Hello Dr. Joshua, ?
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Over the years, I’ve had some problems with numbness. There is a spot on my right leg right above my knee, about the size of a baseball that has never returned feeling. Nothing went wrong for it to go numb, it just did. Also, there is some numbness between my legs, again nothing was abnormal. This morning I woke up, and the middle of my bottom lip is numb and a small part of my chin. I have full movement, when I say numb…it’s not totally numb. It’s partially numb, to where I can still press and feel, but it seems like the outside layers have no feeling. I’m not sure if maybe poor circulation can be contributed…a few medical problems I’ve had are aches in my legs when I sleep, high blood pressure, high cholesterol, and extreme fatigue. I’ve had an EKG, I also wore a halter monitor for 24 hours, with fine results. I’m a 22-year-old white female, 5′6 about 165 pounds, athletic. I really am concerned about these problems, I feel as if I’m too young for these symptoms to happen to me. The fatigue really effects my life in a bad way and I’m not sure if it’s related to the other problems I have. If you could give me any advice, in respect to my doctors they really haven’t been able to help the situation much, their “guesses” and solutions that fail to work just alarm me more. I have yet to tell them of the numb lips, which is my most recent occurence. Any help would be appreciated. Thank you so much. ?
(As of 6/18/2006 The lip is still numb, it seems not as much though, or the area is not as big.”
Dr. Joshua’s Answer:
Numbness is a common complaint. More often than not, the cause cannot be determined. A common cause for localized numbness is damage to the superficial sensory nerves, due to trauma (such as hitting with a blunt object, cutting, pressure such as too tight a pair of shoes etc…), infection, scarring, or some unknown and invisible cause that disrupts the superficial nerves.
The fact that your lip is getting better slowly suggests a superficial nerve damage that heals over time. Whatever caused the numb spot on your leg we may never know.
Fatigue also is a common complaint and there is a wide variety of possible causes.
The way fatigue is evaluated is generally as follows:
A thorough history and physical examination, also a neuro exam (your primary care physician can do it) with a basic lab workup of CBC, TSH, (thyroid function), urinalysis, ESR, CRP, ALAT, AFOS, GT, Albumin, Calcium, Sodium, Potassium, Creatinine. Not all of these are necessarily needed, and some others may be needed - the decision is made by the examining doctor.
Medication should be carefully reviewed to see if any drugs may be causing fatigue.
Hypertension and high cholesterol should be carefully followed, and treated if necessary. In a person so young as yourself, possible causes for secondary hypertension should be carefully excluded. Secondary hypertension means that there is some underlying treatable cause for hypertension. Sleeping habits and lifestyle should be reviewed.
Depression should be considered as a possible cause of fatigue, and treated with psychotherapy or medication if diagnosed.
If any neurological deficit is suspected, a consultation with a neurologist is needed.
I understand it can be disappointing when the doctors can’t determine the cause of these symptoms, but that’s not uncommon in medicine - these are heterogeneous symptoms and the human being is a complex biological entity - sometimes we just can’t pinpoint the cause, and sometimes it needs to be determined that something, if not life threatening or severely disabling, has been sufficiently examined and just has to be accepted.
The above is just general information related to the sort of symptoms you describe. I cannot give any specific recommendations to you because I’d need to take a thorough history and physically examine you for that. Please talk to your own doctor about your concerns.
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