do all symptoms add up to one dx?

[sarah0704]

I am 28 year old female who has been battling many symptoms for over 2 years now.  I was diagnosed wtih RSD after a steroid injection, the RSD responded to stellate ganglion blocks but not as well as was expected.  I suffer from intense joint/muscle pain as well as extreme exhaustion.  I have had low thyroid since I was 12 years old, so was taking levothyroxine and levels are/were normal.  I was sent for further testing to see if something else was "driving" the RSD.  Blood ANA came back 1/642 as well as AHA was abnormal (I believe it was just slightly high) my neurologist thought it was drug induced lupus - even though he stated I had never taken any drugs that cause drug-induced lupus.  I was followed by him and began taking an anti-malaria drug which made me very ill.  He wanted to start methotrexate, but I was very nervous and hesitant about injections so he went with oral prednisone.  Symptoms of pain were reduced about 25-30% while on prednisone, but I became pregnant so we discontinued the medication.  During pregnancy I had very little pain in joints and muscles (still with RSD pain though) but two more stellate ganglion blocks and my pain was almost completely gone!  I did suffer many difficulties with pregnancy including pre-term labor and ended up delivering at 34 weeks.  Two months post partum all symptoms of pain returned.  RSD pain, joints, muscles, concentration/focus was shot, short-term memory was almost gone, dizziness/vertigo, extreme exhaustion (beyond just having a newborn).  My rheumatologist states now that it is not drug-induced lupus but rather a sever case of fibromyalgia.  My neurologist just did an MRI and EEG for memory issues.  The MRI results were normal, but the EEG showed abnormal spike.  He wants to do an extended 48 hour EEG.  I am curious if these symptoms can all add up to one dx, and perhaps he is not lookign at the whole picture?  I wonder this because I see a pain clinic dr for RSD, a rheumatologist (not very trusting of him) for "fibromyalgia", and neurologist for the MRI and EEG for the memory/concentration issues.  Should I be asking for him to review the other notes or will he automatically do this?  Should I seek another opinion?  Am I going about this all wrong?

[sarah0704]

Thank you for your time and suggestion, it is greatly appreciated.

Sarah

[Abhijeet Deshmukh, MD]

Hi Sarah.

I would suggest you wait for the 48-hour EEG recording. And let your Neurologist be your primary focus now. You may offer him the other notes.

You are not at all going wrong with this. Sometimes, it helps to just let things unfold, instead of searching for a diagnosis.

All the best.

DrAbhijeetMD