[62F] With chronic pain, fatigue, and recurring sores

Patient Description

A 62-year-old female presents with extreme fatigue and pain in her hands, feet, back, and shoulders. The pain feels like muscle aches, as if she has been hit with a bat, and has been occurring off and on for over 10 years, with flare-ups a couple of times a month lasting for 2 to 3 days. She also experiences facial and mouth sores that burn, sting, and form blisters, appearing in her nose, ears, chin, lips, and near her eyes, which she has been dealing with for over 20 years. These sores flare up 2 to 3 times a month. The patient has lifelong anxiety, exacerbated by past abuse and the tragic loss of her son in 2011, leading to hand tremors, brain fog, and shakiness. The tremors, which she has had for over 10 years, are mild to moderate and occur both at rest and with action, making activities like writing and applying eye makeup difficult. Brain fog, present for over 15 years, is alleviated by sitting still, watching TV, listening, or reading a book. She also experiences recurring night fevers during flare-ups. Her chronic medical conditions include asthma, mild COPD, recurring pleurisy, idiopathic allergy requiring an EpiPen, recurring mouth and facial sores, recurring fatigue, degenerative disc disease, neuropathy, and depression diagnosed at age 15. She is currently under the care of a spinal doctor for pain management. Her current medications are Lyrica (300mg twice a day), Tizanidine (4mg), Celebrex (200mg twice a day), Montelukast (10mg once a day), Cymbalta (60mg once a day), Medroxyprogesterone (2.5mg a day), Hydroxyzine (25mg a day), Wellbutrin (150mg a day), Estradiol (once a day), and an Albuterol rescue inhaler as needed.

Show More

Arora's Assessment

What might be happening

Based on the information you've provided, several potential conditions could explain your symptoms:

  1. Fibromyalgia: This condition is characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. It often includes symptoms like muscle aches, fatigue, and brain fog, which you've described.

    • Treatment: Management includes medications like pain relievers, antidepressants, and anti-seizure drugs. Physical therapy, exercise, and stress-reduction techniques can also be beneficial.
  2. Chronic Fatigue Syndrome (CFS): This condition causes extreme fatigue that doesn't improve with rest and may worsen with physical or mental activity. It can also include muscle pain, joint pain, and cognitive difficulties.

    • Treatment: Treatment focuses on symptom relief and may include medications, cognitive behavioral therapy (CBT), and graded exercise therapy.
  3. Autoimmune Disorders: Conditions like lupus or rheumatoid arthritis can cause fatigue, muscle pain, joint pain, and skin issues like sores. These conditions often flare up and then improve.

    • Treatment: Treatment typically involves medications to control the immune system, such as corticosteroids and immunosuppressants. Lifestyle changes and physical therapy may also help.
  4. Peripheral Neuropathy: This condition involves damage to the peripheral nerves, often causing pain, numbness, and weakness in the hands and feet. It can be associated with conditions like diabetes or be idiopathic (of unknown cause).

    • Treatment: Management includes medications for pain relief, physical therapy, and addressing any underlying conditions.
  5. Degenerative Disc Disease: This condition can cause chronic back and neck pain and may contribute to your overall discomfort and fatigue.

    • Treatment: Treatment often includes pain management, physical therapy, and sometimes surgical interventions.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Maintain a Healthy Lifestyle: Eat a balanced diet, stay hydrated, and get regular exercise tailored to your abilities. Gentle activities like walking, swimming, or yoga can be beneficial.
  2. Manage Stress: Continue practicing deep breathing, staying present, and prayer. Consider adding other stress-reduction techniques like meditation or mindfulness.
  3. Sleep Hygiene: Ensure you have a regular sleep schedule and a comfortable sleep environment to improve the quality of your rest.
  4. Pain Management: Use over-the-counter pain relievers as needed and as recommended by your healthcare provider. Heat or cold therapy can also help alleviate muscle pain.
  5. Track Symptoms: Keep a diary of your symptoms, including their frequency, duration, and potential triggers. This information can be valuable for your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening pain that doesn't respond to over-the-counter medications.
  • New or worsening neurological symptoms, such as significant weakness, numbness, or tingling.
  • Unexplained weight loss or persistent fevers.
  • Severe depression or anxiety that affects your daily functioning or leads to thoughts of self-harm.

Remember, while this information can help guide you, it's essential to consult with a healthcare professional to receive a formal diagnosis and appropriate treatment.

Show More

1
 Hugs
0
 Comments

Save

6 mo ago


People Also Ask


What are the common symptoms of fibromyalgia?

Common symptoms of fibromyalgia include widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties often referred to as 'fibro fog.' Patients may also experience headaches, irritable bowel syndrome, and mood disorders.


How can chronic fatigue syndrome be managed effectively?

Chronic fatigue syndrome can be managed through a combination of medications for symptom relief, cognitive behavioral therapy (CBT) to address mental health aspects, and graded exercise therapy to gradually increase physical activity levels. It's important to balance activity with rest to avoid exacerbating symptoms.


What are the signs of an autoimmune disorder like lupus or rheumatoid arthritis?

Signs of autoimmune disorders like lupus or rheumatoid arthritis include joint pain and swelling, fatigue, skin rashes, and fever. These conditions often have periods of flare-ups and remission. Diagnosis typically involves blood tests and clinical evaluation by a healthcare provider.


What lifestyle changes can help manage degenerative disc disease?

Lifestyle changes that can help manage degenerative disc disease include maintaining a healthy weight, engaging in regular low-impact exercises like swimming or walking, practicing good posture, and using ergonomic furniture. Physical therapy and pain management strategies are also important components of treatment.

No comments yet

Be the first one to comment

Share your feedback

All Stories


Experiencing symptoms?

Our AI will conduct a medical interview and assess what might be happening. You can also make a post afterwards.

Share your feedback