Is it FM or similar Syndrome? Car accident in 2000

Before accident was suffering from depression, exc.work reviews, then after accident, emotional/physical problems brought poor work evals. I've been in downward spiral since accident, got more sore,gained weight,more depressed. I haven't worked for a year. Had Rheumatic fever at 5-6 yrs. old which created heart murmur. Remember having palpitations 5th grade, I have been having them for a while but not too bad, this past week my cat died, I thought my heart was literally going to come out of my chest and that my head was going to explode. I was in a weakened state due to the virus. Have tinnitus since 10yrs?old, but recently even before sleep apnea test, has become worse, also makes cracking sound. My recent symptoms within last 3 months. Extreme back pain below right shoulder blade, across my back to left shoulder area. Extreme lower back pain when walking.Doc said have a virus, all I was told,not pneumonia. I have bipap machine for sleep apnea. I had 3 different infections in 3 diff. toes last 2 months. Feeling a burning sensation on big toes at the moment. Feet and ankles were swollen about 14 days ago and hurt when bending them.(first time for these foot problems except for arthritis ). My head feels like someone has just bumped me in a car slightly and then stops. but happens again within a minute or so. Trying to feel that while here, it starts from temple area maybe above, and goes to my tongue, eyes, lower lip, and hands. Pinky knuckles where attach to hands have been sore, especially the right. I do have a broken ring finger on that hand. I have broken out with an acne that is just under the skin, but wake up with at least 15 new ones a day.. Sleep apnea mask created after first night,and I still have is, inflammed areas deeper under the skin. I suffer from acid reflux, had endoscopy,but feeling nauseous below that area. Ear doctor says nothing they can do. I never really got cramps until this virus also, calf cramps each leg. Right knee sore. The palpitations take my breath away. Went to physical therapy for about 2 months ending in August. Everytime came home, I was extremely sore that night,next day,sometimes the third day. They wanted me to exercise at home, but I have trouble getting my thoughts and energy together to make a phone call or pay a bill.  I have chest pains above my heart area. Pain on sides/ribs decreasing. I have pain prescription 2 ultracet every 6 hours when needed. I am not even averaging 2 a day.. And when I do take them, I still feel the pain all over, it only decreases slightly.so I make do. My thought process has changed within recent months.I forget what sentence I just said,what I was going to say. I also have hard time seeing the word I'm looking for. I get the first letter,can't see what the rest is. I've had weakness in hands. prescriptions are Fluvoxamine,Lithium,Trazedone,Lorazepam. I am at wit's end,doc not keen of new info. Maybe you can help? Tried to give asmuch info.as possible. THANKS

[Kevin Pho, MD]

There seems to be a variety of issues going on.  If your physician is not helpful, you may want to seek a second opinion.

There is significant overlap between fibromyalgia and psychiatric symptoms.  Approximately 30 percent of patients with fibromyalgia do have major depression or anxiety disorders.  It may be helpful to be evaluated by a psychiatrist to ensure that any depression or anxiety is appropriately controlled.  Your medications of fluvoxamine, lithium and trazedone should be evaluated on a regular basis by a specialist to make sure that they are at appropriate doses.

If the psychiatric issues are stable, you may then want to be referred to a rheumatologist for an evaluation for fibromyalgia.  The diagnosis of this is done on a clinical basis - widespread musculoskeletal pain as well as excess tenderness at "trigger points" are suggestive of fibromyalgia.  

Treatment can be done with tricyclic antidepressants, trigger point injections and biofeedback therapy.  They should each be discussed with your personal physician.  

Another options would be to seek referral to a pain management specialist if no definitive diagnosis could be found.  

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.

Thanks,
Kevin, M.D.