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Have bruise on arms and soft lumps under neck. Diagnosed with fibromyalgia. What do you suggest?

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General & Family Physician
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I am concerned about a few things... unexplained small bruise on inner upper arms two large, soft lumps on either side above my glands - just under my neck liquid/soft bowel movements six or so times a day with urgency diagnosed with Fibromyalgia; depression, cfs chronic migraines controlled by botox injections and trigger pt. injections in my back muscles no RX painkillers i am 50 yrs. old; going thru menopause... please help.
Posted Fri, 22 Nov 2013 in General Health
Answered by Dr. Shafi Ullah Khan 3 hours later
Brief Answer: all explained one by one Detailed Answer: Hello Mam! i got through your query and lets discuss the possibilities one by one 1-Bruises in medial arms: Bruises are always explainable. If there is no trauma history then it might be the bleeding tendencies due to platelets or clotting factors. If they have not been previous pathologies and no hstory of bleeding tendencies. i would say a full blood count would help to assess platelets with some PT APTT and INR to rule out bleeding troubles. If these troubles are ruled out i am sure these bruises are innocuous then, No worries 2-Bumps in the Neck: if they have not been there for long then they will resolve. are they painful? are they mobile? have you any previous throat infections or ear infections? these bumps need examination to seek the pathology. could be a lympnode swollen from nearby infection of ear nose or throat. could be a lipoma, could be a cyst, could be a lymphoma or a metastasized lymph node( but that would be a least possible long shot). A biopsy can help too if examination remained fruitless.but i am sure it wont be anything serious Loose motions with urgency and freequency: As you have been diagnosed with fibromyalgia, the gut in this conditions are prone to irritable bowel diseases. So you need to take good care of your Bowel Habits. Use soft Fibrous diet, Regular healthy bowel habits, proper sleep, no stimulants like smoking , carbonated drinks or caffeine etc, use fluids alot. avoid constipation. excercise, and aggressively treat early symptoms to avoid excacerbation and flare ups. use easily digestible foods, avoid westernised diets,plus you have an esophageal troubles too so that also adds to the trouble. get some metronidazole with fibrous diet. but precaution will be necessary.and lets hope it helps other wise a step up to immune modulators would be necessary. sulfasalazine etc. Fibromylgia and depression: these chronic pain condition are notorious for depression. take a good regular sleep, make a sleep diary for 2 weeks, Add some sleep aid medications if you have difficulty in sleeping. routine and early bed times will help to avoid flare ups and depression. you need a psychological and behavioural therapy too for relaxation training, activity pacing, guided imagery, distraction strategies, proper sleep hygiene etc. Sign up to some support groups.will help . use proper balanced diet, reduce weight, tke supplements vitamins, take good care of your bones health( as you are in menopuase too- needs care) fresh vegetables, fish, fiber, vitamins C,E selenium, zinc and phytochemicals and vitamin d will help the trouble. Migraine: I am sure fibromyalgia is the trigger. follow above guidelines and you will be free of are some triggers you should avoid to avoid headaches. Alcohol - Particularly wine and beer Caffeine overuse or caffeine withdrawal Chocolate Aspartame - eg, NutraSweet and Equal Monosodium glutamate (MSG) - May be found in Asian food, canned soup, frozen or processed foods, and the seasoning product Accent Fruits - Citrus fruits, bananas, avocados, and dried fruit Nuts - Peanuts, soy nuts, and soy sauce Tyramine, a biogenic amine that accumulates in food as it ages, may provoke migraine. Sources include the following: Dairy - Aged cheese Meat - Bacon, sausage, luncheon meat, deli meat, pepperoni, and smoked or cured meat Pickled foods Heavily yeasted breads - Eg, sourdough Vinegars - Especially wine vinegar Some types of beans Nutraceuticals shown to be effective in randomized clinical trials include the aforementioned vitamin B2, CoQ-10, magnesium, and butterbur (Petadolex) and medications wont even be needed any more. 5-Menopause consider some hormone replacement if no contraindication is there like unexplained vaginal bleeding or some malignancy to To provide relief of vasomotor symptoms To reduce the risk of unwanted pregnancy To avoid the irregularity of menstrual cycles To preserve bone To lower the risk of disease To improve quality of life. There are some non hormonal ways to help it too. paroxetine mesylate (Brisdelle) has been approved as the first nonhormonal therapy for vasomotor symptoms (VMS) (hot flashes) associated with menopause I wish you very good luck and take good care of yourself. I hope i was of some help. If you dont have any follow up questions kindly close the thread and rate my answer generously. Regards Dr Khan
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