I was 47 years old before I began to exhibit symptoms. I had known for years my cholesterol levels were just at the upper end of where they begin to consider people for drug therapy. I can only relate my personal experiences here, but my case was interesting in that it was allowed to progress from the onset of symptoms until they had become widespread and quite severe. Here then is the progression of my symptoms.
- Sharp pains begin in my right hand. They are attributed to overuse of a computer mouse. (Mousing stresses the extensor tendons like crazy).
- Pains become symmetrical to my left hand within a month, which I describe as shooting and stabbing. They seem to radiate from the soft tissue, not the joints.
- Both hands experience morning stiffness that lasts less than ½ hour (the gelling of lipids in your hands and feet is what I believe causes the feeling of morning stiffness).Though out the day, I also have a feeling in my fingers I describe as “rubber bands”.
- Within two months, the pain is more like pins and needles (neuropathic pain). It appears spontaneously on both hands and wrists, and on my forearms as well.
- My hands are occasionally falling asleep at night, waking me up (neurapraxia). I eventually attribute this to compression of the Ulnar nerves at the elbows, caused by inflammation of surrounding tendons.
- It also causes burning sensations in my hands I describe as feeling “lit up”.
- The neuropathy symptoms subside after a few months and about the same time my feet become involved, suffering the same burning, shooting and stabbing pains.
- I experience morning stiffness in my feet as well.
- I am more sensitive to tactile pain (pain from light impacts), especially in the direction opposite normal movements, e.g. from the side.
- I experience a general fatigue and malaise.
- At the end, I begin to experience weakness and pain around my right knee.
At the end of my 22 month run of this ailment, I was experiencing shooting and stabbing pains in my hands and feet all throughout the day. The pain was bad enough to bring tears to my eyes. I was also beginning to experience pain and weakness in one knee. In that time, I was turned over to numerous specialists, treated with inappropriate medicines, and took scores of unnecessary and expensive tests, all because my Internist and Rheumatologists did not consider TX.
I had searched the internet continuously for the entire time and joined arthritis newsgroups trying to find someone else with my particular symptoms. I kept coming back to the fact that my pain was not in the joints (non-articular) and in the soft-tissue. I had given it the informal name “soft-tissue rheumatism”. Even though “rheumatism” is a vague and antiquated term, it is still used in modern literature to describe nonspecific arthritis symptoms.
Soft-tissue rheumatism led me to discussions of tendinitis, and one of the obscure causes of tendinitis I read about was a lipid disorder, and in particular type II Hyperlipidemia. Finally, the right combination of search terms had led to a plausible diagnosis. Citations in PubMed began to surface relating arthritis symptoms to Hyperlipidemia, and among those was an article by an American physician, Dr. Charles J. Glueck, written in 1966. Trying to find his article, I searched the internet and found out he was the director of a large regional cholesterol and cardiovascular research center, the Alliance Cholesterol Center in Cincinnati, Ohio.
Dr. Glueck is a lipid specialist and director of the Jewish Hospital-Alliance Cholesterol Center. I emailed him to ask if my symptoms could be indicative of hypercholesterolemia. He immediately replied and confirmed that it was entirely likely. He recommended that I start statin therapy and get my LDL under 80mg/dl and my pain could be gone in six months. Dr Glueck pointed out that the cholesterol crystals in the tendon inflame both the tendon and the tendon sheath, causing pain, and occasionally swelling. With aggressive lowering of LDL cholesterol, over time the body removes cholesterol from the tendon sheath and from the tendon itself, and the local tendon inflammation improves. Eventually, the pain lessens and disappears. Sometimes, the amount of cholesterol in the tendon and the associated inflammation is so great that under muscular stress, the tendon can snap, usually the Achilles Tendon. Hence, if a person has an unexplained rupture of the Achilles tendon, always check LDL cholesterol.
I would like to thank Dr. Glueck for his contribution to this article and his concern for everyone who might be afflicted with this condition.
I went to my HMO to communicate my diagnosis. Despite the record of misdiagnosis and mistreatment, they displayed an amazing amount of apathy and disinterest. Still, they agreed to treat me with Lovastatin (generic Mevacor) 40mg/day. Within three weeks, I could tell that my symptoms were easing substantially. The duration, frequency and severity of the pain was all lessened. During the holiday season, I sensed that my progress was slowing, if not slipping a bit. I attributed this to the increase in dietary fats from holiday eating. They increased my Lovastatin to 80mg/day and my progress again seemed to slowly but steadily proceed. I take the statin before bed, because your liver is a little cholesterol factory that does much of it’s work at night.
Within six months, I was virtually pain free. Today, three years later I am still free of all my HA symptoms. If I quit the statins for even a few days, however, they begin to return. While I was recovering, my perception was that this condition is almost “fluid”. When circulating lipids are low, the pain is reduced. This occurs after the statin has worked all night, say midmorning. The day after an indulgence into fatty foods, the pain is worse. Be good for three days in a row, the pain is eased. Consistent aerobic and resistance exercise (3-4 times per week) also seem to give me more good days.
Next: Lowering Lipid Levels