Discussions By Condition: I cannot get a diagnosis.

Dysarthria and Unilateral Seizures

Posted In: I cannot get a diagnosis. 12 Replies
  • Posted By: NoDrCanDiagnoseMe
  • August 23, 2009
  • 07:04 PM

Lately, I've been experiencing Dysarthria and Unilateral Seizures. These add to my ever-growing list of symptoms, which began at birth. No Doctor has ever been able to diagnose me, so I've been working on my Complete Medical History (for over two years). This week, I finally completed it, and I've created a web page, including photos. I'm calling it, "Diagnosis Challenge", because I've had more than fifty different Doctors examine me, to no avail. Can YOU figure it out? Please help me. I am very sick and I feel that my time is running out. Thank you, for your time.

The URL is: http://nodiagnosis.weebly.com

Have a great day. :-)
Joe

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12 Replies:

  • Okay, I've visited your website and read through the information. I need to make several points here before discussing the matter. First of all, it's apparent that you have multiple health problems, but if you are seeking to identify a single underlying cause that may be responsible, I'm constrained to point out that such a connection does not exist based upon what I've read. As you read through my comments, please bear in mind that my intent here is not to challenge your statements or perspective, but rather to point out that some clarification needs to be made with regard to the manner in which the information is presented and any conclusions being drawn. First of all, let me address the photos. The intensities on the MRI images you mention, ie "white spots" are normal artifact and constitute the fraction of tissues at the cross-section between layers being imaged. You are looking at a slice so to speak, that may divide a vessel, sulci or other tissue formation which produces a partial rather than complete image. Depending upon the type of MRI sequence being performed, areas of intensity or black-out are normal findings. In the absence of the full imaging study, there is nothing of the images depicted that would suggest pathology. Moreover, the only abnormal finding that I can detect on the limited images provided would be possible premature cortical atrophy which would be inconsistent with a person of your years. While this finding in of itself is not necessarily considered pathological in nature, it would suggest influence by certain pre-existing disorders already mentioned. This perception may also be due to the reference point of the image itself by comparison to the other segments. The blanching of your hand on flexion is entirely normal. Skin at the palmar surfaces is more dense and compression of the small capillary beds close to the skin's surface is quite easily accomplished, momentarily displacing blood from the outer reaches. Again, this is an entirely normal finding and does not suggest pathology of any type. The black streaks on the thumbnail merely represents a fungus at the outer edges of the nailbed. This is a common finding and is treatable. The area of the big toe, as well as the other toenails to a lesser extent, would suggest an advanced fungal infection. If this photo is recent, then it's suggested that you seek prompt treatment that may include removal of the nail and treatment of the underlying tissues to prevent complications. Additionally, if you are experiencing symptoms of type II diabetes, then it makes it evermore critical to seek prompt treatment since problems with circulation may also be involved. The edema you mention does not appear to exist in the manner being suggested. Particularly, the general size differential does not appear to be out of context from the multitude of examples observed in other patients and would represent an normal variant. If the size differential were suggested to be the result of edema, then we would see a very marked presence in the lowest portion of the extremity, ie the ankle and foot, and yet the ankles and feet appear to be within normal expected parameters. As for the unusual presentation with your lab studies, I would suggest that the information offered in such a manner is entirely pointless since it is the representation of the lab values at the time of acquisition that gives them relative importance by comparison to other values taken at the same point in time. If you have the independent lab studies from which the collective values were extracted, then it would be far more beneficial to a clinician attempting to evaluate the circumstances relative to the studies. Additionally, some of the complaints represent normal pathogenic exposure and consequences for all humans and therefore, need to be set aside from any particular consideration in looking at the entire clinical picture. In other words, many people develop eczema for instance. This does not suggest, however, that it would be among the criteria with other findings to suggest a certain underlying disorder. By contrast, there are indeed symptoms being mentioned such as hypnogogia that are related to obstructive sleep apnea. The point being made is simply that some connections are being made where none exist, while others that are interrelated are being held out as separate. It's merely important that your rather extensive list be properly grouped so that it represents a practical course of disease-related factors. To the original complaint at the heading of your post, I would like to discuss these symptoms with you. Dysarthric speech is a consequence of neuro-motor or muscular dysregulation. If by dysarthric speech, you are referring to the symptoms mentioned wherein you "trip over your tongue" and experience semantic influency would not technically be defined as dysarthric speech. In other words, the inability to form words or speech as a consequence of relevant motor dysfunction would constitute dysarthria. By contrast, the inability to achieve fluent lexicons of speech can either be neurologic or psychogenic in nature. There are indeed neurologic sequelae that produce certain forms of pathological dysfluency, but testing must be conducted to determine such incapacity or degredation. I would also make mention here that certain medications among your list have a great potential for interference with cognition and mentation. If you have been taking these medications for a considerable time without regular re-assessment, then I would suggest contacting the prescribing physician to discern whether and to what extent each medication remains necessary. As for the unilateral seizures, I would ask you to please describe in more detail what you are experiencing. In other words, don't tell me what you have, ie "unilateral seizures", but rather describe the symptoms