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        New Message Board Archives >> 2004 Posts >> OK.....  Here is the skinny on symptoms Idieas?
        
(Message started by: athos on Jul 17^th, 2004, 1:56am)

Title: OK..... Here is the skinny on symptoms Idieas?
Post by athos on Jul 17^th, 2004, 1:56am

This has been going on since

Most started at 5/31/04

Current problems.
1. Back spasms severe at first have tapered off
2. Sometimes lose control of my legs balance or coordination fall hit various parts of my body most head
3. Urination problem. Feel the need to go bladder is full but sometimes can’t go for several hours
4. Often numb lips?????---don't understand this one
5. Numbness in my fingers hands and arms
6. Neck always very painful for many years
7. Pain down my arms... more so the left one.
8. Weakness in my left arm
9. Fatigue
10. Speed of thinking… takes me a min to remember things
12. Mood swings.
13. Chronic Cluster Headaches for 18 years

Ideas on any or all of these combined symptoms?

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by Gator on Jul 17^th, 2004, 2:17am

List your meds including any OTC stuff taken regularly as well as any herbals you might use. Do you do any gardening - are you around insecticides, fertilizers and weed killers? How about other poisons? What kinds of plants do you have around the house?

Let's do some research into interactions the meds and such. Floridian found several entries on different websites that documented bone and joint pain with depakote use, even though the manufacturer doesn't acknowledge it nor did my doc know anything about it.

Also, someone (sorry - brain not working right now so I don't remember who) referenced MS-like symptoms from iron toxicity in another thread.

If your sysmptoms don't tell a doc anything, these other things could be starting points.

Gator

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by athos on Jul 17^th, 2004, 2:35am

med -
keppra
Trileptal
Lexapro
Valium
Oxycontin

No herbals
Mini bambo and a money tree,
No pets

I have gone through every other med that has been listed on this site, but maybe not in combinations.

No floride in the water, I am not sure the iron content... I am going to a naturalpath to check some of those things next week.

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by Jimmy_B on Jul 17^th, 2004, 7:20am

Do you get or have a light colored rash or difference in color around the bridge of the nose &/or eyes?

I'm asking cause it sounds like it may be lupus, or possibly fibromyalgia along with a nerve root problem along the Cervical spine. (Left Arm).

Did you get Blood Work...specifically Titer Count? Also an MRI of the Cervical Neck & entire spine (Thoracic & Lumbar).

The urination problem could be from a couple of meds your on...Numb lips---a definite side effect of Cervical Nerve root compression as well as the Left arm pain & numbness.

Good Luck Athos...I hope you feel better.

Jimmy

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by sailpappy on Jul 17^th, 2004, 9:16am

;;DGood Day ;;D
From the symptoms you listed and the meds your taking(Not knowing the length of time you have been on each) I would tell you that Oxycontin mask a whole bunch of stuff, I have been off of all meds for 5 weeks yesterday and have been having all of the symptoms you mentioned except for the Back Spasm, My doctor discovered that I have an underlying High blood pressure problem which contributes to many of the symptoms.
Valium,oxycontin and even the keppra help your blood pressure read low, but in my case it was hidding the high blood pressure problem, Oxycontin is also a contributing factor in problems in your digestional tract from long term use.
http://www.purduepharma.com/PressRoom/PI/OxyContin_PPI.pdf Pappy

http://www.gifs.net/animate/sungulls.gif
http://www.gifs.net/animate/sailboat.gif

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by Donna H. on Jul 17^th, 2004, 9:28am

My guess was also going to be a cervical spine issue with the numbness, pain and weakness.

Check out .......
http://www.myelectronicmd.com/get_reference.php?Id=504&condition=PROSTATE%2C%20ENLARGED&symname=P&typ=3

to see if these are your symptoms for the urinary problem.

What are your doses of the Valium and OxyContin? Had an increase lately? Could be a drug interaction.

Your doc is the best/only one to really talk to. We are just lay people guessing.

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by Donna H. on Jul 17^th, 2004, 9:31am

HEY PAPPY.......

