Edited April 2014 from letter dated September 2007
Good morning Dr. I am writing you this letter to provide a detailed update on my seemingly never-ending medical issues. I find that during appointments, with the limited timeframe, I inevitably forget to mention a certain symptom or cannot fully explain a certain experience. Hopefully this format will remedy that.
SINUSES: The initial MRI and X-rays of my face that were done when my eye pain first surfaced both indicated something in my sinus cavity (I can’t remember what it was called). Anyway, you prescribed a round of antibiotics and some Flonase. There was never any follow up on this and I can’t say that I noticed any difference after using the antibiotics. Is this something we need to re-examine to see if the antibiotic was successful?
BUG BITES: Last September after a trip home to Ontario I had several extremely itchy spots on the left side of my body (forearm and belly). These lasted for many weeks and did not appear to be simple mosquito bites, but I was unsure how I’d obtained them. You gave me some Desoximetasone cream to reduce the itching. This cream really had no success reducing the itching. I’ve had a few recurrent outbreaks over the past year where two or three of the bumps re-appear for a couple days then disappear again. For about four months now, all but one spot has completely disappeared and is no longer causing discomfort. The lone spot remaining is very tiny and persists on my left side. It is not even a bump, but every so often it will still become itchy for a few moments of time. This isn’t something that troubles me a great deal other than to say I find it rather odd that a bug bite or plant irritation could persist like this for a year.
HEARING: At the end of July I had my appointment with the hearing specialist regarding the ringing in my ears that I became aware of when I started a physiotherapy exercise. According to the doctor, I am suffering from hi-frequency hearing loss and I am to return to see him in 8 months to see if the condition is worsening. Though disappointing, this isn’t such a huge surprise as my father has suffered from this same affliction for over 30 years and has worn hearing aids as long as I can remember. I must contend that my hearing is nowhere near as bad as my father’s but it certainly isn’t great judging by the volume level on the television that my wife uses compared to me. I guess we can chalk this one up to genetics and AC/DC in my teens.
MRI: I didn’t really get a chance to ask many questions about my latest MRI results. There is narrowing of my spinal column and degenerative disc disease. Will these conditions continue to worsen? Is there any way to reverse the damage? Is it possible that these were the result of or the initiator of all the other problems I’ve had over the past five years?
ALLERGIES: A few years back you had booked me in with the health region for an allergy test. I wasn’t able to attend my appointment due to severe fatigue issues that week and I never rebooked. I wanted your opinion as to whether these independent allergy labs which conduct full allergy tests through the blood and such are genuinely useful or simply scams. If they are of little or no benefit, I think I’d like to rebook for tests within the health system to further investigate whether some allergies may be adding to my problems.
SPOTS BELOW EYES: You’ll recall that a year and a half ago I had a whitish patch removed from below my left eye. Since then I unfortunately have had 2 smaller spots return to the same spot as well as a third spot below my right eye. Each time I visit a new specialist for any of these ailments and they immediately notice these spots and ask if I’ve been tested for cholesterol. I say that I have, but I’m guessing it’s been awhile since my last test. And with the spots returning, would it be prudent for me to be tested again?
EYE STRAIN/HEADACHES: In addition to my visits with you regarding this issue, I have now had appointments or talked to three optometrists and two ophthalmologists regarding this problem with only limited results.
Our family optometrist has seen me twice and prescribed my first pair of eyeglasses. These helped a bit but did not cure my problem and the symptoms seemed to worsen with time. The first ophthalmologist you sent me to diagnosed mild Iritis and prescribed Prednisolone drops. These drops resulted in a very noticeable improvement, but did not cure my problem. I returned to him again a month later and he said there is no longer any Iritis and asked me to see an optometrist of his choosing. The second ophthalmologist you sent me too, whom I saw soon after the first, found nothing other than some dryness and he suggested Omega 3 pills and eye moisturizing drops. Neither has had any effect on my pain and I have discontinued using them.
The optometrist that the first opthalmologist sent me to diagnosed an over-convergence issue in my eyes and prescribed a second pair of glasses similar to my first pair but with a slight prism to help deal with the over-convergence issue. Again, these glasses helped somewhat but have not cured the problem of pain when using computer screens or watching television (I’d even suggest that reading for lengths of time is causing a similar strain which I had not noticed previously but I don’t read nearly as much as I work on a computer so it’s difficult to say for sure). The addition of the prism was something that my family optometrist had also mentioned initially, but we decided to try without first so both optometrists seem to be “seeing” the same things in my eyes. With my problems persisting even with the new eyeglasses, I re-contacted the second optometrist who suggested the only other thing we could try was a progressive lens prescription, which I’m of the understanding is essentially a bifocal type lens. Since both optometrists seem to be on the same page with their findings, I re-contacted my family optometrist as well for a second opinion regarding the progressive lenses. She suggested that something I could try first is basically eye physiotherapy and she put me in contact with another optometrist. I had my eye exams sent to this third optometrist who specializes in the eye physio and she determined that there was nothing she could do.
