Elevated Sed rate, low-grade fevers, & fatigue

This is complicated, and may take some patience and skill to unravel if it persists. You’ve got suggestions of kidney and lung symptoms. Pentasa can cause a lupus-like syndrome, but you’ve been on it for a while which probably makes a reaction like that less likely. Have you got a smart doctor, do you think? I intend to exclude most surgeons with that question, at least for the kind of smarts I’m talking about.

I've been with my GI for 24 years.  He's retiring at the end of this year.  My GP is okay.  She rans labs ruling out Lyme and a few other obvious illnesses. The last thing she did was a urine sample to rule out UTI.  When I told her that my SED was 54 and the fevers continue, she asked me, "how do you want to proceed."  I thought that was her call.  

Your thoughts....

thanks

Joey, you basically have two choices: delay or action. The argument for delay is that lots of mysterious things clear up by themselves. They are sometimes vague “viral syndromes” and sometimes even less well understood than that. If they go away by themselves then you’ve saved time, money, discomfort, and (sometimes) risk (for example of an invasive diagnostic test gone awry). Delay also, unfortunately, leaves you with less information/progress if things get worse.

You could make an appointment with an academic internist, in the hope that he/she will be up to the diagnostic challenge. Your profile says you’re in Syracuse, so someone at Upstate might fit the bill. Maybe your GI (or even your GP) can recommend someone there, but you’re not really looking for a GI to solve *this* problem. Here’s one list that might be useful as a start: http://www.upstate.edu/healthc...ion.php?clinicID=821

Are all of these symptoms definitely new? The puzzle is different if this might include a recurrence of a preexisting condition. Good luck!

Thank you for your thoughts.  The chest discomfort is not a new issue.  I was evaluated by a cardiologist when heart palpitations were so intense, I couldn't imagine something wasn't wrong.  He did every test possible and found nothing except an occasional missed beat.  He said that my palpitations were caused by stress and anxiety.

 The low-grade fever is new.  I had an accident while in NYC a couple of weeks ago.  We were walking the Brooklyn Bridge and I was hit from behind by a cyclist going full speed.  It was a shocking experience, and looking back, we should have handled it differently.  I didn't seek immediate medical care because we were heading home the next morning, and I couldn't imagine getting stuck in a NYC emergency room.  I had a couple of scrapes, but no visible sign of injury.  My chest and right arm absorbed the entire impact.  

I went to my GP and she said that I had a contusion under my right breast.  She gave me Oxycodone and sent me home.  I had 2 chest xrays in June, so she didn't want to radiate me again.  

Sorry for rambling.... I think I've become somewhat complacent over the years, in that, it's become tiring trying to get to the bottom of things.  I was always a determined advocate for myself; always moving forward, never taking no for an answer.  But it's been 25 years of struggling through UC, weeks in the hospital, bilateral hip replacements, surgery for an abcess, Crohn's, Remicade...  I've read hundreds of posts on this site so I know that I'm very lucky.  It would be nice to have some peace and not have to think about what's coming next.

Again, thank you for your time.

You may have lingering soft tissue injuries from the bicycle accident which would explain the flank and back pain and chest discomfort. The low grade fevers and elevated ESR suggest inflammation and maybe an infection of some kind. Were you cut in the accident and if you didn’t get medical treatment did you apply self help first aid with respect to any wounds? Ideally if you are already taking antibiotics that could help but not necessarily will they eliminate all bacterial infections nor will they touch viral. For how long have these symptoms persisted? 

All pain preexists the accident.  I've been examined and tested by my GP and cardiologist.  The only level that's been abnormal to this point is the ESR.  My GP ran tons of bloodwork (6 vials) three weeks ago and all was good, ESR 32, up from 26.  I read the lab report, but I don't know off the top of my head what was ruled out.  I did scape my hand and knee, but both have already healed. The fever started two weeks ago.  It comes and goes (mostly at night) and never goes above 99.5.

Of course I'm worried it's cancer.  I think that the blood work would have showed something??

Thank you for your time.

Something immunological (autoimmune) is more likely than cancer, I think. There are lots of body part, and lots of ways they go wrong. I don’t know what blood tests were done, but I’m sure there are plenty more tests available. Since the chest discomfort isn’t new it’s less likely to be part of whatever’s going on with your flanks and fevers.

Joey,

The fevers are a concern and I would ask your doctor what cancer(s) would be detected on the blood tests you had done. If you are not satisfied with the answers ask for a referral to an oncologist.

FYI, I am a stage 3 thyroid cancer survivor and I have blood tests done every 6 months. What those tests specifically look for is a protein that is produced by thyroid cancer cells. If the results are less than 0.1 there is no activity to worry about. I take synthroid (thyroid hormone substitute) and have my thyroid stimulating hormone levels monitored because the thyroid as well as two lymph nodes that had cancer had to be fully cut out of my body.

Despite having stage 3 cancer I had no discernible symptoms whatsoever. My PCP during a routine annual exam felt (by touch) swollen lymph nodes in my neck, sent me to an ENT specialists and I was quickly diagnosed with papillary thyroid cancer, at age 52. Been cancer free 3 years now.