Pain and swelling in my face

[a_ravesi]

Ok so a little info about me: I'm a 22 year old male. I was diagnosed with a case of bell's palsy back in July 2014 and I took the drug accutane for about 6 months for severe acne I had 3-4 years ago.

For about 6 years now I've had a strange problem. Right around the cheekbones on the upper part of my cheeks I feel constant pain. When I'm relaxed the pain is dull but when I get stressed (going to work, working out, etc) it becomes sharp pain. I will sometimes feel the occasional sharp pain while I'm relaxed too. On top of this, the skin under both eyes has become very swollen. To some it make look like regular bags, but to me it's very unnatural because it feels swollen if that makes sense. There's like a constant pressure on that part of my face and it looks pretty bad. It's to the point where I look in the mirror and I get the feeling that I don't recognize myself because there's been such a change in very little time. If I touch this part of my face it hurts. Not excruciating pain but it does not feel good to rub the area. Heat seems to make it worse and the only relief I've found for this is splashing cold water on my face or an ice pack. I also have these red lines coming out of the outer corners of both eyes.

In just the past year I've developed a case of severe dry eyes. I've been taking restasis since August 2014 and the dryness has improved but now I mostly just feel pain in my eyes, like the actual eyeball hurts. I suffer from daily headaches in the forehead area (I assume this is because of the eye problems). I wake up every morning with very dry eyes.

I've seen two different dermatologists who both said they didn't think it was a skin problem because the skin does not look damaged, just swollen. I've seen an allergist who ran a bunch of tests on me and said I'm not allergic to anything. I've seen two different opthamologists who didn't have an answer for the facial pain but said that it seemed like I was having some sort of allergic reaction on my eyes but had no idea what it was. I've taken zyrtec for a month straight in the past and didn't notice any improvement, I've taken a decongestant and didn't notice any improvement. I do stay in the basement of the house right now which I thought my be the problem but my family recently went to Italy for a week and I didn't notice any change in symptoms while away.

Very recently I've been feeling extremely depressed about all of this because its so difficult to live your life being in pain everyday. I last saw my doctor a week ago he wants me to get a cat scan but my insurance rejected it and he wants me to see a neurologist and a psychiatrist about the depression. I'm not expecting to get answers here but if anyone could offer me any advice at all on where to look or things to try I would really appreciate it.

[TheLightSeeker]

Anytime a_ravesi.

--Q. When I saw the allergist she recommended that I get a blood test for autoimmune disease and it came back negative but I'm not sure if that would catch it since this is with the eyes?

--A. Sometimes, an overactive thyroid may precede or follow Grave's eye disease, while being normal at the onset of this autoimmune eye condition.

In blood tests in the "in-between stage" of active Grave's eye disease and inactive full manifestation of Grave's disease, may show no autoimmune antibodies. The standard tests for Grave's are: T3,T4, TSH and TSI
Note: T3 & T3 could show normal levels-within lab range- and TSH very low. This is a classic sign of sub-clinical Grave's, which would be enough to cause many unwanted symptoms in a large number of patients, however, it could be totally dismissed by some doctors.

The hair loss and fatigue are hallmark symptoms of hypothyroidism, which is not uncommon to periodically appear in Grave's sufferers.
Thyroid autoimmune diseases can alternate from hypothyroid to hyperthyroid, making it very challenging to regulate.
An experienced thyroid endocrinologist, would be the doctor to seek, in such cases.
IDK if your GP knows enough about this to advise you properly.

Prolonged unresolved stress, affects the adrenals greatly and may trigger the hypothyroid state, as stressed adrenals tend to down-regulate thyroid function in order to recover. A 24 hour cortisol test (4x cortisol- saliva- and 2 x DHEA test) would help determine this better.
If at any time you need details regarding anything with thyroid & adrenals,
let me know.

Please be patient-not like being sick, lol!
This may take some time to resolve.

At least it may help you to know that your condition does not appear to be life threatening, but I understand the symptoms can be quite distressing.

Best,
Niko

[a_ravesi]

Hey TheLightSeeker,

Thanks for the response. After looking at the symptoms of Grave's eye disease it does somewhat match up. I have been very fatigued lately and every time I shower there has been some hair loss but I wasn't sure if it was related or just because of the stress of it all. I will mention this to my GP and see what his thoughts are.

When I saw the allergist she recommended that I get a blood test for autoimmune disease and it came back negative but I'm not sure if that would catch it since this is with the eyes?

[TheLightSeeker]

Hey a_ravesi, sorry for your suffering.

You may have been going to the wrong specialists, if my
suspicion is correct.

  Your symptoms are consistent with Grave's eye disease aka Grave's
Ophthalmopathy or Thyroid eye disease (TED), which requires knowledge in Endocrinology & Rheumatology as well.  ( Grave's is autoimmune hyperthyroidism, which falls under the specialty of Rheumatology)

Being a rather rare condition, it could have escaped the ophthalmologists' detection, specially if other Grave's symptoms were not present at the time.
Sometimes, an overactive thyroid may precede or follow Grave's eye disease, while being normal at the onset of this autoimmune eye condition.
In my opinion this possibility should be ruled in or ruled out asap.

Please note that my suggestions and comments are not intended as a replacement for medical advice.

Best wishes,
Niko