themselves in as much detail as possible. With regard to seeking a "diagnosis," it appears that a multitude of physicians have regularly presented you with diagnoses by virtue of the lists depicted on your website. Again, if by diagnosis you refer to some type of underlying pathology that would be central to all of the symptoms mentioned, I would say here that some are related to pre-existing disorders or disease mentioned, while others are coincidental and have little or no relationship to others being contemplated. The "challenge" here may well be to help you make clear distinctions between what symptoms may be related to certain disorders from those that are isolated in context, as well as bring light to factors that do not represent a symptom or clinical finding, but rather normal human physiology. It's obvious by your listed complaints that you may have several disorders of considerable impact. It's important when dealing with disorders or disease that may be life-long to avoid perceiving every nuance of physiology as yet another associated symptom. Another critical acheivement may be seeking a relative state of well-being in the presence of certain existing disease or disorder to the extent that you can realize the best possible quality of life while working with your doctors to diminish symptoms to the greatest extent possible. I'll be more than glad to address any individual questions or concerns you may have, but at this point my impression is a rather mixed one by comparison to the ultimate answer you seek. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • August 23, 2009
    • 10:09 PM
    • 0
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  • Dr. Cottle,Let me begin, by saying thank you, for your reply. My reason for believing that there is only one "main" illness is, that's what I've been told, by several specialists (ex. Multiple Sclerosis, Sjogren's Disease or Lyme Disease). I believe that it's possible for there to be more than one disease process involved. However, there is at least one disease, which remains undiagnosed, because some of my significant symptoms do not fall into any of my current diagnosed illnesses.The reason that I refer to the "white spots" as being abnormal, is that my Primary Doctor has reviewed the entire image set and was unable to identify them, suggesting that if they were from M.S., I would be unable to walk. If he had felt that they were simply cross-sections of something that normally exists in the brain, then he would have said that, instead. But, like you said, without ALL of the images, it's difficult to really determine anything. I'll try to upload them, at some point.The blanching of my hands actually shocked my former Doctor, who said that he had never seen anything exactly like it. Something that I mentioned in my history is, "I've also noticed that, if I squeeze any of my fingers and glide my hand toward the fingertip, I can literally see the blood flowing." I've tested this on my friends and they don't have the same effect. This symptom, like many others, I'm almost embarrassed to mention, because it seems like I'm being way to specific. But, my reason for doing this is, that I've noticed, while doing research online, many of these odd little symptoms can actually be markers (or even hallmarks) for some rare diseases. I just don't want to leave any stone unturned. I recall seeing television shows (ex. Mystery Diagnosis, etc.), where the patient left out what he thought to be an insignificant symptom and it caused the Doctor to miss the Diagnosis, which led to MANY years of suffering (and permanent Nerve damage). The reason why I don't eliminate some of my symptoms is because I'm not qualified to do so. That's the same reason why they aren't grouped "properly". Of course, even if I knew which symptoms went together, different illnesses can have symptoms from every known category, so it wouldn't make much difference.About the black lines on my fingernail, I couldn't remember what they were called, but I looked it up - splinter hemorrhages - they're caused by Endocarditis, Raynaud's Disease, Vitamin C Deficiency, Onychomycosis, Nail psoriasis, Aspirin or Medications that are sold over-the-counter for Headaches, Arthritis, and other minor pains. They may be a sign of a connective tissue disorder, such as Lupus. In addition, they may also be associated with Vasculitis or microemboli. I looked up photos of fungal infections of fingernails, using Google Image Search, and none of the images looked anything like mine, so I'm wondering if they might be caused by one of the other illnesses.Regarding my big toes, according to my Doctor, I definitely have Ingrown Toenails. My nails show no signs of a fungal infection. I looked up, "Ingrown Toenails" on Google's Image Search and the pics are identical to mine.About my edema, I definitely have it, and there is much more fluid on the right side of my body. In fact, it's "Pitting Edema" and it's document by many of my Doctors. I am prescribed Lasix and Potassium, for it. A couple of months ago, I discontinued them, because they weren't helping my edema very much. In fact, when I quit, I only gained twenty pounds of additional fluid. I am much more swollen in the morning. Regarding my ankles and feet, I was actually hospitalized, two years ago, because I had taken on too much fluid (that was back when I first came off my Prednisone - the Doctor took me off of it, too quickly) and I ballooned-out. I had edema, long before that, but it got much worse. My ankles, feet and legs were HUGE! I was even leaking fluid from my skin. Regarding the size differential, my Primary Doctor gave the same response that you did, initially. But, when I took my shirt off, he said, "Oh. Okay. I see what you mean". So, I guess what I should do, is post a picture of my stomach, instead of my legs.Most of my lab results are universal and not dependent on the time of day, so they can be easily interpreted without a range listing. However, I will include the range information, as soon as I get a chance, as some of the tests are dependent on the time of day, etc., as you have stated.Hypnogogia might be related to my Sleep Apnea. I just listed it as a symptom of my Narcolepsy, because it seemed like a more obvious connection (based on my research).As far as Dysarthria, I probably didn't represent my speech problem, accurately. In addition, the nature of the problem has changed, in the past couple of weeks. I'll try to describe it, as best I can: when something aggravates my nervous system (being really tired, which is often, or being stressed), I stutter and, for some reason, I keep repeating the same jumbled/incorrect word. I sound like a broken record. Sometimes, I'll inadvertently interchange the first letter of each word