Age: 56.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Angina pectoris, Asthenia, Balance disorder, Biopsy muscle abnormal, Biopsy peripheral nerve abnormal
Clinical narrative: The following synopsis is confirmed in my medical history where I have had over 100 doctors' appointments, tests, or procedures in the 12 months from Sept/2022 to Sept/2023. I have seen over a dozen specialists working together across multiple health care systems. Appointments, tests, treatments, and collaboration continue without improvements to my condition. Prior to taking the 2-dose Moderna vaccine, I was very active and in good physical condition, exercising 4-5 times a week with good blood pressure and low body fat while working fulltime. 5 weeks after taking the second dose I experienced a shoulder injury in the same shoulder that I received the vaccination and a couple of days later went to the ER with chest pains and was admitted for three days. The test results were inconclusive, but my chest pain persisted. My health continued to decline with chest pain, fatigue, as well as nerve pain in my hands and feet and legs. 12 months later I began to experience a severe rash on my head, face, and upper body. Within six weeks I lost 15 pounds which was diagnosed as muscle wasting and has not resolved.  After seeing several specialists, I was diagnosed with Dermatomyositis and Polymyositis in Nov/2022. I began treatment centered around Azathioprine. After several months with worsening conditions, I began taking Mycophenolate. Conditions continued to worsen, and the dosage was doubled without any improvement. The combination of pain, fatigue, weakness, rash, loss of balance, and continued decline in the function of my hands and feet has resulted in going on disability and loss of employment. The medical team has expanded to the Hospital for a 2nd opinion and their latest diagnosis on August 2nd is Mononeuritis Multiplex.  On Oct 16th muscle and nerve biopsies were performed with several findings including demyelinating polyneuropathy. Hospital is now recommending that the clinic be consulted for a 3rd opinion and pathological study of the muscle and nerve biopsies.   Vaccination o May 6th, 2021 o June 2nd, 2021 Events o Right Shoulder AC Injury o July 7th, 2021 o Admitted to Hospital for Heart Pain o July 10th, 2021 o Dermatomyositis/Polymyositis - Diagnosis o Nov 22nd, 2022 o Psoriasis  o Apr 17th, 2022 o Shingles o May 27th, 2022 o Covid-19 o Aug 5th, 2022 o Mononeuritis Multiplex - Diagnosis o Aug 2nd, 2023   Specialists o Rheumatology o Neurology o Neurological / Plastic Surgery o Dermatology o Oncology o Hematology o Cardiology o Orthopedic Surgery o Pulmonology o Allergist o Physical Therapy o Occupational Health  o Ophthalmology  Testing and Procedures o Labs (UF, ARUP, Advent, Quest, PCP)  o Genetic testing  o CT  o MRI o X-ray o (3) EMG/ Nerve Conduction Studies o Colonoscopy o Endoscopy o Skin Biopsy o Muscle Biopsy o Nerve Biopsy o EKG o Echocardiogram o Cardiac Stress Test Health Systems, Practices o Hospital o Clinic o clinic o clinic o Rheumatology o Hematology o Oncology o Dermatology    Treatments: DM/PM   o Azathioprine 100mg/day o Prednisone 60mg/Day o Hydroxychloroquine 300mg/day o Mycophenolate 1000mg/day o Prednisone 40mg/day o Hydroxychloroquine 300mg/day o Mycophenolate 2000mg/day o Prednisone 40mg/day o Hydroxychloroquine 300mg/day     Medications prescribed for Inflammation/Pain/Nerve Pain/Constitution:   o Meloxicam 15mg o Diclofenac 75mg o Naproxen 500mg  o Hydrocodone/Acetaminophen 10-325 o Oxycodone 5mg   o Gabapentin 100mg o Tizanidine 2mg  o Primidone 250mg  o Pregabalin 75mg o Baclofen 10mg   o Celecoxib 200mg o Duloxetine 60mg o Pramipexole 1.5mg   o Omeprazole 20mg o Dicyclomine 20mg o Terazosin 10mg o Allopurinol 300mg o Triazolam .5mg