I'm the zebra

I remember early on at a medical appointment, the forgettable doctor told me the following. "We have a saying in the medical industry that if you hear the sound of hoofs look for horses, not zebras". She explained that what I was experiencing was common and not likely to be something rare. She was dead wrong.

I later looked up her strange "zebra" analogy to find it is taught in medical school in regards to "a very unlikely diagnostic possibility". I'm not a doctor, but do have a masters degree in my field of practice, mental health. What I was trained was to "consider all possibilities, listen to your client and rule nothing out". So why do we treat the mind any different than the body? Shouldn't doctors be looking for horses AND zebras? And are zebras really so rare after all? I mean... if you're on an African plain wouldn't you be shocked to see a horse instead of a zebra? 

To put that in medical terms. Maybe doctors aren't finding zebras because they're too busy looking for horses. Seriously. The example of the "unlikely diagnosis" is "When someone develops a cough, a virus or infection is a logical cause and tuberculosis is the zebra". As someone who has been treated for TB I find that to be a bad example. How about testing for all of it?

I mean how can a middle class Caucasian person living in a "safe" small city with good food and clean air not only contract tuberculosis, but also have Rheumatoid Arthritis, survive a brain tumor AND have a very rare muscle disease? (Yes, I'm talking about myself here.) I don't think I'm the only zebra at this watering hole. 

Doctors would be wise to rule nothing out and look for horses AND zebras. To take their patients concerns (and not "complaints" as another doctor of mine called them) seriously. And to admit when a horse really is a zebra. Come to think of it... I'm not a zebra after all. I'm a freaking zebra, unicorn, pegasus that poops rainbows! 

Is it or isn't it?

Back in April of last year I was diagnosed with Rheumatoid Arthritis (RA). But recently I've started doubting that diagnosis. I think the symptoms of RA mirrored what could have really been Metabolic Myopathy.

Symptoms of RA include:

• Fatigue
• Pain
• Swelling
• Redness
• Joint Stiffness (especially in the morning or when getting up after sitting a long time)
• Joint Warmth
• Loss of range of motion
• Both sides of the body usually affected the same
• Anemia

The symptoms of the type of Metabolic Myopathy that I have (Primary Coenzyme Q10 Deficiency):

• Fatigue
• Weakness
• Muscle spasms (dystonia)
• Poor muscle tone
• Progressive muscle stiffness
• Abnormal eye movements
• Some other serious stuff I don't have like seizures and kidney failure

What led my Rheumatologist to think I had RA was an abnormal MRI on my right hand (some water retention and swelling) and some abnormal labs. But now I'm wondering if that also couldn't have been MM? 

My muscles have been hugely affected lately by the bronchitis I came down with. Something that my Neurologist said could happen. Last night my hands hurt so much it woke me up multiple times. My hands hurting is one of the first symptoms of RA that I had. But when I thought about it I'm not sure it was a joint pain hurt. It felt more like it could be the muscles in my hands.

The same thing happens to the bottoms of my feet. It can feel like I've been walking all day over rocks and in reality I hardly walked at all. It's very strange. Another major symptom for me is my peripheral neuropathy. As far as I can tell MM can cause that. RA does not. I always assumed it was a side effect from my TB treatment, but now I'm not so sure. Of course I could just also have both (gag).

I'll have to talk to my doctors about all this and see what they think. I'll be curious of the hand and foot pain get better when I'm 100% no longer buggy.