Help my girlfriend solve medical mystery

it is not shingles due to the duration of symptoms. shingles also usually has a characteristic rash that is easy to diagnose.

I'm thinking a connective tissue disease

I concur that it could be this.

However, lyme is worth a shot and is more common. Although, she doesn't really exhibit many of the symptoms of lyme disease, therefore I wouldn't jump on this band wagon.

My 75 YO mom had the characteristic rash for a couple months-the chronic aching went on for over a year.

We live in northern california, 30 min north of SF.

Will the people offering why they think it is lupus or some kind of connective tissue disorder explain their reasoning, versus, let's say, the Lyme Disease explanation.

I'm concerned about the irregular heatbeat episode(s), which both Lyme and lupus note are symptoms. It seems if left untreated these are serious considerations that demand immediate attention, so a competent diagnosis is warranted -- and I'm not competent in any way.

I'd call the specialist who deals with children's Lyme disease just to get some direction. Make reference to that poster's directive to do so.

I apologize if my earlier post forced the OP to divulge information about his health insurance and job status. That wasn't my intent. I'd like to be kept up-to-date on this, in case I can learn from it.

And the Mayo Clinic's notes on Lyme state that it is concentrated in the Northeast, Wisconsin, and Northern California, among other places.

Sounds like Lyme Disease to me. I had it and never had a rash, I also didn't find a tick on myself. She can go to a general practitioner and get a lyme test prescription, but I can't believe no doctor has suggested this yet.

Contact this guy. If he thinks it's worth seeing her, make the trip to Maryland. He seems to actually be helping chronic Lyme patients. IMO, the medical community (Lyme specialists included) is still out to sea with tick-borne illness.

http://lymemd.blogspot.com/

My guess would be Lyme every bit as much as any of the guesses posed here. And yes, I've had it - acute phase treated with Doxycycline and good results for 5 years now. It's still unknown how folks like myself, who got off easy, will end up doing 30 or more years down the road.

Thanks and no worries. She so desperate for a diagnosis she'll divulge anything. She'll be one the phone tomorrow.

We appreciate all the input.

Besides the above mentioned disorders and past medical history is there anything else to explain the heart flutter. High blood pressure or anything like that?

Does she take any medications?

Do you know if any lab results came back out of range, even something as simple as calcium, sodium, anything..just because it might help to understand or rule out more conditions.

As for the 70 pound weight gain, over what period of time was that, and how much was she running previously? I take it she isn't really running now because of the pain, but it still seems very odd to gain that much weight.

Please keep us updated, and let us know as you find out more and rule out different scenerios.

I happen to be a medical doctor

I don't think that the advice being given to you on this forum by laypersons is reasonable.

Attempting to understand a case like this requires taking a detailed history, doing a physical exam, and reviewing test results.

The smattering of suggestions being given to you based on superficial information is unhelpful and misleading.

If you are unsatisfied with your doctor, seek a second opinion.

If your girlfriend wants to lose weight, she should keep a strict diet and/or increase her exercise rather than presuming her weight gain is related to medical illness.

A large number of potential diagnoses are consistent with your girlfriend's presentation. It is not reasonable for people to suggest that tests or subspecialty referrals be requested blindly in shotgun fashion. These decisions should be made by the treating physician, though you can suggest something if you have a particular concern.

Good luck with this difficult situation.

...and this is correct. Whew! Third page before somebody says that a complex diagnosis can't be made online. Continue to search for a doc that will listen to you and work it up!

Dear "doctor". He came to a message board to get input on possibilities. He actually has quite a few suggestions and one "lymes disease" fits her symptoms near perfectly and is therefore not unreasonable. Should she seek another doctor? Of course, but lots of people on here have had a lot of different conditions and are therefore in a good position to offer some advice. This whole "i am a doctor" attitude is exactly why people don't like going to doctors. And to the 3rd year med student who said something about the third page of this thread, you got this medical ego thing down pat.

