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Should I seek rheumatology evaluation
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Should I seek rheumatology evaluation

I'm a 41 year old woman and my question relates to whether I should seek a rheumatology evaluation.  I have a variety of odd symptoms that began approximately two years ago.  Exacerbating issues were that I lived four months in a flat that had a bad mold problem, and then moved into my new house while they were remodeling the kitchen so I was exposed to lots of sheetrock dust.  I developed a chronic cough in the moldy flat, and Albuterol fixed it.  I have now been diagnosed with asthma (following two incidents of waking up in the middle of the night unable to breathe at all) and am being treated for that.  However, I have many other symptoms that seem to have come along with the asthma:  I have a problem with chronic pain on the left side of my face and throat that sometimes affects my voice (began with a bad sinus infection, but now won't go away and there is no infection according to CT scans), an increase in night sweats (I've had night sweats since I was a teenager, but they've been worse than ever), joint pain all over my body, fatigue, a metallic taste in my mouth that I can't get rid of, a strange rash that appears on various parts of my body - looks like little clusters of bug bites, then turns into sores and/or itchy bruises, then crops up on some other part of my body - has been mostly focused on my breasts, upper arms, and legs above the knee, but had two outbrekas on my back and stomach as well - the bruises only appear on my legs and arms), dizziness and nausea and occasional bouts of tinnitis.  I have periodically tried antibiotics (one doctor thought I had an infected submandibular gland and put me on Cefex), and they usually seem to help quite a bit, but I'm not sure if that's just the placebo effect.  I also have an inherited premature osteoporosis (very severe), that seems to come with a multitude of joint problems (e.g. I break easily, but my joints also seem to injure easily - I've had knee surgery and shoulder surgery, and have a tear in my other shoulder-my mother has exactly the same problems, including GI problems and recently diagnosed asthma), and I was once diagnosed with episcleritis in my left eye (which I learned through the Internet is common with connective tissue diseases).  Everything seems much worse lately and I'm concerned about my lack of energy.  The most energy I had was about two weeks after starting the Cefex and I was able to paint my dining room.  I was amazed.  I woke up this morning feeling downright hungover (I don't drink), and that's what prompted me to post this question.  I should also note that I take Nexium (I've had GERD so bad that I had the surgery, which didn't help), and Singulair and Pulmocort for the asthma.  Would a rheumatology evaluation make sense?
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The symptoms of chronic pain, joint symptoms, rash and scleritis certainly points to a possibility of rheumatological disease.  

I would start with a complete blood count, ESR (also known as a sedimentation rate) which is a marker of inflammation, ANA level (an antibody level that is associated with a variety of rheumatological conditions), rheumatoid factor, thyroid test, and liver function tests.  

A rheumatology referral would certainly be reasonable and they would be able to suggest more specialized testing if the above tests are not revealing.

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.
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