or even, say words that don't belong in the sentence. Sometimes, my voice sounds shaky, like somebody who is really nervous (kind of like Sally Struthers' voice, when she used to do those commercials about helping the children). Sometimes, my voice is slurred, sounding like I'm drunk. People often ask me to repeat things and, when I do, they ask me to repeat it again. In those instances, I feel as though I'm speaking normally. You mention that some of my medications can cause problems with my cognition and mentation. I'm confused about that (unintended pun), because the only medications that I'm on, currently, are my pain medicine and testosterone. I've been on my pain medication, for ten years, and I haven't had a problem before now, so I don't think that has anything to do with it. That leaves my Testosterone; I checked it's side effects and, according to what I read, problems with cognition and mentation are not among them. Perhaps you were looking at my list of Previous Medications.Regarding my "Unilateral Seizures", what happens is: I will suddenly get a jolt of what feels like electricity, which stimulates my nervous system on the left side of my body. Parts of the right side of my body ***k, as well, but they are simply tremors. Perhaps what the "Seizures" are some sort of "Body Tremors" (if there is such a thing). Anyway, when I get a jolt, it makes the entire left side of my body jump - the nerves zap the muscles (I look like someone getting shocked by electricity). My face even tightens up, on the left side. If you can imagine hooking-up a TENS Unit on the left side of a person's body, cranking it up as high as it will go and flipping the ON Switch, that's probably the best comparison I can make (although, I don't think TENS Units go high enough, to create the kind of jump that my body does).As far as creating a state of well-being, my quality of life is as good as it can be, given the circumstances. I eat healthy and don't drink or smoke. I don't even drink caffeine. Also, I don't eat ice cream, cheese, sour cream, dressings, etc. and I don't eat breads, pies, cakes, cookies, fudge, chocolate, pudding, etc., either. Most of the time, for breakfast, I eat Corn Flakes or Rice Chex cereal with SoyMilk. For lunch, I eat one plain chicken dog (no bread, just the meat) with low-salt chips. For dinner, I usually eat grilled chicken breast, rice or baked potato w/ yogurt spread and a green vegetable (broccoli, lima beans, green peas, green beans or steamed okra). For a snack, I have grapes or cereal. To drink, I have decaffeinated iced tea and water.I realize that the Medical History I created, is not ideal, but I'll be taking suggestions seriously and making changes, as I can. I appreciate your comments and suggestions. I know that it must have taken a lot of your valuable time and I really appreciate it. Hopefully, my answers have helped to clarify things. If you have further questions/comments, please don't hesitate to write. Thank you, again, for your help. It is greatly appreciated.Joe
    NoDrCanDiagnoseMe 20 Replies
    • August 25, 2009
    • 04:29 AM
    • 0
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  • Well, as a retired neurologist with more than 40 years of practice under my belt, I can say with unswerving conviction that the MRI sequence is represented as normal. There is nothing in either the image or your symptoms to suggest MS. The image of your fingerail does not constitute splinter hemorrhage and regardless of a rather blatent ingrown toenail, a culture would very likely produce fungal spores, evident by the appearance of the skin and more particularly, the nail characteristics. If you actually had signs of pitting edema, the diuretic therapy would have produced remarkable results. Again, I see no evidence in the image that would suggest edema, with pitting characteristics or otherwise. Fluid settles to the lowest point in the extremities and as the condition worsens, other tissues above become involved. Your feet and ankles look nearly symmetrical. I see no evidence of pitting edema. Over my may years in practice and like a good number of physicians, I've encountered patients with extraordinarily advanced and peculiar symptoms that establish a premise whereby it's suggested that I sit and take notes to become better educated about their symptomatology. Since we've apparently met that criterion here by virtue of your response, I'll proceed to suggest as I have in the previous instances that you take an objective inventory of the entirety of listed illnesses, diseases and syndromes to determine how a person could conceivably be suffering from such pathology collectively and yet appear as they do in the facial photo provided. I'll step away from further discussion or involvement at this point, but suggest that you pause to consider whether such an exhaustive list might be worth pursuing from an alternate realm. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • August 25, 2009
    • 11:49 AM
    • 0
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  • Dr. Cottle,Let me begin, by saying thank you, for your reply. My reason for believing that there is only one "main" illness is, that's what I've been told, by several specialists (ex. Multiple Sclerosis, Sjogren's Disease or Lyme Disease). I believe that it's possible for there to be more than one disease process involved. However, there is at least one disease, which remains undiagnosed, because some of my significant symptoms do not fall into any of my current diagnosed illnesses.The reason that I refer to the "white spots" as being abnormal, is that my Primary Doctor has reviewed the entire image set and was unable to identify them, suggesting that if they were from M.S., I would be unable to walk. If he had felt that they were simply cross-sections of something that normally exists in the brain, then he would have said that, instead. But, like you said, without ALL of the images, it's difficult to really determine anything. I'll try to upload them, at some point.The blanching of my hands actually shocked my former Doctor, who said that he had never seen anything exactly like it. Something that I mentioned in my history is, "I've also noticed that, if I squeeze any of my fingers and glide my hand toward the fingertip, I can literally see the blood flowing." I've tested this on my friends and they don't have the same effect. This symptom, like many others, I'm almost embarrassed to mention, because it seems like I'm being way to specific. But, my reason for doing this is, that I've noticed, while doing research online, many of these odd little symptoms can actually be markers (or even hallmarks) for some rare diseases. I just don't want to leave any stone unturned. I recall seeing television shows (ex. Mystery Diagnosis, etc.), where the patient left out what he thought to be an insignificant symptom and it caused the Doctor to miss the Diagnosis, which led to MANY years of suffering (and permanent Nerve damage). The reason why I don't eliminate some of my symptoms is because I'm not qualified to do so. That's the same reason why they aren't grouped "properly". Of course, even if I knew which symptoms went together, different illnesses can have symptoms from every known category, so it wouldn't make much difference.About the black lines on my fingernail, I couldn't remember what they were called, but I looked it up - splinter hemorrhages - they're caused by Endocarditis, Raynaud's Disease, Vitamin C Deficiency, Onychomycosis, Nail psoriasis, Aspirin or Medications that are sold over-the-counter for Headaches, Arthritis, and other minor pains. They may be a sign of a connective tissue disorder, such as Lupus. In addition, they may also be associated with Vasculitis or microemboli. I looked up photos of fungal infections of fingernails, using Google Image Search, and none of the images looked anything like mine, so I'm wondering if they might be caused by one of the other illnesses.Regarding my big toes, according to my Doctor, I definitely have Ingrown Toenails. My nails show no signs of a fungal infection. I looked up, "Ingrown Toenails" on Google's Image Search and the pics are identical to mine.About my edema, I definitely have it, and there is much more fluid on the right side of my body. In fact, it's "Pitting Edema" and it's document by many of my Doctors. I am prescribed Lasix and Potassium, for it. A couple of months ago, I discontinued them, because they weren't helping my edema very much. In fact, when I quit, I only gained twenty pounds of additional fluid. I am much more swollen in the morning. Regarding my ankles and feet, I was actually hospitalized, two years ago, because I had taken on too much fluid (that was back when I first came off my Prednisone - the Doctor took me off of it, too quickly) and I ballooned-out. I had edema, long before that, but it got much worse. My ankles, feet and legs were HUGE! I was even leaking fluid from my skin. Regarding the size differential, my Primary Doctor gave the same response that you did, initially. But, when I took my shirt off, he said, "Oh. Okay. I see what you mean". So, I guess what I should do, is post a picture of my stomach, instead of my legs.Most of my lab results are universal and not dependent on the time of day, so they can be easily interpreted without a range listing. However, I will include the range information, as soon as I get a chance, as some of the tests are dependent on the time of day, etc., as you have stated.Hypnogogia might be related to my Sleep Apnea. I just listed it as a symptom of my Narcolepsy, because it seemed like a more obvious connection (based on my research).As far as Dysarthria, I probably didn't represent my speech problem, accurately. In addition, the nature of the problem has changed, in the past couple of weeks. I'll try to describe it, as best I can: when something aggravates my nervous system (being really tired, which is often, or being stressed), I stutter and, for some reason, I keep repeating the same jumbled/incorrect word. I sound like a broken record. Sometimes, I'll inadvertently interchange the first letter of each word or even, say words that don't belong in the sentence. Sometimes, my voice sounds shaky, like somebody who is really nervous (kind of like Sally Struthers' voice, when she used to do those commercials about helping the children). Sometimes, my voice is slurred, sounding like I'm drunk. People often ask me to repeat things and, when I do, they ask me to repeat it again. In those instances, I feel as though I'm speaking normally. You mention that some of my medications can cause problems with my cognition and mentation. I'm confused about that (unintended pun), because the only medications that I'm on, currently, are my pain medicine and testosterone. I've been on my pain medication, for ten years, and I haven't had a problem before now, so I don't think that has anything to do with it. That leaves my Testosterone; I checked it's side effects and, according to what I read, problems with cognition and mentation are not among them. Perhaps you were looking at my list of Previous Medications.Regarding my "Unilateral Seizures", what happens is: I will suddenly get a jolt of what feels like electricity, which stimulates my nervous system on the left side of my body. Parts of the right side of my body ***k, as well, but they are simply tremors. Perhaps what the "Seizures" are some sort of "Body Tremors" (if there is such a thing). Anyway, when I get a jolt, it makes the entire left side of my body jump - the nerves zap the muscles (I look like someone getting shocked by electricity). My face even tightens up, on the left side. If you can imagine hooking-up a TENS Unit on the left side of a person's body, cranking it up as high as it will go and flipping the ON Switch, that's probably the best comparison I can make (although, I don't think TENS Units go high enough, to create the kind of jump that my body does).As far as creating a state of well-being, my quality of life is as good as it can be, given the circumstances. I eat healthy and don't drink or smoke. I don't even drink caffeine. Also, I don't eat ice cream, cheese, sour cream, dressings, etc. and I don't eat breads, pies, cakes, cookies, fudge, chocolate, pudding, etc., either. Most of the time, for breakfast, I eat Corn Flakes or Rice Chex cereal with SoyMilk. For lunch, I eat one plain chicken dog (no bread, just the meat) with low-salt chips. For dinner, I usually eat grilled chicken breast, rice or baked potato w/ yogurt spread and a green vegetable (broccoli, lima beans, green peas, green beans or steamed okra). For a snack, I have grapes or cereal. To drink, I have decaffeinated iced tea and water.I realize that the Medical History I created, is not ideal, but I'll be taking suggestions seriously and making changes, as I can. I appreciate your comments and suggestions. I know that it must have taken a lot of your valuable time and I really appreciate it. Hopefully, my answers have helped to clarify things. If you have further questions/comments, please don't hesitate to write. Thank you, again, for your help. It is greatly appreciated.JoeJoe:I know this celiac disease/celiac syndrome is the disease of the week, but I've had some of the exact symptoms as you, and my daughter has had most of the others. If you try eliminating gluten from your diet for at least two weeks, you may begin to feel better. Go to mayoclinic.org for more info. The dry eyes, the pain, the "seizures", all of it...ope this helps.
