Discussions By Condition: I cannot get a diagnosis.

Petechiae, bruises, fatigue, shortness of breath ...

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: txpacotaco
  • December 17, 2011
  • 05:29 PM

During the summer of 2010 I had multiple angina attacks that resulted in an angiogram. I was diagnosed with a "very mild" coronary artery disease (not life threatening) - I had a blockage in a branch off my main coronary artery. My cardiologist told me it would either heal open, or heal closed, in which case my body would compensate with new blood flow. I have not had any angina since then, but it did make me more alert as far as my health is concerned.

Last March I started working with my regular doctor to try to figure out what was causing some cyclical symptoms (all-over muscle spasms/cramps, fatigue, bone pain, flu-like sinus and cough issues followed by mouth sores and geographic tongue, along with thrush) that started about 3 years ago. These "flares", as I think of them, tend to last about 2 - 3 weeks and I may have a few months in between them. My doctor ran a CBC with differential and noted that I had an elevated WBC, but offered no diagnosis or follow up.

In June, I saw a different doc at the same clinic for a 2nd opinion. She suggested I come back while I was experiencing a flare up for new blood work. In August I did just that, and my WBC was still elevated. My SED rate, CRP and ANA were all normal. I was referred to a hematologist for the elevated WBC.

The hematologist told me some of my blood tests were abnormal (see below), but she didn't see anything to indicate leukemia, and that the elevated WBC meant there was inflammation going on somewhere in my body. She asked me to come back in 6 months for follow-up testing.

A couple of months ago, I suddenly noticed that the lanula on my toenails had turned red, and around the same time I developed vertical red lines on my thumbnails. At this point in time, the red lines are still there and I now have a red "arc" across the top of the lanula on all of my fingernails. Over the past several weeks I have started noticing that I become terribly fatigued during the day, and I am very short of breath. Something as simple as changing our cat's water bowl leaves me out of breath. My arms and legs feel very heavy and ache as though I have been lifting weights. The "normal" cycle of symptoms I had been experiencing hasn't happened this time - instead, everything just seems to be slowly getting worse without letting up. My stomach is extremely bloated and I can't eat very much at any sitting - just a few bites before I feel too full to eat more. (Despite this, I have gained about 15 pounds since June.)

A few days ago I came down with what I think is a minor cold (runny nose, cough). At the same time, I suddenly developed new petechiae on my wrists, but this time, I also developed bruises . These bruises are dark blue and I have a couple on the inside of my right wrist, one just above my right elbow, and another on the back of my right upper arm. My arms have been very achey since these new petechiae showed up. Both my arms and my lefts feel terribly heavy and I feel as though I don't have the strength to lift things. I become out of breath and fatigued even trying to do minor housework (doing the dishes, taking out the trash, etc).

I have tried 3 things to follow up with my doctors:
Have attempted to make an appointment with the clinic I've been going to for years. The doctor never showed up for the first appointment (I have no idea what happened there), the clinic cancelled the 2nd appt. because I'd made it for the same day and they said my symptoms did not indicate an emergency, and the 3rd time I called for an appointment, their phone system hung up on me. I've decided to move to a different clinic here in Austin (I've been with this one for more than 10 years), but can't get in to see anyone until Jan 5.
I saw my cardiologist and he ordered an echocardiogram and a cardiac perfusion scan. I've had the echocardiogram, and am having the other scan on Tuesday (with a follow-up with the cardiologist to discuss results on Wednesday). He said he does not expect the results to indicate any worsening in my CAD status.
I left a message for my hematologist and they've made an appointment for me to get blood drawn on Monday - they'll call me in for a consultation if my blood test results are abnormal.
At 45 years old, I would expect to feel energetic and healthy, but my intuition tells me something very dangerous is happening in my body. I worry about cancer (which runs in my family). I worry about autoimmune disease (my father has a rare form of vasculitis called Wegener's Granulatmatosis). I worry about worsening heart disease (also runs in my family). I want to make sure I'm asking for the right tests and seeing the right doctors, but the situation with my primary care physician leaves a lot of that up to me.

Any suggestions would be helpful. Has anyone else been through something similar?

Abnormal blood tests in August I mentioned above:

WBC = 13.1 (ref 4.8 - 10.8)
Monocyte % = 1 (ref 6.0 - 12.0)
Eosinophil % = 0.00 (ref 0.9 - 2.9)
HCT = 48 Spun (ref 37.0 - 47.0)
MCH = 34.3 (ref 27.0 - 31.0)
MCHC = 32.7 (ref 33.0 - 37.0)

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