fatigue has lifted some, but my knees are still stiff and somewhat painful, my shins still ache (almost like growing pains or slight shin splits), and my feet still hurt. My foot pain is mostly stiffness, my heels are slightly painful, and my arches are sore. I have been on my feet very little lately mostly because of the pain. Even at my job they have taken several measures to try and keep me in a sitting position while teaching. The pain also doesn’t seem to be any better even after sleeping through the night. The rash and low grade fever that I had has appeared to have gone away as of yesterday, and has not returned today
I followed the spondyloarthropathy link and did notice the symptoms of Reactive Arthritis and it mentions heel pain, so I may see about getting the genetic test it mentioned. As for the Celiac disease I haven’t had any real gastrointestinal or digestive issues (other than the recent heart burn).
As for fifths disease, I haven’t had the red cheeks at all, and none of the children at school have had any of the symptoms. My supervisor is familiar with 5ths disease, so I asked her about it and she said that she doesn’t believe this is what Ive got. However, she mentioned she was concerned about rheumatic fever, because a month or so ago everyone seemed to get strep throat except for me. She said she was now concerned that maybe I got it and just didn’t have the symptoms of strep which if untreated can lead to rheumatic fever.
Upon going over my test results which I will post below, I noticed that I am only 0.01 below testing positive for Lyme disease. So this is still a definite concern for me.
I truly appreciate you all taking the time to respond to my post, and I will continue to keep you updated.
TEST RESULTS -(I highlighted in blue the items that were barely in the normal range, and highlighted in red the items that are abnormal)
Total Cholesterol 111mg/dL –Normal goal of less than 200
Triglycerides 120 mg/dL –Normal goal of less than 150
HDL 28 mg/dL –Normal goal of 55 or higher
VLDL 24 mg/dL –Normal 0-40
LDL 59 mg/dL –Normal is less than 100
Glucose (Glu) 90 mg/dL –Normal 65 to 99
Sodium (Na) 136 mmol/L Normal 136 to 148
Blood Urea Nitrogen (BUN) 12 mg/dL –Normal 5 to 26
Creatinine (Creat) 0.69 mg/dL –Normal 0.57 to 1.0
BUN/Creatinine Ratio 17 –Normal 10.01 to 20.99
Potassium (K) 3.7 mmol/L –Normal 3.5 to 5.5
Phosphate (PO4) 2.8 mg/dL –Normal 2.5 to 4.5
Chloride (CI) 100 mmol/L –Normal 96 to 109
Calcium (CA) 8.9 mg/dL –Normal 8.5 to 10.6
Total Protein 6.3 g/dL –Normal 6.0 to 8.5
Albumin 3.8 g/dL –Normal 3.5 to 5.5
Globulin 2.5 g/dL –Normal 1.5 to 4.5
Albumin/Globulin Ratio 1.5 –Normal is 1.11-2.5
Alk Phos 71 IU/L –Normal 25 to 150
LDH 199 IU/L –Normal 100 to 250
AST (SGOT) 14 IU/L –Normal 0 to 40
ALT (SGPT) 19 IU/L –Normal 0 to 40
GGT 13 IU/L –Normal 0 to 66
TBILI 0.2 mg/dL –Normal 0 to 0.5
Glom Filt Rate (eGFR) 59.01 mL/min –Normal 59 to 129
Lyme Disease (IgG/IgM Ab) 0.9 index –Normal 0 to 0.9
Lyme Disease (Ab Quant IgM) 0.9 Index –Normal 0 to 0.9

Thyroid Stimulating Hormone (TSH) 1.7 uIU/mL –Normal 0.35 to 5.5
White Blood Cells (WBC) 8.8 X 10-3/uL -Normal 4.0 and 10.5
Red Blood Cells (RBC) 4.23 x 10-6/ul –Normal 3.8 to 5.1
Hemoglobin (HGB) 13.6 g/dL –Normal 11.5 to 15.0
Hematocrit (HCT) 39.8 % -Normal 34 to 44
Mean Corpuscular Volume (MCV) 94 fl –Normal 80 to 100
Mean Corpuscular Hemoglobin (MCH) 32.3 pg –Normal 27 to 34
Mean Corpuscular Hemoglobin Concentration (MCHC) 34.3 g/dL –Normal 30 to 36
Red Blood Cell Distribution (RDW) 12.8% -Normal 11.7 to 15.01
Platelets (PLT) 279 X 10-3/uL –Normal 140 to 415
Neutrophils 78 % -Normal 40 to 74.01
Lymphs 15 % -Normal 14 to 46.01
Monocytes 5 % -Normal 4 to 13.01
Eosinophils (Eos) 2 % -Normal 0 to 7.01
Basophils (Basos) 0 % -Normal 0 to 3.01
Uric Acid Level 3.9 ug/dL –Normal 2.4 to 8.2
Rheumatoid Arthritis 6.9 IU/ml –Normal 0 to 14
Sedimentation Rate (ESR or “sed rate”) 4 mm/hr –Normal 0 to 21



GENERAL MEDICAL INFO
Blood Pressure
01/09/09 – 102/60
01/06/09 -128/82
12/29/08 -102/59
08/26/08 -116/74
05/12/08 -116/75


Body Mass Index (BMI)
12/29/08 -23.1
08/26/08 -21.1
05/12/08 -19.5
Weight
12/29/08 -126 lbs
08/26/08 -119 lbs
05/12/08 -110 lbs
I believe that my weight gain is most likely contributed to the fact that I have had much less stress in my life, since I am the type to unconsiously not eat when under stress.

[pseudo2]

Reading over your post, another illness to look into might be dermatomyositis or some other form of myositis (see http://www.myositis.org/template/page.cfm?id=183 for info about DM). Myositis, especially DM, can result in rashes, joint pain, weakness, tiredness, random fevers, and dizziness, to name a few.

Looking over your test results quickly (I may have missed it), I didn't see a CK test (also known as a CPK test), which may give some answers (info on that at http://www.myositis.org/template/page.cfm?id=9).

DM and other forms of myositis are rare, so it's not usually the first thing doctors think of. The ones who usually diagnose and treat myositis are the specialists you're already trying to see, rheumatologists, because myositis falls under the RA family of illnesses.

Good luck.

[richard wayne2b]

Well,I see that a sed rate was not done,which is very important in someone with joint pain.There are many causes of polyarthritis,but in a young female I'd like to see an autoimmune cause ruled out first.They should have done an ANA.

[richard wayne2b]

Your heartburn could be from the various NSAIDS you've been taking.Do antacids help?As far as the dandruff is concerned,it could be from a dry environment,such as being indoors during cold weather,or do you have seborrheic dermatitis(oily,inflamed skin usually between the eyebrows and on the mid-face that is commonly associated with dandruff)?Oh,are you having any reflux symptoms with the heartburn?

[richard wayne2b]

They also should have done an RA latex test.

[Med Stud]

LUPUS!Do the Antinuclear Antibodies