<snip>
>[It should also be noted that as I enter my 70th year (I just turned 69
>yesterday), I appear to be aging at a very slow rate (no discernible aging
>rate at all), have no major disabilities of any kind (except the nuisance
>of presbyopia, no worse in the past 6 years) and have as much energy both
>mentally and physically as I ever did. The major positive factor in this
>malady is that it does not appear to have any chronic effects. Because of
>this, it could well have hormetic benefits and I was not being facetious
>above when I said that.
>
>My major concern is whether or not it is having some exhausting effect on
>my immune stem cell system. But since I almost never get any *other*
>maladies (colds, flu, etc) perhaps my immune stem cells are holding up
>quite well also. It is also possible that my immune system is not reacting
>to this malady in the same manner that it does to most other maladies. This
>could be why I cannot seem to prevent the re-occurrence, which is
>definitely not an external reinfection, but more like a reemergence of
>something which is hiding in my left leg and building its strength (and
>toxins) between episodes. I have wondered whether or not it would disappear
>if I amputated my left leg just below the knee (the only part that ever
>gets swollen and red, though there is almost always a red streak up the
>inside of my leg extending to the also swollen left inguinal lymph node) -
>and sometimes I have felt that it might even be best to do that (if I knew
>that it would eliminate the recurrent malady), but I have always quickly
>dismissed such a thought, since it would only be best for life span and not
>for life quality.
>
>I have also tried hard to correlate its onset with other factors in my life
>at the time, but have had no success at all. This also puzzles me greatly
>because one of my axioms of reality (at least of macroscopic reality) is
>that every event is caused in some manner, so I continue to try to find
>correlations. If it were even a definite period, that would make some
>sense, but the time between has varied from as short as two weeks (but then
>the second one was milder) to as long as 6 months (when I hoped it had
>finally gone away). --Paul].

Just a stab in the dark:
http://www.cnn.com/HEALTH/library/DS/00609.html

Could it be symptoms characteristic of "Lymphedema" that spring up in that
leg every time your body goes after some small intruder. Perhaps that
initial toe/blood infection could have caused some sort of lasting damage to
the lymph nodes in that leg. Just a guess. I don't know where the chills
and mental confusion would come in though. Have you noticed any infections
going around at the same times you have these episodes?

Regards,
Rob Rolen

[Hi Robert,

The lymphatic circulation is definitely involved in whatever Paul gets (or
surfaces) periodically. If the symptoms were longstanding (chronic), it would be
reasonable to consider it the typical lymphedema addressed in the article you
linked. However, these symptoms he described are *completely* gone in 4 days,
and are only maximum for about 24 hours. There is *no* residual swelling or
redness.

The symptoms for the past 2 years have been of such short duration that even if
we had confidence in a particular physician, they would most likely be gone
before Paul could even be seen. As he described, the doctor in Toronto who saw
him twice back in 2000 and 2001 (after the initial worst episodes) couldn't
figure it out and seemed to lose interest. **Kitty]

[The initial chills (lasting typically less than 2 hours and during which I
either pile on blankets and more socks or get into a hot bath) and the mental
state during that phase (I would not really call it "confusion", but I don't
really know how to label it) are almost certainly caused by a toxin of some
kind. During the chills phase there is also an enormous restlessness of all body
parts (I thrash around in bed) and extreme negative sensitivity to noise, touch
and other stimuli (except that I can relax somewhat in a hot bath). After that a
fever (which is easily controlled by aspirin) sets in for 3-4 hours and during
and after that time I can sleep comfortably (which I do). After a total of about
12 hours (depending on the time of day that it began (usually early morning or
late afternoon) I am able to get up and have a little food. Usually I then go
back to bed and sleep some more. Less than 24 hours after the initial symptoms
(one of the first of which is the swollen left inguinal lymph node), all
symptoms are gone except residual swelling and redness in the left foot and
ankle. Over the next 3-4 days this redness subsides and the swelling cycles with
the time that I spent not lying down. Ie the swelling is least after sleep and
greatest at the end of the day. When things were worse, I used to work with my
left foot up on the desk top to reduce the swelling, but I seldom do that any
more. After 4-5 days at most (recently), all left foot swelling and redness are
gone.

There has been no infection of anyone else going around at the same time and
this also would not make much sense since I really physically interface with
very few people. In addition the episodes can happen when I have not been in
anyway near anyone but Kitty for many days.

What I need to find is some curious young doctor/scientist who would take my
case as a challenge to find out just what is causing it, but this kind of person
seems to be a vanishing breed.

The possibility of an initiating toe infection (from a badly damaged left big
toenail) was just that (a hypothesis). There was never any proof that such
occurred and there was no real infective difference between the left foot and
the right foot or any other part of my body where I periodically get cuts and
abrasions due to an active lifestyle. Besides, the damaged left large toenail
(which had been damaged several times before from dancing) was damaged many
months before the first episode.

Actually the most event correlation with the onset of this malady (which began
at the end of a Toronto winter when I had little contact with other people and
none with the countryside of insects, ticks, etc) was the first (and an
intimate) visit in January by a stranger from a remote area with highly
different flora and fauna and endemic diseases (I am of course speaking of Kitty
here). I have always thought that the most likely source of this disease was
something that Kitty brought from Arizona, but of course this is entirely
correlational. In addition, I hasten to add that I attach no blame whatever and
furthermore I would still have wanted this visit to happen even though if the
disease were 10 times more intense and more frequent. --Paul]

[Robert, your link did prompt me to do another PubMed search using words
transient and lymphedema; we hadn't done one in probably 3 years. There was one
paper that came the closest (though far from identical) to describing the
symptoms Paul has experienced. Conveniently the full paper is free online:
"NATURAL COURSE OF LYMPHATIC FILARIASIS: INSIGHTS FROM EPIDEMIOLOGY,
EXPERIMENTAL HUMAN INFECTIONS, AND CLINICAL OBSERVATIONS" -
http://www.ajtmh.org/cgi/content/full/73/6/995
The wording on constitutional symptoms is somewhat confusing and Paul has
emailed the author for clarification and added information about his own
symptoms. We'll update on any worthwhile response. **Kitty]