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GP's Meds hiding symptoms from specialist?

Hi all

GP has sent me to a rheumatologist as she thinks I have ME or fibro. Other than the fatigue and pain, She seems to have ignored some fairly classic ‘neuro’ symptoms not associated with these conditions - loss of feeling, buzzing, pins and needles, nocturia, vertigo, emotional lability, twitching muscles and hyperreflexia including a positive babinski response. Many more symptoms, but you get the drift.

Thankfully, the Rheumy wants to check out the neuro side so I have MRIs of brain and spine on Tuesday.

In the meantime, my GP gave me amitriptyline 30mg for the pain and citalopram 20mg for the irrational emotion and I have been on them for a month or so. When he examined me, the Rheumy implied I wasn’t that bad. My other half nearly lost the plot explaining that I was having a particularly good day having laid in bed for the last 48 hours.

My question is, has the amitriptyline inadvertently confused my potential diagnosis as it has really taken the edge off things for me and consultants usually get to see people med free first.

Scared I’m going to be kept in limboland. Whatever it is, or is not, I just want to know so I understand what I’m dealing with.

Ta ever so

C

Hi Claire,

Going on the basis that amitryptiline is a common medication prescribed by both neuro's and GP's I'd say no, I doubt  that it would confuse things - but I'm not a medic so I may be wrong.

The fact that your rheumy has organised an mri of the brain & spine suggests to me that he's keeping an open mind. Plus of course, he must be aware of the medication that you're on?

Do you keep a diary of your symptoms? It's worth noting things down - keeping them concise and to the point. Most of us have worse and better days so maybe that's what your rheumy meant?

Hopefully the mri will shed a bit of light on what's going on - there are a lot of conditions that have the same or similar symptoms so it's not always straight forward in getting a dx . When I very first saw my GP he originally made a referral for me to see a rheumy. When I went back to him two weeks later with more symptoms he changed the referral to see a neuro instead.

See what the mri throws up first. Good luck!

Debbie xx

 

    

I have a friend with ME and she gets many of those symptoms you have listed as n ot being symptoms of ME

Hi Claire,

I really don't think any medication is so fantastic that it would relieve symptoms to the point they were undetectable to an expert!  If there IS a drug that good, I want some.  ;)

Amitriptyline is prescribed mainly for nerve pain.  As pain isn't measurable/examinable anyway, except from the patient's subjective reports, I don't think the fact you're taking pain relief - even if successful - would have any bearing on what the rheumy could detect on physical examination.

The same with citalopram.  It's an anti-depressant, as you obviously know, but depression isn't something that can be measured by a physical exam, either.  So again, I think the chances of it masking your physical problems to the point they were unnoticeable is pretty much nil.

I really wish there were things that did this!  But from your point of view, nothing to worry about, as it won't alter your prospects of a diagnosis.

Tina

Thanks all.

Think I am just concerned that I am not seeing the right kind of specialist and therefore the diagnosis may be ‘steered’ by what is covered under his specialism rather than what the cause actually is, based on my GP stating I had NO neurological symptoms. However, a family friend in his 90s is a retired neurologist and said I had over 10 classic symptoms !?*. Confused.com.

Will wait and see but just been signed off work for another 3 weeks. That will make 2 months. My boss is being very good on the face of it but I know she is stressed out having a member of her senior team out of the business who can’t give her an idea of when / if she might be able to go back to work. I love my job and miss it and the people but as a senior exec for a big corporate, there is no come back and take things easy. All or nothing … Which worries me for the future.

Rambling now, sorry.

Cx

Surprisingly, there's quite a lot of overlap between rheumatological and neurological conditions, with some disorders in the rheumatology spectrum having possible neurological complications.

So you can't always tell, just from the range of symptoms.  Sometimes it's a matter of luck whether you get referred to the right department first.

I was referred to Rheumatology first.  Unfortunately, in my case, it wasn't the right one, and it was only some four or five years later that I was eventually referred to Neurology, who worked out what was wrong.

But Rheumatology was still a reasonable first guess.  I don't blame anyone for not trying Neurology first, as my symptoms at that time weren't typical of MS, and might have been pretty much anything.

You might be lucky, and Rheumatology's right first time!  But it's very hard to predict which camp something's going to fall into.

Tina

 

Thanks Tina. A little reassurance goes a long way :0)

Cx