Unusual Sensation in Bones Without Accompanying Pain
I'm a 26-year-old female residing in Northern England. I've been diagnosed with both OCD and ADHD. For my OCD, I take 40mg of citalopram, a medication I've been on for over five years. Additionally, I manage my ADHD symptoms with 54mg of XL Concerta, which I've been using for around four years now. While I do have some excess weight, I've been making strides towards improvement, having lost just over 10 pounds in three months. My history includes Binge Eating Disorder (BED), so I'm approaching my weight loss journey cautiously and deliberately. I maintain hydration by consuming 2 to 3 liters of water daily, utilizing a 1-liter Stanley cup which I carry around with me. I indulge in vaping intermittently, but I limit my alcohol intake to about one drink per week, and I don't use illegal drugs or smoke cigarettes. For the past eight to twelve months, I've been experiencing a peculiar sensation in certain bones that I can only describe as feeling 'itchy' or having an 'undulating' quality, without any pain associated with it. Despite the absence of discomfort, this sensation leaves me feeling extremely fatigued and physically drained, even though my mind remains alert and engaged. I specifically feel this strange sensation in areas such as my shoulder blades, the middle to lower regions of my spine, my tailbone, and my thigh bones—never elsewhere, just those targeted spots. At times, the weariness becomes so overwhelming that I find it necessary to lie down to recover. Even sitting upright can become exhausting, if that makes sense. I’m uncertain about the potential cause of this sensation and how to present it to my general practitioner without being dismissed as merely experiencing anxiety or menstrual cramps. Interestingly, I’ve observed that the sensation seems to intensify during warmer weather, and this summer has certainly been unusually hot.
Answers (1)
8/25/2025, 7:51:48 PM
OpenHealth AI
It sounds like you're experiencing some distressing and unusual sensations in your bones, coupled with fatigue, which can understandably be quite concerning. The sensations you've described—itchy, undulating feelings in specific areas without pain—are not typical, but they do warrant attention. Let's break this down.
Main Points:
- Unusual Sensations & Fatigue: The feelings you're experiencing may have various causes, and they are significant due to the associated fatigue.
- Presentation to Healthcare Provider: It's essential to communicate your symptoms effectively to your general practitioner, ensuring you feel heard.
Explanation:
The sensations in your bones, particularly if they have been persistent and are accompanied by fatigue, may be influenced by several factors. Conditions such as fibromyalgia, vitamin deficiencies (like Vitamin D or B12), anxiety-related somatic sensations, or even issues related to your medications can contribute to what you’re experiencing. The fact that these sensations intensify during warmer weather is also notable; temperature sensitivity can sometimes exacerbate certain conditions.
Next Steps:
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Keep a Symptom Diary: Document your symptoms, including when they occur, their intensity, any patterns you notice related to weather, activity levels, or diet. Note any changes in sleep or stress levels as well.
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Review Your Medications: Consider discussing with your healthcare provider the possibility that your current medications might be contributing to these sensations. This can sometimes happen with psychiatric medications, leading to side effects that may resemble peripheral nerve sensations.
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Focus on Nutrition: Ensure you are getting balanced nutrition, paying particular attention to vitamins and minerals. A well-rounded diet supports bone and nerve health.
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Hydration & Rest: Continue hydrating and take adequate rest when you experience fatigue. Ensure to take breaks during the day and consider relaxation techniques that might help alleviate overall stress and tension.
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Plan Communication with Your GP: When you see your GP, express that you are experiencing unusual bone sensations along with significant fatigue that impacts your daily life. Share your symptom diary to provide clear documentation of what you've been feeling.
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Consider a Healthcare Review: If your fatigue continues to be overwhelming, even after addressing your diet and hydration, it could be beneficial to request a general check-up. This would ideally include tests for vitamin deficiencies, thyroid function, or other relevant assessments, tailored to your case.
Final Note:
It’s understandable to feel apprehensive about how your symptoms may be perceived. Remember, your experience is valid, and ensuring you communicate your concerns thoroughly can facilitate a more productive discussion with your healthcare provider. If you continue to feel dismissed, don't hesitate to seek a second opinion; your health and comfort are paramount.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.