Dr. Upendra Kumar Shah
Neurology
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Patient's Query
Hello doctor,
I have pain in my left thumb and right index finger (only when using them) for about nine months. And I just started noticing an electric shock feeling in both wrists when I tap on the underside or twist them a certain way. I also had some widespread muscle twitching, but that got subsided. And I have been noticing something called post-micturition dribble. What could be going on?
Hi,
Welcome to icliniq.com.
It is difficult to comment on limited information. I need more clarity on the symptoms.
Where is the pain? Is it in the pulp of the finger, or joints, or whole of the finger? Is there pain on touching or movement? Is there any tenderness or numbness? Do you experience pain in the morning? Does the electric shock sensation come only on tapping or on some activity such as acceleration of bike, holding some heavy objects for a prolonged duration, etc.?
Regarding the micturition problem, do you have urinary frequency, or urgency, or incontinence? What is the level of hemoglobin and bilirubin?
Please answer my queries.
Patient's Query
Thank you doctor,
I am not sure if the pain is in the joints or not. It seems like it is close to the joints. It is near both joints on the thumb, and on the index finger, it is only near the inner joint. The thumb hurts if I grip something too hard. The index finger hurts if am gripping something and it is pushed towards the middle finger. It does not hurt to touch the finger. There is no tenderness or swelling. No numbness. No tingling. It does not seem to vary with time of day. I am pretty confident that it is just pain, no weakness. I have also had two general physicians do basic tests for weakness, and neither said any weakness.
The electric shock is most prominent when tapping on the wrist's underside, but is sometimes also felt if I am using my wrist and twist it. I do not notice any weakness or trouble accomplishing tasks with my wrists.
My urinary frequency has not seemed to have changed. It is anywhere from once an hour to once every few hours. I sometimes get up once during the night to urinate. I do not have any other incontinence problems other than having a few extra drops coming out right after urinating, which leaves a small spot in my underwear. I have gained 20 lbs (180 lbs now), so maybe this leakage is due to being overweight?
My bilirubin was 3.6 mg/dL, hemoglobin was 18.1 g/dL, and red blood cell count was 5.98 10*6/mm3. I have been taking magnesium, B12, and vitamin D supplements. Supposedly magnesium supplements can increase hemoglobin?
I also tested white blood cell count, hematocrit, MCV, MCH, platelets, zinc, glucose, BUN, creatinine, eGFR, sodium, potassium, calcium, and protein. All of those were normal.
Hi,
Welcome back to icliniq.com.
Urinary problem seems to be a normal phenomenon. Finger pain and wrist associated problems are looking like non-neurological diseases, and they are probably due to elevated hemoglobin. Other possibilities are small joint arthritis, hyperuricemia, etc. It seems to be metabolic in origin rather than neurological illness.
You need to evaluate elevated hemoglobin, elevated bilirubin, and multiple small joint pains. If you are smoking, please stop that and then check the hemoglobin level.
You can check your uric acid level, reticulocyte count, liver function test, RA (rheumatoid arthritis) factor, ESR (erythrocyte sedimentation rate), CRP (C-reactive protein) and so on. This seems to be non-neurological illness. Please consult with a general medicine doctor.
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