    Anonymous 42789 Replies
    • August 25, 2009
    • 00:32 PM
    • 0
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  • Thanks Guest,Actually, it's funny that you would mention Celiac Disease, as I was recently diagnosed with it. I've been on a gluten-free diet, for three months, and my diarrhea is resolved. I miss eating bread, but it's not worth being sick over, so I have vowed to never eat it, again. I have found some gluten-free bread, at my local Health Food Store, but it's costly, at a price of $6.99, for a very small loaf (and, they freeze them, so the only thing it could be used for, is toast - I still may try some, anyway, to satisfy my bread craving - hehe).Thank you, for your reply. If I hadn't known about Celiac Disease, your information would have been very helpful, so keep up the good work. I always enjoy meeting compassionate people, like you, who take time out, to help people on here. If I ever get well, I plan on doing the same thing.Thanks again. Have a great evening. :-)Joe
    NoDrCanDiagnoseMe 20 Replies
    • August 26, 2009
    • 01:42 AM
    • 0
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  • Dr. Cottle,I have virtually no knowledge of MRIs, so I wouldn't even attempt to challenge your opinion. I will, however, have to disagree with you, regarding my symptoms, as I have nearly all of the symptoms for MS (according to WrongDiagnosis.com's list):Sensation changes YESMovement symptoms YES * Blurred vision YES * Double vision YES * Red-green color distortion YES * Blindness in one eye NO * Eye pain MILD * Rapid involuntary eye movement NO * Flashing lights YES * Partial vision loss I Wear Glasses * Vision impairment in one eye BOTH EYES * Muscle weakness YES * Coordination difficulty YES * Clumsiness YES * Balance difficulty YES * Unsteady gait YES * Limb tremor YES * Arm tremor YES * Leg tremor YES * Limb stiffness YES * Paresthesias (pins and needles) YES * Pain YES * Loss of feeling YES * Numbness YES * Hand tingling YES * Hand paresthesias YES * Foot tingling YES * Foot paresthesias YES * Facial paresthesias YES * Facial tingling YES * Babinski sign - a particular abnormal foot reflex Had the test, don't know the results - do recall that it hurt really bad!!! * Abnormal foot reflexes Don't Know * Cognitive impairments YES * Concentration difficulties YES * Attention difficulties YES * Memory difficulties YES (Long Term) * Judgment difficulties YES (BIg TIME !!!) * Slurred speech YES * Bladder control problems MILDBowel incontinence NOParalysis Hx OfImpotence Many Reproductive ProblemsBalance disorders YESEmotional symptoms YESDon't get me wrong, I'm not saying that I have M.S.. I'm just saying, that it's possible. It's also possible that I have Sjogren's Disease or Lyme Disease. It's most likely some type of Autoimmune Disease which affects the Central Nervous System and causes Inflammation & swollen organs.My Primary Doctor told me that the lines on my fingernail are called "Splinter Hemorrhage" and that, "there is some controversy over the cause, but some believe that it's caused by an infection of the heart. I wouldn't worry about it, though".My Doctor said, regarding the problem with my toenails, "You have ingrown toenails and what you need to do is, just after you bathe, take a piece of cotton ball and twist it, until you have a piece about two inches long. Then, fold that in half and wedge it under the corners of your toenails; that way, when the nails grow out, they won't be digging into the skin. As far as the infection goes, I'm going to be prescribing you antibiotics for what I believe to be Prostatitis, so we'll be killing two birds with one stone. If all of these things don't take care of your toenail problem, we're going to have to remove part of each nail, and that can be quite painful, so let's hope that this does the trick".For a long time, I've had "Pitting Edema" and, to show you that I know what I'm talking about, "pitting edema" is where fluid builds up, under the skin and anytime you lean against something (or press in, on your skin, using your finger), it leaves an impression of whatever pressed into your skin. The impression remains for quite a while, and then, slowly returns to normal. One thing that I noticed, today, while examining my legs, is that they are nearly the same size (they are still swollen with fluid, however, and are still pitting)I've uploaded two pictures, to my web page:1) my torso - this is a much better picture, to go by, than the one of my legs that you saw, a couple of days ago.2) my leg, with an impression - I took the picture, in bad lighting, so the impression is a little hard to see.Why are you being so presumptuous about my health? The problem with Doctors, these days, is that, the moment a patient hands over a list of symptoms, the presumption is made, that the only illness the patient is suffering from, is Hypochondria. Do you realize how incredibly rare Hypochondria is? Have you ever watched the television show, "Mystery Diagnosis"? It's about people who have been misdiagnosed, by their Doctors. They suffer, for years, and are put through unnecessary (and often dangerous) tests, medications, surgeries and treatments. Others are told that it's "all in their head", prescribed Anti-Depressants and referred to Psychiatrists. The show always has a happy ending, as, the patients, eventually, find legitimate medical Doctors, are given appropriate diagnoses and treatments, which lead to their recovery/management of their illness. They always recommend the same thing, "If you're getting the run-around, from your Doctor, move on, to another Doctor and another one, until you find one that has the answer".One of my favorite expressions, that I hear from medical "professionals" is, "You're too young to be so sick!". I started hearing that, when I was nineteen years old and I still hear it. Or, how about, "Stop focusing on symptoms!" (I'll stop focusing on them, when a Doctor STARTS focusing on them. As long as I suffer, I'm going to search for an answer).Even if you don't believe me, when I say that I'm sick, you have to believe my tests results. Take my lab work, for example. Why do you think I have elevated Sed Rate, C-Reactive Protein, Creatine Kinase, Beta Globulin, Alpha-2 Globulin, Alkaline Phosphatase, AST, ALT, Total Protein, Total Complement, C4 Complement and so MANY others? Why do I have no Testosterone or DHEA? Why are my organs swollen (Hepatomegaly & Fatty Liver, Cardiomegaly - also, my Gall Bladder is only functioning at 50%) What makes you think that you can judge someone's physical condition (much less, their exact diagnoses), by the appearance of their face?! What do you expect my face to look like? Should my eyeballs be hanging out, nose rotting, lips bleeding, cheeks covered in pus-filled lesions? You can't judge a person's health, by the look of their face. My lab results have proven that!In your "final suggestion", you say that it might be worth pursuing from an alternate realm. I'm confused - to what alternate realm are you alluding?Please don't think I'm ungrateful. It just gets very frustrating, when I'm let down, over and over. I keep saying that I'm going to give up, on finding a diagnosis because, every time I think I've found a Doctor who has the education, to be able to help me, they turn out to be just like the rest. But, I can't give up. I want to live, so I'm going to keep trying, until I find a Doctor, who will take me seriously.