So good to see you posting!!! Will write you later tonight....watch your e-mail.

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by athos on Jul 17^th, 2004, 4:12pm

I have a fusion c-spine c5-c7 and I have a herniation at c4

Title: Re: OK..... Here is the skinny on symptoms I
Post by Not4Hire on Jul 17^th, 2004, 4:53pm

on 07/17/04 at 07:20:31, Jimmy_B wrote:

...my same thought (fibromyalgia) JB... not that I know anything/much about it.. but my sister has lupus and some of the same symptoms.

KEN!... I only know that 3 of the drugs you mention are "downers" : Lexapro, Valium, and oxycontin... the others I will "look up". But the c o c k tail you describe is pretty strong. I very well remember that your ....general level of lucidity was very high about 6-8 months ago and now....well, ya sound kinda out-of-it.... sorry, but that's MY take.... and I HAVE been following your story pretty carefully.

Look bud.... we don't want ya on the "Short Bus"... get back to your doctor, wear a helmet, don't try ANY of my remedies at HOME, and I hope yer feeling better soon....

DISCLAIMER: we are NOT doctors--our support is given because we CARE.....

good luck pard....n4

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by athos on Jul 17^th, 2004, 5:32pm

My lucidity is not too bad... Cathi talks to me on a regular basis and lets me know if she thinks that I am out of it or not..... Ususally based on the pain my conventraion is good or bad....

Right now I am wheelchair bound until they figure out why my legs keep buckling....
I have enough brusies and cracked ribs to give in to the wheelchair idea. Once fell on a chair knocked myself out but split my ear open.. just Connor and Kira ages 6-9 were there. Freaked them out pretty good as I lay in a growing pool of blood.... Nothing lasting but a scar on my ear. But my poor kids scared them to death. Connor thought I was dead.

Lexapro is an anti-depressant
Valium they have me on to get me to sleep at night... Otherwise i don't go to sleep until 3 am
Oxycontin is a downer yes... But the cocktail seems to help the CH down to a much better level, but might be causeing other problems.

Question would cervical problems cause stability problems?

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by Jimmy_B on Jul 18^th, 2004, 7:40am

on 07/17/04 at 17:32:45, athos wrote:

Question would cervical problems cause stability problems?

Kinda
...Neck-related dizziness
Whiplash injuries or neck manipulations performed by different health professionals can make you dizzy. This kind of dizziness is not usually severe.
You may get headaches and neck pain when you hold your head very still because you find that moving it around makes you dizzier. This causes tension in your neck muscles, which begin to ache, and the pain may then go on up into your head. Headaches and neck pain can make people wrongly think that their dizziness is being caused by a neck problem.

Check out this site...

www.rnid.org.uk/html/leaflets/dizziness_and_balance_problems.htm

I really hope you find the cause of these issues. I'm sure you probably already discussed this with a neurologist, but have you ever seen a Rheumatologist? It may be worth a shot.

Jimmy

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by Donna H. on Jul 18^th, 2004, 9:02am

Maybe you ought to talk to your doc again about Valium being used for sleep. There are better drugs than that to make one sleep. It is not known as a sleeping aid. I know they relax you and that can make you drowzy, but so will Melatonin and other non-addictive drugs.

As your might guess, someone very close to me has a serious drug problem which developed while trying to wait out back pain. It really scares me and I wouldn't want it to happen to you.

His OxyContin level had to keep being increased until he was taking 160-some per month of a high dosage, plus Vicodin.....when he tried to quit or taper down, it was too late. He has now been going to a Methadone clinic for 2 years and is finally tapering down 2mg. per month.

The doc had him come in once per month for a new prescription (doc never saw an X-ray) at $90.00 and sent him on his way. And.....he's one of three in this family who is addicted... innocently.

It's awful. Please be careful. I'm honestly not trying to imply that you have this habit. I just want to share with the world what can happen if we're not careful and not informed.

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by Rock_Lobster on Jul 18^th, 2004, 12:06pm

Lyme Disease?

