Hello and thank you for your reply! I know it is really confusing, and. I can't blamme new drs that come into the picture. This joourney has been 15 yrs and very few answers.what started with very little pain, then pain deep in muscles moving from legs up to include srms, then pressure pain (blood presure cuff agony to simple hugs being painful and then finally the last 2. Yrs the Skin burning pain that came suddenly-first. In my arm and then across my upper back...eventually widespread.when I went to my last appt. It was my first one with this specialist....his resident had done the history, biopsy on foot and ankle done by him and he gave me the results. There wasn't much much discussion with him. He just said that biopsy results does not explain the pain in my upper body, and no matter what hospital did it. When he asked why I looked confused I told him that I didn''t understand how this pain could start in the upper body and have Made so much change to my skin on my arms etc, but end up being positive in my feet(the last place it hit). He asked if I had dry mouth which is a resounding yes(at ny Worst have actually bought a bottle of water with a visa card I was so desperate). So he told me to stop elavil and start methotrexate and in 3 months he may do a lip biopsy for sjogren's. That was about it. I. Have been on fentanyl patCHes and dilaudid for 2 years to cope. With the burrning. I had beEn taking oxycontin for the muscle pain but when it switched To the skin it didn't help one iota. I have an. Uncomfortable relationship with my family physician because when the pain type switched so drastically and accutely I was not content to just take all this pain medication. I wanted to find an answer to what had changed and what was happening to me. He was not happy about that, told me it was pain syndrome at one point and demanded I stop looking for answers.last year he said "There Is nothing meDically wrong with You!" When I approached him about seeing soomeone for small fiber neuropathy skin biopsy. I appreciate your advice about getting another. Dr. However That is pretty impossible. In canada, and especially in my position with my family physician (we have severe shortage). Perhaps the sspecialist has read famiily dr.'S opinion of it being in my head and pre-judged my case..I don't know. But I do know that having a third site done would 99 per cent prove it''s not in my head(rather in my skin lol). It Was my request to have it done in the first place that found SFN in my feet after all. No doctor that has seen me recomended it . Another med site's neuro suggested it after I gve him a brief description of events.so I guess I just hang on til my 3 moonth. Appointment to see what happens next. I'm just tired of "seeing What happens" when I truly believe doing the third site biopsy wouuld give uus answers. I've been patient for 15 years!!! Thank you againn and if youu have any suggestions,please advise!

Well, you really seem to be between a rock and a hard place. You really need another doctor to look at this objectively...and I agree an addition site of the skin biopsy would prove helpful.

Frankly, starting the methotrexate is backwards to protocol. They should test FIRST for the Sjogren's, not AFTER taking it. Methotrexate can possible alter the result of the lip biopsy...as it's an immune suppressant. So your results may come back negative when you really may have Sjogren's and the methotrexate is masking it.

Sorry to hear your options for medical care are so limited. Have you tried some of the supplements listed on the stickies to see if you get any relief?? If not, that would be the place to start.