To Not know how to go about this? (dr related)

[GreatFuckability]

I need to see my GP. For a while now i've been having some symptoms

• exhaustion, to the point that on the weekends where I don't have my children i often sleep for 24 hours plus, as its the only way I can get through the rest of the time. I'm a student and I'm seriously considering dropping out of my course as I'm so tired I barely make it through lectures without falling asleep, let alone take in any information.
• pain, I have some issues with my back that are old, but over the last six months my arms, shoulders and neck hurt, as do my hips and hands.

-weird sensations in my face, not numbness as such, but like pins and needles, or like there is hair on my face, but there isn't. -bowel issues

I'm on medication for depression and every time I see my doctor about any of these things, they say its either the medication or a symptom of the depression, but mentally i've been really stable for a good while now, so i can't see how its linked.

Anyway, my AIBU is that I really dont know how to address this with the doctor, do i make a list of everything? My doctors make a big deal about only looking into one thing at an appointment, but how do i know if these things are related or not? Help me, mumsnet!

Can you ask for a double appointment ?

I am with Mari50 - some of your symptoms may related to your medication. However, I wouldn't assume that without investing other causes of your symptoms. I would certainly make a list of the issues but I would not run off a list of blood tests you would like - GPs see this sort of complaint a lot and know what blood tests are needed. If you see a GP who won't at least do some basic bloods, go and see another

Lots of people are deficient in vitamin D and you could well be as you are a student (presumably indoors in lecture hall a lot) and staying indoors at the weekend. Depending on how good your diet is you may well be B vitamin deficient too. If you're not already I would probably start taking a multivitamin to at least boost your levels

I would not assume they will find a cause - often the bloods come back normal, so please don't pin your hopes on them finding something to explain all your symptoms. If there is something they will find it, but these things often end up without a specific identified cause. Fibromyalgia has already been mentioned I think, which is a diagnosis of exclusion - I.e you could explain these symptoms as that once other things such as vitamin deficiencies, anaemia, thyroid disease or coeliac have been excluded (not an exhaustive list)

I hope you have some luck with the next doctor you see

Sounds like a thyroid issue

I might be far off the mark here, but I think it's worth mentioning. If you get blood tests and they come back clear (for thyroid and vitamin deficiencies as other have suggested) I think that with the pins and needles sensations you ought to ask for a referral to a neurologist, as it could be something like MS.

I really hope it isn't- but exhaustion, weird sensations, bowel issues and pain can all be symptoms of it.

Another possibility, given the bowel issues, is Crohn's disease. It's an autoimmune disorder so can often have other symptoms like joint problems, and exhaustion.

I'm a continence nurse, if you don't get the answers you want ask to be referred to your local continence service. Sometimes it just gives you another load of ideas and they can write to your gp with suggestions. Definitely ask for a neurology referral, depression, tiredness tingling etc can all be symptoms of other conditions.

Ask to try new medication. There are huge amount of antidepressants around and finding one that suits you is important. Also you should of been offered counseling which can be the key to controlling and beating the depression.

Please don't give up, stay strong. Talk to your course leaders and get support.

Bloods: you need vitamin D (25OH) vitamin b12, thyroid (full panel so not just TSH but free T3/4 and antibodies. Ferritin, blood glucose and hba1c.

If they start with the 'side effects' thingvthen say ok, can we try another medication then because these symptoms are not tolerable and are interfering with my life.

When you get the results, ask for a printout, the reference ranges for thyroid in particular are too broad and you can be within range and still have symptoms. If your tsh is over 1.25 ask them to check thyroid further.

They need to rule out MS. Your symptoms could indicate that but don't panic - it's more likely they are down to a vitamin deficiency etc.

Have you had any viral illnesses within the timeframe of these symptoms?

Sounds very much like cfs/me is a possibility.

Definitely speak to your doc, it could be any number of things and you aren't being silly.

I'm a GP. this isn't really what we mean when we say no more than one problem. You have lots of symptoms which may or may not be related. More than one problem is, say, come for a review of your angina and then announce at the end of the appointment that you've got a skin condition you'd like me to see.

In this case I'd love it if you said at the start that you have quite a few symptoms, you're not sure if they are related or not and so you've written them all down. And yes, if your surgery books double appointment then ask for one.

On those symptoms as given I would definitely do bloods which would include checking for anaemia, thyroid, vitamin D and B12, diabetes and various others. Depending on your age and what the bowel issues are that may or may not prompt a referral.

Hi OP,
Just tell the doctor what you've told us.
With your symptoms I'd expect the following bloods to be ordered as a first line:
•Full Blood Count-looking for anaemia
•Iron Stores (Ferritin)- can have anaemia if levels are low; even if circulating Haemoglobin levels satisfactory.
•Thyroid Function Test
•B12 & Folate
•Vitamin D
•Coeliac antibodies (although you don't mention your bowel habits in your OP, some of your symptoms tally with Coeliacs).
•Fasting blood glucose & possibly Hb1Ac.
Get the above done first and ask for a copy of your blood results-don't be fobbed off . Good luck.

The receptionists at my Dr have never asked anything. I just ask for an appointment and they give it to me. Just tell them it's personal if they ask.

Just wanted to throw another possible diagnosis into the mix - coeliac disease. They thought my mum had a b12, iron and vitamin d deficiency before she was diagnosed with coeliac disease. All were solved once she changed her diet after her diagnosis. Obviously that also causes bowel problems and fatigue.

Oh and she took a list of her symptoms with her and that's how she finally got the correct diagnosis

thank you so much everyone! some excellent ideas.

going private isn't an option for me, student+ single parent = broke most o the time! but thank you for the suggestion.

citalopram is what I take, and i've never had side effects beyond the initial feeling a bit rubbish when i first started taking them and that was 7 or 8 years ago.

no illnesses that i can think of. I had bronchitis quite badly 2 winters ago, but that was a long time before this stuff started.

The bowel issues are really bad diahorrea, to the point where some days i'm afraid to leave the house and I never go out without immodium in my bag. on a good day i only go 2 or 3 times. on a bad day it can be upwards of 20. even through the night sometimes which doesn't help my energy levels! I will definitely ask about the continence service.

i've made a list of all the things you've suggested and recommended and will ring the GP in the morning. my GP does same day appointments mostly.

thank you all again!