Age: 56.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Anti-cyclic citrullinated peptide antibody, Arthralgia, Blood immunoglobulin G, Blood thyroid stimulating hormone, C-reactive protein
Clinical narrative: 1. What date did you receive your first dose, and what date did you receive your second dose?   I got my first shot on 3/15/21. My second was on 4/12/21. My third was on 11/22/21 2.   What symptoms or illnesses had you had (if any) before getting vaccinated - hard to remember, I know, but in the two weeks or one month prior...?  Nothing notable. Some soreness in my right wrist, most likely caused by repetitive stress. Lots of hours working on the curriculum.   3.   How long after receiving the second dose (it was the second dose, not the first, right?) did you start having symptoms? Two months.   4.   What were all the symptoms? The more specific & concrete you can be, the better. It began with soreness and tightness in the groin area. It became difficult to sit for the long periods the coursework required within two weeks of the program's start.  Although I had been walking 1-2 miles twice daily, it became increasingly painful and exhausting to walk, and I was quickly down to ¼-1/2 mile and then none. During this time, knee and shoulder pain increased to the point it was difficult to push my body up to get out of bed. I would take baths, but getting up out of the tub was very difficult. It was terribly painful to bend my knees, and to push up with my arms meant almost unbearable shoulder pain. After about a month of worsening symptoms, I went in to see a doctor.  The appointment date was July 21st, 2021 5.   Did any of the symptoms resolve on their own or seem to clear up and then come back before you went to see a doctor (or PA or nurse or whatever it was)_No.    6.   Who did you see and when (approximate dates - doesn't need to be exact)? I saw Dr. in General Medicine on July 21st, 2021. She prescribed a 7-day prednisone pack that tapers from 30 mg to 5.    7.   What did they tell you? Did they suggest a diagnosis? What treatment(s) did they prescribe? What happened after you took the treatment(s)? My regular Family Medicine doctor, called me on July 23rd and told me he thought I had Polymyalgia Rheumatica. (PMR)  From his notes:  ASSESSMENT / PLAN: Symptoms are somewhat compatible with polymyalgia rheumatica, but the onset was somewhat abrupt. I will continue on prednisone 20 mg for now till I see me in clinic next week. I will also order some further lab work to rule out rheumatoid arthritis.  I responded well to the prednisone. I chose to taper somewhat aggressively, but with the guidance of two different rheumatologists. Dr. was the first. I began working with Dr. on 9/23/21 to deal with the PMR. The groin and knee pain subsided completely. Shoulder pain on the left side lingered due to a suspected rotator cuff tear. I had one Cervical Epidural on February 21st, 2022. It helped for four days, and then I was pretty much back with the same symptoms that proceeded the shot. In a follow-up phone appointment with Dr. (Anesthesiologist), who did the procedure, we decided that a second shot was unlikely worth the risk, given where it was going.   8.   What symptoms do you have now? Briefly after my third shot 11/22/21, I began to experience severe arm and wrist pain on my right side. It became almost impossible to sleep lying down.  Numerous attempts to get help from pain management went without reply. I crashed my car on 12/28/21. I began working with Dr. in physical medicine on 1/13/21. He attributed the pain to a pinched nerve in my lower cervical vertebrae. He also noted that the substantial presence of spinal stenosis had not changed significantly since in the results of an MRI from a year earlier. The bones showed no change, yet I had what was acting like a pinched nerve. Standard pain meds, such as Norco were completely ineffective. He prescribed Gabapentin. I didn't get much relief until I reached 1200 mg a day and started 30 mg Cymbalta. Given that I got relief from prednisone for the PMR and the brief reprieve from the epidural (dexamethasone), I think most of what I'm dealing with is inflammation that is taking somewhat damaged areas over the top, pain-wise. Given the PMR's advent and another flare-up after my third shot, the connection to an autoimmune reaction to the vaccines seems a pretty reasonable conclusion.    9.   Did they clear up and come back (or get somewhat better & come back even if they didn't clear up completely)? I found Voltaren(Mobic) gel helped relieve some of the pain. I live with varying wrist, hand, and middle finger pain on the right side and some on the left. Shoulder and knee pain vary from 3-7 levels. It is the worst in the mornings and the night. That said, I am to a point where I can sleep long enough to maintain some sense of normalcy. I find putting socks on the left side, where my knee is most painful very challenging. Pulling my pants up when they slide down and doing things like putting a belt through belt loops in my pants are painful. The belt and belt loops require that I put the belt in before putting the pants on. I can't take the pain of doing it when the pants are on. I quit taking Gabapentin because it was causing tremors. I quit the Cymbalta due to other side effects. I stopped using Voltaren gel because it was causing my lips to crack (I have had reactions to Mobic in the past. Because I don't have groin pain like I did with the PMR, It seems to be under control, but overall inflammation remains a daily struggle.    10. What are they saying now? I haven't had a checkup in a while. Frankly, "help" has been so inadequate, come so slowly, and included many side effects I have lost faith in western medicine. I will get a blood panel to see where I'm at and what they have to say. I suspect they'll want to restart prednisone, which I'd rather not do.