Question: Hi, I am a 32 year old female. 1 year ago I began having ear and lower jaw pain. This is not a firm diagnosis, but an oral surgeon thought that I might be having an immune reaction to my dental implant that was in the area I had pain in (the lower jaw). Perhaps related, or not related, 3 or 4 months ago I developed two swollen lymph glands in the occipital region (where the neck and head meet) on the left side of my neck (same side that I am having jaw and ear pain on). 2 months ago I developed pain in my neck in the same area as the lymph nodes. One month ago I developed pain in my left shoulder. 3 weeks ago I developed stabbing, shooting, aching nerve and muscle pain in my left arm. 2 weeks ago it developed into pain (though less intense) in my other arm and my left leg. There is also now some numbness in my left arm and hand. I also have some blurred vision and occasional pinching pain in my left eye. I am unsure whether the jaw and eye pain are related to the neck, shoulder, and extremity pain. However, I wanted to give you the whole picture. I have had a cervical x-ray and Jaw X-ray. They only show swelling. A head MRI without contrast was normal other than lymph node swelling in the jaw area that I could not see or feel for myself like I can in the occipital region nodes. An oral surgeon removed my dental implant one week ago, but wanted me to get checked out by an internist because he was unsure all of these things are related and if they have anything to do with the dental implant. I saw an internist today and he seemed unconcerned that my lymph nodes have been swollen for months. He said the x-ray showed nothing of importance and gave me pain pills and said to do physical therapy. I told him I am worried about the lymph nodes and why exactly my other symptoms are happening and asked for a cervical MRI. He said to do the therapy first...this seems to me very unconcerned and I am wondering if I saw the right kind of doctor for these symptoms. I did have blood work done, but I am not sure what all he had checked. Previous blood work 2 weeks ago showed all normal results, except for an elevated white blood cell count. However, I had a cold the week before the blood tests and this may have caused the rise in wbc. Am I seeing the right doctor for this? Should I be pressing harder for an MRI? Is there anything else I should be insisting they check? I feel like my symptoms are progressing and I keep adding on symptoms over the months as the Dr. seems to have a watch and wait until I am showing some kind of obvious sign as to what is happening rather than actively seeking a diagnosis. I would like to add that I was very healthy until this year. I have never had back or neck or any other problems before this year. I am a vegetarian that loves to exercise and it has been horrible being in pain constantly and so immobile this year... I am losing so much strength. I am also often lethargic, but I have no weight loss or night sweat symptoms. Thank you for any advice!!

Thank you for the information Dr. XXXXXXX XXXXXXX

I am unable to get in anywhere quickly for evaluation. Given the symptoms, would it be appropriate to seek diagnosis at the nearest emergency room? Would they be able to give the appropriate tests for diagnosis or would this be an inappropriate place to seek diagnosis? Yesterday my oral surgeon gave me prednisone for inflammation and initially I felt some relief from pressure in my neck and head and shoulder, but today my nerve pain and neck pain is back with vengeance. Would you recommend asking my oral surgeon if its alright if I stop this medication until I know if an infection is present or not? Thank you for your quick reply.