And so here I am, with this nagging eye pain/headache issue that has been going on for almost one and a half years now. I have not tried the progressive lenses, but needless to say, I am skeptical that they will work. Having had five physicians whose sole focus is the eye look at this situation and none of them finding a way to remedy it, I have real doubts that this is a vision issue. Is it not possible it is a muscle issue, especially considering all the other problems I seem to be having with my muscular system?
BACK PAIN/ MUSCLE ISSUES: As you are aware, I continue to have significant trouble with back pain, particularly on the right side of my upper back ‘beneath’ my shoulder blade. This pain becomes most prevalent when I’m in a sitting position for more than 20 minutes. This problem is showing no signs of disappearing and in fact seems to be slowly worsening. I’m going to relate a series of “symptoms” and experiences to you here for no other reason than they all seem to involve my muscles in some fashion.
First, a quick note about the PMS Cyclobenzaprine you prescribed me in January. I took this stuff for a couple days and had to quit. It was horrible stuff that seemed only able to put me to sleep. I felt absolutely awful and found it was pretty much impossible to stay awake and it did very little alleviate the pain in my back.
The physiotherapy I’ve been doing, admittedly not with the persistence required, has shown very limited success in fixing the pain in my back. Initially, my physiotherapist performed a series of acupuncture type applications designed to trigger spasms in my back muscles that lead to relaxing the tense muscles. I endured this treatment, and I do mean endure, for about five weeks at which point it became clear this needling was doing nothing but making my back sore (similar to bruising). I found that the weekend after having this procedure on a Friday were quite trying as I was quite sore and feeling fairly under the weather. So I stopped getting this treatment and have not had any since.
Additionally, the physiotherapist showed me several exercises to perform, one of which requires me to roll on my back on top of a large rolling pin like apparatus. This exercise is successful in cracking my spine which feels remarkably good, especially after a long day at work. But regrettably, while this back crack feels quite nice, it does little to actually alleviate, let alone fix the pain in my back. Other exercises involve using a rubber resistance band and are designed to work my shoulder and back muscles. Again, while these exercises are successful in working my muscles, something that I am in dire need of, they do not seem to have any success in remedying my back pain.
As I mentioned on the phone last week, the biggest change in my daily routine has been the return to public transit as apposed to driving to work each day. I am therefore standing up rather than sitting for most of an hour each morning and afternoon. This certainly seems more agreeable to my back than the driving position, particularly on the way home from work. When I drove, that 40 minute drive was especially painful after a full day at the workstation. But let it not be mistaken that I am without pain during these commutes. It is better than driving, but still painful. And when I get home, more than anything, I need to lie down or at least recline for awhile to alleviate the strain throughout my back.
Accordingly my weekends are better than weekdays as I’m able to recline and lie down or just not sit upright as much on the weekend. That’s not to say that sitting down for meals or at the computer like I am now when writing this letter the pain does not present itself. But as you can imagine, I don’t spend 8 hours at the computer or dinner table. Still, it makes entertaining guests difficult, notably when trying to play cards or a board game for example. Any situation requiring me to sit in an upright position for any length of time eventually leads to irritation of my back in that upper right spot eventually radiating outward across my back and even to the right front of my chest. I’d even go so far as to say there have been the occasions when I’ve even felt a slight tingling/numbness in my right arm. It’s not frightfully numb, more akin to the sensation you feel when you bump your funny bone.
My most recent MRI and X-rays certainly account for some of the discomfort I often feel in my neck and across my entire back. Unfortunately the test results do not seem to point to a cause for the very specific troubles on the right side of my body. I have been to see the spine doctor once already and he’s asked me to come back at the end of a day to see if he can notice anything when the pain is at its worst. The flipside to this, as you may have guessed, is that he can’t push or touch anything on my body that provides any insight as to why I have this pain. Still, he seems to want to try this Prolotherapy treatment, which from what I’ve read is an injection of fluid into my ligaments. This injection will cause inflammation resulting in increased blood flow to the area and eventual repairing of the muscles. I’m a little leery of this procedure, not only because there is some question to its effectiveness but also because we have yet to establish why the pain is happening. It doesn’t address all the other muscle ailments that I seem to be suffering. And, I fail to understand how treating ligaments will help cure something that to me seems to be occurring in the middle of my muscle and radiating outward.
