Back in August, Aharon was having severe back muscle spasms. He was almost constantly in pain and could barely move. He went to a nearby doctor who told him he was just overworking himself and that his muscles would eventually adjust to his new job. In the mean time, she recommended that he take it easy after work and maybe get the occasional massage to help the muscles relax. She prescribed him flexeril and motrin 800. Neither even made a small difference in the pain. Eventually, his back started to feel better except for some occasional pain that he had experienced before. We figured it was all because of long hours at work and adjusting to a new mattress.
Then, one Sunday in September, Aharon woke up with terrible joint pain and a low grade fever. He said he felt like he had the flu, although he had no stomach pains, congestion, or sore throat. Although the fever went away later that day (and then occasionally came back only to leave again and never hit 100 degrees), the joint pain only got worse and worse. He would wake up in the morning unable to move. After a couple hours, he'd have some mobility back, but he just wasn't his normal old self. This continued all through September and into October. Finally, when the pain made its way into his knuckles, shoulders, and returned to his back, I took him to my doctor. (I've been seeing her for almost 10 years...she is great!)
After almost an hour of gathering family history and talking about all his different symptoms, we had a few suspicions, including the following:
- Rheumatoid Arthritis
- Lyme Disease
- Lupus
- Polymyalgia Rheumatica (rare in someone in their 20's, but it has happened before)
A few days later, his blood work came back. He was negative for RA, lyme, and antinuclear antibodies. He didn't even have a high SED rate, indicating that his body wasn't suffering from any type of inflammation. The only thing unusual was a high count of strep antibodies. Our doctor decided to change her focus away from autoimmune (which she'd started treatment for) and instead consider rheumatic fever or a strep infection in the joints. She instructed him to finish the prednisone and then begin a full round of penicillin. She also gave him a higher dose of flexeril for his back figuring that it was work-related instead of another symptom.
Within three days of coming off the prednisone, his pain had completely returned. After a few days, he returned to the doctor because the pain was worse than before and he had been having bouts of small chest pains. She gave him another round of prednisone, this time keeping him on an extremely high dose for almost a week, and drew more blood. Those tests would show that the strep antibodies had decreased, but weren't gone. She decided a echo cardiogram was necessary to rule out rheumatic fever. (The echo revealed nothing unusual.) She also referred him to a rheumatologist, and told us she figured polymyalgia but wanted a rheumatologist to make the final call.
Last Wednesday, Aharon went to the appointment. He had been sent a packet of paperwork to complete before the exam. It had gone into extreme detail about family health history, current symptoms, medications that had been tested and how he had felt with the different medications, and all of his blood work results.
The doctor spent under 10 minutes in the room with Aharon. She flipped through his paperwork and asked him a few questions about being depressed. She then poked his knees, chest, and back in a few areas. She then announced that he had fibromyaliga, gave him a script for an anticonvulsant and for an antidepressant and told him to come back in 3 weeks. When he questioned her diagnosis and pointed out the strep antibodies in his blood and his fast reaction to prednisone, she told him that strep antibodies aren't ever a cause for concern if you don't feel sick, and that any problem will react well to prednisone for a short time. (He was on prednisone for almost a month! That's not a short time.)
I'm very skeptical. While there is some medical documentation of "fibromyalgia" responding to prednisone, I believe that to accept that research you also have to accept that fibromyalgia is, in fact, an autoimmune disorder. If it is an autoimmune disorder, why do doctors almost exclusively prescribe medications that work with your brain and not with your immune system the way prednisone does? There are too many issues here. Secondly, how often do you hear of males in their 20s being diagnosed with fibromyalgia? And on top of that, how often do you hear that diagnosis after the first visit? Fibromyalgia is notoriously difficult to diagnose. It seems to me that she just didn't want to put any work into his case.
Long story short, we did not fill the prescriptions. The next few weeks will be spent gathering all of his medical records from the various doctors he's seen about this problem, and then we will be attempting to get an appointment with a rheumatologist with Henry Ford Hospital. I'd trust Henry Ford Hospital over Port Huron Hospital any day.
Unfortunately, this all falls at a terrible time. We are almost to our insurance deductible for the year, and the year is about to end. That means more bills next year. I have to attend the ATA show for work in a couple of weeks, and I'll be gone for a full week. This pushes the time frame for a doctor's appointment back farther, because I insist on attending with him.
So hopefully we'll have a concrete, believable answer soon enough and a treatment plan for Aharon. Our busy season at work is quickly approaching, and Aharon will go from 27 to 32 hours a week to 45 to 54 hours a week. This all began when he was working short 27 hour weeks. I don't know how he'll make it through long weeks.
I'm ready for the new year to get here.
