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Re: Question for Dr. M, Pain & FMS

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Tue, 28 Dec 1999 21:08:47 -0600 (CST)

At Tue, 28 Dec 1999, Gina wrote: >
>Hello Dr. M,
>I finally got in to see my PCP about this severe pain that is moving
>around. He told me he thinks I have fibromyalgia (FMS) and IBS. He
>didn't do any tests to come to this conclusion, and I felt totally
>brushed off by him, he even told me I would have to be responsible for
>my own solutions to these flare ups/pain. He also said I will have
>chronic pain like this and have to learn to deal with it--all this with
>no work up to find out what the pain is from and whether it is a problem
>that can be treated.

I would recommend a consult with a rheumatologist to evaluate you fully.

>Also my toes have been turning purple and I showed them to him and he
>said it's a sign of GOOD circulation??? I don't believe this, since I
>know I have very poor circulation in my legs (have had a vein stripped
>that had filled with over 100 blood clots, in 1995). I also had a deep
>clot in that leg as well a few years ago. When my toes and feet turn
>purple, it is a sign that my blood is pooling up and isn't able to go
>back up. Wondering what your opinion is on this?
>

All I'm saying is - consult with a rheumatologist. :-)

>Also want your opinion on my lack of reflexes in feet/ankles and
>patella's. My PCP said it's normal and not to worry about it. Is it
>normal to not have any reflexes from the knees down??? Couldn't this be
>related to the other problems I am having instead?

NOt the most common set of symptoms - I'm gonna sound like a broken record but "rheumatologist".

>He also said it can't be a nerve compression because I can move my toes
>up. Is this true?

There's a difference between sensory (feeling) and motor (movement). You can have a pinched nerve in your back and be able to move but be in pain or have reduced sensation.

>I'm at a loss as to what to do now about my pain. I feel it is way too
>early for my PCP to just give up and call it something without even
>doing the diagnostics needed to rule out other problems first. He feels
>that by having done a colonoscopy, and EGD and a CT scan, he's done with
>diagnostics. He also told me he would not refer me for an MRI because
>he didn't think my insurance company would approve it--I don't see why
>not at this point, since the other tests were done and din't find
>anything, wouldn't an MRI be in order now???

Maybe the rheumatologist will order some tests. ;-)

>This is my 4rth PCP this year, I like him generally, I am just
>disappointed in yesterday's visit with him and the lack of action on his
>part. He doesn't even want to see me again for 3 months--talk about
>leaving me hanging :(
>Gina

Let me know how it goes at the rheumatologist. 

--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York


**Note:  Opinions expressed here are for educational purposes only
and, as such, do not constitute a physician-patient relationship.
This information is not intended to supplant the need for you to
consult with your physician prior to choosing therapeutic options
and/or interventions.


**Private emails cannot be entertained due to time constraints,
consequently no private emails will receive a response.


**Thank you for your understanding ;-)



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