Should I Trust My Diagnosis or Get a Second Opinion?
I am a 26-year-old female living with limited GPA disease. For the past five years, I have been managing my condition with a regimen that includes prednisone and Azathioprine. Recently, my rheumatologist decided to reduce my maintenance dosage from 5mg to 0mg. Unfortunately, this change did not yield positive results, as I experienced severe joint pain and a flare-up, leading to my return to a 5mg dose. Despite being back on this dosage for about two weeks now, I continue to suffer from intense joint pain, overall bodily weakness, morning numbness in my legs, as well as muscle soreness and stiffness. Additionally, I have noticed the sudden appearance of hard, round hematomas solely on my left leg. These formations are quite large and were bright red on the first day, gradually fading like a bruise over a week. They occur exclusively around the knee area on my lower left leg and are quite painful initially, almost like I’m housing a solid mass inside my leg. My family doctor has suggested that these symptoms could indicate Erythema Nodosum, but the appearance of my bruises leaves me skeptical. Could it be possible that I genuinely have Erythema Nodosum? I’ve included images in the comments showing the bruise on its first day and again as it fades.
Answers (1)
8/2/2025, 3:02:05 PM
OpenHealth AI
It's understandable to feel uncertain about your diagnosis, especially when dealing with a chronic condition like GPA disease and the accompanying symptoms you've described. It's important to trust your instincts; if you feel that your health is not improving or if new symptoms arise, seeking clarification is your right as a patient.
Key Points:
- You are experiencing persistent joint pain, weakness, morning numbness, and the appearance of hematomas.
- You have been recently transitioned off medications with negative results and are back on treatment but still facing symptoms.
- Your doctor's suggestion of Erythema Nodosum is worth evaluating further given your symptoms and concerns.
Explanation:
Erythema Nodosum is typically characterized by painful, red nodules that can feel like deep nodules under the skin, commonly occurring on the legs. It can be associated with various conditions, including infections, medications, and other autoimmune diseases. The hematomas you're describing, especially their sudden appearance and progression, also warrant careful assessment as they may indicate something that needs a closer look.
Next Steps:
-
Monitor Symptoms Closely: Keep a detailed record of all your symptoms, including their intensity, duration, triggers, and any new developments. This will help provide a comprehensive overview for your doctor.
-
Request Further Evaluation: Consider discussing your symptoms again with your rheumatologist, emphasizing the persistence of your joint pain, weakness, and the hematomas. Ask if further testing is warranted to explore other potential diagnoses, including Erythema Nodosum or other relevant conditions.
-
Second Opinion: If you're feeling uncertain about the current management plan or the recent changes in medication, seeking a second opinion from another rheumatologist can be beneficial. It can provide you with reassurance or alternative treatment options.
-
Lifestyle Adjustments: While waiting for your next appointment, prioritize self-care. Focus on gentle movement to maintain joint flexibility, manage stress through mindfulness or relaxation techniques, and ensure you are hydrating and nourishing your body adequately to support your overall health.
It's critical to advocate for yourself and seek clarity when you feel your health is not where it should be. You deserve to receive care that addresses all aspects of your health.
Related Questions
Can Cerebral Small Vessel Disease Lead to Changes in Behavior?
My mother, who is 78 years old, a non-smoker, and has no known previous health issues, has recently been diagnosed with moderate cerebral small vessel disease. Over the past five years, she has exhibited some peculiar behaviors, which I previously attributed, at least in part, to the impact of the pandemic. For instance, she expressed concern over whether QR codes might pose health risks. Additionally, she has voiced apprehensions about security tags found in retail settings for similar reasons. Furthermore, she has become increasingly detached from her two grandchildren, aged 5 and 2, declining to babysit them even for brief periods due to feelings of anxiety. This leads me to wonder: could her unusual behaviors be linked to her recent diagnosis, or are they more likely a result of psychological issues such as heightened anxiety?
