Determined to kick this new habit, she began seeing a psychiatrist who recommended a “safe and natural remedy” for her to use as a sleep aid. It sure seemed to work. Each night, after taking one of these tan-colored pills, she would doze off quickly and awaken in the morning feeling refreshed. Best of all, this pill was just a supplement—totally safe and no prescription required.
Rheumatologists must ensure they ask about dietary supplements, not just medications, because patients often won’t think to volunteer that information.
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Ellen felt fine and her life returned to normal. Then, out of the blue, she began a slow descent into misery. First, she noticed an odd, eerie feeling; she felt stiff—very stiff actually, as though her entire body was becoming encased in concrete. She visited her primary care doctor, who was baffled. A rheumatologist raised the possibility of systemic sclerosis, but the absence of Raynaud’s phenomenon made this diagnosis suspect. Then came the pain. Ellen was plagued by debilitating myalgia and an unrelenting stabbing sensation in her extremities that a neurologist surmised was due to a rapidly developing polyneuropathy. The million-dollar workup she underwent yielded few helpful clues, except for an unexplained peripheral eosinophilia (see “Eosinophilia: A Practical Guide for the Rheumatologist,” p. 1). In fact, she seemed to be harboring eosinophils everywhere: her blood, her bone marrow and scattered throughout her cement-like soft tissues.
