A Difficult Diagnosis

A history

It’s February 2022. As I pull into the parking garage of a local hospital, I review the progression of the unknown condition that’s brought me here. At today’s appointment I’ll recount its many symptoms, a constellation of afflictions that’ve launched a profound assault on my quality of life. I’ve rehearsed the story, cautiously trimming inessential details. There’s much to express in a limited timeframe, and I can’t risk babbling incomprehensibly; if I want to get closer to a diagnosis, I’ll have to present a coherent narrative. I’m bordering on desperate, doggedly trying to uncover the culprit that’s ravaging my body. Over the past two years, numerous doctors have evaluated me. None of them have offered an adequate diagnosis. The madness has to stop.

Four years ago, I observed left elbow pain and a dull ache at the back of my left hand. They were mild discomforts exacerbated by certain physical activities: weightlifting, long bouts of typing, and sustained phone usage. I acclimated and didn’t seek care until two years later. During that gap, my condition dissuaded me from going to the gym, which was once a staple in my life. I spent long periods of time fixed to a computer for work and later for a post-baccalaureate program. When I eventually made my way to an orthopedic specialist, I was assumed to be a physical therapist’s calling. There was no cause for concern. Then, my presentation evolved dramatically.

I developed burning at the back of my hand. Fingertip symptoms followed: paresthesias and sharp pain triggered by exertions such as typing on a keyboard or tapping on a phone. I felt deep forearm fatigue that escalated to burning. Over time, the symptoms have become bilateral, present at both sides of my body.

More recently, I’ve been met with the onset of burning at the trapezius, shoulder, clavicle, and chest. There are tender spots present laterally at the front of my neck; palpating some of them triggers mild pain down parts of the shoulder, chest, and arm. Even my armpits occasionally hurt.

For the longest time, I’ve dealt with soreness high up at the back of my neck. It’s prompted me to change pillows multiple times. As my symptoms have progressed, the sensation has morphed into a deep ache accompanied by occasional discomfort that rises up the back of the head.

My medical history is dizzying and elaborate. Yet, I’ve been allotted just 20 minutes to communicate its entirety to my new primary care doctor.

Ironically, spelling out my assortment of pains will literally be painful. Half a year earlier, a laryngologist diagnosed me with muscle tension dysphonia, a voice disorder that can cause pain at the throat when speaking. At our appointments, she’s observed excessive tension in the muscles around the voice box when I speak, but the tension isn’t secondary to any abnormality in the larynx. In these cases, she’s described, there’s often mechanical misuse of the voice. The gold standard for treatment is voice therapy, which I’ve undergone for months to no avail.

Over time, I’ve become skeptical. My throat issue exhibits curious characteristics that make me wonder about its place in the broader diagnostic puzzle. Parts of the front of my neck are always in pain, even when I’m at rest. It’s as if I’m being incessantly choked, and the surrounding area feels inflamed. The discomfort is diffuse, running inferiorly along the front of the neck.

I suspect that most or all of my symptoms have a common link. Without objective proof, this idea is mere conjecture. Still, I can’t help but wonder: is there a unifying explanation?

from Hacker News https://ift.tt/E0xtz4Y