
Suggest Treatment For Fibromyalgia, Headache And Difficulty In Breathing

Differential diagnosis and need more information
Detailed Answer:
Hi XXXXXXX wells, thanks for asking from HealthcareMagic.
I can understand your concern. You mentioned that doctors have made the diagnosis of "Fibromyalgia". Please note that the fibromyalgia is a diagnosis of exclusion. It means when every other possible cause has been ruled out by clinical examination and investigations, then it is suspected.
Please let me know:
- What all investigations have been done yet?
- What is the duration of symptoms?
- Is there any such family history?
- Are there any trigger points (specific points over body which cause pain on pressing or pain occurs at those points only)
Answering these questions can help me to reach some conclusion. Now coming to probable diagnosis as per your symptoms, it could be
- A migraine with cervical spondylosis
- Noncompressive myelopathy due to B12 deficiency, post viral infection.
- Peripheral neuropathy
- Multiple sclerosis
Hope you will understand my point. If you are having any doubts, please do let me know.
Thanks. Take care.


Possibility of Fibromyalgia or MS
Detailed Answer:
Hi xxxxxxxxxxxxx, welcome back.
Thank you for providing me your detailed history. After analysing it, I found that
- You are having asymptomatic thyroid nodules and goiter
- You are having muscle spasms, trigger points and and family history of same
- Your MRI brain had some findings similar to MS. But your spinal tap were normal.
Now if we narrow down your diagnosis, there are two possibilities
- Multiple sclerosis - It can be suspected based on your features and MRI findings. Negative CSF studies can not rule it out. CSF examination is not a good test to diagnose it. MRI brain and spine findings are the main criteria.
So you must ask your neurologist to do nerve conduction studies and electromyography of you. It will rule out nerve damage or demyelination due to MS.
- Fibromyalgia - After ruling out MS, we can suspect fibromyalgia. It can only be suspected after ruling out other organic illness (all blood tests and investigation are normal).
Please send me your fresh reports. If normal, I will tell you what to do about fibromyalgia.
Hope it will help you. If still having doubts, do let me know.
Thanks. Take care.


Rheumatoid arthritis and low Aldolase
Detailed Answer:
Hi XXXXXXX wells, welcome back.
I have checked your reports. You have two important findings
- RA factor positive - It means you are suffering from Rheumatoid arthritis. It is an auto-immune disorder which involves mainly small joints of body and gradually spread to involve medium joints also. It can cause muscular pain, spasms, generalised weakness, morning stiffness, deformities in limbs.
This is the most probable cause of your symptoms. It can involve other organs also like nerves, skin as it can be associated with other auto-immune disorders.
- Low Aldolase enzyme - Aldolase deficiency is a genetic disease which present with haemolytic anaemia, coarse facial features. Your haemoglobin is 16g%. So I don't think you are suffering from it.
You should consider RA seriously. Consult rheumatologist for management. X rays of your hands, back and feet are needed to know about severity. RA can be controlled by medication like steroids, immune-modulators and painkillers, along with regular physiotherapy.
Hope it will help you. If still any doubts, do let me know.
Thanks. Take care.

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