I’m curious if there could be a muscular disease cause for this pain. I most certainly can feel significant tightness in my back muscles that pull directly to the epicenter of the pain on the right side of my back. But additionally I’d like to mention other muscle related “oddities” that I experience. Now that Sophie is with us, I have taken to going for walks with her and Stephanie somewhat regularly. These walks can be anywhere from 20 minutes to 50 minutes of casual walking with me pushing Sophie in her stroller. I’ve noticed that most times I begin to experience strain in the muscles on the outside of my hips; both sides, right where my hip joint flexes while walking. It’s not anything I’d describe as pain, more a discomfort that is quite noticeable and can make walking a bit uncomfortable.
Also, at the beginning of July, my parents were visiting for two weeks and I went golfing with my father. We played three times over that two week time frame, only golfing nine holes each time. Each time I experienced noticeable fatigue in most of my muscles, but particularly my right shoulder. In fact, after the final game it was downright in pain and felt as though I’d ripped the muscle. I still can create discomfort in this shoulder if I put my hands behind my back and move my shoulders forward, but it is improving. This concerns me since two years ago I spent over a year with an odd twinge in that same shoulder that would present itself when reaching to scratch my left shoulder, for example, or when catching and throwing a ball. Small, quick movements would send a short shock of pain through that shoulder and It would briefly become weak. I came to see you about it but you were on vacation so I was examined by another doctor and was prescribed PLO Transdermal/DIC8% which again did nothing. The twinge seems to have disappeared, though I have not thrown or caught a ball in that time to be 100% sure.
And finally, most recently I’ve begun to feel a mild sensation in the muscles running up along the side of my neck. The sensation is quite mild at this point and is located mostly just below my ear and behind my jaw. Again, I mention this in spite of its seemingly minor status because it is yet another set of muscles in which I’m beginning to feel discomfort and these tend to get worse rather than better.
I also notice that many of my joints seem very loose for lack of a better term. When walking, my knees often feel wobbly. My shoulders and hips can also feel loose. I even sprained my elbow by basically just straightening my arm! No doubt part of this has to do with my lack of conditioning, however, considering the wobbly joints, the easily irritated muscles and joints, the pain in my back and neck, and the ongoing fatigue that is an everyday part of my life, physical exercise on a regular basis is most difficult for any meaningful length of time. And to make matters worse, my appetite shows no signs of abating. I crave food, particularly sweets almost constantly. With no exercise in my daily regimen you can imagine that my weight gain is becoming a concern. Luckily I continue to have a good metabolism which keeps me from becoming ridiculously obese, but I definitely could lose 30 pounds or more. And with these issues continuing to plague my body, the poor physical conditioning will only worsen.
So here I am, at my wits end, paranoid that I’m a raving hypochondriac, unable to explain symptoms worth a damn but knowing that my body has gone to hell. It has now been over five years since the initial extreme fatigue issue first reared its ugly head. I feel as though my body is disintegrating around me and I have no idea why. I don’t even know what to call this. All I know is that it is ruining my life! I can barely stand the work week. I am terribly irritable. I’m becoming ever more isolated and introverted not being able to do things with friends and family. And now I worry that I won’t be able to look after my daughter as she gets older and becomes increasingly mobile.
With all the tests I’ve had conducted over these past five years, can you positively confirm that all these symptoms, all five years worth, are not related? There is no possible way I don’t have a muscular affliction that is causing my muscles and joints to deteriorate? There’s no neurological affliction or (I hate to be so cliché) brain tumour that is causing the fatigue, irritability, the short shooting pains that preceded my eye strain, and the eye strain headaches? Could this be a severe allergy or an environmental toxin/reaction? Cancer? Anything? I cannot accept that I’m perfectly healthy? For 30 years I had practically nothing wrong with me. Never broke a bone. Rarely sick. I was healthy and athletic the entire time. Then, as if turning a switch, I have had nothing but constant unexplained illness and pain evolving from one symptom to another, from one place in my body to another for five years and counting with no signs of it ever coming to an end I implore, have we absolutely ruled out every plausible medical explanation for this miserable corrosion of my body and mind?
I greatly appreciate you taking the time to read this. I hope I have not been too great an inconvenience and I value your insight, advice, and help as I continue to seek a remedy to my plight.