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Tell me about the joint/bone pain, please! (Read 14777 times)
Bfrey
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Tell me about the joint/bone pain, please!
12/01/11 at 08:49:35
 
I am still in limbo regarding my TMEP dx; I have an appointment next week with a Univ. of PA derm and will get have my skin biopsy sent to Dr. Castell's lab.  I have a clinical dx of TMEP and two biopsies that were suggestive of TMEP but not positive.  Of course my concern is if it is TMEP, finding out if it is systemic.  My other symptoms that might suggest systemic involvement are esophagitis (taking Xantac 300 mg. b.i.d.), flushing (which I attribute to my hysterectomy 1 1/2 years ago, although the flushing started 6 months are hysterectomy instead of immediately, which is much more common).  Also about the time my hot flashes started I began having bone pain.  I also attributed that to the hysterectomy.  I had my annual gyn. visit today and asked if the hysterectomy (ovaries out as well) and lack of estrogen in my system are causing the joint pain.  I was surprised when she said no.  It's worst at night time; I sleep on my side and when I roll to the other side it's very painful, and sometimes gettting out of bed can be a real ordeal.  If I'm sitting for over 20 minutes or so my back and legs hurt when I get up.  I also have a tingling toe and foot that comes and goes; last year it was so bad I finally saw a neuro for that and all tests came back negative, including nerve conduction.  I notice I am clenching my left foot much of the day without meaning too.  I don't have any bone pain other than my back and legs.  Does this sound familiar??  I'm getting anxious to find out what is going on.
Many thanks,
Beverly
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Joan
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Re: Tell me about the joint/bone pain, please!
Reply #1 - 12/01/11 at 11:53:46
 
Hi Beverly,

  It does sound familiar.  In the beginning, I could barely put my feet on the floor when getting out of bed because they hurt so much.  I also had a lot of pain around my joints, especially back and hips.  Sitting still caused the worst stiffness and pain!

  If you had a store of estrogen, the hot flashes might not start immediately.  That definitely can cause flushing, but so can mast cell degranulations.

  I've found that being on a proper dose of H1 and H2 antihistamines and an occasional Tylenol has reduced my flushing and pain to nothing most of the time.  Occasionally, I'll have a bad day or two and experience a little flush or pain, but very manageable.

  You might want to ask your doctor about increasing your meds.
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Re: Tell me about the joint/bone pain, please!
Reply #2 - 12/01/11 at 12:20:34
 
Ditto what Joan said.  When my mast cell disorder was really flaring I took so much Tylenol!  It was worst at night... my hips, knees, elbows, shoulders, and the small joints in my hands and feet.  Sometimes the pain would be so bad that I couldn't fall asleep until the Tylenol kicked in.  Other times I would fall asleep OK, but wake up with my joints screaming at me for laying in one position too long.

Gastrocrom made the biggest difference for me on this symptom.  In my case, I believe that the joint pain was due to a combination of histamine and antibody-antigen complex formation (histamine makes complexes unusually sticky, so they lodge in places like your joints, kidneys, small blood vessels, etc...).  My ANA levels weren't high enough to set off any alarm bells, but the pain was very REAL and felt like descriptions I've read about lupus.  Not all mast cell patients get this kind of pain... Joan and I just both happen to have a mast cell disorder plus an autoimmune disorder.  Post-surgery is a common time to develop an autoimmune disorder because it causes so much physical stress on your body.

Heather
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Lisa
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Re: Tell me about the joint/bone pain, please!
Reply #3 - 12/02/11 at 02:45:04
 
This is very interesting Heather and it makes sense to me now why I´m having lots of stiffness and joint pain too.   I find that if I´m off of the singulair much then the pain really makes itself known!!!  

I have seen, however, with my son´s and my own case that since we both have autoimmune markers, these markers are showing where the MC mediators are causing inflammation.   His markers are more specific to the connective tissues and sure enough this is where he has issues, in his joints and connective tissues - pain, inflammation.    So, at least with the autoimmuners, this seems to be the damage the mediators produce in us, at least drawing these conclusions from my son´s and my case.
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Mousse
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Re: Tell me about the joint/bone pain, please!
Reply #4 - 12/02/11 at 08:10:51
 
Joint and bone pain are probably my worst symptoms. I have a very hard time @ night trying to find a way to lay that doesn't hurt. I have just started with antihistamines - when do you take the singular? Thanks, Cindy
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lynda51
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Re: Tell me about the joint/bone pain, please!
Reply #5 - 12/02/11 at 09:05:00
 
Hi Beverly,

I too have the pain in my lower legs and lower back.  When I am in a flare the pain in the long bones will continue up above my knees and go into my lower arms as well.  I have been through Taxol treatments with breast cancer.....I liken the pain to the pain those treatments caused.  It is a 7 or 8 on a  1-10 scale.  I find it is worse in the morning too.  It is a deep bone pain, like someone is holding that long bone in a vise grip!  And it just radiates....ugh  I will also get the same kind of pain it at the end of a "series of symptoms" when I eat (food is my big mast cell trigger).  

