My diagnosis unsure - could my Dr. be missing something.

By mdr1963 September 22, 2010 - 12:42pm

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I apologize up front for the length of the information. I felt if you didn't have it all it would make sense. So I start by saying "Today September 22nd I decided to write down all of my ongoing health problems with dates so I could keep track. Since all of this happened so sudden with no injury or illness it just makes me ask is there something we are all missing. I am contemplating asking for a lyme's disease test because some of these symptoms are common with that illness. I have no remembrance of a bite or seeing a rash or raised area. All I know is the way this hit me and what has progressed since it did is baffling me.

Friday August 6 2010
I feel fine and full of energy and prepare for a big party the next day

Saturday August 7, 2010 I wake up dizzy and disoriented feeling like I am coming down with stomach flu. I have cramping and nausea. After taking meclazine the dizzy feelings fade however I am tired and just not myself feeling on and off nausea and very tired. I was having a pain this same day in my ear but with the dizzy spell felt it may be an attack of Minieres again. I called my ear Dr on the 9th to let them know and they set up an appt to check my tube but I wasn’t able to see them until 8/24 as Dr. Richter was on vacation.

Sunday August 8 2010. I wake up a bit more refreshed then the day before. I head outside to work in the yard and clean up from the party the earlier day. I am achy and tired but seem to be making a recovery from the prior day.

Monday August 9th. I wake up and get out of bed. My hip on the left hand side is sore as if my sciatic nerve is acting up (not an uncommon thing for me). I told myself I would give it a day to see if it would relax.

Tuesday August 10th. My hips are much more painful today. It hurts to walk across the floor. I call my Dr. Office in hopes of getting an OMT manipulation treatment. All appointments are full the next available is Thursday August 12... For the next couple days while waiting to see the Doctor I take it easy and stay home. I put a cold pack on my tail bone and do stretches to try to relieve the pain. The ice helps while applied but quickly diminishes. The stretches help but I stiffen back up quickly.

Thursday August 12 I go to see Dr. Freese and she does an OMT treatment on me. I stand up and I am pain free. This is not the normal response as it usually takes until the next day for the pain to completely diminish if not after another treatment. My next appt was scheduled for August 20.

I continued to feel pain in my hips but it isn’t as bad as before I went to see my Doctor on the 12th. As the weekend goes on my back starts to bother me mostly on the left just under the shoulder blade. It hurts to lie down and get up as well as pain was felt when I took a deep breath sneezed or coughed

Monday August 16 I try to get out of bed and I can’t move. My back is in total spasm at this point in the area mentioned above. My boyfriend has to pull me out of bed as I am screaming in pain. I am having trouble even breathing without pain at this point. Walking standing and sitting are adding to the pain nothing relieves it.

I call the Dr Office and get in for an appt. The Doctor opts to not do an OMT treatment since I am in such pain. At this point I also tell her my neck is starting to hurt as well but the most pain is in my back. She suggests muscle relaxers, a pain reliever (vicodin) and maybe therapy. I said lets wait on the PT since I was already going for my hand (another unrelated injury). I wanted to see if the muscle relaxers would help so she could continue with OMT.
I start taking the muscle relaxers that night as well as the pain killers. Although between the two some relief was given but if the meds wore off the pain came back as strong.

August 18 2010
I wake up that morning and my left knee which was not giving me any pain has become swelled three times its original size from 14 inches to 15.5 inches. I can hardly walk on my knee as the pain is much like a knife is being driven in under my knee cap and twisted. There is also pain and pressure around the meniscus. The pain in my neck has continued to climb in degrees of pain... I call my Dr’s. Office and my primary is not in. I tell the reception in desperation, while holding back tears, (yes it hurt that bad), I must see someone or I am going to the emergency room. They get me in to see Dr. Simone.

Dr. Simone evaluates my knee and decides to order two blood tests an acid test and an ESR/SED test and an x-ray on my knee, lower spine and Pelvis.

I go that afternoon for the x-rays and go home.

