### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
swelling, hands & feet I have Fibromyalgia, & arthritis, but was hospitalized in April w/elevated LFT s (@ last testing it was @ 207 ) & a WBC of .13, just under a 1, which is back to normal & they figured out that what caused that was the Topamax I was on for Migraine preventative. They think the elevated LFT s is due to too much Acetaminophen in Vicoden ES & Fiorcet w/codeine & changed my pain med to something w/o Acetaminophen. I m scheduled to have additional blood drawn ordered by a Gastroenterologist. That said, my new symptoms are starting out with right hand swelling stiffness and pain then left hand swelling stiffness and pain and now feet as well. This morning my left hand was so swollen the skin was taught & shiny. Usually my right hand is the 1 that is swollen and especially around the knuckle of my pointer finger but is the closest to the hand part. All of that said, what could possibly be causing this?

### output:

Hi, As you have been diagnosed with Fibromyalgia and arthritis, the reasons to have swelling is due to this factor itself. As you may be off late consuming too much of the painkillers and this may have troubled the kidneys.  Why don't you look for the creatine test. As this may help us to understand the cause of swelling. If the creatine levels are high, there is a possibility that kidney is not able to filter out the metabolic waste. Usually this is common with people taking painkillers in excess in fibromyalgia and arthritis. For now, you should go with what the physician guides you, may be a diuretic will be prescribed and maybe they can ask you to reduce or stop completely the painkillers if they suspect the kidney is getting malfunction.  Also, physiotherapy might be advised for the pain and aches due to arthritis and fibromyalgia. You can use stocking if the swelling is persisting for longer. This will help the venous Chat Doctor.  Hope I have answered your query. Let me know if I can assist you further. Jay In