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I do not believe, from what you have posted, that you need to go to the ER right now. However since I can not examine you, if are worried, going to the ER is the safest thing to do....
So, what should you do next in order to get to the bottom of what is going on? I think I can point you in the right direction. Please allow me to explain:
At this point I think the best thing for you to do would be to gather up copies of all your medical records and travel to a large University Teaching hospital. At an institution like that you could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.
The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this. That being said there are many excellent teaching hospitals all across the country and I am sure that there is one near you.
I know that it is going to take significant effort on your part, but I believe that going to one of the "Medical Mecca's" is your best chance to – finally -- get to the bottom of what is going on.
Does this make sense to you?
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Thanks in advance,
Dr. Rick MD FACS