[32F] Experiencing widespread pain, stiffness, and autonomic symptoms

Patient Description

A 32-year-old female reports suffering from widespread pain described as pressure under the skin, stiffness, and aches for several weeks. The pain intensity fluctuates between 2 and 8 out of 10 and occurs randomly without any identifiable triggers. Accompanying symptoms include low blood pressure, high heart rate, difficulty maintaining straight gaze, unexpected weight gain, joint tenderness, gastrointestinal upset, and diarrhea. The patient has a family history of autoimmune disease (mother with Hashimoto's) and a personal medical history of eosinophilic asthma diagnosed in 2020. Current medications include Cellcept (1500mg), Methotrexate (25mg), Cymbalta (20mg), and Wellbutrin (75mg), which have been taken for the past 3 years. The patient has allergies to Lidocaine and sulfa drugs.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible conditions that could be causing your symptoms:

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It's often triggered by a stressful event, including physical stress or emotional (psychological) stress. However, fibromyalgia can also gradually occur without any triggers.

    • Treatment often involves a combination of medications, exercise, stress management measures, and healthy lifestyle habits.

  • Chronic Fatigue Syndrome (CFS): This condition causes severe, continued tiredness that is not relieved by rest and is not directly caused by other medical conditions. The cause of CFS is unknown, but it may be related to an immune system response to viruses.

    • Treatment focuses on symptom relief.

  • Autoimmune diseases: Given your family history of Hashimoto's disease and your current diagnosis of eosinophilic asthma, it's possible that your symptoms could be related to an autoimmune condition. Autoimmune diseases can cause a wide range of symptoms, including fatigue, pain, and inflammation.

    • Treatment typically involves managing symptoms and preventing complications.

  • Side effects of medication: Some of your symptoms might be side effects of the medications you're taking. For example, methotrexate can cause fatigue and gastrointestinal upset, and Cymbalta can cause high blood pressure.

What you can do

  1. Schedule an appointment with your doctor to discuss your symptoms. They may want to run some tests or refer you to a specialist for further evaluation.
  2. Keep a symptom diary. This can help you and your doctor identify any patterns or triggers related to your symptoms.
  3. Try to maintain a healthy lifestyle. Regular exercise, a balanced diet, and adequate sleep can help manage many of the symptoms you're experiencing.
  4. If you think your symptoms might be related to your medication, do not stop taking them without first consulting your doctor.

What you should look out for

Contact your doctor immediately if:

  • Your symptoms significantly worsen
  • You develop new symptoms
  • You have difficulty breathing
  • You experience severe pain

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 mo ago

People Also Ask

What are the common symptoms of fibromyalgia?

Common symptoms of fibromyalgia include widespread musculoskeletal pain, fatigue, sleep disturbances, memory issues, and mood swings. The pain is often described as a constant dull ache that lasts for at least three months.

How can chronic fatigue syndrome be managed?

Chronic fatigue syndrome can be managed through a combination of lifestyle changes, such as regular gentle exercise, a balanced diet, and good sleep hygiene. Cognitive behavioral therapy and medications to manage specific symptoms like pain or sleep issues may also be recommended.

What are the potential side effects of Methotrexate and Cymbalta?

Methotrexate can cause side effects such as fatigue, nausea, and gastrointestinal upset. Cymbalta may lead to high blood pressure, dizziness, dry mouth, and sleep disturbances. It's important to discuss any side effects with your doctor.

How does a family history of autoimmune diseases affect my health?

A family history of autoimmune diseases can increase your risk of developing similar conditions. It is important to monitor for symptoms and discuss your family history with your healthcare provider, who may recommend regular check-ups or specific tests to catch any early signs of autoimmune disorders.

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