August 20th I go back to see Dr. Freese, mostly to get my x-ray and blood results. She decides not to do an OMT treatment due to my knee. The x-rays show there is swelling and slight arthritis on my pelvic bone. She decides to have an MRI of my knee done at this point, tells me to continue with the muscle relaxers and pain meds as needed, and to ice the knee. The blood test results were not in as far as she could see but did say that ESR/SED test needed to be redone as there was something wrong with the blood draw they had taken a couple days earlier.

August 23rd I call the Dr’s office to see where we are with the MRI scheduling and leave a message for Erica.

August 24th I go to see Dr. Richter about the ear pain and the dizzy spells. I find that there was some scabbing next to my ear drum that could have caused those issues. He cleans the ear and sends me on my way. I never have another dizzy spell and the local ear pain subsides.

August 25th still having no word on the MRI I called the Dr's. Office again and leave another message for Erica.

August 26th, having still no word on the MRI I call the insurance company to find out what the hold up is only to discover nothing has been submitted by the Dr’s office. I immediately contact my Doctor office and this time asks to speak with Erica in person no more voicemails. She tells me she has no form and then goes to my chart only to return with the form, saying she misplaced or lost it. She sets me up that day for the MRI on Monday morning and takes care of the referral that afternoon.

August 30th I go for my MRI

August 31 2010 I called the Dr. Office for an appt to discuss my results and any further diagnosis with my neck pain and stiffness which is becoming worse every day. I get to see Dr. Simone again. He decides to try an OMT treatment and discovers that I have what he termed a rib pop on the left side of my back, the same area I was crying about back on the 16th. On this day my pain level was 8 out of 10 (10 considered to be child birth pain) Dr Simone also gives me another prescription for a refill of pain meds and changes the Muscle relaxer to Skelexin.

The results of the MRI are showing roughing of the cartilage under the patella and fraying of the meniscus as well as overall swelling. He refers me to Dr. Mazzei at this point to have the knee checked out. I had surgery on this knee 4 years ago this past July and feel this must be the same problem but thought it odd to come on so quickly and dramatically almost over night.

I continue icing the knee and putting heat on the neck and continue with the muscle relaxers and pain killers.

September 3, 2010 I go back for a follow up with Dr. Simone, he does an OMT treatment on my neck and upper back. I am getting some relief from these treatments but only for a day or two. Heat is good but only while applied. We schedule another OMT appt for September 8, pain is still in the 8 range for all.

The 4th through the 6th I prepare for our final summer party. I am with the help of the pain meds able to get around slowly. By the end of the night on the 6th my left leg was very painful and at this point my right leg was becoming sore.

September 8, I have another OMT treatment with Dr. Simone. He is having difficulty with my neck as it grows tighter each time. I also mention that my left jaw is becoming sore. Although my boyfriend heard a clicking sound one night the Dr doesn’t think TMJ is the cause but it may be due to the neck strain. He suggests Physical Therapy to try to relax the muscles. An appt is made for that afternoon. Dr. Simone gives me another prescription for refills on both the pain meds and the muscle relaxer. In the mean time I started to complain about my right knee tightening up and starting to swell. I told Dr. Simone I think it is just muscular because I relied on it to much when the other one was so bad. He suggested using a cane to take the pain off but to discuss this with the PT folks as well. He gave me a refill for the pain meds but upped the strength since I was not sleeping well and also a refill of the Muscle relaxer.

The PT visit was an evaluation on my neck and jaw. As for treatment all that they did was ultrasound on my temporal jaw bone. However painful it was decided this is not caused by TMJ as my jaw does open straight. It is the result of the neck strain. PT also recommends not using a cane since I am already so out of whack in my shoulders and neck this could make it worse. He said I should continue to use my knee and try to walk on it icing it often or putting heat on it if ice doesn’t work.

I continue treatment with the PT on 9/10, 9/13 and 9/16, and 9/22 being the most recent and another one coming up for the 28th.

