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Muscle Loss in Arms,weakness,lethargy.
Oct 10, 2002

Hi hope you can take the time to hopefully help sort me out. For about the last ten weeks I have been having pain and aches in my arms. There has been a lot of muscle loss in the upper arms & shoulders but more so in the arms. I am very skinny guy anyway and weight is now 8 stones. I think I have lost 1/2 stone in that time. I have had a temperature during the night which has been constant since the pain started in my arms. My appetite is virtually zero now and I'm only getting by on small snacks. I have been sleeping a lot some days. After having a night sleep of around 8 hrs I'm going back to bed 2 hours later and sleeping around 6 more hours, which is very unlike me. Im very worried. I'm a gay male and have been at risk for HIV infection. There are no other symptoms really apart from the pain and aches in my arms and extreme tiredness. The only other thing i have noticed is my hands sometimes go very very cold at odd times. Previous medical history: about 10 yrs ago I had a problem with my right eye, blurred vision. I saw a number of specialists and they told me I had a cotton wool spot at the back of the macula. I had a HIV test as they thought it was connected, but the test was neg. I have had a few tests since then, but have not had a test done in over 3 yrs, and have been at risk for infection during that time. The only other problem I had was about 5 yrs ago I lost an awful lot of weight and they could not find a problem with me. The doctors said it was a mental health problem. I lost lots of weight and felt tired run down. I went privately to see a doctor for a second opinion and he did a stool test. I had Giardia and must have had this for quite sometime. This was treated with the appropriate drugs. At the moment I am taking no medication whatsoever. My weight is 8 stone, I am 5'10" in height, and my body looks painfully thin in front of the mirror. I'm desperate with worry. I went to the doctor last week and he gave me a form to take to the hospital for blood tests for the following: Clinical chemistry= UE , Glucose, TFT , LFT. Haematology = FBC and thats the tests he wants to do... I'm scared to death of going for another HIV TEST. I simply will NOT go for another HIV test...unless I'm sure the symptoms I present with are or could be related. I am also a smoker of around 20 per day if that helps you with your information. Also for about the same time, I have noticed a hard small white lump on my tounge swelling. I showed my doctor he said its a pimple (?). Its been there for about 10 weeks or more.

Response from Ms. Fields-Gardner

There are so many reasons for weight loss and weakness/lethargy that you can (and should) start ruling things out one by one.

If you have no appetite and get by on snacks that don't provide you with enough calories to maintain a good weight, you need to find out why and do something about it. Loss of appetite can happen because of many reasons, including an infection or other condition and depression or other psychological reasons.

For those of you "listening in" a stone is equal to about 14 pounds. At 5'10" I would expect you to be somewhere around 155-190 pounds (or 11 to 13.5 stone). The amount of weight you have lost is certainly a contributor to your weakness and your need to sleep so much (your body is likely trying to conserve energy because you don't feed it enough). Feelings of coldness can happen with such extreme weight loss (not to mention smoking!).

With that much weight loss it is difficult for your body to even mount the response required to develop a fever, so I would suspect an underlying problem. Maybe a flare-up of a previous infection or maybe a new one. And finally, but certainly not the least of your problems, smoking 20 cigarettes per day will certainly contribute to loss of appetite and other complications.

What you describe may or may not be related to HIV. If you are at risk for infection and think it might be a factor (or your doctor thinks it might be a factor), it would be worth settling that side of the equation by getting a test done.

I think you need a "makeover" from head to foot. Take all of the things that you have mentioned (and any you have not) to work up a "laundry list" with your doctor and nurse about what risk factors should be worked on. Ask for a referral to a psychologist, psychiatrist, or social worker who can work with you to get through the steps necessary to turn things around. Do it now.


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