And two more doctors, trial and the 3rd year med student,

who aren't really helping this guy and his gf. Of course it's a complex issue that defies easy diagnosis.

He knows the information from this thread isn't full-proof and not always reasonable. It's an anonymous running forum, not a medical board. From his experience, the line that doctors are only "practicing" medicine is apt.

This has been going on so long that he's searching for some direction. He hasn't had an established physician over the course of her escalating conditions, which is one of the mitigating issues.

He initially asked for some basic idea around this slew of unusual events, and your 3rd page helpful response is to see a doctor. Man, thanks for that. Is he billable now?

interestinggggg wrote:

Besides the above mentioned disorders and past medical history is there anything else to explain the heart flutter. High blood pressure or anything like that?

Does she take any medications?

Do you know if any lab results came back out of range, even something as simple as calcium, sodium, anything..just because it might help to understand or rule out more conditions.

As for the 70 pound weight gain, over what period of time was that, and how much was she running previously? I take it she isn't really running now because of the pain, but it still seems very odd to gain that much weight.

Please keep us updated, and let us know as you find out more and rule out different scenerios.

The only thing that comes back with any consistency is low vitamin D. BP is always low. She also has type 2 Von Wilderbrands.

Of course we will seek another opinion.... A third or 4th if you count the Fibromyalgia guy. Its just that the answer seems to be "nothing seems to be wrong".

I'm here just seeking direction because I cant believe someone has, for example, an ear pain that keeps them up all night, but no ear infection, and a head xray that shows no jaw issues. Something has to be wrong... No one is seeing it.

With regards to the weight gain... The 70 lbs was over a period of 8 years and did coincide with decreased activity due to pain and fatigue as well as aging and maintained food intake. (as well as a 30 lbs gain for me due to injures and increased food intake!)

However now she does portion control, little/no alcohol.

For exercise... She did a gentle 10 mile bike ride 3 weeks ago, was exhausted for days. Two weeks ago she did a 2.5 mile walk/jog. Ended up with fever and ear pain.

Your girlfriend is obese, has one or more psychiatric diagnoses (fibromyalgia sounds very reasonable and there is probably an anxiety component), and perimenopausal. None of this sounds like a huge mystery from what you've written. The fact that these problems have resisted further diagnosis for three years despite extensive evaluation and testing reinforces this theory. Further it sounds like there was a pretty credible trigger for some of her problems, namely getting laid off at approximately the time this all began. Chronic or post-acute Lyme is currently a popular trashcan diagnosis and almost every symptom has been ascribed to it. I have sympathy for your girlfriend but I think it is extremely unlikely that this is the solution to her problem.

Yet another "doctor" saying that lymes disease is a trash can diagnosis but he suggests fibromyalgia and a psychiatric problem. How easy is it to get a medical license these days? None of the things you mention has the possibility of making someone tired for days after an easy bike ride.

doctor wrote:

Your girlfriend is obese, has one or more psychiatric diagnoses (fibromyalgia sounds very reasonable and there is probably an anxiety component), and perimenopausal. None of this sounds like a huge mystery from what you've written. The fact that these problems have resisted further diagnosis for three years despite extensive evaluation and testing reinforces this theory. Further it sounds like there was a pretty credible trigger for some of her problems, namely getting laid off at approximately the time this all began. Chronic or post-acute Lyme is currently a popular trashcan diagnosis and almost every symptom has been ascribed to it. I have sympathy for your girlfriend but I think it is extremely unlikely that this is the solution to her problem.

Headcase.

I don't even have to read beyond your first few sentences.

oh pleases wrote:

Yet another "doctor" saying that lymes disease is a trash can diagnosis but he suggests fibromyalgia and a psychiatric problem. How easy is it to get a medical license these days? None of the things you mention has the possibility of making someone tired for days after an easy bike ride.

Being fat and depressed can make you tired for your entire life, believe it or not