A friend of mine recently had this... caused by a tick bite. I thought of this as he had unexplained bladder problem, in addition to a shitload of other symptoms.
ie face muscle problems
fatigue
disturbed sleep
pain/numbness in extremities

http://www.xpressnet.com/bhealthy/symptoms.html

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by mynm156 on Jul 18^th, 2004, 4:20pm

Prior to 5/31/04

Did you have any sort of infection that required you take antibiotics?

MYNM156

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by athos on Jul 18^th, 2004, 5:40pm

no infections

Title: Re: OK..... Here is the skinny on symptoms I
Post by Kris_in_SJ on Jul 18^th, 2004, 8:44pm

Hi,

I'm a little bit new to the board, so don't know you or your history, but I'm also a (retired and no longer practicing) R.N.

Besides the fact that you're on a really strong cocktail (the Oxycontin is especially scary because of it's addictive qualities), your symptoms are suggestive of a couple things that need to checked out and, hopefully, ruled out.

Those would be MS and ALS (Lou Gehrig's). I'm not trying to scare you, but they need to be ruled out! I hope you're doctors are working on doing that.

Hugs,

Kris

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by athos on Jul 18^th, 2004, 9:28pm

It is kind of ironic that the initials of Microsoft and the initials of Multiple Sclerosis... are the same....

MS

Title: Re: OK..... Here is the skinny on symptoms I
Post by Prense on Jul 19^th, 2004, 4:16pm

One thing to consider with MS is that many of the symptoms tend to come and go. "Normally"; blindness, numbness, fatigue and pain will come on for a few weeks and then disappear for a while. Also, the recurring symptoms may not recur in the same part of the body. It's a horrible condition and I hope you don't have it.

Chris

Title: Assuming it is MS ... (1)
Post by floridian on Jul 19^th, 2004, 4:34pm

Going on the assumption you may have MS, and that further tests will be done to determine what it actually is --- you may want to think about some of the dietary changes that have been shown to help with MS. If it is MS, you have a headstart. If its something else, you can let your diet go back to however it is now.

1) Bromelain and trypsin - bromelain is a protease from pineapple. Trypsin is a protease from humans & animals. Phlogenzym, which is a mix of these enzymes, has been shown to help with several autoimmune diseases, including MS. Eating a large amount of pineapple, kiwi, or fresh figs can have the same effect.

Quote:

Lik Sprava. 2003 Apr-Jun;(3-4):109-13.

[Effect of phlogenzym in long-term treatment of patients with multiple sclerosis]

Mialovyts'ka OA.

An assessment was carried out of clinical effectiveness of the drug phlogenzym in 74 patients with remitting, remitting-progressive, and secondary progressive course of multiple sclerosis. Phlogenzym intake for up to one to three years resulted in decline in the incidence of complications, with their degree having come to be lower, duration of remissions longer, progression of the illness slowed down. The data secured suggest to us that phlogenzym is a safe agent. It can, we believe used in a therapeutic regimen for those patients presenting with remitting and remitting-progressive types of the course of the disease.

Quote:

J Autoimmun. 1999 May;12(3):191-8.

Prevention of murine EAE by oral hydrolytic enzyme treatment.

Targoni OS, Tary-Lehmann M, Lehmann PV.

Institute of Pathology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, 44106, USA.

Clinical trials that test the efficacy of Phlogenzym (consisting of the hydrolytic enzymes bromelain and trypsin and the anti-oxidant rutosid) as a treatment for T cell-mediated autoimmune diseases including multiple sclerosis (MS), type 1 diabetes and rheumatoid arthritis are presently ongoing. We tested the effects of Phlogenzym treatment in the murine model for MS, experimental allergic encephalomyelitis (EAE), a disease induced in SJL mice by immunization with proteolipid protein (PLP) peptide 139-151. Oral administration of Phlogenzym resulted in complete protection from EAE. In Phlogenzym-treated mice, the dose response curve of the PLP:139-151-specific T cell response was shifted to the right, that is, the primed T cells required higher peptide concentrations to become activated. Additionally, the T cell response to this peptide was shifted towards the T helper 2 cytokine profile. Both effects are consistent with an increased T cell activation threshold. In support of this interpretation, we found that the accessory molecules CD4, CD44, and B7-1 (all of which are involved in T cell co-stimulation) were cleaved by Phlogenzym, while CD3 and MHC class II molecules (which are involved in the recognition of antigens by T cells) and LFA-1 were unaffected. These data show the efficacy of oral Phlogenzym treatment in an animal model of T cell-mediated autoimmune disease and suggest that the protective effect might be the result of an increase in the activation threshold of the autoreactive T lymphocytes brought about by the cleavage of accessory molecules involved in the interaction of T cells and antigen presenting cells. Copyright 1999 Academic Press.

