Lyme Disease

[michelle_f]

Ten years ago while living in Georgia I begun to become extremely confused. I was so confused and at a loss of concentration that I remember putting off any "hard" decisions until my thoughts became clear again. At the time, I was attempting to be a vegetarian, so I blamed a lack of protein for my condition (though I still drank milk and ate cheese). About a month after the severe lack of concentration started, I awoke one morning feeling extremely ill. My stomach throbbed, I was extremely weak, and I had a severe headache. However, I still went to my job waiting tables. Once I got there, I realized that I also had the sensation that my feet were no longer a part of my body. I could feel my feet and knew they were there, I just felt as if my body instead began at my ankles and extended a couple of inches above my head. Strange, I know, but this is exactly how I felt. When I got off work I had begun to feel better and ate some dinner. That was a mistake, because the rest of the night my stomach trobbed again. The next day I woke up with a slight rash that swept across my body over the next few days (started at my feet and worked itself up my body - it was light, as if it was underneath my skin). That day I was in an outdoor wedding and ended up fainting from the heat (I was running a fever and it was mid-August in Georgia). I went to a doctor who basically laughed at me and said the rash was nothing. Once the rash left, I began to feel arthritic pain in all of my joints. This lasted about a week. I have never had any other arthritic pain since, but do seem to have problems with my memory and concentration (though this could just be stress). I also had a rash since that time that followed my spinal cord, but was told that it was eczema (it does run in my family and I have since had what appears to be eczema on other joints and psoriassis). I told a person who was a doctor in Louisiana about what happened, and he thought it was lyme disease even though I never got the bull's eye rash. Does anyone know if Lyme Disease can cause the symptom's I described?

[Boardcertifiedderm]

Dear Michelle:

You did not state if the symptoms of arthritis and peripheral neuropathy (tingling, numbness in the distal lower extremities) has persisted but I assume some of the symtoms have, hence your post.
You did not also mention any physician visits in the last 10 years. I'm sorry your personal physician did not take your symptoms seriously, but transient rashes, even with fevers or arthritis can be caused by many different viruses, etc, most of which are self limited. Unfortunately this does not appear to be the case for you.

You need to see a specialist for a complete examination and labwork. There is simply no substitute. Self diagnosis and asking around often leads to frustration. If insurance is an issue, most states have MediCaid. It may take some work and time but you should be able to make it eventually to a specialist such as a rheumatologist. When Medicaid is involved, going to a University Center is the best bet.

As for your symptoms, a rash with fever, arthritis and peripheral neuropathy can be caused by lyme disease but there are a host of other causes. This might even not be related to your present problems. That is why an expert diagnostician is called for. Over ten years if the symptoms have continued there is some expectation that a diagnosis should be able to be arrived at. The fact that an eczema like rash developed over your spine does not mean it is related to your nevous system. Conversely, the lack of a "targetoid" rash at the time of onset, does not rule out lyme disease either.

When persistent arthritis is present, especially in conjunction with bonafide neurological symptoms (numbness of the extremities) we do seriously consider both autoimmune diseases and infectious causes such as lyme disease. Less well defined diseases like fibromyalgia, that may or may not have a psychological component (ie how you process pain) are diagnoses of exclusion only.

The totality of your symptoms will be cosidered by the doctor. When a patient has a lot of complaints, yes one does consider as I put it "how their brain processes pain" and "psychological" components are considered. That said, physician specialists are trained to be excellent "sorters" so I will state all your symptoms accurately and try to give a timeline for their onset. Sometimes and often the symptoms are not all one disease either. Sometimes as you discribe your tingling, ie if it's a sock distribution, yes we think about the psychological. Still metabolic diseases such as diabetes can cause this, neurological diseases, MS, lyme, etc are all considered. Spinal stenosis is another cause of weakness and or numbness in the lower legs.

Although all physicians recognize medical science is far from perfect, given the lack of a diagnosis and the length of time you've had to live with this, going to the University for an evaluation is my suggestion. Doctors do wish to help you and one bad experience, given the severity of your symptoms, would not, if it were me, discourage me from trying harder to get this problem identified. Call the general medical clinic at the nearest University and after they see you, then they can consder referring you to a specialist.

board certified dermatologist