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Smoker. CT Scan, X-ray, And Colonoscopy Done. Reason For Swelling And Tingling Of Hands And Feet?

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Posted on Tue, 12 Mar 2013
Question: Female, 24 YO, smoker 1 pack a day, have 3 children, weight 125, height 5'7, do not drink. I will try to be very brief. 3 months ago out of nowhere I got terribly ill. Severe diarrhea for 3 days. Thought it was food poisoning that would go away. The diarrhea went away but chronic constipation came, headaches, rapid weight loss (was 160 3 months ago now 125 with no exercise and no change of diet) severe back pain and pain under both rib cages, aorta feels like its going to explode out of my stomach (yes I'm very skinny so it's more obvious but frightening) my toes go numb, arms, legs, feet, and hands tingle, appears as bad blood circulation, now my veins in my feet will bulge upon standing and walking as well as my left hand veins, while my right hand becomes swollen so far without vein pain, my blood pressure has gone from 22 years of "normal" to 107/70 then will go to 187/91. I feel so weak. I use to be abla to lay down and move around without noticing movement to now laying down and not having strength to turn or even move my legs. I'm concerned about everything stated. I have had ct, mri, x-ray,colonoscopy, endoscopy, and an ultrasound. Findings were severe gastroenteritis, fluid filled loops of small bowel, cysts on both ovaries, enlarged uterus, & benign small liver lesion. The severe pain in my stomache has slowly subsided but after I eat or lay down it feels like someone pouring acid on my back -right side near bottom rib cage close to spine. And my back constantly hurts from my bottom up to my bottom ribs closest to spine. I'm very worried that I have a clot somewhere which could be causing the swelling and tingling in hands and feet. My problem is I can't find a doctor who will take me seriously!! I have refused all pain meds because I don't want any. I just want to get better!! So my question is what do you think could be an underlying problem? I'm not asking to be diagnosed because I know that is not an option here. I need to be pointed in the correct direction. Who to see, labs, or procedures that can be done. Anything you can say to help me PLEASE!!
doctor
Answered by Dr. Charles S Narasi (3 hours later)
Hello, XXXXXXX,
You mention that CT,MRI,Endoscopy (Upper) and Colonoscopy
were all negative. At the time you had the diarrhea, the X-ray
findings showed changes in the bowel.
You mention a lot of tingling and numbness of the hands and feet.
You also mention different aches and pains.Your blood pressure is
also fluctuating.
How were all the blood tests ? What kind of blood work was done.
Have the doctors ruled out Celiac disease ,Auto-immune disorders
such as Systemic Lupus ? Blood calcium levels ,electrolytes,
Vit-B12 levels ?
Your symptoms are suggestive of some sort of neuropathy .
We need to know what is causing this. You also neeed to have
thyroid blood work done.
If not done recently, I suggest small bowel series to look for
any abnormalities. If any , you may have to undergo capsule
endoscopy .
I hope you can discuss these with your physician.
I wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (11 hours later)
Thank you for your response. My ct from first er visit results were " no findings " blood test showed low pottassium level. Discharged with pottassium pills. Small clinic X-ray showed severe constipation and was given instruction to go to er. Went and they gave me another x-ray and discharged me with instructions to do enema. Enema did basically nothing. Even tried many many times/different days still nothing. Colonoscopy/endoscopy showed h pylori positive, 1 benign polyp, severe gastritis, z-lined esophagus, hiatal hernia, negative celiac biopsy but no biopsy result for crohns. All other biopsies negative. Ultrasound showed cysts on ovaries, enlarged uterus, small calcification left kidney (confirmed no stone) and small benign liver lesion. Liver mri was done with results showing no lesion found. I have copies of all lab work, and mri, ct, ultrasound, and X-rays. I paid a company to give a second opinion on first ct- results were severe inflammation of small intestines wall thickening with fluid filled loops of jejunum and ileum. I will give you my most recent blood work results from er on 01/29/13 WBC 7.1 k/mm3, RBC 4.45 mil/mm, HGB 13.9 gm/dl, HCT 40.4 %, MCV 91 UM3, MCH 31.2 PG, MCHC 34.4 %, RDW 13.5, PLT 240, MPV 8.8 UM3, NEUT 50.2 %, LYMPH 36.4 %, MONO 6.9 %, EOS 6.0 %, BASO 0.5 %, NA 141 mmol/L, K 3.6 mmol/L, CL 105 mmol/L, CO2 28.3 mmol/L, Glucose 80 mg/dl, BUN 9 mg/dl, Creatinine 0.8 mg/dl, estimated GFR 93, BUN/CREAT. Ratio 11, Calcium 8.7 mg/dl.
I have these blood tests done on 12/18/12 SED Rate 1 mm/hr, C Reactive Protein <0.300 mg/dl, Rheumatoid Factor <10 lU/ml, TSH 1.540 ulU/ml. Not sure if this matters but I was menstruating during 12/18/12 blood tests. I was doing research around December 1, 2012 and found info about B12 Pernicious Anemia and called my doc office and was given orders to check that plus a few more levels on 12/16/12: B12 361 PG/ML, Folate 6.10 ng/ml, Vitamin D 25-OH TOTAL 27 ng/ml, a Lipase level of 96(F) u/l.
I asked for a B12 shot early December but after getting it never noticed anything different. That is all that was done for the test results I stated above.
I have charted my blood results from beginning to now and some are high and low but nothing that has made me look sane per say.
