Question:
I found your website and would like to ask your opinion. I am a 34 y.o. LPN and mother of 2 boys. After delivering my first son 8 years ago I began having joint pain, numbness in hands/feet, and fatigue. I was thought to have RA , like my father, and was placed on Prednisone. This seemed to aggravate my numbness, and I began having tourniquet sensations above both knees, and "heavy" weakness of extremities. Over the years these symptoms continue and while pregnant with my second son I passed about 7 kidney stones and had hydronephrosis which resolved. I have GI symptoms and terrible fatigue. I don't know how much longer I can continue working and trying to appear "normal". I am exhausted all of the time. My ANA started at 1:140 and the highest last year was 1:320, speckled pattern. MRI revealed a significant Chair malformation and decompression was recommended; I had this surgery in 2001, but no change in my symptoms and the neurologist believed there was another "process" going on. I have Raynaud's in my hands and my legs go numb from any constricted position or whichever side I lay on at night. Other tests per rheumatologists reveal no other clues. I definitely feel worse when under stress or I try to work/shop like I used to. My muscles will feel "spastic" and twitch for hours afterwards. I can not take any muscle relaxers or steroids or it seems to exacerbate my weakness/numbness. I do have frequent headaches that hurt in the "back" of my head and now I have been told my hormones are "pre menopausal"; Iam trying to decide about taking hormones, my mother had breast cancer. My question is this. I find it hard to believe that at 27 y.o., I went from healthy and active and now I can barely get through a day. I have to take naps and rest up to do the simplest chores. My only health problem before this was endometriosis. Can you please give me your
opinion? Can someone have MS without "plaques" on the MRI; can someone have lupus with no other abnormal lab work than slightly positive ANA? I am not depressed (which of course is not to say this change in my life hasn't gotten me down at times) or under extreme stress. I have a family I have always wanted and am so tired of not feeling like enjoying my boys. Can you please give me some advice on what I should do?

Answer:
This is not MS (as the MRI would show lesions in MS patients). A positive ANA is not specific for lupus and many symptoms you have are not specific for any connective tissue disease. The neurologist has likely done Nerve Conduction Studies to see if you have a peripheral neuropathy (which is actually more common by the symptoms you describe in Sjogrens than in other connective tissue diseases). Ask the doctors involved in your care if you may have Sjogren's syndrome (it often has a positive ANA) and also what can be done about the numbness and burning you feel and how you can pace yourself to help to manage the fatigue.