View Full Version : Issues after section hike...
grrickar
10-31-2004, 23:01
All - I know that many of you have endured lyme and west nile, so I thought this might be a good forum to get some advice on what to discuss with my doctor about some issues that I am having.
I recently got back from a 134 mile section hike - my first ever. I was understandably tired a lot and my knees and feet are still a bit achey. My issue that started during my hike was that one night I had heart palpitations (I have had these before, doctors blamed various things but no cause was ever found - so no history of heart disease) and I was extremely hot in my sleeping bag. I even felt nauseated that evening. The meal had a god deal on onions in it, and believe me or not, but indigestion has led to these palpitations before so I was not too concerned with it. (One doctor had even told me to take Gaviscon to remedy the indigestion issue when it happens)
It has been about two weeks since my hike and I have consistently been having night sweats. I have never had these before except when I was really sick and running a fever. I am not feverish when I go to bed, but hours later I awake and my clothes and sheets are soaked. The room is cool (I like to sleep with the room about 70) and I don't cover up much so that can't be the issue.
The other thing that has me nervous is that I feel achey all over from time to time like I have the flu, but the symptoms come and go and never last longer than a couple of hours at a time. I have not ran a fever that I know of (unless I'm spiking one in my sleep)
If I was coming down with something, I would think it would have hit me by now or that I would be over it, but it appears neither is the case. I have no known health issues, and I have read about the causes of night sweats and nothing really seems to apply to me (at least as far as I know).
I am going to the doctor to hopefully get to the bottom of this, but any of you who have had similar experiences, I'd be interested in any information that you might have that I should discuss with my doctor.
Hammock Hanger
10-31-2004, 23:13
All - I know that many of you have endured lyme and west nile, so I thought this might be a good forum to get some advice on what to discuss with my doctor about some issues that I am having.
I recently got back from a 134 mile section hike - my first ever. I was understandably tired a lot and my knees and feet are still a bit achey. My issue that started during my hike was that one night I had heart palpitations (I have had these before, doctors blamed various things but no cause was ever found - so no history of heart disease) and I was extremely hot in my sleeping bag. I even felt nauseated that evening. The meal had a god deal on onions in it, and believe me or not, but indigestion has led to these palpitations before so I was not too concerned with it. (One doctor had even told me to take Gaviscon to remedy the indigestion issue when it happens)
It has been about two weeks since my hike and I have consistently been having night sweats. I have never had these before except when I was really sick and running a fever. I am not feverish when I go to bed, but hours later I awake and my clothes and sheets are soaked. The room is cool (I like to sleep with the room about 70) and I don't cover up much so that can't be the issue.
The other thing that has me nervous is that I feel achey all over from time to time like I have the flu, but the symptoms come and go and never last longer than a couple of hours at a time. I have not ran a fever that I know of (unless I'm spiking one in my sleep)
If I was coming down with something, I would think it would have hit me by now or that I would be over it, but it appears neither is the case. I have no known health issues, and I have read about the causes of night sweats and nothing really seems to apply to me (at least as far as I know).
I am going to the doctor to hopefully get to the bottom of this, but any of you who have had similar experiences, I'd be interested in any information that you might have that I should discuss with my doctor.
For a week I would wake in the night to find my sleeping bag soaking and me as well. I felt like I had a mild case of the flu but wrote it off to dehyration. Then my head started to explode and I passed out. The hospital said I had West Nile Fever and later after tests Lyme showed as well. You should ask your doctor to order a test for Lyme. Good Luck, Sue/HH
mediclimber339
10-31-2004, 23:55
Yeah, get the full spectrum of blood work and cultures done. You don't want to mass around with either West Nile or Lyme. Also if you stayed in any shelters or lean toos get a test for Hanta virus. It's carried in rodent droppings and you can never be too safe. Just a paramedics opinion.
grrickar
ONce you figure out what is causing this would you please let us know.
orangebug
11-01-2004, 07:30
These are very nonspecific symptoms. Lots of things should be and will be considered. A Lyme test is of doubtful value, as false positives and negatives are common. Hantavirus is unlikely as you are able to write and breathe.
West Nile is a good thought, but so is TB. I'd consider looking at your risk of GERD and sleep apnea. I think there is some reason to consider atypical angina.
I'm glad that you have the smarts to head to a real world doctor and get to the root of this.
Bill...
slatchley
11-01-2004, 07:51
I couldn't disagree more. With the prevalence of Lyme's and ehrlichiosis, that's a good place to start, despite the false readings. This sounds like one of those two to me, as a total layperson, but one who has had at least two cases of ehrlich. and 10 cases of Lyme in my immediate family.
orangebug
11-01-2004, 09:15
In medical school, we were taught that when you heard the drum of hooves beating, saw manes flowing across the plain, heard whinnying and such - first look for horses and later look for zebras.
Lyme and erlichiosis are part of a good differential diagnosis, but such symptoms are unlikely to occur acutely during a section hike. I anticipate that other conditions are more likely from this description.
Toolshed
11-01-2004, 10:29
GET TO THE DOCTOR ASAP.