Title: Assuming it is MS ... (2)
Post by floridian on Jul 19^th, 2004, 4:41pm

Some evidence that Vitamin D helps prevent MS - not sure if it reduces the course of the disease once established, but there's a fair chance it might.

Vit D is fat soluble and stored in the liver. Taking too much for too long can cause toxicity.

Quote:

Neurology. 2004 Jan 13;62(1):60-5.

Vitamin D intake and incidence of multiple sclerosis.

Munger KL, Zhang SM, O'Reilly E, Hernan MA, Olek MJ, Willett WC, Ascherio A.

Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115, USA. kgorham@hsph.harvard.edu

BACKGROUND: A protective effect of vitamin D on risk of multiple sclerosis (MS) has been proposed, but no prospective studies have addressed this hypothesis. METHODS: Dietary vitamin D intake was examined directly in relation to risk of MS in two large cohorts of women: the Nurses' Health Study (NHS; 92,253 women followed from 1980 to 2000) and Nurses' Health Study II (NHS II; 95,310 women followed from 1991 to 2001). Diet was assessed at baseline and updated every 4 years thereafter. During the follow-up, 173 cases of MS with onset of symptoms after baseline were confirmed. RESULTS: The pooled age-adjusted relative risk (RR) comparing women in the highest quintile of total vitamin D intake at baseline with those in the lowest was 0.67 (95% CI = 0.40 to 1.12; p for trend = 0.03). Intake of vitamin D from supplements was also inversely associated with risk of MS; the RR comparing women with intake of >or=400 IU/day with women with no supplemental vitamin D intake was 0.59 (95% CI = 0.38 to 0.91; p for trend = 0.006). No association was found between vitamin D from food and MS incidence. CONCLUSION: These results support a protective effect of vitamin D intake on risk of developing MS.

Quote:

J Steroid Biochem Mol Biol. 2004 May;89-90:575-9. Related Articles, Links

Why the optimal requirement for Vitamin D(3) is probably much higher than what is officially recommended for adults.

Vieth R.

Department of Laboratory Medicine and Pathobiology, University of Toronto, and Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Canada M5G 1X5.

The physiologic range for circulating 25-hydroxyvitamin D3 [25(OH)D; the measure of Vitamin D nutrient status] concentration in humans and other primates extends to beyond 200nmol/L (>80ng/mL). This biologic "normal" value is greater than current population norms for 25(OH)D. Concentrations of 25(OH)D that correlate with desirable effects extend to at least 70nmol/L, with no obvious threshold. Randomized clinical trials using 20mcg (800IU) per day of Vitamin D show that this suppresses parathyroid hormone, preserves bone mineral density, prevents fractures, lowers blood pressure and improves balance. Calcium absorption from diet correlates with 25(OH)D in the normal range. Health effects of Vitamin D beyond osteoporosis are mostly supported by the circumstantial evidence of epidemiologic studies and laboratory research. These include prevention of cancer and the autoimmune diseases, insulin-dependent diabetes and multiple sclerosis. One mcg per day of Vitamin D(3) (cholecalciferol) increases circulating 25(OH)D by about 1nmol/L (0.4ng/mL). A recommended dietary allowance (RDA) is the long-term daily intake level that meets the total requirements for the nutrient by nearly all healthy individuals (it would presume no sunshine). If 70nmol/L is regarded as a minimum desirable target 25(OH)D concentration, then current recommendations of 15mcg per day do not meet the criterion of an RDA.

