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Write-up: On 10/2/00, I had an appt. with my PCP and I was dx''d with acute bronchitis and prescribed Zithromax but after taking this, I still was no better. I saw my PCP again on 10/10/00 and she prescribed Cefzil and administered a flu shot. I told her that I thought a flu shot was not to be given if a pt is sick. She replied that it was ok since I was not running a high-grade fever. I did tell her that I had been feverish prior to this visit. I then told her that I had heard of cases in which a pt received a flu shot and then got the flu. To this, she replied, "Well, you''re sick anyway, so why does is matter?" During this time, I was being treated for Insulin Resistance with Glucophage and Amenorrhea with Loestrin Fe. Three days, post vax, I awoke in the middle of the night, with excruciating pain in my left arm, between my shoulder and elbow. The pain lasted a few days but then started in my right arm, in the same location. Days later, I awoke, late at night, with my hands throbbing and swollen. My doctor prescribed Vioxx, Relafen and Darvocet for pain; with no relief. She admitted that the flu shot could have caused my symptoms. She then referred me to a Rheumatologist. After testing, this doctor was leaning toward a dx of rheumatoid arthritis. I saw 2 Allergists, as well as my Endocrinologist and all 3 doctors told me NEVER to take another flu shot. One of the allergists also dx''d me with "Poisoning by antibiotic." My Endocrinologist dx''d my problem as serum sickness. I now take Plaquenil, Celebrex and prednisone. My Rheumatologist has found WBC in my right knee. One physician feels that my lymphatic system has been attacked as a result of the flu shot. In addition, I have had a flare of gout. It has been one thing after another. The 60 day follow-up report the pt states sed rate continues to be high, last reading was 45. Sed rate is coming down; however, she now has a new internist and rheumatologist; both concurr that she is experiencing an autoimmune reaction to the flu shot as the timing between the flu shot and the onset of my symptoms is too suspicious and cannot nor should not be ignored. The pain in her upper arms was studied via x-rays and MRI''s. She is currently recovering from shoulder surgery; she will see her orthopedic surgen for follow up on 07/30/2001. Insulin resistence. The patient is a 41 year old white female former patient of MD. with a history of insulin resistence, hypertension, obesity and amenorrhea. The patient was initially seen because of weight gain. She was worked up, had thyroid function test, 24-hour urine for cortisol. These were apparently remarkable. She also had an insulin level which was elevated and subsequently she diagnosed as having insulin resistance. The patient returns to the clinic today and reports she is being evaluated by an immunologist because of some joint pain which started several months ago. The patient tells me that her father had diabetes mellitus. Her paternal grandfather and her paternal uncles also have diabetes mellitus. There is no history of dyslipidemia. The patient does have obesity. However she says she is not dieting and has a poor appetite for the past 4 months. She says with diet she was able to lose about 100 pounds. She currently weights 232 pounds and she is 5''8" tall. She is also on Glucophage 850mg t.i.d. The patient does report a history of (white coat hypertension). She also reports that she has irregular periods for about 6 to 9 months now. She says she is on birth control pills for about 15 years. However she was out on birth control pills because of amenorrhea rather than contraception. She says she now has very light periods (2 days only). The patient denies any galacturia, denies any dark pigmentation of the skin. She denies any headaches, denies any focal motor or sensory deficits, denies any peripheral vision cup, diplopia or blurred vision. Otherwise no complaints.
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