When You Hear Hoofbeats, Think Horses Not Zebras

I must confess, I am a huge fan of the medical mystery genre whether reading about these in print or watching these on television.  The phrase, “When you hear hoofbeats, think horses not zebras,” is often quoted in the medical world, and was coined in the late 1940s by Dr. Theodore Woodward. It was meant to be advice to medical interns that when searching for a solution one should always consider the obvious possibilities rather than the unlikely ones.

medical

Unbeknownst to me I had become the main character in my own medical mystery drama that began the fall of 2017. My symptoms? Unexplained joint pain, tenderness, and numbness/tingling that came upon me quite unexpectedly during a time when I was my healthiest – eating clean and being active.  I wanted to know the source of my hoofbeats, and in my search for an diagnosis and cure I saw ten health care professionals, took a number of medications and supplements, underwent blood labs, ultrasounds, and x-rays, endured the replacement of silver dental fillings, changed my eating habits drastically, sweated through exercises and stretches, and attended healing and prayer services. Cue the haunting music as I reach back to the recent past.

In summer of 2017 I began a new diet and over the period of a year I lost nearly 30 pounds.  I wrote about it this blog post.  It was a time in my life when I found a happy balance with food and activity.  Coincidentally, at this same time a mysterious symptom appeared – a tingling and numbness in my back.  It wasn’t painful so much as annoying.  As I pondered what the cause could be all sorts of zebra-like diseases ran through my mind.  Was this the beginning of MS or Parkison’s or a tumor? I mentioned this symptom at my yearly physical in October 2017, but my doctor did not seem too concerned, and said we should wait and see if it resolved on its own. Well, my back was still bothering me a month later and was followed in subsequent weeks with mild joint pain and swelling in most of my joints including my back, neck, hands, feet, wrists, elbows, shoulders, and hips. 

Unfortunately, my doctor was retiring and I was unable to see her for a follow-up. I was able to get a new primary doctor, and the earliest appointment I could get was in February 2018 with her nurse practitioner. In the meantime I decided to be proactive thinking the back issue was simply a pinched nerve or a disc out of alignment, and I went to a chiropractor.  A month of chiropractic treatments did not help my back and my joint pain and tenderness was steadily increasing.  

back pain

In February the nurse practitioner saw me and scheduled me for a back X-ray and suggested physical therapy for my ailments.  I also had some blood labs done. The results of the x-ray showed nothing serious, and I followed up with physical therapy shortly thereafter. I did stretches and exercises for over two months. I also saw a massage therapist to get some help with the joint pain and numb feeling in my back.  Neither of these therapies relieved my symptoms. However, when the blood work results came in, they showed a possibility for an auto-immune condition, and in July I went to see a rheumatologist for answers.

The rheumatologist did more labs, plus more x-rays, and ultrasounds. In a nutshell, the testing confirmed I indeed had joint inflammation, but could not pinpoint the cause. I wasn’t sure if I was more relieved or more concerned. The back tingling was likely the result of joint swelling in my vertebrae possibly impacting my nerves.  I was offered medication to treat my pain – Prednisone, Plaquenil, Methotrexate.  I did not want to medicate without getting to the source of my symptoms and these medications had serious side effects.  The rheumatologist suggested a gluten-free, dairy-free and sugar-free diet to help improve joint pain as an option.

In August I saw a naturopathic doctor to see if she could offer any insight to my situation and prescribe the best diet for my symptoms.  She was highly recommended by my family members as an expert in diet and I was hoping she would have some answers.  We reviewed my complaints and she said I presented like a patient she had whose joint pain was caused by a bad root canal who also had dental problems.  I had just had a root canal done two months prior, and had old silver fillings in my teeth, and I began thinking my dental work was at issue.  She provided a diet that might also help with inflammation, and I began seriously avoiding gluten and dairy and eating sugar in moderation. 

dentist

I made an appointment to get my dental work looked at and followed through on getting fillings replaced and my root canal examined.  My teeth felt better and my root canal work was not at issue, but my joints did not feel better.  A year after the start of my first symptoms I still had no discernible explanation or relief. I altered my diet though the remainder of 2018 and took Advil and Aleve like they were M&Ms.  Everyday tasks were manageable, but there was always that undercurrent of pain when lifting, walking, cooking, and moving.

