Misery, exhaustion, and fatigue again

April 6, 2017 1:45 PM

This was me at the end of January. I was having horrible fits of exhaustion, got treated for a UTI with three days of Cipro, and felt all better! At least for February. At the very end of February or the beginning of March, it all started again and has steadily been getting worse.

At least I've gotten much better about articulating what's going on, I guess. I'm back to episodes of crushing fatigue and exhaustion, with slightly elevated temperature, aching (mostly in the back), shivering/chills, and sometimes no appetite (I somehow kind of assumed without thinking that this was what everyone meant by exhaustion, and only discovered otherwise a couple of weeks ago). I've lost about seven pounds since the beginning of the year. I feel like I could just fall over dead. So far I have had a clear chest x-ray, pretty much normal blood work, and one urine sample with white blood cells last week followed by one this week without. I am very frustrated and discouraged and will probably be looking for a new primary care doctor. I do have MS and have had it for over 20 years. However, I'm pretty sure this is not my MS for a number of reasons. I had another visit to an urgent care clinic today and there was no real diagnosis although I got a prescription for an antibiotic. What else do I need to ask? What do I need to push for? Where do I go? Do I just wait and see if I die?

posted by sockasm to Health & Fitness (7 answers total)

At this point I think your top priority should be establishing care with a primary care physician. Most complaints that do not fit the textbook description of a common condition cannot be handled adequately by urgent care, and I think you have long since surpassed that complexity threshold.

I appreciate that you have reasons to believe this is not MS, but given your history and your level of frustration, I would strongly urge to go for a check in with your neurologist -- even if this is unrelated to your MS, it could be related to something else your neurologist has seen (e.g. a condition that often goes hand in hand with MS), and at the very least another set of eyes on the issue may spark the theory that leads to getting you relief.
posted by telegraph at 2:05 PM on April 6, 2017 [1 favorite]

Response by poster: Just to clarify: I have a primary care physician, sort of. My old one left the practice in February and I set up with a new one in March.
posted by sockasm at 2:08 PM on April 6, 2017

I was reading your symptoms, especially the chills/shivering and back pain, and I thought kidney infection or kidney stones.

Googling up white blood cells in urine seems to support this opinion.

"I feel like I could just fall over dead."

This sounds like emergency room stuff, not just urgent care.
See if you can get an escalated opinion from your PCP.
posted by the Real Dan at 2:51 PM on April 6, 2017 [1 favorite]

Urgent care prescribed antibiotics without making a diagnosis, or even a presumptive diagnosis? Did they not tell you to follow up with your existing physician? That should be your primary goal right now--hi doc, I went to urgent care, they prescribed this antibiotic, but they've left me no clearer on what the antibiotics might be intended to treat. I feel very unwell and need an appointment as quickly as your staff can arrange one.

IANYD, but if you've recently been treated for a UTI there's a possibility that it may have evolved into a kidney infection. Were the urine samples all evaluated by the urgent care facility, or by your new doctor? If the former, have them send those records to your doctor if they haven't already.
posted by late afternoon dreaming hotel at 2:51 PM on April 6, 2017

Response by poster: There was a urine sample with my PCP exactly a week ago that was positive for white blood cells. They contacted me with the results by putting something on the patient access part of the website Sunday night asking me to come in to give another sample for a culture. I went in Monday to do that, but that sample was clear. Then today I felt horrible and went to urgent care, and that sample was also clear. I have the test strips and can test myself here and I got a very weak positive earlier today. Urgent care said I should follow up, but I had already told them I thought I might need to find another primary care.
posted by sockasm at 3:06 PM on April 6, 2017

Does it hurt to tap on your back around your flank? Do a like a karate chop motion. (Near the bottom of your ribs on your back?) Do you have side pain? If so, that could definitely be kidney. When I had a severe kidney infection I had barely any UTI type symptoms and I think they had to culture the sample to get a positive. I didn't realize how bad it hurt until the doctor chopped on my back with his hand.

This definitely sounds like it may earn you a trip to the ER. They would be equipped to do more tests like an ultrasound, labs, and give you IV hydration which can help with the fatigue and dehydration.
posted by Crystalinne at 6:37 PM on April 6, 2017 [1 favorite]

Response by poster: Is this really an okay thing to go to the ER? When I've been seeing my primary care and UTC for the same thing and just getting nowhere?
posted by sockasm at 7:03 AM on April 7, 2017