Dd saw the rheumatologist. While nothing in his area jumped out, he's not able to formally rule out yet because she was on steroids. He ran labs, and will run them again in 4 weeks. He wanted to see what her labs looked like on and off steroids.
This is the same kiddo from the depression thread.
Not too sure of my point here, just looking for ideas I guess.
Dd was on steroids and antibiotics for 10 days for a sinus infection. (Post meds, she's still stuffy and her ears still have fluid; very unusual for her. Doc is trying to get her in with allergist sooner.)
While on those meds, labs were run for psych med levels, and I asked to include vitamin D (I always ask to throw it on most labs because of location).
Lithium level was fine.
Her TSH was 7, so psych agreed with weaning off lithium, even if the steroids played a role.
Her D was 11 . We're now doing about 70k a week, will recheck in a few weeks, and adjust dose. We'd do 50k a week, but no medical professionals are worried about the extra 20k, and it's easier to remember giving daily vs skipping 2 days.
Within 48 hours of stopping the steroids, her joint pain was very obvious, and her knees were a little swollen. Off to the regular doc again. (This isn't new, but was never this obvious!)
Doc ordered ANA, rheumatoid, lupus, basic labs, lyme, and some other tick stuff. So far, most everything has been negative/normal except for whatever shows inflammation, which was expected. We are still waiting for the non Lyme tick panel. If this panel is negative, doc wants to send her to a rheumatologist (we've got allergy, sleep, neurologist, and neuropsychologist scheduled already for various reasons).
We're also doing an elimination diet (top 8, using Whole30 minus fish). We've done it in the past, but not well (ds has always been bad with food), and symptoms were vague which is not easy to track.
In the past dd has had a mix of positive and negative gluten antibody results. Because of a positive, her doc will throw it in when GI stuff flares. Why haven't we eliminated? It's hard to without an absolute yes, and when it doesn't cure vague stuff. We are now cutting it, not sure if it'll be reintroduced. GI ran it, and she was negative.
A lot of dd's vague pain is usually caused by constipation. Even what sometimes seems like period cramps or chest pains! But, what teen wants to live on miralax?! So the cycle is pain to the point of terrified anxiety, confirmation of poo, mega cleanout dose, maintenance dose for a few weeks, then refusals, several months later it starts again.
Oh, 3 nights ago, dd said she thinks the allergy eye drops and nasal spray might be causing some reaction. We stopped, and she says she's ok.
Now I'm all over the place without a point!
Is it possible for environmental allergies to cause joint pain and swelling? What about a food intolerance?
She's overweight, but not obese (she can swim laps, so she's not terribly out of shape). She's bloated. Joint pain. Some joint swelling. Low D. Chronic constipation (I've always thrown this under the common-in-autism umbrella). Possible sleep apnea (also blamed autism for poor sleep). Was having tendinitis in the wrists. PMDD. Asthma. Allergies (only known is dust, for which she carries an epi!).
Add in the psych stuff. Some has always been there, like the anxiety. But some, like the scary stuff possibly looking like bipolar, are new-ish.
What else would a rheumatologist be looking for?
I know dd could have a different diagnosis for everything, and have stand alone psych difficulties. But I'm not going to pretend that I'm not hoping for something like gluten intolerance with psychiatric symptoms and sleep apnea. She's not going to be scoped for celiac because the local GI wants classic symptoms (weight loss, pain after eating, etc).
I was diagnosed with sleep apnea prior to gaining weight. My father snores. My mother was just diagnosed, but is quite large. So we have a family history. Dd has weird dreams similar to mine when I fall asleep without cpap, which is why we're going for a study, even though her fatigue can be from the depression alone. She doesn't tolerate SSRIs.
Her D in February was 40, and she was quite depressed and fatigued. In January her anxiety was off the charts. In April, the psych stuff took primary focus for everyone's safety. In a few weeks, she'll have a combination of family based therapy, dialectical behavior therapy, applied behavior analysis, and behavioral activation (we have some going now, but the combination starts next month. In-home providers are being DBT/ABA/BA trained for overlap).
Am I missing a rock to look under?
I know to keep a binder so each doc can see what other docs say. I'm hoping for communication, but not holding my breath.
Edited by amo_mea_filiis., 01 September 2017 - 06:40 AM.