In November of 2018 I finally saw my new primary care doctor for the first time for my yearly physical.  I reported to her the same things I had said to my old doctor, the nurse practitioner, the chiropractor, the massage therapist, the physical therapist, the rheumatologist, the naturopathic doctor, and the dentist.  I was still experiencing joint pain and tenderness with a numbness and tingling in my back.  I explained that I did not want to medicate to control pain without knowing the cause and wondered if she had any new suggestions.  I was sent for a few more tests with a follow-up in January to discuss the results.

Between appointments I began to notice that something was off with my digestion.  I was following a healthy diet and avoiding foods that cause inflammation, however, one to two hours after eating I would get a bellyache that lasted almost thirty minutes or longer.  It would happen fairly regularly after meals.  I’m not sure how long it had been going on, but now that I was listening even more carefully to my body, this new symptom worried me, too.  There was another zebra in the room – I was imagining the worst, again.  At the follow-up appointment with my primary doctor it was suggested I see a nutritionist. 

belly

Have you been counting?  This nutritionist would be my tenth health care professional looking for the cause of the “hoofbeats.”  It was at this time I was prayed over at a prayer service and went to a healing Mass. While my symptoms weren’t making me bedridden they were ever-present, and it was challenging to do every day tasks.  My prayers were a plea for healing and a remedy.

At the nutritionist appointment I reviewed my symptoms and history AGAIN and begged for a solution.  Throughout the appointment I felt discouraged.  It was more of the same stuff I had heard before about diet and lifestyle.  I was given a modified diet to follow with the usual healthy recommendations, but two things stood out; drink more water and take probiotics.

Drink more water.  Take probiotics.  For some reason I actually heard this with resounding clarity.  Doing these two things might help me feel better.  I should try them.  I did an amateur search on Google and a lack a water in one’s diet seriously impacts joints.  I was honestly under-hydrated, and before and during my health difficulties I had taken at least three different courses of antibiotics. Friends, these two suggestions were to keys to solving the mystery of my condition.  My joints needed more water. 

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I rarely drank water.  The extent of my beverage intake on any given day was one to two cups of coffee (made with water, obviously) and a few sips of water with my meals. None of my previous blood labs showed me as being dehydrated, but water was key to my recovery.  I began making myself drink water throughout the day.  My joints were improving with each day.  When I added the probiotics, my digestion improved dramatically, and I no longer needed to avoid the foods I was previously eliminating from my diet. My gut had been messed up from the antibiotics and the lack of water was making it worse.

In addition to the elimination of my joint pain and back tingling, my brain fog has lifted, my dry eye condition improved, and my occasional throbbing headaches have subsided.  Each day I wake up without joint pain and numbness in my back, yet I’m suspicious that tomorrow it may return.  But it hasn’t.  I can open jars and squeeze a sponge without an explosion of pain.  I can turn door handles and crochet blankets and hit a pickle ball without my joints aching.  I don’t need two hands to pick up my lap top.  I no longer need eye drops and Advil and gluten-free bread.  I shake my head in disbelief at the simplicity of my remedy.  I thank God for this relief and feel so blessed to be enjoying all the simple things that previously had been so difficult.  I am also grateful for the prayers of my family and friends throughout this journey, and the healing advice from my nutritionist.  It took over a year and a half, and I was considering seeing health care professionals eleven and twelve (gastroenterologist and allergist), but thank goodness I didn’t waste more time look for zebras in their offices.

Cheers to drinking more water! 

water

2 thoughts on “When You Hear Hoofbeats, Think Horses Not Zebras

  1. frank Occhiuto

    Sarah,

    Wow, you have been through a lot. I am so happy you are feeling better and have found a solution after much search!

    I took try to drink a lot of water and I also take a probiotic each morning. The chiropractor (who is my favorite doctor for advice) states taking a probiotic daily is something I can do to boost my immune system (as it was challenged by the little ones at the preschool).

    I have quit my preschool job as I was getting ill too often and the latest bout in March was severe. I am counting my blessings as well.

    Happy Easter to my friend!

    Kathy O.

    (PS: I loved the images with your post.)
    ________________________________

    Liked by 1 person

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