- CASE FILE
possibly MS vs Neurosarcoidosis vs Paraneoplastic Syndrome symptoms-needing exact diagnosis! Onset of progressing symptoms since May 2017
ABOUT THIS CASE FILE
Other than Scarlett Fever x3 as teenager, acne in young adulthood and a CIN III/LEEP result, and post children urinary incontinence. The only medication I took continuously was allergy medication due to seasonal (really yearly allergies) for skin itch. I think I was basically healthy until 2005 when I had a Bell's Palsy episode, afterwards I had not been able to see out of one of my eyes. Went to some follow ups and was told there was nothing wrong. Over the next few years, I was diagnosed as hypertensive, hyperlipidemia and diabetic and started taking medications for these. Had an episode of 1 time sudden blinding headache and MRI showed 2 lesions in my brain in 2010. I had multiple elevated WBC's, bilateral plantar fascitis tendons released, bilateral carpal tunnel released, some shortness of air due to hemoglobin at 8.2/anemia found with fibroid tumor (Leiomyoma) removed during hysterectomy and urethral sling placement in late 2013 (Only experienced vaginal dryness after). I became uneventful until another Eye appt later diagnosed me with Glaucoma, and eventually a higher diabetes A1C at 8 led me to make the decision to get the gastric sleeve in 10/2015. Highest weight was 194, and got to 134 lbs in early 2017. Also lost the the hyperlipidemia and diabetes status. Still having to take my 2 hypertensive medications though. Then 3 months later I had to have my gallbladder out. That summer (2016) I had some extreme abdominal pain and some palpitations and ultimately was found to have a zinc toxicity. In May 2017, I had some daily dizziness, monitored my BP, which was lower and stopped one of the blood pressure pills and gained 10lb in 1 week. Went to NP, resumed that med and started a lab workup at that point. retested for zinc and possibly nutritional deficiencies, with everything being normal but dizziness continuing. In November of 2017 I noticed I was having alot of Right femur pain. More labs, xrays, MRI arthrogram, Orthopedic Dr visits, physical therapy with resolving only to the dry needling that area. 3 days later I awoke like I was drunk, could not stand straight, extremely dizzy, and slurring words. The next day seemed better, but that night I had sudden onset right side chest and back pain with the ER ruling out a pulmonary embolism, but my white count was high (With no infection) and my D Dimer was elevated. Both of these staying elevated for some time after. I then went to see a cardiologist, and after those multiple tests, everything was normal. I then sought out a neurologist. After her labs and my PCP's lab everything but my high folic acid was normal. The MRI of my whole back was normal and brain showed 15 lesions now (up 13 from 2010) and Lumbar puncture which she said was normal, but my CSF did have a high myelin protein and low glucose, 0 bands. She seemed stuck on my past history of diabetes, even though I never had any neuropathy pains until just around this time ever and my A1C is 5.6 now. EMG turned out normal. sent for Biopsy though of my left leg and finally got a diagnosis of Small Fiber Neuropathy. While she had no other advice for me, I sought a second opinion, who suggested he suspected I had neurosarcoidosis. This then sent me to a rheumatologist and finally after 2 visits and swollen supraclavicular nodes, I finally got the PET Scan the 2nd Opinion Dr suggested I get. This showed no suspected systemic sarcoidosis, but did have an increase of FDG uptake on my Left ovary. The rheumatologist has never reported the findings back to me after several weeks, i then went back to my PCP, and after the exam realized the lymph node swelling could be possibly something and I got the Pelvic US and Neck US. Pelvic US suggesting I repeat in 6 months and that the lymph nodes are observed as well as thyroid nodules. He then sent me to an ENT, who basically told me they are not a concern, too small to biopsy and to repeat the thyroid US in 6 months. Over the last few months and a multitude of other weird symptoms, I had to trade in my paid off stick shift car, because my left foot is completely untrustworthy now (Went to an automatic, But hey I have a new car!) To my symptoms adding up on a weekly basis, and still no treatment for "whatever" is wrong with me. I come to work everyday, but just last week started to decrease my day by a half an hour to help me function better. My evenings consist of going home and laying on the floor, because I can still visit this way and it seems this is the only way my feet, fingertips and teeth do not feel frostbit. I feel like I am fatigued because I try all day to keep myself upright and wear my self out. Weekends are spent recovering from the whole week. So I now have no desire to go out and do things with my friends. I could not do a garden this year either, because I knew I would not be able to maintain it. My vision is getting worse by the day as well. My weight gain is solely restricted to my abdomen. Also note, when all my labs were being normal, I did stop all my allergy medications at that time, and even though I questioned the neurologist and rheumatologist about it causing my levels to be normal, now that I am off of them, my SED rate is high now.