Brief Answer:
Need a workup, then a diagnosis, and then, a treatment plan. GO CAVS!

Detailed Answer:
Good evening. Your symptoms can be a variety of things from a viral illness to hormonal imbalances to nutritional deficiencies.

I don't know if you have a regular doctor who you see but based on how you're now feeling I would want to do a good history of how things have been for the past 6-8 weeks and understand things actually STARTED 1 week ago...problems like this tend to develop SLOWLY and if you think back to when things really started happening that you just didn't pay too much attention to for whatever reason you'll likely find that instead of 1 week...you may even be able to remember things happening of one sort or another 1 month ago....possibly even a year ago.

After the history and physical examination which would include a good revision of the oral cavity, the teeth, gums, eye movements, and other cranial nerve functions I would like at the fingernails for any signs of metabolic or nutritional deficiencies. I would then, perform a quick cognitive set of tests such as either a Montreal Cognitive Assessment Test or a St. XXXXXXX University Mental Status examination.

I'd then, send you for some lab workups to include a complete blood count together with electrolytes, liver, and kidney function tests. I would get thyroid tests to include not just a TSH but also an FT4 and depending on the results I would look at your T3 levels as well. I would look carefully at B12, folate, Magnesium, and calcium levels and if there were any suspicion for a parathyroid dysfunction I'd run a PTH level.

I'd also not forget a URINALYSIS even if you WEREN'T complaining of typical symptoms of a urinary tract infection since that is the most likely thing that doctors miss getting which IF POSITIVE can affect thinking and alert status like nothing else with just a touch of the appropriate antibiotic. So, get the urinalysis and if indicated a culture and sensitivity.

As far as the taste in the mouth I would consider things such as nutritional deficiencies or even gastric reflux issues without necessarily the feeling of acid indigestion...again something that can exist without TYPICAL SYMPTOMS and fool everyone including the doctors.

As far as your writing not "looking" like yours...I think we'll get some mileage out of the cognitive testing so no worries there.

That, young lady is how I might work you up if you were my patient in one of the most Rockin-est and Rollin-est of towns in the USA, XXXXXXX OH....although I was looking your town up of Goldendale....and it looks so picturesque in the State of XXXXXXX It must be absolutely gorgeous up there.....and likely mostly temperate climate all year long? I've only been to XXXXXXX for a convention in the recent past but I just thoroughly enjoyed myself....it's very beautiful country up there.....

And so after all of that workup and with the help of a few laboratory testing I think whoever handles all that will be in a much better position to say exactly what might be bothering you.

Well, you get well now...tell your doctor that he should consider a few of the things I've mentioned if lacking for ideas....otherwise, you just might use some of your FREQUENT FLYER MILES to catch a Big Bird out East....after all, there are all sorts of reasons....aside from getting you better that you could think of for taking a bit of a vacation here to enjoy the Summer....it's been very nice the past couple of weeks especially since they're dressing the city up for the Republican National Convention.....they are doing feverish work to transform so much of the city.....it was a real shot in the arm for this town.....even STARBUCKS started popping up like crazy even more than it had already been...although of course, we can't hold a candle to the STARBUCKS density factor out there in XXXXXXX ..I literally saw Starbucks stores that were across the street from one another in downtown Seattle!

Now, tell me....are you a Golden State Warrior fan or are you partial to King James? LOL! That's OK....if you side with the West Coast...I completely understand and can assure you that my recommendations are still the best possible! HA!

If your question was adequately responded to could you do this lad a favor and not forget to CLOSE THE QUERY if you've no more questions?

I sincerely hope you start to feel a bit better and are able to take advantage of at least one of the suggested tests I mentioned in order to obtain the best treatment possible and start turning things around.

This query has utilized a total of 42 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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