    NoDrCanDiagnoseMe 20 Replies
    • August 27, 2009
    • 04:22 AM
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  • Okay, it's not practical to create a debate on the forum, but I'll make a final comment and then let you continue your search for answers. A person's appearance is very often telltale of signs of severe illness, not what type, but merely severe illness. This can often occur in the presence of chronicity to a single pathogen, not to mention the dozens upon dozens of illnesses and diseases that you state being afflicted with at some point in time. There are characteristics of many of the diseases you mention which affect the morphology of the body in very subtle, sometimes dramatic, ways. My point was that your general appearance is entirely inconsistent with such exposure or chonicity. You suggest that it's possible to have MS or other diseases and I'm contending that while absolutely anything is possible, it's not medically probable. You are attempting to suggest that you represent an extremely rare enigma whose symptoms defy the laws of medical science. My contention is that based upon the logistics of medical science and practice, a single individual would not be susceptible to, nor be afflicted with, such a volumous array of diseases without a compound effect on ability to thrive. A cascade effect begins to manifest that results in general inability to thrive as a living organism. You don't even remotely represent such factors. As for your laboratory tests, I've already commented that it's entirely improper to compile an aggregated list from single-point tests taken over time that indicate range inconsistencies "at one time or another" throughout your medical history, which attempts to portray a lab study that would constitute an extremely sick individual. It is not the case, however, and I'm sure that you realize the individual tests as they truly exist do not make a similar dramatic depiction in any manner. It is my opinion that you are intentionally attempting to create a morose clinical picture by establishing factors relative to your laboratory studies which do not correspond with the normal parameters of diagnostic studies. Again, I'm of the opinion that the challenge here has little, if nothing, to do with attempting to uncover a mysterious and ellusive single pathogenic process responsible for your symptoms. I've carefully reviewed the extensive medical history that you've provided and it's entirely inconsistent with the known characteristics and probabilities associated with illness and disease in humans. By contrast to your posted information, together with what I've observed, your portrayal would be far more consistent with Münchausen syndrome to the largest extent. This is, however, strictly my opinion based upon the evidence at hand. I wish you all the best in obtaining resources necessary to determine the cause for your florid symptoms. You should also be aware that any information obtained from sources such as an internet forum are intended strictly for informative purposes and are in no way representative of medical evaluation or treatment, and; do not constitute supplantation of direct medical care or treatment by your doctor(s). Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • August 27, 2009
    • 11:19 AM
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  • Okay, it's not practical to create a debate on the forum, but I'll make a final comment and then let you continue your search for answers. A person's appearance is very often telltale of signs of severe illness, not what type, but merely severe illness. This can often occur in the presence of chronicity to a single pathogen, not to mention the dozens upon dozens of illnesses and diseases that you state being afflicted with at some point in time. There are characteristics of many of the diseases you mention which affect the morphology of the body in very subtle, sometimes dramatic, ways. My point was that your general appearance is entirely inconsistent with such exposure or chonicity. You suggest that it's possible to have MS or other diseases and I'm contending that while absolutely anything is possible, it's not medically probable. You are attempting to suggest that you represent an extremely rare enigma whose symptoms defy the laws of medical science. My contention is that based upon the logistics of medical science and practice, a single individual would not be susceptible to, nor be afflicted with, such a volumous array of diseases without a compound effect on ability to thrive. A cascade effect begins to manifest that results in general inability to thrive as a living organism. You don't even remotely represent such factors. As for your laboratory tests, I've already commented that it's entirely improper to compile an aggregated list from single-point tests taken over time that indicate range inconsistencies "at one time or another" throughout your medical history, which attempts to portray a lab study that would constitute an extremely sick individual. It is not the case, however, and I'm sure that you realize the individual tests as they truly exist do not make a similar dramatic depiction in any manner. It is my opinion that you are intentionally attempting to create a morose clinical picture by establishing factors relative to your laboratory studies which do not correspond with the normal parameters of diagnostic studies. Again, I'm of the opinion that the challenge here has little, if nothing, to do with attempting to uncover a mysterious and ellusive single pathogenic process responsible for your symptoms. I've carefully reviewed the extensive medical history that you've provided and it's entirely inconsistent with the known characteristics and probabilities associated with illness and disease in humans. By contrast to your posted information, together with what I've observed, your portrayal would be far more consistent with Münchausen syndrome to the largest extent. This is, however, strictly my opinion based upon the evidence at hand. I wish you all the best in obtaining resources necessary to determine the cause for your florid symptoms. You should also be aware that any information obtained from sources such as an internet forum are intended strictly for informative purposes and are in no way representative of medical evaluation or treatment, and; do not constitute supplantation of direct medical care or treatment by your doctor(s). Best regards, J Cottle, MDBoy, it took me long time to read thru all. I think he is overacting on many fronts, especially unnecessary tests, drugs, and conclusions. He needs to follow Bioneuroenergenology laid out by Late Dr. Robert C. Bright and he will start to improve. There is only one disease., i.e., brain is not in control of all body functions. Please follow the link....http://forums.wrongdiagnosis.com/showthread.php?p=193133#post193133This man, if come to Phoenix area, I can check him out free. Please read my other replies on this forum.Good Luck,With Best Regards,Garla ArjunaPArjuna85210@yahoo.com
    PArjuna 43 Replies
    • August 27, 2009
    • 09:24 PM
