Age: 38.0
Sex: F
Vaccine: ANTH, MEN
Symptoms: Muscular weakness, Musculoskeletal stiffness, Nausea, Pain, Paraesthesia
Clinical narrative: Service member feels that her chronic fatigue, fibromyalgia and migraine headaches were exacerbated by the anthrax vaccine. Reports history of fibromyalgia, chronic fatigue and migraine headaches; they had gone into 'remission' in late 2000. 1) Migraine headaches - Hx of tension-type headaches with onset around 1993. Around April 2000, began experiencing different type of headaches that were evaluated and treated by a civilian Neurologist and were later diagnosed as migraines. With these headaches, service member experiences associated symptoms of dizziness, facial paresthesias, phonophobia, photophobia, blurred vision, muscle weakness, and nausea. Without treatment, these headaches can last several days and interfere with both work-related and social activities. They occur 4-5 days per week and typically last up to 72 hours. In late 2000, stopped all headache medication and reported a remission of headaches. Medical records between November 2001 and February 2003 support this. After she deployed and received 3 anthrax vaccines, her headaches were more severe and more frequent. She also began experiencing a third type of headache that is constant and daily. 2) Fibromyalgia / myofascial pain syndrome - history of generalized body aches starting in 1992-93. Diagnosed as myofascial pain syndrome and fibromyalgia in August 1995. The diagnosis of FMS was documented in her medical records two weeks prior to her separation from service in 1995. This pain is aggravated by prolonged standing, sitting, lying, walking, repetitive actions, exertion, and with extreme changes in temperature. The pain interferes with work, household chores and exercise. She typically had 1 'good day' per week prior to late 2000. She also reported associated fatigue, stiffness, paresthesias, sleep disturbances and depressions. Prior to her deployment in 2004, she had been tried on a variety of medications to include Toradol, Elavil,Prozac,Zanaflex,Ultram,Serzone,Vioxx,Flexeril, and Neurontin. She had also tried warm compresses, distraction, physical therapy, Tai Chi and relaxation techniques with limited pain relief. She uses TENS and / or NMS and Lidoderm patch as part of her daily treatment regimen. 3) Chronic fatigue syndrome - history of chronic fatigue with symptoms starting in 1992-93, but not diagnosed until around 1998 'feeling exhausted.' Using a scale of 0 (= not at all fatigued) and 10 (= as fatigued as I could be), her level of fatigue averages between a level 6 and 9. Her fatigue is associated with clumsiness, difficulties with memory and concentration, generalized feeling of weakness, anxiousness, and depression. Her chronic fatigue significantly impacts her performance in both home and work settings. She was not able to work outside the home between 1998 and 2000. She required assistance with her household chores. Her fatigue does not demonstrate a consistent daily pattern. She is tired upon awakening. She takes naps, but does not feel refreshed after napping. When her pain is increased, her fatigue is also increased. She attempts very little strenuous or physical activities, because when she does, she experiences post-exertional malaise which may last 2-4 days. In late 2000, service member was able to stop all of her pain medications and reported a remission of her fibromyalgia and chronic fat. Her medical records between November 2001 and October 2003 support this. After she deployed and received 3 anthrax vaccines. Cleared for deployment during the latter part of November 2003. Received her second anthrax vaccine on 1/28/04. Her medical records noted that she woke up the next day (1/29/04) with body aches and severe flu-like symptoms, lightheadedness and a severe headache requiring a visit to the emergency room lasting 5 hours. Her records from that visit also mention a fibromyalgia exacerbation.