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Family Medicine (Expert Forum)
Nobody knows
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
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Nobody knows
by jgrossi, Jan 03, 2003 12:00AM
In January of 2001, I began to run fevers for about 2 weeks (usually above 101), I went to a clinic and the doctor told me to come back if fever did not break and she would test me for Leukemia (scared the hell out of me), CBC was normal, about five days later I went to ER because fever was not gone and I was losing weight (160 to 147), they ran a battery of blood test, everything was normal except for elevated AST and ALT they felt I had hepatitis, ran hepatitis panel twice, negative for hepatitits.
From this point on I went to my family doctor all the time, every test he did came back negative (SED Rate, CBCw/diff, liver counts returned to normal, chest x-ray normal, MRI of head, upper spine and neck normal, urinalysis normal, blood cultures normal), he then sent me to an infectious disease specialist who also ran a battery of test all coming back normal, except for a titer test he did for CMV, which said I had active CMV, he told my PC he felt this was possibly causing my problems. I did some reading and CMV usually does not affect people whom are healthy. Could this have been different in my case?
My doctor started me on Zoloft and after taking it for about four months I had to stop because of side effects (diarhea and night sweats), he then put me on Effexor 75XR, which I was on before, this seems to work (takes away headaches and dizziness), but I still have night sweats at least three times a week, the night sweats are not soaking me to the point where I feel chilled or have to change clothing or bed sheets. I noticed an elarged lymph node in my neck in July and showed that to my doctor and he decided it was fine and it did not feel "cancerous", about a month ago I had a fine needle aspiration and it came back negative for any cancerous cells.
Could the effexor be causing my night sweats? I keep having this fear from reading that I have some sort of cancer considering the night sweats. I also occasionally feel warm, but when I take my temp it is never about 99.4 and my doctor says that a true fever is 100.4 or above.
If I had some sort of cancer would by blood work, SED Rate, x-ray of showed something? I can't seem to close this ordeal from constant worrying. I have had constant upper back pain for about 6 months, but was told it is probably due to posture since spinal MRI and Chest X-ray were negative.
I am a 27 y/o male, who has always been pretty healthy, I do smoke and suffer what seems to be depression.
Any thoughts on the test run so far or any others you may feel necessary would be great or am I just stressing myself out so bad, that I am causing these lingering symptoms on my own (night sweats and back pain)?
Thanks for all your help,
Jason
From this point on I went to my family doctor all the time, every test he did came back negative (SED Rate, CBCw/diff, liver counts returned to normal, chest x-ray normal, MRI of head, upper spine and neck normal, urinalysis normal, blood cultures normal), he then sent me to an infectious disease specialist who also ran a battery of test all coming back normal, except for a titer test he did for CMV, which said I had active CMV, he told my PC he felt this was possibly causing my problems. I did some reading and CMV usually does not affect people whom are healthy. Could this have been different in my case?
My doctor started me on Zoloft and after taking it for about four months I had to stop because of side effects (diarhea and night sweats), he then put me on Effexor 75XR, which I was on before, this seems to work (takes away headaches and dizziness), but I still have night sweats at least three times a week, the night sweats are not soaking me to the point where I feel chilled or have to change clothing or bed sheets. I noticed an elarged lymph node in my neck in July and showed that to my doctor and he decided it was fine and it did not feel "cancerous", about a month ago I had a fine needle aspiration and it came back negative for any cancerous cells.
Could the effexor be causing my night sweats? I keep having this fear from reading that I have some sort of cancer considering the night sweats. I also occasionally feel warm, but when I take my temp it is never about 99.4 and my doctor says that a true fever is 100.4 or above.
If I had some sort of cancer would by blood work, SED Rate, x-ray of showed something? I can't seem to close this ordeal from constant worrying. I have had constant upper back pain for about 6 months, but was told it is probably due to posture since spinal MRI and Chest X-ray were negative.
I am a 27 y/o male, who has always been pretty healthy, I do smoke and suffer what seems to be depression.
Any thoughts on the test run so far or any others you may feel necessary would be great or am I just stressing myself out so bad, that I am causing these lingering symptoms on my own (night sweats and back pain)?
Thanks for all your help,
Jason
Doctor's Answer
by Forum-M.D.-DT, Jan 04, 2003 12:00AM
Thank you for visiting the Family Practice Forum
It does not sound like cancer to me.
CMV can be present following viral illnesses such as Mono. Many people after a bout of Mono can have symptoms such as aches and pains and even intermittent "sweating". (and understand, in many cases, even if infected with a virus such as mono, one may not feel particularly "sick").
It sounds like it was a good idea to stop Zoloft as diarrhea and night sweats are potential side effects caused by Zoloft.
Interestingly, Effexor, in my opinion causes night sweats more frequently, even than Zoloft.
You have done a very good job of describing the tests run and the results. I really get the impression that your doctor and the specialists you have seen have been very thorough in their evaluation of your symptoms.
Stress can indeed cause aches and pains but not typically "night sweats". I would suspect the night sweats are more likely a side effect of the medication. Sometimes a "drug holiday" ... i.e. under the care of your physician, ALL medications are stopped for a week or so. This may be something to speak with your doctor about and may be helpful in determining to what extent the symptoms you describe are "medication related"
It does not sound like cancer to me.
CMV can be present following viral illnesses such as Mono. Many people after a bout of Mono can have symptoms such as aches and pains and even intermittent "sweating". (and understand, in many cases, even if infected with a virus such as mono, one may not feel particularly "sick").
It sounds like it was a good idea to stop Zoloft as diarrhea and night sweats are potential side effects caused by Zoloft.
Interestingly, Effexor, in my opinion causes night sweats more frequently, even than Zoloft.
You have done a very good job of describing the tests run and the results. I really get the impression that your doctor and the specialists you have seen have been very thorough in their evaluation of your symptoms.
Stress can indeed cause aches and pains but not typically "night sweats". I would suspect the night sweats are more likely a side effect of the medication. Sometimes a "drug holiday" ... i.e. under the care of your physician, ALL medications are stopped for a week or so. This may be something to speak with your doctor about and may be helpful in determining to what extent the symptoms you describe are "medication related"
I have been experiencing upper back pain for the past 7 months too. My seems to be more on the right side, under the shoulder blade and round to under my arm. Now the left side is beginning to ache. The pain is not intense, it's more like an dull ache that's with me every day. If I'm standing or walking for long periods it seems worse. My primary md thinks it's myofascial, I'm not so sure. I also suffer from occassional fatigue. I've been reading alot of posts on this site and there are many of us who suffer from chronic pain and other problems. It's hard not to worry when you feel lousy. Good luck to you. ronnie