I will note changes of concern by order of first lab to next: HCT levels 40.9-43.9-39.6-43.6-40.4. MCH 30.8-29.5-30.4-30.3-31.2. I was not given these at the most recent er visit: AST 11-14-13-17 U/L, ALT 16-11-14-10 U/L, ALK PHOS 90-63-63-57 U/L, Protein 7.8-7.6-7.4-7.8 g/dl, albumin 4.5-5.1-4.2-5.0 gm/dl, amylase 33-40 iu/l, PLTs 284-317-291-295-240 k/mm3, Neut% 60.6-57.6-63.4-50.2, lymph% 28.9-26.8-31.7-29.8-36.4, EOS% 3.1-5.1-2.5-6.0, BASO% 0.3-0.4-0.4-0.5. CO2 levels fluctuate low to high also.
I am about to go buy a blood pressure monitor and see if they have anything else that I may need. My head is pounding, back hurting really bad, I haven't used the bathroom in over 7 days, and I'm just severely weak. I have an appt with a new GI doc tomorrow since the one I was going to mailed me a certified letter stating she will no longer be my doctor. So if this helps please please let me know. If you need anything else... I have it so just ask. Thank you!
doctor
Answered by Dr. Charles S Narasi (2 hours later)
Hello, XXXXXXX,
I can understand your frustration. All your blood work
looks good. I am glad that your Celiac tests were normal.
Your B-12 level is on the low normal side and with the
history of H.Pylori and stomach problems, I really think
you are B-12 deficient and that is the reason for your
neuropathy symptoms. I want you to continue with B-12 injections
1000 micrograms once a month. As for the constipation I would
recommend a PEG solution (Polyethylene glycol) daily according
to the label instruction untill you start having diarrhea. Then you
can cut back the dosage till you have a normal bowel movement.
I see you only had Rheumatoid factor. I would like you to get XXXXXXX and DNA antibodies, Serum Complement levels, and also
immunoglobulin levels.
I wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (41 minutes later)
This is excellent advice. I have been in a cloud filled with family, home life, taking care of my 3 boys all under 5, and this for the past 3 months so that little bit of advice means so much! Why 3 hospitals and 2 different GI specialists couldn't tell me this... I have no clue. I am very happy I found this site and greatful for your advice! I will write these tests down and take them to the new GI Specialist tomorrow. I have a primary doctor I will be seeing at the end of this month as well so if the GI Specialist doesn't agree with this advice I know my Primary Physician will write me the blood work orders. I forgot to mention while viewing my ultrasound the tech measured the wall of my gallbladder which was at the high end limit of normal gallbladder wall thickening. If the gastritis and stomach issue have caused damage to my gallbladder will the medicine you stated interfere with a gallbladder problem? If so, what kind of procedure would show definite gallbladder function? I truly appreciate your advice! :)
doctor
Answered by Dr. Charles S Narasi (9 hours later)
Hello, XXXXXXX,
Gallbladder thickening may indicate chronic inflammation.
Obviously , you did not have stones, but you could have
gravel or sand like cholesterol crystals. The test to check
your gallbladder function is called HIDA scan (Nuclear) with
or without CCK (Cholecystokinin) injection.
Omeprazole will not affect the test nor will Miralax (Peg solution).
I wish you the very best.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Charles S Narasi (6 hours later)
Hi Dr. Narasi,
Sorry to keep asking questions but I am a little worried at the moment. I went and bought a wrist BP monitor last night. Well I checked it 3 times last night and had normal BP 120/80 but my pulse was 96. Nothing too crazy. Well this morning I checked it as soon as I woke up and it was 139/96 pulse 89. An hour later it was 136/86 68 pulse. Then I started getting pain in my stomach and felt like I had to go to the bathroom. I read something someone wrote one time about checking while going to the bathroom so I wore it on my wrist. Anyway as soon as I sat down my BP read 120/87 118 pulse, a minute later it read 136/103 111 pulse, a minute later it read 134/100 111 pulse,
8 minutes later after I finished 141/102 86 pulse, 6 minutes later 134/96 104 pulse. I must add there was blood mixed with my bowel movement as well as a significant amount of mucus. Should I be concerned? Are these numbers okay? I'm feeling lightheaded and almost like my face is "about to" go numb. I have my GI appt in an hour and I will be giving him this info as well. Thank you for your help!
doctor
Answered by Dr. Charles S Narasi (2 hours later)
Hello, XXXXXXX,
By now ,I am sure you are seeing the GI-specialist.
I am sure the fluctuations in BP and pulse are due to anxiety.
Bloody stool with mucus may indicate some type of colitis.
I am sure the doctor would be able to address those concerns.
Wish you all the best.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Charles S Narasi

Gastroenterologist

Practicing since :1962

Answered : 693 Questions

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Smoker. CT Scan, X-ray, And Colonoscopy Done. Reason For Swelling And Tingling Of Hands And Feet?

Hello, XXXXXXX,
You mention that CT,MRI,Endoscopy (Upper) and Colonoscopy
were all negative. At the time you had the diarrhea, the X-ray
findings showed changes in the bowel.
You mention a lot of tingling and numbness of the hands and feet.
You also mention different aches and pains.Your blood pressure is
also fluctuating.
How were all the blood tests ? What kind of blood work was done.
Have the doctors ruled out Celiac disease ,Auto-immune disorders
such as Systemic Lupus ? Blood calcium levels ,electrolytes,
Vit-B12 levels ?
Your symptoms are suggestive of some sort of neuropathy .
We need to know what is causing this. You also neeed to have
thyroid blood work done.
If not done recently, I suggest small bowel series to look for
any abnormalities. If any , you may have to undergo capsule
endoscopy .
I hope you can discuss these with your physician.
I wish you well.