Title: Assuming it is MS ... (3)
Post by floridian on Jul 19^th, 2004, 4:48pm

The role of fats in MS is not a settled question, but there is some evidence that changing the diet to include less fat, and fats of the right type may have an effect.

Quote:

Lancet. 1990 Jul 7;336(8706):37-9.

Effect of low saturated fat diet in early and late cases of multiple sclerosis.

Swank RL, Dugan BB.

Department of Neurology, Oregon Health Sciences University, Portland 97201.

144 multiple sclerosis patients took a low-fat diet for 34 years. For each of three categories of neurological disability (minimum, moderate, severe) patients who adhered to the prescribed diet (less than or equal to 20 g fat/day) showed significantly less deterioration and much lower death rates than did those who consumed more fat than prescribed (greater than 20 g fat/day). The greatest benefit was seen in those with minimum disability at the start of the trial; in this group, when those who died from non-MS diseases were excluded from the analysis, 95% survived and remained physically active.

Quote:

Nutrition. 1991 Sep-Oct;7(5):368-76.

Multiple sclerosis: fat-oil relationship.

Swank RL.

Swank Multiple Sclerosis Clinic, Department of Neurology, Oregon Health Sciences University, Portland 97201.

Between 1949 and 1984, 150 patients with multiple sclerosis consumed low-fat diets. Fat, oil, and protein intakes; disability; and deaths were determined. With a daily fat consumption less than 20.1 g/day (av 17 g/day), 31% died, and average deterioration was slight. A daily intake greater than 20 g/day (av 25 or 41 g/day) was attended by serious disability and the deaths of 79 and 81%, respectively. Oil intake bore an indirect relationship to fat consumption. Minimally disabled patients who followed diet recommendations deteriorated little if at all, and only 5% failed to survive the 34 yr of the study, whereas 80% who failed to follow diet recommendations did not survive the study period. The moderately disabled and severely disabled patients who followed diet recommendations carefully did far better than those who failed to follow the diet. In general, women tended to do better than men. Those patients treated early did better than those in whom treatment was delayed. High sensitivity to fats suggests that saturated animal fats are directly involved in the genesis of multiple sclerosis.

Title: Assuming it is MS ... (4)
Post by floridian on Jul 19^th, 2004, 4:56pm

Antioxidants.

Quote:

Nutr Neurosci. 2003 Jun;6(3):189-96.

Lipoprotein oxidation, plasma total antioxidant capacity and homocysteine level in patients with multiple sclerosis.
Free radical-mediated peroxidation of biological molecules, especially of lipids, is implicated in the pathogenesis of a number of diseases like multiple sclerosis. Low concentration of antioxidant vitamins: beta carotene, retinol, alpha tocopherol and ascorbic acid have been observed in serum or cerebrospinal fluid of multiple sclerosis patients. On the basis of these observations, we studied the potential lipoprotein oxidation and total antioxidant capacity in the pathogenesis of multiple sclerosis. Lipoprotein oxidizability for plasma in vitro, serum levels of autoantibodies against oxidized low-density lipoproteins, plasma total homocysteine levels with vitamin B12 and folate, and plasma total antioxidant capacity were measured in twenty four patients with multiple sclerosis and twenty four healthy sex- and age-matched person as control. In multiple sclerosis patients during an attack, a significant increase in both in vitro lipid oxidizability for plasma and in the levels of autoantibodies against oxidized low-density lipoproteins, and a strong decrease in plasma total antioxidant capacity were detected. Plasma total homocysteine levels were significantly higher in multiple sclerosis patients whose plasma vitamin B12 and folate levels were lower but not statistically significant, than controls. The present study indicates that lipoprotein oxidation may be important factor in the course of multiple sclerosis and in vitro measurements of plasma oxidation kinetics as an indication for lipoprotein oxidation might be useful as an additional tool for the clinical diagnosis of multiple sclerosis.

Quote:

J Neuroimmunol. 2004 Mar;148(1-2):146-53.

Alpha-lipoic acid is effective in prevention and treatment of experimental autoimmune encephalomyelitis.

