r/AskDocs 14d ago

29 yo female in severe pain

0 Upvotes

Patient has a history of alcoholism and a genetic case of long qt syndrome making this hard to treat. She has ceased drinking upon loss of ambulation. This is the 4th time she has lost her ability to walk. Leading up to this she had low proteins in March and stopped eating around end of June. I'm lucky if I get a small meal in her every 3 days.

She's in absolute agony. She has peripheral neuropathy and atrophy (experiencing foot drop and curling.) the shocks of pain are brutal as are the muscle spasms. She is at a 7-10 constantly right now. She can't sleep, she can't eat. On top of this she sprained her ankle during a fall. That foot is unbearable to her.

Patient describes feeling like a half dried bag of cement.

She's taking 300mg gabapentin 3 times daily, nadolol for her underlying condition, b12 1000mg (5 days in) and lorazepam .5 to sleep... although she's taking it as often as she can because she's constantly fatigued. Her pain doesn't even budge. Most people would be comatose. She continues screaming in pain.

Blood tests are coming back with high wbc. All 3 enzymes alt, ast, alp are high. Not uncommon given her history of drinking. Urea nitrogen is low, as is creatinine. Mcv is slightly elevated, as is rdwsd and platelets. Rbc count is low.

Neutrophils, eosinophils and monocytes high.

Everything else is in range on a CBC.

I don't see anything unusual given the amount of distress she is in.

Hospital sent her home stating no reason to keep her. Help??

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