[44F] With multiple symptoms including foot pain, swelling, and emotional distress

Patient Description

A 44-year-old female presents with a range of symptoms affecting her daily life. She reports chronic pain, burning, tingling, and swelling in her feet for almost a year. Additionally, she experiences leg swelling, numbness, and weakness, which have impacted her ability to walk and balance. She has constant lower back pain and hip pain that radiates towards her back and down her leg, described as nerve pain, persisting for a few weeks. She also reports extreme thirst and dizziness for the past few days. Emotionally, she feels sad, overwhelmed, and cries almost always, triggered by anything negative or stressful, and has been experiencing these feelings for a few months. She has had thoughts of harming herself but would not act on them. She experiences light headaches, vision changes such as blurred or double vision, and changes in bowel and bladder function. For the past week, she feels like food gets stuck when she eats, accompanied by daily heartburn and a sharp pressure in her chest. She also experiences nausea and has noticed slight weight gain recently. Her menstrual periods have been heavier, more painful, and shorter over the last six months. She has a family history of diabetes, heart attacks, strokes, Alzheimer's, melanoma, ankylosing spondylitis, and fibromyalgia. She uses a vape and has allergies to grass, trees, dust, mold, fur, feathers, and tobacco. Her vaccinations are up to date, including the COVID-19 vaccine. She is currently using a Trelegy inhaler every other day and taking Keto ACV vitamins daily.

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Arora's Assessment

What might be happening

It sounds like you are experiencing a range of symptoms that could be related to multiple underlying issues. Here are some possibilities:

Feet Symptoms (Pain, Burning, Tingling, Swelling)

  • Peripheral Neuropathy: This condition can cause burning, tingling, and pain in the feet. It is often associated with diabetes, but can also be caused by other factors such as vitamin deficiencies, infections, or exposure to toxins.
  • Chronic Venous Insufficiency: This can cause swelling in the legs and feet, as well as pain and a burning sensation. It occurs when the veins in your legs are not working effectively to return blood to your heart.

Emotional Symptoms (Crying, Feeling Overwhelmed)

  • Depression: Persistent sadness, crying, and feeling overwhelmed can be signs of depression. This condition can significantly impact your daily life and requires professional treatment.
  • Anxiety: Feeling overwhelmed and crying easily can also be symptoms of anxiety disorders.

Lower Back and Hip Pain

  • Sciatica: Pain that radiates from your lower back down your leg could be due to sciatica, which is caused by irritation of the sciatic nerve.
  • Lumbar Radiculopathy: This condition involves nerve pain that radiates from the lower back to the legs and can be caused by a herniated disc or spinal stenosis.

Thirst and Dizziness

  • Dehydration: Extreme thirst and dizziness can be signs of dehydration, especially if you have not been drinking enough fluids.
  • Diabetes: Extreme thirst can also be a symptom of diabetes, which can cause high blood sugar levels.

Eating Difficulties and Heartburn

  • Gastroesophageal Reflux Disease (GERD): Feeling like food gets stuck and experiencing daily heartburn are common symptoms of GERD. This condition occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus).

Vision Changes

  • Diabetic Retinopathy: Changes in vision can be a complication of diabetes, affecting the blood vessels in the retina.
  • Other Neurological Conditions: Blurred or double vision can also be related to neurological issues.

Menstrual Changes

  • Hormonal Imbalances: Heavier, more painful, and shorter periods can be due to hormonal imbalances, which can be influenced by stress, weight changes, or underlying conditions like polycystic ovary syndrome (PCOS).

What you can do

Feet Symptoms

  • Peripheral Neuropathy: Consult a doctor for a proper diagnosis and treatment plan. In the meantime, you can:
    • Keep your blood sugar levels under control if you have diabetes.
    • Take over-the-counter pain relievers like ibuprofen.
    • Wear comfortable, supportive shoes.
    • Avoid standing for long periods.

Emotional Symptoms

  • Depression and Anxiety: Seek help from a mental health professional. You can also:
    • Practice relaxation techniques like deep breathing or meditation.
    • Engage in physical activity, which can help improve mood.
    • Reach out to friends or family for support.

Lower Back and Hip Pain

  • Sciatica and Lumbar Radiculopathy: Consult a doctor for a proper diagnosis and treatment plan. In the meantime, you can:
    • Apply heat or ice to the affected area.
    • Take over-the-counter pain relievers like ibuprofen.
    • Avoid activities that worsen the pain.

Thirst and Dizziness

  • Dehydration: Drink plenty of fluids, especially water.
  • Diabetes: If you suspect diabetes, consult a doctor for a proper diagnosis and treatment plan.

Eating Difficulties and Heartburn

  • GERD: Consult a doctor for a proper diagnosis and treatment plan. In the meantime, you can:
    • Avoid foods and drinks that trigger heartburn, such as spicy foods, alcohol, and caffeine.
    • Eat smaller, more frequent meals.
    • Avoid lying down immediately after eating.

Vision Changes

  • Diabetic Retinopathy and Other Neurological Conditions: Consult a doctor for a proper diagnosis and treatment plan.

Menstrual Changes

  • Hormonal Imbalances: Consult a doctor for a proper diagnosis and treatment plan. In the meantime, you can:
    • Keep a menstrual diary to track your symptoms.
    • Maintain a healthy diet and exercise routine.

What you should look out for

Given the severity and range of your symptoms, it is important to seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Sudden or severe pain in your chest, back, or legs.
  • Difficulty breathing or shortness of breath.
  • Sudden changes in vision or severe headaches.
  • Thoughts of self-harm or suicide.

Remember

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5 mo ago


People Also Ask


What could be causing the burning and tingling sensation in my feet?

The burning and tingling sensation in your feet could be due to peripheral neuropathy, which is often associated with diabetes but can also result from vitamin deficiencies, infections, or exposure to toxins. Another possibility is chronic venous insufficiency, where the veins in your legs are not effectively returning blood to your heart, causing swelling and pain.


Why am I experiencing extreme thirst and dizziness?

Extreme thirst and dizziness can be signs of dehydration, especially if you haven't been drinking enough fluids. They can also be symptoms of diabetes, which causes high blood sugar levels and can lead to increased thirst.


What might be the reason for my lower back and hip pain that radiates down my leg?

The lower back and hip pain radiating down your leg could be due to sciatica, which is caused by irritation of the sciatic nerve. Another possibility is lumbar radiculopathy, which involves nerve pain from the lower back to the legs, often due to a herniated disc or spinal stenosis.


Why have my menstrual periods become heavier and more painful recently?

Heavier and more painful menstrual periods can be due to hormonal imbalances, which might be influenced by stress, weight changes, or underlying conditions like polycystic ovary syndrome (PCOS). It's important to consult a doctor for a proper diagnosis.

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