Concerns About My 9-Month-Old's Eye and Head Issues
My little one is nearly 9 months old, adjusting to 7 months since he was born at 32 weeks. He currently weighs 17 pounds 10 ounces and is approximately 27 inches tall. He is receiving iron supplements, vitamin D, and antibiotic ear drops due to his health conditions. Recently, I've noticed some unusual behavior with his right eye; he tends to squint when he focuses on bright screens like my phone or toys, and sometimes, particularly when he's excited. Occasionally, he rubs his eyes afterward and might blink prior to or after squinting. Generally, he doesn’t seem distressed at any point during these moments, but I have observed that startling him seems to interrupt this behavior. Moreover, he has developed a new rightward head tilt; he used to tilt to the left, which was corrected through physical therapy. This change happened suddenly. He also has bilateral ear tubes, and we learned just yesterday from our audiologist that the right tube might be blocked. An eye examination revealed no serious issues, but they noted he has blocked tear ducts, which causes crusty eyes when he wakes in the morning. An interesting observation is that when he cries, he often squints his right eye while the left remains open before it closes afterward. Ordinarily, he blinks in unison, and he sleeps with his eyes fully closed. The eye specialist reassured us that these quirks are typical for infants. It's worth mentioning that at birth his face had a nerve issue resulting in temporary paralysis on one side, which resolved itself within two weeks. I can’t help but wonder if there’s a connection between these symptoms and his ear situation. We were instructed to administer ear drops for a week, with a follow-up scheduled in three weeks. While his ear doesn’t appear to be infected, he has been habitually tugging at his hair and that ear. Back in June, we encountered concerning bloody discharge from that ear, which the ENT specialists couldn't explain. Initially, I was alarmed and feared it might resemble seizures, but the occurrences aren’t consistent, and he ceases the squinting when I call out to him. On a positive note, developmentally, he is progressing as expected. As a first-time mother, I am seeking any insight or advice on these matters.
Is It Possible for Two Weeks of Starvation to Result in Lasting Brain Damage?
I am a 29-year-old female who recently endured a challenging period of inadequate food intake that lasted nearly two months, during which I consumed around one meal every two days. This was followed by an intense episode of depression where I did not eat at all for two or three weeks. My memory from that time is quite unclear due to its foggy nature. During this phase, I experienced hallucinations, overwhelming apathy, and notable physical symptoms, including a sodium concentration of 139 mmol/l and sudden hyperreflexia. Regrettably, when I sought medical assistance, the hospital neglected to provide thiamine or any essential nutrients during my critical illness, leaving me puzzled and unsettled—a situation my legal counsel is currently investigating. I am deeply anxious about the possibility of brain degeneration or electrolyte disturbances leading to irreversible damage, such as Wernicke-Korsakoff syndrome. Given the extent of my undernourishment and starvation, could this have serious long-term effects? My cognitive abilities have not returned to their previous state, and I was once a high-performing individual in the creative field. All I desire is to regain my mental clarity. I would greatly appreciate any guidance or reassurance from those knowledgeable about this issue.
Duration of THC Detection in Urine
As a 23-year-old male weighing 79 kilograms and standing about 5 feet 6 inches tall, my body fat percentage falls between 30 and 35%. Although I don't consume cannabis regularly, I recently took approximately 15 to 20 puffs about a week ago. In order to obtain my driving license, I am required to undergo a medical examination, and any indication of THC in my urine would likely lead to a disqualification. I’m seeking information on the duration THC remains detectable in urine. Additionally, are there any recommended ways to expedite its elimination from my system?
Throat Lump Concerns and Illness Duration
A 16-year-old female, weighing 53 kg (117 lbs) and standing at 5'8" (172 cm), is currently prescribed Desmopressin Acetate at a dosage of 50 micrograms twice daily. I’ve noticed a small bump located at the back of my throat, close to the uvula. While I’m unable to visualize it myself, I can distinctly feel it with my tongue. This lump has been present for over a year, so I believe it isn’t related to a cold or similar illness. Its presence is bothersome, causing noticeable discomfort, particularly during swallowing, and I’ve observed that the pain seems to have intensified over the past month. Additionally, I’ve been curious about my tendency to remain ill for extended periods after contracting a cold or similar virus from family members. I tend to experience severe symptoms compared to others, often leading to vomiting, decreased oxygen levels, extreme dizziness, and in some cases, fainting spells. This illness can incapacitate me for a month or longer. I’ve raised these concerns with my general practitioner, who appeared uncertain regarding both the throat lump and the prolonged duration of my illnesses. She mentioned I am "immune compromised" but did not provide a clear explanation. This label confuses me, as I thought those with compromised immune systems fall ill frequently, while I only seem to get sick every 18 months or so, which is less than what's typical for many people. I have additional health conditions—specifically, Postural Orthostatic Tachycardia Syndrome (POTS), Central Diabetes Insipidus, and Reactive Hypoglycemia—but I'm unsure of their relevance to my current issues. Any insights or guidance regarding these symptoms would be greatly appreciated. Thank you!