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  • "Dr." Cottle,If you think I'm not going to respond to your comment, you're sadly mistaken. You have a lot of nerve, accusing me of this! Did you mistrust your patients, in this manner, when you "practiced" medicine? Why did you have to play the "Münchausen" card? You could have just told me the truth: that you don't know what's wrong with me. I don't know why some Doctors can't admit that they simply don't possess the level of education, necessary for making a proper diagnosis, in some instances. There's no shame, in it. I guess you're afraid that your ego can't handle the truth, but it would be absolutely impossible, for you to know every detail about every illness known to man. There are far too many rare illnesses, alone. Speaking of which, it's funny that the one rare illness you think I might have, is Münchausen syndrome.You know, I had a hunch about something, so I checked it out. I figured that this type of behavior has been a pattern, for you, and I was right! I typed your name in the search box, here on WrongDiagnosis.com and my oh my, you've been quite the busy *****r. So many people, so little time, eh? Accusing people, left and right, of exhibiting signs of neurosis and psychological problems, rather than addressing their real symptoms. Why do you even post, on here? You're not helping anyone. Telling people that their physical problems are caused by stress, anxiety, tension, family problems, death in the family, problems at work, relationship issues and financial problems is negligent. You're in no position, to tell someone that their problem is psychosomatic. You're not a psychiatrist. Furthermore, these people aren't coming to you, asking for psychiatric advise. They're trying, desperately, to find out what's physically wrong with them (as am I).On every link that I clicked, your diagnoses were minimizing. No matter what symptom a person has, you suggest the most minor of all causes. You know, stress isn't the cause of every symptom. And, you can't dismiss a person's physical symptoms, without first checking to see if there is a "physical" cause. I'm still clicking on the links and, in every post I've read, thus far, you've suggested psychological causes.You know, perhaps you should have been a psychiatrist. You seem to think that everyone's problems are in their head, and you already know how to write prescriptions for anti-depressants (I'll bet the pharmaceutical companies loved you). At first, I was very hurt, by your comments. But, now that I see it had nothing to do with me, personally, the ONLY thing that bothers me, now, is knowing that there are MANY more, out there, just like you. The whole reason we're here, is to get away from people like you. You are the problem. I can't expect you to understand, though, because you've never suffered from a serious, chronic illness. How do I know this? Because, if you had, you would have an OUNCE of compassion AND you would give people a chance. I'm convinced that you actually go searching for people like me, just so you can attack us, with your insults and accusations. I didn't come here, for this. I came here, for help.I found a thread, where you said, "I simply reserve the right to remain purposeful and retain my dignity as long as I can draw a breath". I can totally understand that. The thing is, how purposeful are you, if you don't help people like me? There's certainly no dignity in walking away, when you could be helping me. And, how purposeful do you think MY life is? I want to help people, too, but I can't do that, in my condition.In another thread, you said, "the notion of help is centerpiece to the patient's perspective alone. As physicians, what we do best in the selfless interest of patient care is to attempt with all dispatch to absolve them of the illness and disease which plagues to no end. Help in such matters is of little consequence if incomplete". Either you don't know what that means, or you're being hypocritical. Or, a third possibility (and I'm hoping this is the one), you believed it, at one time, but you've forgotten what it truly means. Are you really here, to help people? Because, if you are, then why am I still without an answer? Is there some reason why I don't deserve to live a pain-free life? I don't expect you to by sympathetic or compassionate. You're obviously not the humanitarian-type. I mean, if you can walk away, knowing that I still need help, then you're here for no one, but yourself (and your ego).Why don't you assume, for a minute, that I'm telling the truth about my illnesses and symptoms. Are you willing to take the chance of abandoning a sick person, just because you "think" that I'm lying? I don't know why I'm trying so hard, to get your medical opinion because, even if the Wizard could give you a heart, you still don't have a brain!
    NoDrCanDiagnoseMe 20 Replies
    • August 28, 2009
    • 08:36 AM
    • 0
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  • Again, I remain firm in my opinion on the matter. It is, after all, only my medical opinion. I have thoroughly reviewed your extensive postings and visited your website. No one is abandoning you because you are not under the care and treatment of a doctor on this forum in any form whatsoever. Clinical diagnosis is not possible via the internet, nor does communication here constitute medical treatment or advice. The absolute most that you can expect to obtain from an internet health forum is medical information. As for your captions of my comments over time, you should be aware that physical symptoms can manifest in the entire absence of physical disease and a great number of persons who visit this site are extremely frustrated because the medical community is unable to identify and treat an underlying cause for their physical symptoms. It is both innate and through social training that humans make the direct association between physical symptoms and physical disease, but such direct association is not a medical fact at all. When diagnostic tests prove negative for organic disease, it sends many patients looking for the "right" doctor who can simply tell them what they've convinced themselves to be the case. They are also very frightened by the fact that if such disease cannot be detected, then their outlook is quite bleak indeed. As for my opinions regarding your own symptomatology, you seem equally if not more frustrated that the entire range of physicians who have evaluated you cannot determine the underlying cause you seek to confirm, should paradoxically be determined by an online internet health forum. I realize that you will contend it to represent desperation, but I'm constrained to point out that if the extent of medical science acting through logical and analytical approach cannot determine the nature of your condition, then any lesser and irrational or desperate course cannot possibly result in greater accuracy or insight. Several points need to be driven home; first of all, this forum is not charged with any responsibility for responding to your inquiry in the manner expected or encouraged. It is an open, public forum and I merely happen to be a retired physician who is participating in the forum like any other member or guest. I have no greater responsibility to you in performing as you suggest, nor am I guilty of any wrongdoing by stating my opinions. Again, this is not a doctor's office and you're not under medical treatment or evaluation in the formal sense by any means whatsoever. Now how you choose to see the circumstances based upon those parameters is entirely up to you, but I had been in practice for more than 40 years and I'm simply telling you that your presentation is both highly irregular and demonstrates strong characteristics associated with Münchausen syndrome. If information obtained here is not to your liking or expectations, then you are under no obligation to remain exposed to it. Please feel free to post for any response from members or guests that may be elicited and I'll refrain at this point from any further discourse on the matter. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • August 28, 2009
