Ask an expert

22 Sep 2021

Painful & Stiff Joints, esp. knees, swollen and purple feet
I've been having excruciating, debilitating joint pain, to such an extent where I struggle to get up or move around once I’ve been sitting for long periods at a time. Went to my GP after my friend recommended, I do the online symptom checker It came up with most likely Rheumatoid Arthritis and second to that Polycythaemia. Main reason for doing the online symptom checker was to share these symptoms with my GP, mainly because by the time my doctor consults me, I never remember all my symptoms, I get really anxious when I go to doctors. She then sent me for a panel of blood tests through the clinic because I don’t have medical Aid. The following tests were done: TSH, T4: Rheumatoid factor, FBC + ESR, HbA,C & FBC. I have no idea what these tests mean. I had gone for them and have an appointment with the acute Dr. on 4th of October at 10h, wasn’t sure why I had to wait so long? For the past two days the pain has increased and discoloration of my feet and being swollen has become unbearable which in turn I called the clinic to find out if all my results have come through, so that I can go to the emergency rooms at the hospital with this pain but that they also have access to my results, if need be, and the clinic have them. The nurse briefly had a look at my results and said all my markers were normal, except my haemoglobin and haematocrit markers were higher then normal. She said the one should be btw 12 – 15 and mine is 16.3. I managed to obtain many of my blood results from over the past years to take along if need be and every single one of the full blood count tests the markers for the same, Haemoglobin and haematocrit were above the normal markers, ranging from 16.3 – 16.9 since 2012 – now. One the one Lab result had the following comment, of which I was not informed of at the time, nor did I go retest back in 2014 when this result came out. These markers have been high since 2012 – to now and I have managed to obtain 4 full blood count results during this time. “Equivocal Pilycythemia – suggest repeat Hb / Hct if clinically indicated” I know my body and everything is completely out of whack. I have RLS and drink Oxpola for my legs, I have a degree of insomnia, and was prescribed Tripiline many years ago. I use to weigh 75kg a year ago, I now weigh 59kg, I have underactive thyroid and am on Eltroxin. I’ve always had a bit of a oily skin but now my skin as extreme dry and itchy I can’t go without moisturizer, I had regular period, but now I have my period twice a month. My knees feel like they going to shatter when I climb up and down the stairs at home. My feet feel like balloons going to pop, and I have to cover my fingertips with cotton wool and plaster because It’s really sore and sensitive when I type on my PC and I have to word. I now fall asleep within seconds to such an extent that I am holding something and waking up I would notice that I actually fallen asleep with this in my hand and dropped it. I get severe migraines but now it feels as if I am going to pop a vein in my head. My left arm I have pins in needles even just holding my phone in the bed reading the news, it goes numb. This morning I woke up with a severe migraine again, and my migraines more often than not causes my blood pressure to drop to the extend where It feels like my sugar levels have dropped, start sweating and my hands are trembling. But to this migraine this morning, my neck and upper back towards the middle (spine area) is really sore and the pain extends to the left side of my body over my shoulder just above my breast. I never used to get sick with flus and colds, but when I now get sick, it’s really severe, last time I was sick I got booked off from work for 2 weeks. Have I got reason for concern? How do I approach this going to the hospital if my symptoms get worse without dr’s only doing basic testing and telling me “Everything comes back normal” when I know I am everything but fine? How would I go about getting answers as to why my haemoglobin and haematocrit is and never has been (referring to results over 10 years) btw the normal markers, without being turned away? I am not saying that I will ever get the answers, but knowing that I have done what I could and that the doctors have really tried, and I don’t get better I will be able to make peace with that and I will be able to accept whatever comes my way. Please Help!!!
Answer 66 views
Arthritis expert

04 Oct 2021

Thank you for the detailed history.
The fact that the Hb and Hct have remained relatively constant over 10 years makes it highly unlikely that you have polycythemia. If you are a smoker. that may explain the elevated Hb and Hct.
You have not provided your age, which is important, especially regarding your menstrual history.
The fact that "everything else is normal" makes it unlikely that you have rheumatoid arthritis.
The most likely diagnosis to explain all your symptoms is Fibromyalgia syndrome.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical examination, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
Voting Booth
Have you entered our Health of the Nation survey?
Please select an option Oops! Something went wrong, please try again later.
28% - 9929 votes
72% - 25892 votes