[31O] With complex symptoms including fatigue and neurological issues

Patient Description

A 31-year-old individual assigned 'other' at birth presents with a complex array of symptoms, including persistent fatigue, memory loss, brain fog, executive dysfunction, double vision, pelvic pain, joint pain, depression, anxiety, hallucinations, and nearly constant nausea. The fatigue is exacerbated by heat, stress, alcohol, and both excessive and insufficient sleep, as well as minor exertion and eating. It significantly impacts daily life, causing moodiness and confusion. The patient experiences weight fluctuations, alternating between compulsive eating and lack of appetite, with recent weight gain followed by uncontrollable loss. Joint pain is described as a general ache with sharp pain during movement, rated as a 6/10 in severity. Pelvic pain is cramping and can reach an 8/10. Numbness and tingling are noted, especially in the feet and calves, and in the hands when raised. Muscle weakness and coordination difficulties are present. Vision issues include crossing of the eyes, blurriness, and visual hallucinations. Speech is slightly slurred, and there is difficulty coughing. The patient has a history of asthma, autism, ADHD, OCD, bipolar disorder, DID, subclinical hyperthyroidism, and suspected Ehlers-Danlos syndrome. Allergies include apples, grapes, cinnamon, peanuts, almonds, hazelnuts, and sesame seeds. Current medications are buspirone, bupropion, sertraline, risperidone, guanfacine, estradiol, progesterone, acamprosate, phenibut, piracetam, eflornithine, minoxidil, gabapentin, propranolol, and vivitrol, with the latter potentially worsening nausea. The patient also has CPTSD and a history of alcohol use disorder.

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Arora's Assessment

What might be happening

Your symptoms suggest a complex interplay of conditions. Here are some possibilities:

  1. Chronic Fatigue Syndrome (CFS): Given your profound fatigue, memory issues, and brain fog, CFS could be a consideration. It often involves fatigue that worsens with physical or mental activity but doesn't improve with rest.

  2. Fibromyalgia: This condition can cause widespread pain, fatigue, and cognitive difficulties, which align with your joint pain and fatigue.

  3. Ehlers-Danlos Syndrome (EDS): Your hypermobility and skin symptoms suggest EDS, which can also cause joint pain and fatigue.

  4. Autoimmune or Neurological Disorders: Conditions like multiple sclerosis or lupus could explain your neurological symptoms, such as double vision and numbness.

  5. Mental Health Conditions: Your depression, anxiety, and hallucinations may be related to your existing mental health diagnoses, which can also contribute to fatigue and cognitive issues.

  6. Medication Side Effects: Some of your medications might contribute to nausea, fatigue, or cognitive changes.

What you can do

Fatigue and Cognitive Issues:

  • Prioritize rest and manage stress through relaxation techniques like meditation or yoga.
  • Maintain a regular sleep schedule.
  • Use MDandMe to journal your symptoms and identify patterns or triggers.

Joint and Pelvic Pain:

  • Gentle stretching and low-impact exercises can help manage pain.
  • Consider consulting a physical therapist for tailored exercises.

Nausea:

  • Eat small, frequent meals and avoid triggers like alcohol.
  • Ginger tea or peppermint might help alleviate nausea.

Mental Health:

  • Continue with your prescribed medications and therapy.
  • Engage in activities that promote mental well-being, such as mindfulness or creative hobbies.

General Health:

  • Stay hydrated and maintain a balanced diet.
  • Regularly review your medications with your healthcare provider to manage side effects.

What you should look out for

Seek medical attention if you experience:

  • Sudden worsening of symptoms.
  • New or severe neurological symptoms, such as vision changes or muscle weakness.
  • Severe or persistent nausea and vomiting.

Remember, it's important to consult with healthcare professionals for a formal diagnosis and treatment plan. Keep track of your symptoms and share this information with your provider to aid in your care.

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2 mo ago

People Also Ask

What could be causing my persistent fatigue and brain fog?

Persistent fatigue and brain fog could be due to conditions like Chronic Fatigue Syndrome (CFS), fibromyalgia, or Ehlers-Danlos Syndrome (EDS). They can also be exacerbated by stress, sleep issues, and certain medications. It's important to consult with a healthcare provider for a thorough evaluation.

How can I manage my joint and pelvic pain effectively?

Managing joint and pelvic pain can involve gentle stretching, low-impact exercises, and possibly consulting a physical therapist for personalized exercises. Over-the-counter pain relief and heat therapy might also help, but it's best to discuss options with your doctor.

Are my medications contributing to my nausea and cognitive issues?

Some medications can contribute to nausea and cognitive issues. It's important to review your current medications with your healthcare provider to identify any potential side effects and adjust your treatment plan accordingly.

What should I do if my neurological symptoms suddenly worsen?

If you experience a sudden worsening of neurological symptoms, such as vision changes or muscle weakness, it's crucial to seek medical attention promptly. These could indicate a more serious underlying condition that needs immediate evaluation.

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