OpenHealth Q&A

Seeking Guidance in My Health Journey

**Age/Gender:** 34 years old, Female **Postpartum Status:** 11 months since giving birth **Existing Medical Issues:** I have a history of Addison’s disease, endometriosis, polycystic ovary syndrome (PCOS), attention deficit hyperactivity disorder (ADHD), irritable bowel syndrome (IBS), occipital neuralgia, and chronic migraines. **Current Medications:** I am on a daily dose of 2mg Prednisone (reduced from 5mg as of April), along with Vyvanse, Pristiq, continuous use of Nikki birth control, pantoprazole, and metformin ER. I have also been receiving occipital nerve blocks every three months. Recently, I added meloxicam to my regimen, which seems to relieve joint pain, though it hasn't alleviated the discomfort in my neck. Lately, I feel completely overwhelmed and in agony, despite my primary care provider's reassurance that my lab results look normal, aside from an increased CRP level. My quality of life has drastically diminished. ### Main Concerns (Emerging Since Late 2024): - Gradual worsening of pain primarily located on my right side, starting from: - My neck, progressing to the shoulder, elbow, and wrist. - Pain has now extended to my right hip and knee, which have started to swell and feel strained after a recent incident. - Both sides of my fingers are also experiencing discomfort. - Additionally, I’m dealing with persistent lower and mid-back pain. ### Recent Developments: - I noticed a painful and swollen lymph node in my right groin area, which throbbed and created discomfort in my pelvic region for about four days. ### Systemic Manifestations: - I’m dealing with chronic fatigue, difficulty concentrating, an aching sensation throughout my body, and morning stiffness that can last several hours. Moving my body often feels laborious, as though my legs and overall frame are excessively heavy. - Occasionally, I develop rashes, including new allergic dermatitis from jewelry that I previously wore without issue. - My ability to care for my young daughter is suffering due to increasing pain and limited mobility, as is my performance at work because of issues with my dominant hand and computer use. ### Neck and Spine Examination (Results from 7/8): - An X-ray revealed possible compression between C3 and C4, along with indications of a potential disc herniation. - An orthopedic examination suggested that my right arm and shoulder pain likely originates from neck issues that may involve nerve damage. - I had an MRI planned for 7/19, but it was unfortunately denied by my insurance. - A follow-up with a spine specialist is set for 7/31. - An EMG test is scheduled for 9/9. ### Updates from Physical Therapy (May 2025): - The physical therapist observed that all my joints exhibit significant hypermobility and recommended evaluation for hypermobile Ehlers-Danlos syndrome (EDS). - Unfortunately, my shoulder and neck pain worsened during therapy sessions, leading to a referral to an orthopedic specialist due to a previous labral tear in 2020. ### Recent Lab Results (Drawn 7/8/25): - ANA IFA (with reflex): Negative - CCP IgG: 16 (Normal)<20 - Lyme Antibody with Reflex Immunoblot: Negative - **CRP: High at 0.84** - Rheumatoid Factor: Normal at <3.50 - ESR: Normal at 6 - Uric Acid: Normal at 5.3 - Lyme, Anaplasma, Babesia: Negative - TSH, High Sensitivity: Normal at 0.946 (Normal Range 0.550-4.780) - T4 Free: Normal at 0.73 (Normal for ages 20-39: 0.61-1.82) - Vitamin D: Normal at 45.7 (Normal 30-100) - **Platelets: High at 469** - **MPV: Low at 9.0** - **MCHC: Low at 31.4** - WBCs: 12,000 (This has been a stable count for me since my Addison's diagnosis in 2018 while on prednisone) I'm at a loss as to how to proceed. With a family background of autoimmune diseases, including lupus, rheumatoid arthritis, Graves’ disease, Hashimoto's, and Sjögren's syndrome, it’s concerning that I cannot see a rheumatologist due to my negative ANA results. There is clearly an issue with my health, and I feel a strong need for guidance on the next steps.

Answers (1)

7/18/2025, 6:41:08 PM

OpenHealth AI

It sounds like you are going through a very challenging health journey with multiple complexities. Your experience of pain, fatigue, and mobility issues, combined with a history of various medical conditions, underline the need for a thorough and multi-faceted approach to your health and well-being. Let's break down the main points and focus on actionable steps you can take right now.

Key Points

1. You're experiencing worsening pain and fatigue, affecting your quality of life.
2. There are concerning symptoms such as swollen lymph nodes and significant joint pain.
3. You have a family history of autoimmune diseases, which amplifies your worries.
4. Recent lab results show elevated CRP and some other abnormal values, though autoimmune markers were negative.

Explanation

Given your complex medical history and the myriad symptoms you’re presenting, it’s essential to approach this systematically. The pain, joint issues, and increased CRP indicate inflammation, which can often be seen in autoimmune or connective tissue diseases.

Your concerns about the delayed MRI and an inability to see a rheumatologist due to negative ANA results, while frustrating, do not limit the necessity of exploring other diagnoses or specialists that might be able to help.

Next Steps

1. Follow Up with Your Spine Specialist: Since your spinal examination has revealed possible compression and disc issues, ensure you discuss your recent symptoms in detail. Ask if the symptoms you experience (joint pain, fatigue, etc.) may relate to your neck and spine problems.

2. Pain Management: Since meloxicam has provided some relief, consider increasing your focus on non-pharmaceutical methods:

   • Gentle Stretching & Physical Therapy: Continue with physical therapy but focus on gentle, pain-free movements to build strength gradually. Sometimes, low-impact activities like swimming or water therapy can be less painful.
   • Heat and Cold Therapy: Using heat on sore areas can help relax muscles; ice can reduce inflammation and swelling.

3. Monitoring Symptoms: Keep a daily log of your symptoms, noting pain levels, fatigue, and any new symptoms like the rashes you experience. This can be useful for future appointments.

4. Explore Autoimmune Considerations: Discuss with your healthcare provider the possibility of seeing a rheumatologist who specializes in unexplained systemic symptoms, especially since you have a family history of autoimmune diseases.

5. Nutritional and Lifestyle Support:

   • Consider integrating an anti-inflammatory diet, rich in fruits, vegetables, whole grains, and healthy fats. Omega-3 fatty acids found in fish or flaxseeds may be particularly beneficial.
   • Stay hydrated and monitor your sleep quality since fatigue tends to exacerbate pain.

6. Emotional Support: Given the overwhelm you’re feeling, connecting with mental health services to address any anxiety or stress can be beneficial for your overall well-being. Support groups for individuals dealing with chronic pain or autoimmune conditions can also provide emotional resilience.

7. Remain Proactive About Lab Results: Given elevated CRP and abnormal blood counts, remain vigilant and discuss potential further testing or monitoring with your primary care provider to rule out any other possible conditions.

Reassurance

While it’s completely valid to feel overwhelmed by what’s happening in your body, remember that you are taking significant steps to understand and improve your health. Your symptoms deserve attention, and pursuing them actively will help find the right answers. Continue advocating for yourself in your healthcare journey. You are not alone in this, and support is available.