[19F] Experiencing chronic bone pain and multiple systemic symptoms

Patient Description

A 19-year-old female presents with chronic, deep aching bone pain that moves around various parts of her body, including legs, feet, hands, wrists, lower arm, and lower back. The pain is sporadic, lasting from one hour to three days, and occurs after activity or randomly. She also experiences occasional numbness in her right leg, fatigue, loss of motivation, and unexplained weight loss despite an increased appetite recently. The patient has been dealing with depression and anxiety since age 16, with symptoms including suicidal thoughts, intense hot flashes, sensitivity to cold, and mood swings. Additional symptoms include dizziness with near fainting, vision loss, brain fog, memory loss, slurred speech, constipation, bloating, pale skin, acne, menstrual cramps, sharp pain in lymph nodes with occasional swelling, and a rubbing sensation in the right upper femur. She has a history of undeveloped Achilles tendons, a bone island in the right femur, low mono and high lymph counts, and deficiencies in vitamin D and B12. She is severely allergic to morphine and ketamine but is not currently on any medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible unifying diagnoses include:

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It amplifies painful sensations by affecting the way your brain processes pain signals.

    • Treatment often involves a team approach, including your doctor, a physical therapist, and possibly other health professionals. What works for one person might not work for another, so you may need to try a variety of strategies.
  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue may worsen with physical or mental activity, but doesn't improve with rest.

    • Treatment for chronic fatigue syndrome focuses on symptom relief.
  • Autoimmune disorders: These are diseases in which the body's immune system attacks healthy cells. They can cause a wide variety of symptoms, including fatigue, pain, and inflammation. Examples include lupus and rheumatoid arthritis.

    • Treatment typically focuses on reducing symptom severity and controlling the autoimmune process while maintaining the body's ability to fight disease.
  • Vitamin Deficiencies: You mentioned having low vitamin D and B12 levels. These deficiencies can cause a range of symptoms, including fatigue, weakness, constipation, and depression.

    • Treatment typically involves dietary changes and/or supplementation.
  • Anxiety and Depression: These mental health conditions can cause physical symptoms like fatigue, difficulty concentrating, and body aches.

    • Treatment typically involves a combination of medication and talk therapy.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to relieve your symptoms:

  1. Regular exercise: This can help reduce symptoms of fatigue and improve your mood. Start slow and gradually increase the intensity and duration of your workouts.
  2. Healthy diet: Eating a balanced diet can help boost your energy levels and improve your overall health. Make sure to include plenty of fruits, vegetables, lean proteins, and whole grains in your meals.
  3. Good sleep hygiene: Make sure you're getting enough sleep each night and that your sleep environment is conducive to good quality sleep. This can help reduce fatigue and improve your mood.
  4. Stress management: Techniques like meditation, deep breathing, and yoga can help reduce symptoms of anxiety and improve your overall well-being.

What you should look out for

Reasons to see a doctor more urgently:

  • If your symptoms worsen or you develop new symptoms
  • If your pain becomes severe or you have difficulty moving
  • If you experience severe mood swings or thoughts of suicide
  • If you notice any changes in your bowel habits, such as blood in your stool or severe constipation

Please remember that while I strive to provide accurate and helpful health information, this advice is not a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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7 mo ago

People Also Ask


What are the common symptoms of fibromyalgia and how is it diagnosed?

Common symptoms of fibromyalgia include widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. Diagnosis is typically based on a history of widespread pain lasting more than three months and the presence of other symptoms, as there is no specific test for fibromyalgia.


How can vitamin D and B12 deficiencies affect my health?

Vitamin D and B12 deficiencies can lead to symptoms such as fatigue, weakness, depression, and neurological issues like numbness or tingling. These deficiencies can be addressed through dietary changes and supplementation.


What are the potential causes of chronic fatigue syndrome?

The exact cause of chronic fatigue syndrome is unknown, but it may be triggered by factors such as viral infections, immune system problems, hormonal imbalances, or psychological stress. Diagnosis is often based on ruling out other conditions.


How can anxiety and depression contribute to physical symptoms like pain and fatigue?

Anxiety and depression can lead to physical symptoms due to the body's stress response, which can cause muscle tension, fatigue, and changes in appetite and sleep patterns. These conditions can also amplify the perception of pain.


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Anonymous#24703

7 mo ago

You need a couple rounds of 50k units of vitamin D!! Vitamin D deficiency can cause crazy side effects

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