Alpha-lipoic acid (alpha-LA) is a neuroprotective metabolic antioxidant that has been shown to cross the blood brain barrier. We tested whether alpha-LA is capable to prevent MOG35-55-induced experimental autoimmune encephalomyelitis (EAE), an established model of multiple sclerosis (MS). Daily oral administration of alpha-LA, starting at the time of immunization, significantly prevented EAE progression as compared to control mice. This was associated with a reduction of CNS infiltrating T cells and macrophages as well as decreased demyelination. We then tested alpha-LA in a therapeutic protocol aimed at suppressing EAE after its onset. Intraperitoneal (i.p.), but not oral, administration of alpha-LA significantly prevented disease progression when compared to vehicle-treated controls. Similarly, we observed significant reduction of demyelination and inflammatory infiltration. ... In addition, alpha-LA inhibited the proteolytic activity of MMP2 and MMP9 only at very high doses. Our data indicate that alpha-LA can effectively interfere with the autoimmune reaction associated with EAE through mechanisms other than its antioxidant activity and supports further studies on the use of alpha-LA as a potential therapy for MS.

Quote:

J Neurol. 2004 Mar;251(3):261-8.

The role of oxidative stress in the pathogenesis of multiple sclerosis: the need for effective antioxidant therapy.

Gilgun-Sherki Y, Melamed E, Offen D.

Laboratory of Neurosciences, Felsenstein Medical Research Center, The Sackler School of Medicine, Tel Aviv University, Petach Tikva 49100, Israel.

Accumulating data indicate that oxidative stress (OS) plays a major role in the pathogenesis of multiple sclerosis (MS). Reactive oxygen species (ROS), leading to OS, generated in excess primarily by macrophages, have been implicated as mediators of demyelination and axonal damage in both MS and experimental autoimmune encephalomyelitis (EAE), its animal model. ROS cause damage to cardinal cellular components such as lipids, proteins and nucleic acids (e. g., RNA, DNA), resulting in cell death by necrosis or apoptosis. In addition, weakened cellular antioxidant defense systems in the central nervous system (CNS) in MS, and its vulnerability to ROS effects may increase damage. Thus, treatment with antioxidants might theoretically prevent propagation of tissue damage and improve both survival and neurological outcome. Indeed, several experimental studies have been performed to see whether dietary intake of several antioxidants prevents or reduces the progression of EAE. Although a few antioxidants showed some efficacy in these studies, little information is available on the effect of treatments with such compounds in patients with MS. Well-designed clinical studies using antioxidant intake, as well as investigations based on larger cohorts studied over a longer periods of time, are needed in order to assess whether antioxidant intake together with other conventional treatments, might be beneficial in treating MS.

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by athos on Jul 19^th, 2004, 10:41pm

Neuro surgeon and MRI of the brain will be this week and next, and then see if they are going to fuse more of my neck. Hope that will help.

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by DJ on Jul 19^th, 2004, 10:57pm

Athos,

Have you had an MRA of the arteries in your head? The MRA is done with the same machine but it's different than the MRI. The MRA shows the condition of the carotid arteries in the neck/head (which the MRI won't show) to rule out any vascular problems.

Just a thought....

-DJ

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by athos on Jul 19^th, 2004, 10:59pm

Floridian......

Wow that is a lot to digest... a lot to think about and to study.. you are going to have my up for awhile diggin into this info... thanks!!!!!!

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by Samantha_Smith on Jul 20^th, 2004, 9:45am

My heart goes out to you Athos. I can't imagine how scared you must be. You're in my thoughts and prayers. Samantha

Title: Re: OK..... Here is the skinny on symptoms Idieas
Post by Cathi04 on Jul 20^th, 2004, 10:29am

LOL... Ken...soooooooooooooo, what did ya do while I was gone?? LOL!!
Seriously, this is not the time to explore ironies...it is time... past time, to become rabid about this situation, Ken....get the fusion in the works, but GET A DR who is really ready to find out what this other stuff is..and treat it!
You have got some great "jumping off points" here...let's get this fixed, once and for all...
Cathi