[23F] With severe leg pain, migraines, and systemic symptoms

What might be happening

Based on the symptoms you've described, several potential diagnoses could explain your condition. Here are some possibilities:

1. Deep Vein Thrombosis (DVT)

• Rationale: The sudden onset of calf pain, warmth, and swelling, especially with a history of prolonged immobility, raises concern for DVT. This condition involves a blood clot forming in a deep vein, usually in the legs.
• Typical Treatments/Testing: Diagnosis often involves an ultrasound of the leg. Treatment may include anticoagulant medications to prevent the clot from growing or breaking off and causing more serious issues like a pulmonary embolism.

2. Paroxysmal Nocturnal Hemoglobinuria (PNH) Complications

• Rationale: Given your history of PNH, some of your symptoms, such as severe fatigue, weight loss, and weakness, could be related to complications of this condition. PNH can lead to hemolysis (destruction of red blood cells), which can cause severe fatigue and other systemic symptoms.
• Typical Treatments/Testing: Blood tests to check for hemolysis, kidney function, and overall blood counts. Treatment may involve medications like eculizumab or ravulizumab, which are designed to reduce hemolysis.

3. Nutritional Deficiencies

• Rationale: Severe lack of appetite and minimal food intake over several days can lead to nutritional deficiencies, which can cause weakness, fatigue, and other systemic symptoms.
• Typical Treatments/Testing: Blood tests to check for deficiencies in vitamins and minerals. Treatment involves dietary changes and possibly supplements to address deficiencies.

4. Migraine

• Rationale: Your description of bone migraines suggests severe headaches that could be migraines, which can be debilitating and cause significant pain.
• Typical Treatments/Testing: Diagnosis is usually clinical, based on your symptoms. Treatment may include medications to prevent migraines or to relieve symptoms when they occur.

What you can do

Leg Pain and Possible DVT

• Seek Immediate Medical Attention: Given the potential for DVT, it's crucial to see a doctor as soon as possible. This condition can be life-threatening if not treated promptly.
• Avoid Prolonged Immobility: Try to move your legs periodically, even if you're mostly bedridden, to promote blood flow.

Severe Weakness and Fatigue

• Consult Your Doctor: Severe weakness and fatigue, especially with your history of PNH, require medical evaluation. Your doctor may need to adjust your treatment plan.
• Stay Hydrated and Nourished: Even if you have no appetite, try to consume small, nutrient-dense foods and stay hydrated. Consider liquid nutritional supplements if solid food is difficult to manage.

Migraines

• Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help, but consult your doctor for stronger medications if needed.
• Rest in a Dark, Quiet Room: This can help alleviate migraine symptoms.

General Tips

• Track Your Symptoms: Use MDandMe to journal your symptoms, track progress, and get insights. This can be very helpful for your healthcare provider.
• Seek Support: Don't hesitate to reach out to friends, family, or a healthcare provider for support during this difficult time.

What you should look out for

Given the severity of your symptoms and the potential for serious underlying conditions, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

• Sudden Shortness of Breath or Chest Pain: This could indicate a pulmonary embolism, a serious complication of DVT.
• Severe, Unrelenting Headache: If your migraines worsen or are accompanied by neurological symptoms like vision changes or weakness, seek immediate medical attention.
• Severe Weakness or Fainting: This could indicate a serious underlying condition that needs prompt evaluation.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and treatment plan.