Dr. Hitesh Kumar
Neurology
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Patient's Query
Hi doctor,
I have been having these weird sensations mainly in my left leg but sometimes in both legs. It feels like a cold sensation inside my left leg below the knee. I would not say it is numbness but it just feels cold. But my leg is not cold to the touch. I do not have diabetes that I know of. I am a 25-year-old male about 150 pounds. I recently lost over 100 pounds. Ever since I lost all that weight I have felt this sensation in my legs. The sensation does seem to go away when I stand up and walk for a bit. It seems to get worse if I am sitting for a while. My cardiologist checked my leg and he said everything is fine heart-wise. He said it could be a nerve issue. I also consulted with another doctor and she thought it could be a pinched nerve but I do not know about that either. So I wanted to ask if you have a suggestion on what it could be and what I should do to get it treated.
Hello,
Welcome to icliniq.com.
I would like to know some details about your symptoms.
1. When you underwent bariatric surgery?
2. Since when these symptoms started?
3. Which side below the knee feels such a sensation? - inner side or outer side or back side or front side?
4. Do you get this sensation at the left foot also?
5. Do you have any lower back pain? If yes, please describe.
6. Apart from sitting, have you noticed any other aggravating factor for your symptoms?
7. Are you on any regular medications? If yes, please tell me.
8. Do you have any associated muscle weakness in the left foot or leg?
9. Have you had any pain over the left knee, particularly the outer side?
Investigations to be done
Regarding follow up
Patient's Query
Hi doctor,
Thank you for the reply,
1. I got bariatric surgery just about one year ago.
2. These symptoms seemed to start a few months after bariatric surgery. So I would have felt it for about six months.
3. I would say I feel the sensation on the back side of my calf or inside my calf muscle.
4. I do not really feel it in my left foot. Sometimes it can make my left foot feel cold but it mostly stays in my calf area.
5. No lower back pain at all. I do not have any type of pain anywhere.
6. I cannot really think of anything else that makes it worse besides sitting for an extended period of time.
7. Yes, my daily medications are Zoloft, Remeron, Xanax, and Metoprolol.
8. I do not have any muscle weakness that I can tell. I go to the gym regularly and I do not have any issues when I lift weights.
9. I have not had any pain in the leg. I have had a spot on my outer left thigh that seemed to go numb when I was lying in bed but that has seemed to have gone away.
Hello,
Welcome back to icliniq.com.
As you mentioned there has been a six-month gap between bariatric surgery and these left leg symptoms, it seems unlikely to be associated with the bariatric surgery procedure directly.
With a history of the feeling of coldness in the calf region, which gets aggravated by prolonged sitting but no tingling or burning or pain, or weakness. History is not directly pointing toward a specific diagnosis.
Also as you mentioned you are on antidepressants and anti-anxiety medications too.
One remote possibility which can be thought of is left common peroneal nerve entrapment at the fibular head.
One possibility can be vitamin B12 deficiency that occurs after bariatric gastric surgery due to decreased absorption.
Some evaluation can be suggested to try to search for the reason.
Few non-specific sensory symptoms may also be present in patients suffering from depression or anxiety. But organic causes should be ruled out..
Investigations to be done
Regarding follow up
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Neurology
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