I also called my Dr. Office that day to ask about the blood test results as I never received any word on them and forgot to ask Dr Simone earlier that day. I was told the Acid test was fine and the ESR level was 45. Since I have no clue what these mean I asked and the MA told me it was due to inflammation. She also said I would be retested at my next visit on Oct 7th.

September 15, 2010 I saw Dr. Mazzei for my Knee. Upon examination and review of x-ray and MRI both he and the PA felt this was a similar occurrence of the same problem I experienced 4 years ago on my left knee which at this time the swelling had decreased but the knee circumference is still 15inch. Dr Mazzei was more concerned with my right knee which now has swelled to 15.5 inches and looked just like the left. The pain felt more muscular on the right and I shared that thought. Dr. Mazzei said he felt there could be an underlying problem such as arthritis. They should order some test to see.

I was told I would have a treatment with injections of a silicone material in my left knee and fluid drained from my right. I am still waiting for a date for that procedure.

After this appt with Dr. Mazzei I decided to decrease the pain killer intake. I decided to only take it a night when I slept and only 3 extra strength pills through out the night.
I was able to get a couple nights of 4 hours of sleep but it is different every night most of the time I wake up every 1-2 hours still.

September 16th, I go for another PT appt for my neck. This time the treatment seemed to give me more relief however within a couple days the pain returned.

The following days were the same. Pain is onging in the knees, and neck which is now radiating into my left shoulder. Getting out of bed each morning is a chore. I feel like the tin man who needs to be oiled each morning to get my joints moving.

September 22nd PT was great the PT did a deep muscle massage and a few other things. Relief was awesome. However as I started to move and use these muscles through the day that bit of relief wore off. I know that it can take a couple days for the massage to really take affect. I am being patient. As I sit and wait for the Knee procedure appt.

Just This morning I woke up and my left index finger hurt to bend to the point of not wanting to bend it. I noticed this afternoon pains in my joints in and around my left elbow. I also notice the night of the 20th what appeared to be 2 bites of some sort, (spider) on my back however I don't believe these are related this is the first time I noticed them. I cannot believe in less then 2 month I could go from feeling perfectly fine to feeling like I am 80 years old. How does something like this start out of no where with no known cause and then spin out of control to where it is today.

Has anyone ever been through this or can anyone give some thought to what other causes may be so I can talk to my Primary phyiscian and get to the bottom of it.

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mdr1963

I should also note that I do drink over 100 oz of water daily, My every day meds include Allegra 180 and vivelle DOT, as well as daily does of acidopholus. My diet is well rounded and healthy, my weight is 143 and I am 5'4". Prior to all of this I was very active, walked every day and had no pains or illness to speak of. I turned 47 years old 7 weeks ago. I live on a lake, and I have a cat and a dog. My alcohol intake in minimal and I do not do any drugs other then those prescribed by my Dr. Last night was the first night I discontinued completly the vicoden as I did not like how it made me feel although it helped the pain it wasn't worth the other symptoms that went it. I continue to take the Skelexin and use Arthritis strength - extended release tylenol for pain. I cannot take NSAID or and Cox ( I think that is the name) drugs such as Celebrex due to an allergic reaction. I have no other known allergies then those two meds.

September 22, 2010 - 1:12pm

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Cary Cook BSN RN (reply to mdr1963)

Hi MDR

The elevated sed rate and the all over body pains suggest a rheumatic or autoimmune illness. Of course, we can not diagnose you, but my suggestion would be to see a rheumatologist. Rather than treating each joint separately, the rheumatologist will take a thorough history, look at the whole picture with all the symptoms and rule out things such as lyme disease, rheumatoid arthritis, etc.

Because the treatment you have had does not seem to be controlling the symptoms let alone finding a diagnosis, a rheumatology consult seems like a good idea. Two heads are better than one, as they say. If nothing else this will rule out a host of illnesses and narrow things down for you.

If we can help further, please let us know. Good luck and keep in touch. Your experience will help others.

September 22, 2010 - 7:00pm