I have the experts who have posted above me  (a bit intimidating).... Wink   But I thought I read somewhere that most histimine is "made" in our body in the early morning hours.  Have any of you read this?  If that is true, it could explain having more discomfort when you wake up???...not sure.  

I had a Dr. tell me that the mast cells in the brain, if irritated, can cause a "mis-communication between synapses." This can also cause different types of neuropathy  (in reference to the tingling in your toes and the extra stress in your left foot). And as with most of our testing, it would give a normal value when tested for conduction. (Whether or not it is a "true" neuropathy, it still exists for us!)  It is my understanding that the only way to determine if that is the case is with a specific/magnified MRI of the brain. (It could show "more than normal" mast cell activity.)

Talking about autoimmune diseases.  I have two..Hashimoto's thyroiditis diagnosed at age 25 and Sjogrens (recently diagnosed).  I have also had a complete hysterectomy (age 35).   Interesting correlations??  

I wish you the best in all of your testing!  I hope the end result is a difinitive answer and a good treatment plan!   Hugs, Lynda
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Joan
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Re: Tell me about the joint/bone pain, please!
Reply #6 - 12/02/11 at 15:19:04
 
  You're right, Lynda, the body produces the most histamine in the early morning hours, many times the amount produced during the day.

  Have I mentioned that I took Taxol when I had undiagnosed SM?  I had to take a lot of meds so I didn't react to it, and prednisone for 7-10 days after each treatment to keep the inflammation and pain down.  Oh, that hip pain!!!

Mousse,

  When I've had some tingling in my feet, taking vitamin B12 and magnesium has helped.  It might not work for everyone, but it has for me.  I think prostaglandins must cause some of my pain and stiffness when I occasionally have it, because Tylenol makes it disappear (can't take other NSAIDS.).
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Bfrey
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Re: Tell me about the joint/bone pain, please!
Reply #7 - 12/04/11 at 05:34:55
 
Thanks for sharing your experiences with me, ladies.  I want to be 100% sure the TMEP dx is accurate and then continue with tests to see if it is systemic before changing meds.  It helps me to know exactly how the joint and bone pain is affecting everyone.  Three more days to derm #2....then about a week or so for biopsy #3 results...then hopefully on the path to knowledge and relief!

Beverly Smiley
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Joan
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Re: Tell me about the joint/bone pain, please!
Reply #8 - 12/04/11 at 13:53:11
 
Hope all the tests give you good news!
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Re: Tell me about the joint/bone pain, please!
Reply #9 - 12/05/11 at 08:38:21
 
Bev, I have TMEP to. But it is not systemic. I have systemic symptoms. I have esphogatis, gastritis, reflux, esphogeal errosion, hives, joint pain, bone pain and many other symptoms. But I just want to set your mind at ease, that many of us have all those things but it is not systemic masto for us. My bone and joint pain has been so bad that I have had to pull over while driving and I would cry and have to try and get a hold of myself, there has been times where I couldn't open a door, zip a zipper, change my babies diaper, pain in my feet so bad where I could barely walk. I'm 33 and when it get's bad like that I feel like I'm 80 years old. BUt one thing I have learned through these nice people on here is as soon as you feel the pain coming on take some pain meds because if you don't get a hold of that pain before it gets out of control it is harder and takes longer to get under control at a more tolerable level.  My pain is usually in my feet, hands, knees and long bones too. I take ibuprofen and it works the best for me, it is a trigger for some masto patients but others can take fine. Also have you been able to trigger out your triggers? Dairy I find causes the bone pain for me. Gluten is another big one too. Another thing that makes my pain worse is being cold, having cold hands or feet so using hot pads or heated rice sacks which are so easy to make also help tremdously. Good luck on your appointment.
Melissa
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Bfrey
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Re: Tell me about the joint/bone pain, please!
Reply #10 - 12/06/11 at 11:20:43
 