Endocarditis symptoms (http://cardiologychannel.com/endocarditis/)
The symptoms you discuss are the same as the symptoms I had in 1994. I was diagnosed with Endocarditis. An infection in the valve of my heart. I was close to death when I finally went. My Cardio & ID Doc estimated based on the amount of bacteria in my bloodstream that I wouldn;t have made another 24 hours. (8 years later the valve was replaced, but that is a whole different story). I ended up in the hopsital for 2 weeks and on IV antibiotics for 8 more.
The heart palps, the re-occurence and remission of symptoms and the night sweats are all telltale signs of something very bad.
If it isn't endocarditis, consider yourself lucky, but whatever,
DO NOT WASTE ANY MORE TIME, PLEASE - GET TO A DOCTOR !!!!!!
(Also, they determined I got mine from a dental visit 2 weeks prior to have a cavity filled - Have you had any dental work lately? or any cuts on your mouth that could allow strep bacteria from your mouth into your bloodstream?)
I wish you the very best in whatever the diagnosis!
HikeLite
11-01-2004, 10:48
If I remember correctly, night sweats are classically associated with Hodgkin's disease, but other illnesses could cause it also. You should see your physician.
http://www.aafp.org/afp/20030301/1019.html
Don't panic about your symptoms, but do get checked out. About three years ago I also had palpitations, night sweats, and aches which resembled the flu. After a cardio test the doc said I have the heart of a 25 year old (actually 40 at the time). Anyway, the diagnosis was the onset of good old hypertension. In my case I was put on an Rx of Toprol XL which basically took care of the problem, however, you have to stay on it. Nasty habits like smoking and working in a high stress job also were factors. Hope your diagnosis and treatment is simple. An afterthought, after noting you age, when I was 30 years old I developed over a period of days chest pains, nausea, pain radiating into the arms and went to the hospital (military at the time) and heart problems were ruled out. They kept me in for two days and even did the barium GI tests along with others. In the end all checked out and the conclusion was that the pain was muscuskelatal (sp?) in nature. That episode went away without taking any drugs.
grrickar
11-01-2004, 12:37
Doctor Appt is tomorrow - will let everyone know. Thanks for the advice, you guys are the best. :clap
creaky bones
11-01-2004, 15:28
Good luck!
If it wasn't part of your original cardiac work-up, or even if it was (because then was then and now is now), you might consider a 30 day event monitor. Some cardiac dysrythmias come and go in short bursts and can cause a lot, if not all, of your symptoms. They're very treatable and they can occur in any age group.
Creaky Bones
grrickar
11-02-2004, 23:46
Blood work came back normal, and the dr. did not think I had anything to worry about. Another series of tests were to be completed tomorrow at a lab, and he will have the results then. White blood cell, hemoglobin, BP, kidney and liver function all were normal. I think that probably rules out an infectious disease as the cause of the issues.:clap My biggest concern was West Nile. I did not get bitten by ticks as far as I knew.
As for the heart assessment, my own take on that is that I started having issues early in the hike, and went on for 7 more days many,many more miles without incident. I would think a cardiac issue would have taken me down if I in fact had one, seeing how a good many of those miles involved climbing.
orangebug
11-03-2004, 06:44
Okay, this began early on in the hike. Many things would be considered, and some will be conjectured. Hydration, electrolyte disturbances, and exhaustion may have played a role. Have the symptoms left yet?
Glad to hear the scary things appear to be ruled out.
Although you may not have been aware of a tick bite, it is still a possibility. I had night sweats, severe headache, loss of appetite, profound weakness a week after a hike in Montana, and my symptoms were initially misdiagnosed. A second opinion from a doctor who was knowledgeable on tick diseases came back as presumptive Rocky Mtn Spotted Fever, who immediately put me on a course of doxycycline. I recovered quickly with the antibiotic. You can't afford to wait when it comes to tick diseases (RMSF, erlichiosis, Q fever, babesiosis, Lyme, etc). Some of these can be extremely serious, even fatal. Serology tests are notoriously unreliable - there are times when a precautionary course of antibiotics is advisable. This may be one of those times. I urge you to get a second medical opinion and want to wish you best of luck and a speedy recovery.
orangebug
11-03-2004, 08:22
It sounds unlikely that a tick borne disease is present if this began early in a section hike. However, there is some literature suggesting that it is reasonable to take a single dose of doxycycline after exposure to tick bite as a preventative measure for Lyme disease, about once per week. We don't know exactly where grrickar was hiking or the risk of Lyme and other tick borne diseases.
The cost of doxycycline is minimal, as are the risks of adverse events. I'd recommend discussion with grrickar's doctor. I could probably dig up the citation (NEMJ ~June 2002?) if he/she didn't run a quicky Medline search for themself. It still makes sense to stay with the original physician who has a plan for evaluation and treatment underway.
Toolshed
11-03-2004, 10:13
Grrickar,
I am very happy to hear that your blood tests came back fine!!! I think it is always wise to be more cautious in these matters. Of course, I also understand that unless one has been there, they cannot really comprehend how devastatingly fast a strep infection in the bloodstream can kill a healthy adult.
Good luck with your prognosis - I wish you the very best.