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    Need your insight...
    aheilmann posted:
    I've been struggling with joint pain, hypothyroidism, and frequent fatigue off and on for about 10 years. I had a positive ANA a few years ago, but a rheumatologist didn't think it was a big deal. In addition, I had aseptic meningitis last year. Since then, I have recurring migraines, occipital neuralgia, myofascial pain, sensitivity to cold and light, dry mouth, extreme fatigue and malaise, a positive ANA with a titer of 1:640,weird symmetrical swollen areas on my hands (they look like ganglion cysts in the fatty pads of my knuckes), a Rheumatoid Factor of 12, and an elevated ESR of 28. I had a lumbar puncture with slightly elevated cerebral spinal fluid (nothing major). The most recent rheumy visit didn't turn up anything. He said he didn't think anything was wrong. My neurologist believes I have fibro. The last rheumatologist I saw specialized in Lupus--so my Neuro suggested I go to a different rheumatologist--they don't have an appointment until February. I would love to hear your feedback and insight on this.
    Scott Zashin, MD responded:
    Challening symptoms. I don't have a lot to offer as it is always best to be able to speak to and examine the aptient.. I think a second opinion makes a lot of sense. I see many patients seeking their third opinion..A lot of times a diagnosis may not be apparent on the first or second visit so it is best to give your doctor some time to get to know you and your symptoms.
    aheilmann replied to Scott Zashin, MD's response:
    Thanks for your suggestions!

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