Question
Oh, thank you, Dr. Boss, for your willingness to share your expertise with me!  I am so grateful for any help you could possibly give to me!
To answer your questions, 1: Yes, I do recall them injecting a dye into me that made me smell something like ammonia.  That was only for the MRI.  I do not believe I have had a CT scan (although I have had a CAT scan...maybe they are the same thing).  It has never been suggested that I have circulatory abnormalities.
2: Yes, I have had detailed blood work done.  Nothing out of the ordinary except a high ANA reading as I said...350.  Everything else was fine.
3: I have had physical therapy, which didn't really do much.  Very, very aggressive massage therapy (deep tissue) helps, although I have yet to find someone who can get deep enough!  I usually lie on a golf ball to get deep enough into the tissues to get relief.  As a grad student, all this therapy is so expensive...and just frustrating especially when the relief is so temporary.
4:I take Centrum every day...and that is the only supplement I take.
5: I am taking Neurontin, 800mg of Ibuprophen, OrthoTricylen (of which I am not taking this month just to see if it helps things), and Strattera for ADD, which I have been taking for a year.

I hope this is enough information for you.  Again, thank you so very much for caring and for your willingness to help me.  It means the world to me!
--April
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Followup To
Question -
Greetings!  I have been experiencing an unknown problem with my body and have gone to numerous doctors, neurologists, rheumatologists, but am left without an answer.  I am desperatly hoping that you will be able to suggest what my problem might be.  I am not looking for a diagnosis, but simply ideas to point me in the right course of treatment, etc.  
First of all, I am a 27 yr. old caucasion female in graduate school.  I am 5'10", and weigh 140lbs.  I exercise regularly and eat a good diet.  I have never broken any bones, and have never been hospitalized. I am psychologically stable and in very good overall health.  
My problem is concerning the right side of my body.  I have had this problem for four years, and it has increased in intensity over time.  I have had several cat scans and MRIs, which come back as normalwith a little arthritus in my neck.  The pain runs from the base of the right side of my neck, to the right muscles in my jaw, to my throat area, to my shoulder/arm, to the muscles in my right side abdominals, to my hip, and down to my calf and into my foot.  The pain is not in my joints, but seems to be localized only in my muscles.  The pain is most intense in my right shoulder blade area.  I can describe the pain as continual; I feel it to some degree all the time.  At minimal, it is a nagging pain...almost like an itch in my muscles.  At maximum, it feels like someone is pulling me on a string from the top of the right side of my body down to my right foot...almost like my muscles are so tense they will tear.  I get frequent debilitating migraine headaches again at the right side of my body localized in my head only on the right side, which seems to be somewhat related to the right sided pain.
The curious thing is that it is only on my right side.  My right foot and hand are frequently tingly and get considerably warmer and redder than my left.  My right arm at times goes very warm then numb.  My right eye at times gets very red.  Massage therapy feels unbelieveably good at the time, but seems to worsen the condition several hours later. Exercise and strength training improves the problem if done consistently over time.
I am desperatly looking for any possibley answer to this problem and am open to ANY suggestions of what it might be...maybe even a blocked artery, nerve problems, spinal cord issues, etc., nutritional info., etc.  I am weary of seeing countless neurologists who have no answer or idea of what it might be, as my MRIs and xrays and cat scans are all very normal, only with a little arthritus in my neck.  Please please tell me all the information you may know of what this problem could be.  I am desperate for answers.  Thank you for any information you can give to me.  

--April
Answer -
Dear April,

I am very sorry for your suffering and discomfort and stress that this is causing you.  I hope that I may be of some help and that we can figure this out and point you in the right direction.

I have a few questions for you.

1)Have any circulatory studies been done involving the head and neck region?
The reason I ask this is that your symptoms do sound like possible circulatory abnormalities.  The fact that your hand and feet get red and turn tingly is a concern.  This can often be neurological, but it sounds like you have ruled out the neurological component with all of the testing and evaluations.  I understand that you have had CT and MRI studies, but did they ever do these studies with contrast or dye injected into you?  These may be helpful in your case.
On the other hand, the sensation of warmness that you describe does not usually come with circulatory abnormalities, but is common with neurological problems.

2)Have you had detailed blood work done?
I think that it would be very important to have a detailed blood chemistry workup done to determine if anything peculiar is going on.

3)Other than the massage therapy, have you had any other type of treatment?

4)What, if any, nutritional supplements do you take?

5)What, if any, prescription medications do you take?

April, I would appreciate it if you would forward your answers to these questions to me as soon as possible.  I will do everything that I can to help lead you in the right direction.  I am going to look a few things up and await your reply.  You will reply back to me through allexperts.com.  I have seen many patients with difficult histories and problems such as this.  Together, we will find out what it is and what to do.

I look forward to your reply.

Dr. Boss

Answer
April,

Thank you for your reply.  You were very concise and I am more than happy to try to do what I can to help you.  I am going to ask a few more questions as your case is a bit puzzling as it is always a little more difficult to help someone that I cannot examine.  

1) What type of treatment did the Physical therapist perform and why do you feel that it did not work?

2) Have you noticed any difference with the neurontin?

3)Does the ibuprofen help with the pain?

4) Do you notice any inflammation of muscles or tissues?  I mean noticeable puffiness of the area.

5) Do you have multiple "knots" or "tender spots" in the muscle around the shoulder blade, lower neck, buttocks, hip, forearm, calf?

6) When you have the massage therapy and get relief, how long does the relief last and how much relief do you get?  Do you feel no symptoms, 50% relief, etc?

Now I am going to ask you several other questions regarding your bowels and GI tract.  I will provide the relation after getting your answers and replying back to you.

1) Do you have at least one bowel movement per day?

2) Do you ever experience constipation and/or diarrhea?

3) Do you have indigestion, stomach pain or discomfort after eating, bloating, or gas on a regular basis?

4) How much water do you drink on a daily basis?  How many ounces?

5) Do you eat well balanced meals daily or do you eat a lot of restaurant or fast foods?

6) Do you drink coffee, soda, milk, alcohol on a daily basis?

7) Do  you have problems sleeping? How many hours of sleep per night?  How restful is sleep?


It sounds like they have ruled out circulatory abnormalities as a problem.  I have seen cases such as this turn out to be myofascial dysfunction which is a problem of fascia, or the gluelike tissue that holds the muscles and other tissues of the body together. There is specific treatment that will correct this and eliminate the symptoms.  I am hoping this is your problem but these further answers will help.  I am thinking that a proper evaluation by a doctor (chiropractor or medical) who is trained in this area, such as myself, will be of great benefit.  

When replying to these questions, also let me know where you are located, city and state, and I can try to locate a doctor who can check you out for this type of problem and forward that name to you.  

I understand that you have spent a lot of money already regarding your condition and the positive side of this is that most of my patients with a fascia problem respond rather quickly.  Sometimes it takes a lot of work on the patients part in the area of nutrition and exercise, but they do respond well and get good results.  

I do not want to give you any false hope as I am not sure at this point that this is your problem, but your symptoms and answers fit the profile.  

I look forward to your reply and will reply back to you as soon as I can.

Have a good evening and keep up hope.

Dr. Boss