Discussions By Condition: I cannot get a diagnosis.

fever, then muscle ache, then parasthesia to left side of face?

Posted In: I cannot get a diagnosis. 4 Replies
  • Posted By: DRJOHNG
  • May 10, 2009
  • 05:11 AM

ok long story short ( cause my muscles ache to even type) had a fever first for 2 days along with minor muscle ache like DOMS then the DOMS increased in pain over 3 days to the point where i could barely write legibly as my forearm muscles were on fire. now 4 days later, I have severe muscle soreness in most every muscle including throat and arms (like ive worked out my whole body for 5 days straight and then waited for the muscle soreness A.K.A."DOMS effect" to kick in. well it has and i havnt lifted a finger in days so to speak!) and now i am developing left side face parasthesia but no droop like Bells P. YET!

WHATS MY DIAGNOSIS?

I am a physician but do not want to have this disclosed at work so I have little resourse to diagnose. i have diff diagnosed it to be a type of Viral problem affecting my muscles such as viral myosistis. but have little experience with it. can someone here help? thanks in advance. john

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4 Replies:

  • Well Dr. John, I'm sure you'll agree that under the specific medium through which we're communicating, a "diagnosis" would be a far reach at best but I'll offer the following: At first blush, your symptoms would suggest influenza. Acute viral myositis tends to develop as the symptoms of flu are resolving rather than at onset and as you know, can rarely cause rhabdo in some patients. A CK level, urinalysis and a few other labs would naturally be of help here, but suffice it to say that if it's restricted to acute myositis, resolution would be 1-2 weeks. You did not mention any lymphadenopathy or any prodrome that involved a derm rash, or history of immunocompromisation, so I'll skip over a few other possibilities because while I'm not suffering myo pain, I don't care to "type" unnecessarily. ( I did note that despite your discomfort you took steps to respond to a forum question by another member. Many thanks.) As for the paresthesia, most clinicians tend to call the horse after the race if a Bell's ultimately develops. If indeed it appears that something like a Bell's or Ramsay Hunt is developing, then a steroid pack would be a good idea. Lastly, and merely out of curiosity, I would ask why you haven't sought direct evaluation outside the professional workplace? Not that it requires a response, but I'm constrained to point out that a multitude of sources exist to obtain evaluation that are confidential in nature. The matter of the swine flu epidemic is naturally captioned here, but in the absence of further information, I'll leave it at that. Based upon limited imformation, this sounds like influenza but a few labs and direct eval would be wise. Best regards, J Cottle, MD
    JCottleMD 580 Replies Flag this Response
  • DR Cottle thanks for the reply! As I am in the medical field and have coleagues that can prescribe to me, i have been prescribed an omega 3 Lovasa, Flexeral and vicodin. I am hoping the symptoms (which are only muscle soreness in every major muscle and some weakness such as diminished hand grip) resolve. I am actually going to wait another 24 hours before going in for blood work. I understand that you believe it is the flu I am experiencin g but unlike the last flus I have had, I have never experienced this type of all over body pain with inability to completely grip shut my hands, pump gas, open med bottle, etc. Please advise further if possible. thanks again Dr JG and BTW the parasthesia to left side of face has resolved as I was taking naprosen.
    DRJOHNG 2 Replies Flag this Response
  • Okay, if you don't mind me asking, what type of physician are you?Acute myositis, if that's what you're experiencing, is not a requisite for influenza. Simply because you may have experienced a former infection with influenze A or B, does not suggest that it's not the case here simply because you now have symptoms similar to myositis. Again, without a CK, urinalysis and some other labs to confirm what's actually taking place, I would not throw caution to the wind where the onset of rhabdomyolysis may be a complication. My impression of influenza is merely based upon your description and seasonal probabilities, but the internet is absolutely no place to go in search of a diagnosis, accurate or otherwise. Also, I'm perplexed why you would be prescribed Lovaza as a therapeutic regimen for your symptoms? What is the impact of an Omega-3 supplement on your condition? Also, if you're experiencing muscle pain and weakness, why would someone prescribe Flexeril, a muscle relaxant of all things? It certainly won't correct diminished grip strength. Lastly, why Vicodin as a first-line choice for the muscle aches and pain? Tylenol 3 would have been far more appropriate under the circumstances. I'm lost. Again, please explain what type of physician you are and what type of doctor prescribed the highly uncharacteristic regimen noted.My direct suggestion here is to avoid treatment of the muscle symptoms in the absence of clinical labs necessary to make a determination of the underlying cause and the labs should have preceded any decisions to treat your condition. If you don't mind me saying so, your approach to this matter, as well as the treatment being provided by your colleague, is highly uncharacteristic for a physician.Best regards, J Cottle, MD
    JCottleMD 580 Replies Flag this Response
  • Hmm, I can imagine that you feel very uncomfortable. A few years ago I suffered from muscle ache, too, sometimes even had kind of muscle spasms. I had to take Flexeril for quite some time and the muscle problems slowly improved. I never got a clear diagnosis although I contacted to physicians - none of them could really tell me what the problem was.
    HarryOS 3 Replies Flag this Response
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