Questions, questions, more questions

[GiniaJ49]

Hello all. I am a 59 year old woman with multiple health issues, including a histoy of metastatic melanoma (was in 5 lymph nodes) and also SLE (lupus) diagnosed one year before the melanoma was diagnosed, but likely present for years.

I am (I hope) in remission for the cancer (6 years thus far) and was with the lupus, but may be having a mild flare. However, although I don't need to add anything more to my health history, I am experiencing some issues that are alarming and until early this morning, I hadn't put together, but then it came to me that my newest symptoms may be MS related. One of my melanoma buddies from MD Anderson Cancer Center in Houston was about to have radiation, etc. for new lesions that showed up on her MRI of brain and caused mild symptoms and then a smart Oncologist decided to check further and she was instead diagnosed with MS, not brain cancer.

Last November a lesion showed up in my MRI. It was in the frontal lobe. MD Anderson decided to "watch it" unless it began causing symptoms. I was to have another scan in one year. It's time now. In the meantime, I about 5 6 months ago (following a motor vehicle accident) began having episodes of vertigo. They were terrible at times and mild at other times. I saw an ENT and my hearing is fine and he could not get me to have an episode of vertigo while in his office, although he did the thing with the chair that tips back, etc. several times. He told me to come back in if the dizziness started up again. It didn't for a while, but recently has returned and at times it is more like simple dizziness and others like vertigo.

Then I also began having sharp pain in my right side, near the ribcage in December. That has continued and feels like something is there (like a tight band) and sometimes it hurts terribly. Then my right hip began hurting, like nerves were inflamed, not like bone pain. Same side.

I also have trouble walking straight some days. I lose my balance and walk like a drunk skunk (according to my son). I have been known to get up at night and lost all sense of balance when walking to the bathroom. This is becoming more and more frequent.

I have had 10 urinary tract infections this past 6 months, with incomplete emptying at times, kind of like spasms.

I recently also noted that my vision in my right eye (same side as other issues) seems off, but not terribly so....just "off" or fuzzy sometimes.

I was sent to have a bone scan for the hip pain a few days ago. Should know the result of that tomorrow. They were looking for lesions. I am due to have an MRI in two weeks (for the cancer checkup) of the brain. I had CT scans of the abdomen to see if something could be found to figure out the side pain (which feels like a stabbing sensation.

Last night, in the grocery store, I began to lose my balance and blamed it on my hip, but I was feeling fuzzy before I lost my balance.

I went to sleep as soon as I got home, but early this morning the thought came to me that this could be MS. I also had an episode of pins and needles and numbness in both arms the other day and right as I type this. It has happened before.

So, we have:

1.  Vertigo/dizziness of 6 months duration
2.  Pain in right side (perhaps referring to my hip, OR possibly a lesion in my hip?) of 6 months duration. Could this be MS HUG?
3.  A known probable  lesion in my brain (I think R. Frontal lobe if I remember correctly) of at least 12 months duration. It was stressed in MRI report that it COULD possibly be an "artifact" or metastatic lesion.
4.  Pins and needles sensation, both sides
5.  Oh yeah, recent headaches
6.  Very Frequent UTI's, also of 6 months duration
7.  Constant feeling of imbalance and unsteadiness of approximately 6 months duration

Some of these things COULD be caused by a melanoma metastasis of brain or bone
Some of these could be Lupus related
But putting them together, it also seems possible that MS might be involved.
I was told that I might have Fibromyalgia also (very recently by my Rheumatologist) as I hav e aching or sore spots elsewhere at times, also of relatively recent duration. But the hip and side pain could not be caused by that, nor could the vertigo or dizziness or imbalance.

What do you all think? I DO NOT want another health issue, but if somethng is going on, I want to know and get it treated properly. I can handle anything if I know what is going on.

Thanks in advance.

[Quixotic1]

Hi, you are correct that all of these thing can make teasing out new symptoms or new lesions very complex.

Were you ever treated with an anti-TNF (anti-tumore necrosing Factor) medication for your Lupus?  These are meds like Embrel, Remicade, Humira, etc.  These are used in some autoimmune diseases and have been shown to make MS worse or make it show up.

I would encourage you to have the urinary issues checked out by a urogynecologist to look for signs of a neurogenic bladder.  This would point more toward MS, though it might be possible in Lupus - I don't know.

As for a referral to a neuro-otologist for the evaluation of the recurrent vertigo.  Occurring right after some kind of trauma that could have whip lashed your neck or bumped your noggin makes a mechanical vertigo more likely.  When the doc tipped the chair back and turned your head he was doing the Hallpike Maneuver to elicit signs of BPPV - Benign Paroxysmal Positional Vertigo.  BPPV can be elusive.  It may show normal testing for a long while and then be positive.  The reason is that is is caused by loose crystals that sit on the waving hairs within the semicircular canals.  The crystals may be unstable and be dislodged intermittently.

BPPV is always positional.  And the vertigo is fairly characteristic.  The wild whirling episodes occur when in certain positions like looking up, moving forward, rolling over in bed, lying down, etc.  The active whirling (dizziness) lasts usually 15 seconds or less, but can leave you feeling unsettled in space for hours or days thereafter.

You might need a test called a VENG - Video Electro Nystagmo Gram.  That can often help in determining if you have vertigo from a central cause - as is frequently seen in MS or from an inner ear cause - which would not be from MS as it is due to a mechanical cause and involves peripheral nerves.

A spinal tap might also be useful as Oligoclonal Bands would not be likely in Lupus, and I do not believe that metastatic melanoma would cause them (I am not sure about this).

When a person has more than one thing that can wreak havoc in the nervous system, it gets really hard to tease out MS.  

I have stopped worrying about my spelling :))  It is what ti is.

Quix

[Heather3418]

Go to a site called "iespell" and download a FREE version of their spell check.  I have used it for years.  Hope its helpful to you.  It will spell check anything that you are currently writing, no matter what web page you are typing on.  It will show under "tools" on your tool bar in your broswer and you just click iespell and it starts checking your spelling.

Heather

[Lulu54]

and there is no way to spell check your posts- I don't worry too much about my typos - we can all understand the intent of the words! :-)

[Lulu54]

Hi GiniaJ, welcome to our MS forum here at medhelp.  I hope you get some answers or at least reassurances to your questions.

We constantly remind ourselves here that even thouugh we have MS, we have to stay open to the possibilities that something else could also be wrong and causing symptoms.  The reverse is definitely true for you - it would be too easy to blame the cancer or lupus on your symptoms when it could be something else.  But keep in mind that Lupus can be a mimic of MS as well.

I trust your doctors will be doing a thorough workup of you - the brain MRI should also be of help.

Here's hoping that you are not picking up another serious disease to add to your list - but you are so right that knowing is at least half the battle.

Welcome again - we'll look for you around.

be well,
Lulu

[GiniaJ49]

By the way, excuse my many typos. Could not find how to edit my post.