Question: If a new female 60 yr old (post menopausal for 6 or 7 years) patient were to come to you with the following symptoms, what would be your first thought as to a diagnosis without doing any lab tests: pain in side of left breast (for sure not breast cancer) for 3 yrs, small lump left side throat just under chin (prominent when that area itches) - just discovered, area on back of right side of head at hair line that is sore, raised and itches on occasion (not sure it is a lump yet), dull pain left side under ribs (9 years), trouble breathing as if my throat is closing up, exterior muscles of jaw and next feel "tight", my whole head (and hands at times) itch(es) at various times during the day, sweating all day off and on, sweating at night especially back of neck (for over one year), pain in butt area, both sides (for over a year), where you sit (like sitting on two rocks), pain in a small specific genital area above the vagina (like a cramp - has been there for 4 years), AND Last of all - excess sleepiness - several hours after I wake I take a 3 hr nap every day (for almost 2 yrs) - it is not sleep apnea).
I have been diagnosed with two diseases, lupus neuphritis (17 years) and Sjogren's (30 yrs) and have many doctors. But I believe they are so focused on the specific areas they treat, that when I mention other symptoms I'm dismissed. AND I DO NOT WANT TO OVER REACT EITHER. Would just appreciate your first thoughts on what these symptoms might mean and what to do next. Thank you.