Q:I have been in ill health for a number of years mainly due to impaired circulation, first Raynaud's and then erythromelalgia with the addition of numerous other debilities including arthritis, migraine, slow transit colon , plus such recent complaints as ME, allergies, candida, not absorbing vitamins and minerals, or imbalance of hormones and adrenal glands, not producing sufficient stomach acids and gastric guices and an allergy to amalgam fillings (I have had most of them removed and will have the remainder done shortly.) I also had a hysterectomy about eight years ago. I experience tremendous pain on my left side, just below my waist which increases after sitting. When I had the hysterectomy I was told my ovaries were enlarged due to my circulatory disorder and that was what was causing the pain. My health declined after the hysterectomy. I am now 41 years of age and have had Raynaud's since the age of 19. The erythromelalgia developed shortly after the hysterectomy, and I am unable to tolerate the heat. My body feels trapped and on fire and the sun affects me dreadfully, but the cold affects me dramatically also. My whole body aches and pains especially in the morning when I have to support it until I have sufficient strength to clean my teeth. My doctor recently suggested that I see a psychiatrist saying she would probably be able to help in some way especially wth the pain. I was reluctant but I went to see her as I would try anything to get relief. I was prescribed an anti depressant lofepramine which made me feel much worse. I felt weaker, unsettled, I lost interest in everything, I lost my will to attempt anything. I felt tired, nauseated, thirsty, irritable. I just wanted to lie down but I couldn't sleep. My body welcomed rest, but my brain didn't. It felt confused and unsettled, so I was unable to relax for long. I would get up to do something but would have to lie down again. I went back to see her and she put me on fluoxetine (Prozac), and this gave me exactly the same feeling; I mentioned it to her but she told me it wasn't the capsules and I had to persevere. I have been taking them for 17 days now and I feel I am getting worse. Could anyone advise me on the medication and could anyone give me any more details on my circulatory disorder?" L. R. , North Yorkshire.
A:Yours is an all too common cocktail of environmental and doctor induced diseases a combination of allergies and problems undoubtedly caused by the hysterectomy. (I can't tell you how many letters we get from women who report continual pain or problems after a hysterectomy.)Typically in situations like yours, what medicine cannot explain it attempts to blame on the patient. Obviously your doctors think your problems are all in your head, or they wouldn't be prescribing "happy pills". The last thing you need is more medical intervention in the form of anti depressants, which often have the effect of causing the very symptoms you are trying to treat.
As we reported in WDDTY Vol 2 No 1, Prozac can cause anxiety and insomnia and anorexia, as well as affect nearly every system of the body. It can also interact with numerous other drugs and shouldn't be taken with them. I wouldn't even bother going back to that psychiatrist, as she seems neither concerned about your views nor clued up on the potential side effects of the drugs she is so quick to prescribe. One note of warning. Wean yourself off the drug gradually as abrupt discontinuation can lead to disturbed sleep, irritability or drowsiness.
Your depression and upset about your health is normal and justified. What seems most necessary is for a more enlightened doctor to determine which problems of yours are environmentally induced (caused by a combination of diet, toxic overload, allergies, and possibly pathogens like candida albicans) and which are a result of the hysterectomy.
We would recommend that you see a clinical ecologist who can do tests to determine what environmental factors are causing your illness. As you know, Raynaud's disease causes extremities to turn white on exposure to cold, and later red and purple when circulation returns.
Erythromelalgia, on the other hand, is characterized by painful, hot redness of the feet and often even the hands.
The best treatment is to avoid the sun and to raise and cool the feet during an attack.
Many sufferers report relief by taking aspirin during an attack and far better success than with drugs like propranolol, which constrict arteries.
There are also nutritional approaches to improving circulation. Besides a healthy diet, you should include two or three servings of oily fish (mackerel, salmon or herring) in your weekly diet (fish oils seem to promote healthy circulation) or investigate the possibility of taking fish oils supplements (omega 6 essential fatty acids), which increasingly have been shown to improve circulation.
You might also try taking certain vitamin and mineral supplements. Nutritional specialist Dr Steven Davies recommends that people with Raynaud's disease take daily vitamin C (one gram), vitamin E (600 IUs), evening primrose oil 500 mg (4 capsules), MaxEPA, the fish oil (4 capsules) and magnesium (200-400 mg).
Finally, many patients living with chronic pain from operations have found relief with acupuncture or massage.
Again, alternative practitioners out there:any suggested approaches for L.R. and our other readers living with chronic pain? If there are no scientific studies to prove the effectiveness of a particular regime, tell us about your clinical experiences.