Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Joint swelling, Joint warmth, Laboratory test, Loss of personal independence in daily activities, Magnetic resonance imaging
Clinical narrative: Few days after Covid 19 vaccine #1 on 4/29/21 - I had reaction on site, had some palpitations and 5 min after Covid 19 vaccine, I had a warm flush feeling in chest to throat, nurses stayed and watched over me until resolved. Stayed 30 min, all symptoms fine when left to go home. Then evaluated by allergist on 5/17/21 to be cleared for 2nd dose on May 28th.  Because I had no allergy to ingredients in Covid 19 vaccine I was given permission for second dose. My husband and I saw both knees swollen at bed time on 5/3, no injury and no prior swelling (I was walking and running daily without issue)  Next several days knees still swollen making it more difficult to walk, felt like I bumped or tweaked my knee which I DID NOT.  Proceeded to get worse over next week and proceeded to make appt to see  Dr 5/17/21  (previous PCP), explained that both knees started swelling. Left knee is much worse than right. She sent me to orthopedic for evaluation. Cardiac chest pains sporadically, palpitation's started and seemed to be getting worse during the week. Made Dr appt to see my cardiologist to evaluate on 5/25/21 (morning appt). Saw  Dr. Had in office EKG and eval, Dr looked at leg and significant swelling to be sure not related to heart.  Explained got Moderna vaccine on 4/29 and fine until then and have appt to see ortho same afternoon. He put me on labetolol 200mg 2x a day for HBP and chest pain which may be being caused by whatever is going on he thought. Order stress tests to be sure.  Cannot run on treadmill for stress test so Dr ordered dobutamine tress test, completed but had allergic reaction to Difinity dye. Completed a second test to get better pictures. That test complete, showed strong heart, need to stay on BP med until other medical issue resolved.  **Dr follow up in January 2022 - Chest pains gone for last few months did have some palpitations over last 2 weeks with movement due to pain level exacerbated. Also had flutter under left shoulder blade in back while laying down. This was felt twice in one day.  Dr conducted office eval and put me on a  on halter monitor for 2 weeks to be sure everything still OK.  (Debilitated state during visit on 1/11/22, little to mobility at this point (more detail explaining below) Went to Orthopedic doctor on 5/25/21. Dr did x-rays both knees, exam, discussed that there is nothing he can see causing what is going on to be causing the amount of fluid build up / swelling and painful stiffness. Dr drained my left knee and sent me for bloodwork to look for infection or what may be causing this. On crutches 5/25/21 due to inability to walk. Knee fluid tested too. Results given - Positive ANA, suggestive of Lupus or Sjogren's disease. Referred to primary and instructed that I need to see a  Rheumatologist. Made appt 7/16 Dr  - Rheumatology Left knee proceeded to swelling and get worse High - CRP blood level. Unable to walk without crutches or bad limp  including painful stiffness, swelling and warmth on the knee. MAY, JUNE, JULY, AGUST Started vision changes in May, blurry, halos, light sensitivity - saw ortho - Previously saw eye Dr in early spring 2021, needed new glasses distance and close up (1st time needed as adult) given to me in spring 2021 no longer work, went back to eye doctor for re eval, changed script slightly. a few weeks later stopped working. Saw optometry to re eval 7/16, slight script change. Did not want to pay for new glasses, seemed to be getting worse. Per last visit will watch over next few weeks or months.  As of today eyes seem to be stable and not worsening. Following up as needed. Thyroid was getting swollen in early June(had 2nd dose of vaccine May 28th) Thyroid swelling was creating pressure in neck, saw Dr on 7/2/22. She had been following me once a year to make sure no issues arise. Had goiter years ago, no blood work changes or ultrasounds with thyroid issues arose.  All was preventative, goiter was not an issue after that one year when started seeing her years ago. I was just cleared in March for regular my regular annual visit & ultrasound.  I had a bug in January. On 7/2/21 she immediately did eval, we discussed vaccine on 4/29 and she believes I may have vaccine thyroiditis, she has seen and heard of some cases and seem to go away after 3 to 6 months.   She put me on prednisone, completed bloodwork, had ultrasounds and saw her every 2 weeks until Fall - referred to Dr general surgeon to see if benefit of removal of thyroid whereas bloodwork is not showing anything.  No, no benefit to remove.  He believe this to be part of whatever auto immune is going on.  ***Result of last visit with  Dr, she is at a loss expressed to me each visit feels as though she is missing something but no other diseases related to thyroid are seen on any test. Ok to refer out, yes please.  **Referred by Dr. to a Thyroid specialist - had visit, discussed and reviewed all info from Dr. and was cleared. No symptoms at this time and hadn't been in a while. All thyroid issues seem to be resolved, will call back to see if necessary.  We also discussed pockets of neck swelling, base of neck and she is sure not related to thyroid. These were seen by Dr.  in August, and went away after a few weeks and returned in late September. These pockets of swelling are an ongoing issue and is currently being evaluated today by my PCP saw 1/12/22 and one of several to be evaluated by Dr. of rheumatology. I have appt later today 1/19/22.   Heat intolerance, cannot be out side or in any heat without turning brick red, profusely sweating and feeling ill. Could not do any outside activities, cannot walk, run, go to beach, garden, shop, sit or otherwise. My whole summer was gone. I bought anew vehicle due to the intolerance of heat and more increasingly Dr appointments to find out why my body was out of control as it seemed.  After several weeks of this I bought a used car and took on a car loan 1st time in my life out of necessity. Car has A/C so I can continue to commute to work with the heat intolerance issue and being able to work without being ill. Feeling ill with any prolonged exposure to heat was inevitable, still is an issue, better with Fall and Winter but know it is an issue with inside heat intolerance as well.  Sweats, body / night sweats and chills occur every week a few days a week. No one can tell me why yet, I have been tested for infections and other possible causes. Nothing has come up. Ongoing issue. Appetite - I have less than half of appetite, no longer crave food, coffee, water. Ongoing issue. Dr of rheumatologist seen  on 7/16/21. She is unsure of what is going on. Sent back to ortho to look further, done, had MRI in July, had follow up with Dr, nothing that is going on is causing all of this, he believes to be auto immune issue, back to rheumatologist. Took a couple visits and me getting worse, unable to walk well, most days on crutches and presented for  appt in  wheelchair. Dr started me on Metheotrexate 1 5mg once a week -  while I was awaiting a new rheumatologist in October. I was seeking new doc because she kept sending me back to ortho as I was getting worse, waited 3 months to get to bigger hospital  Started Folic Acid for side effects of hair loss from med. Had 2 oral  doses, bad side effects, stopped per Dr.  She wanted me to start Metheotrexate injections once a week after teaching with nurse. By the time they coordinated the appt I was in with new Dr. on 10/22. He did eval, looked over all previous med notes, discussed with my husband and I and agreed to continue with injections to see if helps. He did more bloodwork and found a positive ANA . Methtrexate should help with in 3 months. My Left leg knee joint proceeded to get worse, had 2nd ortho appt form ortho DR. to rule out ortho issue again for Dr.  That is when she started me on a med finally - methotrexate oral.  In Aug I had bilateral hip and groin pain that debilitated me, I was on the couch for a week.   Got permission from work to work remote on days cant walk between knee and this. Done. Had upper body pain woke with on 10/11/21. it hurt so bad all over, could not function, lasted few days. This pain settled in both my shoulders and both my elbows so each day after that I felt like I had been beaten by a baseball ball. Continued pain stiffness, swelling in hips, groin, left leg on top of it.  End of December my right knee is doing everything the left did when starting and has been bad since then creating severe immobility, painful stiffness and swelling, cracking and popping.  A few days later early January 2022 my hands are wrists are effected creating an issue working and feeding caring for myself. As of today I am getting ready to start a new med in hopes I get some relief. I am unable to drive, walk, cook, clean, shop, dress without help. I have a wheelchair as of 1 month ago so I have a way to get around  when I have seen myself getting so bad, I use in my home when not on the couch. I also continue to see doctors and continue care to see what I can do to get some quality of life back.  My husband does all that is needed to raise our 16 year old and take care of house, work and me! He physically picks me up from sitting to a standing position so I can use cane or crutches to get to bathroom or my bedroom where wheelchair doesn't fit. This is very panful and sometimes impossible.  The joints involved are both knees, both hips, both groin, both elbows, both shoulders, both writs and hands, since 1/11 my feet are having same symptoms of other joints. Dr is treating me for undifferentiated arthritis that he believes to be rheumatoid arthritis. Starting Humira today.  I am devastated that my life has been taken from me and away from my family, I was eating well, exercising, working full time, feeling top of my game everyday before vaccine, a clear cut decline in quality of life is obvious.