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Arthritis (Expert Forum)
What is happening to me?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
What is happening to me?
by Conniekim, May 22, 2006 12:00AM
Up until 1 1/2 years ago I was in great shape. I was an open heart circulating RN but due to Rt. arm and neck injury I currently am not working. I am 44 years old. I've ran 2 marathons and use to bike the MS 150. But, now I have the following sypmtoms and lab results and feel exhausted and achy all the time. My neck discomfort really causes me concern. My rheumatologist doesn't seem concerned. My IM states she thinks I might have MCTD. Any suggestions would be greatly appreciated. Not sure if I should see another Rheumy., what's going on, or if this is all in my head.
Labs: ANA is now 1:80 speckled - was normal, Sed Rate 23H, Cardiolipin AB IGM 10H, Immunoglobulins IGM 826. Everything else is within range.
My sypmtoms are: hair thinning, dry, irritated eyes, frequent eye twitching, occ. floaters, sinus congestion, post nasal drip at noc, frequent canker and mouth sores, occ. throat fullness and difficultly swallowing pills, neck pain/stiffness with frequent burning sensation to right side of neck - cervical epidural injection x2 with little relief, neck clicking with moving of head C3-4, C4-5, C6-7 disc-type defects, occipital pressure, frequent HA’s, occ. heartburn, palpitations with occ. PVC’s, hypertension starting 2 weeks ago, dry skin, occ.SOB with stair climbing, Bilat. elbow pain, Rt. arm/elbow tendon repair- chronic inflammation/pain (dx 2/06), Lt. tendonitis, frequent bilat. arm vibrations and tingling, occ. hand numbness at noc, cold/numb/painful fingers when exposed to cold/stress, fingers change to white/red when exposed to cold, frequent bilat finger stiffness/ swelling(difficulty removing rings), achiness especially in am, occ. new onset of fingers cramping, Rt. thumb cortisone injection x1, occ. abd. bloating, occ. constipation, occ. abd. burning/discomfort (? ulcer), occ. bilt hip pain - normal MRI, hips clicking/popping when walking upstairs, bilat knee achiness - occ. Lt. knee swelling -normal MRI’s, increased pain and stiffness in bilat knees when sitting for long periods/crossing legs, night time leg cramps, occ. bilat ankle stiffness, new onset of bilat toes cramping, Rt. great toe stiffness and pain at joint, cold/numb/painful toes when exposed to cold or stress, feet turn blue when exposed to cold, stress or circulation cut off due to positioning, difficulty sleeping, decrease sex drive, occ. night sweats, malaise, fatigue
History
Pneumonia x1, Raynaud’s dx 1994), Slight bowing in the anterior leaflet of the mitral value, Trace tricuspid regurg., Ruptured Ovarian Cyst, Boutonniere Finger - right middle finger - splinted 1997
Surgeries
T & A, Fissure repair, Bartholin cyst I&D, C- Section X 2
CTR - RT and LT., D & C, Rt. tendon repair and release
Medications
Ovcon 35, Claritin prn, Tylenol prn, Norco prn, Prevacid 30 mg 1 po qam, Lodine 500 mg BID, Procardia XL 30 mg - 1 po q noc, Hydrochlorothiazide 25 mg - ½ tab po q day, Elavil 25 mg - ½ tab po q noc
Gravida 3, Para 2 -Miscarriage
Labs: ANA is now 1:80 speckled - was normal, Sed Rate 23H, Cardiolipin AB IGM 10H, Immunoglobulins IGM 826. Everything else is within range.
My sypmtoms are: hair thinning, dry, irritated eyes, frequent eye twitching, occ. floaters, sinus congestion, post nasal drip at noc, frequent canker and mouth sores, occ. throat fullness and difficultly swallowing pills, neck pain/stiffness with frequent burning sensation to right side of neck - cervical epidural injection x2 with little relief, neck clicking with moving of head C3-4, C4-5, C6-7 disc-type defects, occipital pressure, frequent HA’s, occ. heartburn, palpitations with occ. PVC’s, hypertension starting 2 weeks ago, dry skin, occ.SOB with stair climbing, Bilat. elbow pain, Rt. arm/elbow tendon repair- chronic inflammation/pain (dx 2/06), Lt. tendonitis, frequent bilat. arm vibrations and tingling, occ. hand numbness at noc, cold/numb/painful fingers when exposed to cold/stress, fingers change to white/red when exposed to cold, frequent bilat finger stiffness/ swelling(difficulty removing rings), achiness especially in am, occ. new onset of fingers cramping, Rt. thumb cortisone injection x1, occ. abd. bloating, occ. constipation, occ. abd. burning/discomfort (? ulcer), occ. bilt hip pain - normal MRI, hips clicking/popping when walking upstairs, bilat knee achiness - occ. Lt. knee swelling -normal MRI’s, increased pain and stiffness in bilat knees when sitting for long periods/crossing legs, night time leg cramps, occ. bilat ankle stiffness, new onset of bilat toes cramping, Rt. great toe stiffness and pain at joint, cold/numb/painful toes when exposed to cold or stress, feet turn blue when exposed to cold, stress or circulation cut off due to positioning, difficulty sleeping, decrease sex drive, occ. night sweats, malaise, fatigue
History
Pneumonia x1, Raynaud’s dx 1994), Slight bowing in the anterior leaflet of the mitral value, Trace tricuspid regurg., Ruptured Ovarian Cyst, Boutonniere Finger - right middle finger - splinted 1997
Surgeries
T & A, Fissure repair, Bartholin cyst I&D, C- Section X 2
CTR - RT and LT., D & C, Rt. tendon repair and release
Medications
Ovcon 35, Claritin prn, Tylenol prn, Norco prn, Prevacid 30 mg 1 po qam, Lodine 500 mg BID, Procardia XL 30 mg - 1 po q noc, Hydrochlorothiazide 25 mg - ½ tab po q day, Elavil 25 mg - ½ tab po q noc
Gravida 3, Para 2 -Miscarriage
Doctor's Answer
by Kevin Pho, MD, May 23, 2006 12:00AM
, May 23, 2006 12:00AM
The next step can be a neurosurgical evaluation to further look at the neck.
Many of the symptoms seems to be coming from the neck and associated possible nerve compression. Initial evaluation can be done with a cervical MRI to evaluate the disks as well as for any protrusion. Electrodiagnostic testing, such as an EMG can be considered to look for possible nerve damage.
If there continues to be symptoms suggestive of rheumatological disease (i.e. joint, muscle pain etc.), another rheumatological opinion can be considered - perferably at a major academic medical center.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
Many of the symptoms seems to be coming from the neck and associated possible nerve compression. Initial evaluation can be done with a cervical MRI to evaluate the disks as well as for any protrusion. Electrodiagnostic testing, such as an EMG can be considered to look for possible nerve damage.
If there continues to be symptoms suggestive of rheumatological disease (i.e. joint, muscle pain etc.), another rheumatological opinion can be considered - perferably at a major academic medical center.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
Sounds like you need ot go to HSS (Hospital for Special Surgery) in New York--look them up on the internet. Also , good webste for Lupus is DXLupus.org---there are really good rheums at HSS. It would be worth your trip and this hospital has many specialists in the areas of your problems. Read about the hospital on the internet and you will see that they could get to the root of the problems. Many people go there for surgeries etc on joints...etc. Good luck.