[47F] Experiencing increased neuropathy and general malaise

Patient Description

A 47-year-old female with a history of diabetes, diagnosed in June 2020, presents with increased stage 4 neuropathy in the feet and toes, characterized by numbness and stiffness. The patient also reports fatigue, dizziness, a mild headache in the sinus region, loss of appetite with mild nausea, and increased sleep duration of approximately 12 hours per day for the last 3 days. The patient has little energy and poor concentration, which she attributes to the lack of restful sleep and increased stress. She is currently taking Lisinopril, Effexor, and insulin for diabetes management but has recently discontinued Glipizide and Norvastatin. The patient has a known allergy to Rocephin, which causes anaphylaxis and hives. No over-the-counter medications or supplements are being taken.

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Arora's Assessment

What might be happening

Based on the information provided, the following conditions may be contributing to your symptoms:

  • Diabetic Neuropathy: As a diabetic, you are at risk of developing neuropathy, a condition that affects the nerves in your body. This could explain the numbness and pain in your feet and shins. Diabetic neuropathy can progress over time, especially if blood sugar levels are not well controlled.

    • Treatment typically involves managing blood sugar levels and medications to relieve symptoms.
  • Chronic Fatigue Syndrome: This condition can cause severe fatigue that doesn't improve with rest and may worsen with physical or mental activity. Other symptoms can include loss of memory or concentration, unexplained muscle or joint pain, and extreme exhaustion lasting more than 24 hours after physical or mental exercise.

    • Treatment often involves a combination of medications, therapy, and lifestyle changes.
  • Depression or Anxiety: These mental health conditions can cause physical symptoms such as fatigue, headache, and loss of appetite. They can also cause excessive sleepiness and difficulty concentrating.

    • Treatment often involves a combination of therapy, medication, and lifestyle changes.
  • Sinusitis: This is inflammation of the sinuses, often due to an infection. This could explain your headaches in the sinus region.

    • Treatment often involves antibiotics, nasal sprays, and sometimes surgery for chronic cases.

Please note that this is not an exhaustive list and other conditions could also be causing your symptoms.

What you can do

  1. Consult with your healthcare provider: Given the complexity of your symptoms and your medical history, it's important to discuss these symptoms with your healthcare provider. They can provide a more accurate diagnosis and appropriate treatment options.

  2. Monitor your blood sugar levels: If you're not already doing so, regularly monitoring your blood sugar levels can help manage your diabetes and potentially slow the progression of diabetic neuropathy.

  3. Maintain a healthy lifestyle: Regular exercise, a balanced diet, and adequate sleep can help manage symptoms of chronic fatigue syndrome and improve overall health.

  4. Mental health support: If you're feeling stressed or suspect that you might be dealing with a mental health condition such as depression or anxiety, consider seeking support from a mental health professional.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms significantly worsen or you develop new symptoms
  • You experience severe pain
  • You have difficulty breathing
  • You have changes in vision or speech, or sudden severe headache
  • You have thoughts of harming yourself or others

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

People Also Ask


What are the common symptoms of diabetic neuropathy and how can it be managed?

Common symptoms of diabetic neuropathy include numbness, tingling, pain, and weakness in the affected areas, often starting in the feet and legs. Management typically involves controlling blood sugar levels, pain relief medications, and lifestyle changes such as regular exercise and a healthy diet.


How can chronic fatigue syndrome be distinguished from general fatigue, and what are the treatment options?

Chronic fatigue syndrome is characterized by severe, persistent fatigue that doesn't improve with rest and may worsen with physical or mental activity. It often includes symptoms like memory or concentration issues, muscle or joint pain, and prolonged exhaustion after exertion. Treatment may involve medications, therapy, and lifestyle adjustments.


What are the potential side effects of discontinuing medications like Glipizide and Norvastatin?

Discontinuing medications like Glipizide and Norvastatin can lead to changes in blood sugar levels and cholesterol management, respectively. It's important to consult a healthcare provider before stopping any medication to avoid adverse effects and ensure proper management of underlying conditions.


How can sinusitis be effectively treated and what are the signs that it might require medical intervention?

Sinusitis can be treated with decongestants, nasal sprays, and sometimes antibiotics if a bacterial infection is present. Signs that it might require medical intervention include severe or persistent symptoms, high fever, or symptoms that worsen despite treatment. Chronic cases may require further evaluation and possibly surgery.


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