Melissa,
    Thank you for your note.  I'm a little confused....new to this, so bear with me Smiley   If your TMEP is not systemic, how does the doctor explain the severe joint pain?  It is something completely different from TMEP?  For being so young at 33 there should be a reason why you have so much pain.  Did you have a BMB to rule out systemic TMEP?  
Thanks again,
Beverly
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Re: Tell me about the joint/bone pain, please!
Reply #11 - 12/06/11 at 16:27:40
 
Beverly, I'll try to explain the best I can....hopefully someone else with more experience will jump in. Mast cell degranulation releases those chemicals like histamine it also causes other inflammatory mediators like brandykinin, leokotrienes, prostaglandins, etc to be released. Mast cells are in your skin, lungs, intestinal tract, your nose, connective tissues,around blood vessells and nerve endings. All those different mediators can cause pain, inflammation, and other stuff. A lot of us have joint and bone pain and do not have systemic mastocytosis. I can understand how if mast cells are in connective tissue I can understand how we can experience joint pain but the bone pain....that is harder to explain. Maybe someone else can answer this.....is there mast cells in the bones, or is the long bone pain caused by inflammed tissue surrounding the bone that just makes it feel like it is the bone hurting when it is really the tissues? Anyone??? All I know is just when I think understand masto I realize I still have a ways to go. Lol!
I have not have a bone marrow biospy because my tryptase level was only 3.4 or 4.3 can't remember and have been told by a few doctors and others on here they generally don't do a bone marrow biopsy unless your tryptase is 20 or above. So I don't need one. My diagnoses came from my skin biopsy. TMEP is hard to diagnose and is often given as a differential diagnoses and clinical correlation is necessary. Is that what your skin biopsy came back as? A differential diagnoses of TMEP? That is what mine came back as and one doctor over looked it and another doc confirmed the TMEP. I have had full work ups for all autoimmune diseases and they are negative except for APS. But was diagnosed with fibro also.
Anyway I don't if this helped... hopefully some else will explain it better. Take care
Melissa
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Re: Tell me about the joint/bone pain, please!
Reply #12 - 12/07/11 at 05:52:47
 
Melissa;
You sound like me! The bone/joint pain,etc. You (again) explained things very nicely as far as how the degranulaation relates to release of mediators & histamine! I got my TMEP diagnoses from a skin biopsy. My allergist wants me to have a BMB, to see if it IS systemic-even tho I have fairly normal tryptase levels. So- it seems each dr. is different in their conclusions... He gave me a script to "hang onto for when I get a bad flare for a tryptase reading. As murphy's law would have it, Ive been feeling more stabile lately (due to the ketotifen I wonder?, watching my diet,& taking an extra zantac?)  IF there are mast cells in our bone marrow- it would explain the bone pain. I would swear my Bones ache, not just the muscles,etc:but- a massage therapist told me the pain I feel in my biceps,hips, hands etc could be the connective tissue/muscle fascia... All I know is I cant do half the stuff I used to!
we're all in this TOGETHER Smiley
lori
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Re: Tell me about the joint/bone pain, please!
Reply #13 - 12/07/11 at 08:49:04
 
I have had really bad joint pain lately.  Wonder if it is because I am weaning off my gastrcrom?

On the other hand, I just moved recently and I am sure that has something to do with it as well!
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Bfrey
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Re: Tell me about the joint/bone pain, please!
Reply #14 - 12/08/11 at 10:29:15
 
Well I'm back in limbo.  I saw Dr. Roling from Univ. of PA Hospital yesterday.  My hunch that my original dermatologist did not know what she was talking about proved correct.  Dr. Roling was wonderful and has seen 100s of cases of TMEP and I feel like I am in good hands now.  He took 3 biopsies (with no local anesthesia, just saline, which make them almost pain-free) and is sending them to his lab, but he promised if they don't give us an answer he'll find a way to get them to Dr. Castell's lab.  He does not think I have TMEP.  The fact that the Clobetesol cleared it up is one reason (derm #1 said "If the Clobestesol clears it up that means it is TMEP, and if the rash comes back it would mean the TMEP is severe and possible systemic"). Dr. Roling said Wrong Wrong Wrong!!!  And this is what I learned from this board as well.  I asked if he had another idea as to what the rash is and he doesn't; he's hoping for answers from the biopsies.  Me too!! Smiley  He said some rashes just can't ever be explained, and I can accept that.  But I'll need to do some investigating about the bone pain if it's not TMEP; my gyn. gave me an Rx for Lyme testing (we are in prime Lyme territory in PA).  I am so, so happy to have found this board and for the recommendations to get a second opinion.  I will let everyone know if/when I get a dx!!
Many thanks!
Beverly
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