    • 08:16 PM
    • 0
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  • Okay, it's not practical to create a debate on the forum, but I'll make a final comment and then let you continue your search for answers. A person's appearance is very often telltale of signs of severe illness, not what type, but merely severe illness. This can often occur in the presence of chronicity to a single pathogen, not to mention the dozens upon dozens of illnesses and diseases that you state being afflicted with at some point in time. There are characteristics of many of the diseases you mention which affect the morphology of the body in very subtle, sometimes dramatic, ways. My point was that your general appearance is entirely inconsistent with such exposure or chonicity. You suggest that it's possible to have MS or other diseases and I'm contending that while absolutely anything is possible, it's not medically probable. You are attempting to suggest that you represent an extremely rare enigma whose symptoms defy the laws of medical science. My contention is that based upon the logistics of medical science and practice, a single individual would not be susceptible to, nor be afflicted with, such a volumous array of diseases without a compound effect on ability to thrive. A cascade effect begins to manifest that results in general inability to thrive as a living organism. You don't even remotely represent such factors. As for your laboratory tests, I've already commented that it's entirely improper to compile an aggregated list from single-point tests taken over time that indicate range inconsistencies "at one time or another" throughout your medical history, which attempts to portray a lab study that would constitute an extremely sick individual. It is not the case, however, and I'm sure that you realize the individual tests as they truly exist do not make a similar dramatic depiction in any manner. It is my opinion that you are intentionally attempting to create a morose clinical picture by establishing factors relative to your laboratory studies which do not correspond with the normal parameters of diagnostic studies. Again, I'm of the opinion that the challenge here has little, if nothing, to do with attempting to uncover a mysterious and ellusive single pathogenic process responsible for your symptoms. I've carefully reviewed the extensive medical history that you've provided and it's entirely inconsistent with the known characteristics and probabilities associated with illness and disease in humans. By contrast to your posted information, together with what I've observed, your portrayal would be far more consistent with Münchausen syndrome to the largest extent. This is, however, strictly my opinion based upon the evidence at hand. I wish you all the best in obtaining resources necessary to determine the cause for your florid symptoms. You should also be aware that any information obtained from sources such as an internet forum are intended strictly for informative purposes and are in no way representative of medical evaluation or treatment, and; do not constitute supplantation of direct medical care or treatment by your doctor(s). Best regards, J Cottle, MDDr. Cottle,Know much about lymes disease? I was in third stage disseminated lymes before they diagnosed me with it in Oct. 2007. Prior to that I had over 25 CNS symptoms and fever for over 10 months. Ended up in MayoClinic and initial diagnosis was possible MS or viral encephylitis and they recommended spinal tap. I had the tick bite rash since I spend months in Pennsylvania for work but didn't recognize the rash and didn't know what lymes was. Within 4 months of getting rash, I started losing all muscle control, vision problems, etc..Ended up in hospital yet again after return from mayoclinic and got spinal tap which confirmed lymes. After 3 days on doxy I felt like I got my life back. I could feel my left side of my face, could walk again without falling and could pick up my own coffee cup (which I could not before or even use a fork due to lack of muscle control, no more bells palsy, headaches, or fever. So many symptoms that doctors thought I was depressed prior to diagnosis). After doxycycline, I was so amazingly better. The only remaining symptoms were eye droop and still weakness in right side of body and some loss of taste in certain parts of tongue.One year later, symptoms started returning but just hand action tremor, fatigue, and intermittent eye droop. Four weeks ago got dysarthria and went to doctor and got steroids and amoxycillin which helped a bit. Then it recurred 10 days later. More steroids. One week later, the dystharthria came back and has stayed now for 5 days so far and I am falling down because leg muscles are giving out. Some discoordination. Ended up in ER two days ago with difficulty swallowing and breathing. ECG showed some arrhythmia. Feel like sleeping 15 hours a day but I am usually hyper and swim and use treadmill and eat very healthy foods--far more than suggested vegetable daily serving. Having action tremor in hand and very weak and some radicular pains that are debilitating but last ony about 3-5 seconds. Could this be my lyme was not treated fully in the first place? MRI and CT normal.
    Anonymous 42789 Replies
    • August 28, 2009
    • 08:59 PM
    • 0
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  • Dr. Cottle,Yes. Your job, here, is done. Now, perhaps you can hurl insults at homeless people or wave rack of lamb under the noses of starving, third-world children. Where there are down-trodden people, Dr. Cottle will be there, to discourage and defame them. You know, I can easily debate your previous post, but the bottom-line is, I'm too tired, to waste my time with someone who clearly has no interest in helping me. It's apparent, that your reason for being on this site, is to seek attention.I'm still reading threads, with which you are involved (there are 500 posts, in total), and you seem to make a habit of getting on your soapbox. I've noticed that you have four main agendas:1) You disagree with other Doctors, who post responses on this site2) You think that many (if not most) illnesses have no physical cause3) You have accused a lot of posters of saying that they definitely have one disease or another4) You have an attitude of "No Doctor has ever been wrong, nor will they ever"These are dangerous notions, as they are entirely dismissive of patients' complaints. And, your diagnoses are based purely on assumptions about the patients' motive for seeking treatment.While we're talking diagnoses, it's my advice, that you seek psychiatric counsel, for your Megalomania.So, why don't you seek attention, somewhere else. There are plenty more people, like me, for you to harass (though, I wish you wouldn't). You'd think, with these being your twilight years, you might do something positive with your life.Why didn't you just tell me that you didn't know what was wrong with me? Or, tell me that you don't want to help me. But, to insult me and accuse me of such a terrible thing as Munchhausen, I just don't understand how someone could do something so horrible and still be able to live with himself?Okay, I'm done arguing with you. You can argue with yourself, if you want to, but I have more important things to do.
    NoDrCanDiagnoseMe 20 Replies
    • August 29, 2009
    • 02:42 AM
    • 0
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