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Dr. Tom
Dr. Tom, Board Certified MD
Category: Eye
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Experience:  30 years experience treating patients with eye problems
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I began experiencing extreme fatigue about a year and a half

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I began experiencing extreme fatigue about a year and a half ago. Because I am obese my doctor did a sleep apnea test which came back negative. Following that I was prescribed a Vitamin D supplement.

I then began having muscle pain (I would stand up from sitting in my desk chair or lounging on the couch and my leg muscles would ache as if I'd exercised vigorously), joint pain (fingers would hurt from holding a book, elbow from holding a phone).

Then I noticed some facial swelling below my ear had come back; it had previously been diagnosed in my teens as a saliva gland blockage. Once in a while my tongue would swell and I've always had dry eyes.

I went to see a new doctor and she connected all these symptoms to the possibility of Sjogren's Sydrome. She made an appointment at a rheumatologist.

While waiting to see him, my symptoms got even worse. My job had production standards and the fatigue and joint pain were causing me to not meet them. They said to me that I was in danger of being terminated within 30 days if I didn't do better. I began having panic attacks at this point. I walked in one day and quit, leading to my eventually losing my health insurance as I could not afford COBRA.

I finally saw the rheumatologist. I had seen a different doctor at his practice for depression 7 years prior. He said that my lab work showed I had mild Sjogren's, if at all, and that it would not explain the severity of my symptoms ... he said clearly it was "just" my depression and I need to see a psychiatrist.

I have since been on two anti-depressants, seen two psychiatrists and been in therapy. I only feel worse. The psychiatrists both said that my physical symptoms simply "do not make sense" as far as depression or anxiety and that the doctors are missing something. One psychiatrist said clearly I had received a "waste basket" diagnosis when I was sent to her. Not a good feeling.

I feel like a ping pong ball. I am sick most days and I feel like no one is listening to me or taking me seriously. At this point I feel like I need to fight to get the right tests done and see the right kinds of doctor because I do not have time to waste as I am sick of feeling sick and want to move on with my life. I don't have any money to waste, either. I will have to put any visits and lab tests on credit card now as I have no income and no health insurance yet I can't get any type of assistance because I have no dependents and am not "officially" disabled.

I just need some idea of anything I can do for myself to alleviate some of this, some clue to a specific type of doctor to see, some idea what to tell them to get the right test done ... anything, any help or guidance would be invaluable.

Thank you.
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Tom replied 1 year ago.

Dr. Tom :

Hi, I'm online now and would be happy to help you with your question.I understand what you are asking. Just reply and we'll get started. Dr. Tom

Dr. Tom :

Good morning. It appears that you are off-line and we cannot get an effective chat going until we are online at the same time. I have some thoughts about the problem that you have posted, and would like to share them with you when you are available. Please let me know when you get back online and I'll make the time to go over this with you.

Customer:

I am online now and will continue to be this afternoon; I can make a point to come back at a certain time if that's helpful.

Dr. Tom : Hey okay I see you are online give me just a minute to get my computer up thanks
Dr. Tom : Well you certainly have been experiencing off a lot of trouble lately. Are you available to chat for a few minutes?
Customer:

I am available now.

Dr. Tom : Great, I'm glad to be in touch with you now.
Dr. Tom : With all the various symptoms and signs that you have described in your posting it very much sounds like you have chronic fatigue syndrome. There is an excellent description of the syndrome on the mayo clinic website. I can get you the link for that. As you may know, chronic fatigue syndrome does not always present exactly the same in each patient. But you certainly present most of the symptoms. While I know you have to consider the expenses, the best thing for you to do would be to find a center that specializes in chronic fatigue. Those academic departments have many specialist all in one place and you would get the most efficient use of your medical dollars if you could be seen by someone who specializes in an area. If you will tell me what large city is closest to where you live I'll see if I can come up with an appropriate sefor you. Does this make sense?
Dr. Tom : That misspelled word was supposed to be Center.
Customer:

I had heard of that, and wondered about that myself. Someone, not a doctor, who has CFS mentioned it to me but told me if you are obese you are automatically excluded from a CFS diagnosis! They also said a past diagnosis of major depression was exclusionary.

Customer:

I am in North Carolina and would travel anywhere I could in-state to get help.

Customer:

Greensboro is closest, but I could also get to Winston-Salem or Charlotte.

Dr. Tom : Ok....give me a few minutes and Ill find a reference for you....stand by, o
Dr. Tom : There doesn't seem to be total universal agreement on either of those points. And you certainly have to take a hard look at chronic fatigue syndrome.
Customer:

That's good to know. If they're not hard and fast rules that you "can't" have it with either of those thigns, then it does give me some hope that it could be the answer because of the fatigue.

Dr. Tom : Good luck, there is a behavioral science center at Duke University which appears to have a clinical study going on which might allow you to get into a trial program. Here is the website link. http://clinicaltrials.gov/ct2/show/NCT00540254. Please let me know if that helps and if I can answer any other questions.
Customer:

Thank you!

Dr. Tom, Board Certified MD
Category: Eye
Satisfied Customers: 263
Experience: 30 years experience treating patients with eye problems
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