I'm lost and starting to feel really frustrated with life due to how much my pain and fatigue are affecting my ability to be a human. I'd really appreciate some input on how to proceed with my medical care given that my doctors are just bouncing me from specialist to specialist.

Here's a list of issues I've dealt with. Diagnosed conditions are in italics, symptoms marked with a * have gotten worse.

I've had this whole slew of issues at least since I was a pre-teen:

• (painful menstruation)* and Pre Menstrual Dysphoric Disorder
• acid reflux*
• sudden episodes of throwing up, extreme abdominal pain, but no one else who ate the same food is affected
• chronic diarrhea, (abdominal pain)*, sudden urges with abdominal cramping (diagnosed as IBS despite colonoscopy showing chronic inflammation)
• very tender abdomen, it always hurts when my abdomen is palpated
• environmental allergies, anaphylaxis with nuts, asthma
• seborrheic dermatitis
• dermatographia, skin easily turns red when scratched, extremely sensitive skin (including adhesive allergy) and fragile nails
• dry eye that can last for up to 10 minutes despite crying or artificial tears
• high degree of myopia
• migraines, including hemiplegic
• narcolepsy
• chronic fatigue (can't be away from home for 3 hours)*
• vision going black, vibrations in head, sounds of vibrating when going from crouching to standing*
• achy fingers, pain when gripping
• "bone" pain that gets so bad I can't sleep (cause never identified)
• grinding knee pain
• hypermobile (at least a 5 on the Beighton scale)
• plantar fasciitis
• most pain I experience will not be resolved by taking ibuprofen or acetaminophen
• constant bodily anxiety and high heart rate

Issues that started as a young adult:

• Hidraadenitis Suppurativa
• excessive sweating
• corneal abrasion that has not healed after nearly 2 years
• retinal tears and detachment
• tuberculosis (was treated; started to become septic when it came to a head)
• became allergic to peanuts from one day to the next
• did not respond to nuts on skin prick test despite history of anaphylaxis, did show up on IgE test
• unexpected random local reactions to allergy shots despite being at maintenance
• loose teeth and receded gums despite habitual flossing and brushing with fluoride toothpaste
• multiple joints starting to feel weird/unstable, do weird things, or are painful
• vitamin D deficiency (unsure how long this has been going on)
• menstruation pain now comes with lower back pain
• often have high blood pressure when arriving at the doctor's office, but this is random and goes away in the same visit

And now issues that started this year (I'm now in my late 20s):

• vocal cord dysfunction
• damaged disk
• heart pounding and tachycardia when laying down
• suddenly developed a rash after using Testim gel for 2.5 months
• yellow booger-like discharge (swab came back with abnormal microbiota, unspecific)
• cysts on inner labia that keep popping and refilling (can be so painful I can't sleep)
• nearly daily abdominal/pelvic pain that prevents me from being able to concentrate (worst issue at this moment)

I take medication for and/or manage everything that is currently diagnosed. Note that I started HRT (testosterone) a few months ago. The only symptoms that began after starting HRT were the cysts and discharge.

In 2014 I saw a gastroenterologist for GI issues after being hospitalized for what seemed to be pancreatitis (was not identified as I was in a rural area at the time). I was tested for celiac twice, (one was slightly positive, one negative), H pylori (negative). This gastro did a colonoscopy, the report said I had a patulous GEJ, patchy increased intraepithelial lymphocytes (involving villous tips), gastric oxyntic and antral-type mucosa with patchy minimal chronic inflammation, scattered lymphocytes and plasma cells. I was diagnosed with IBS despite these results, and was advised to lower my stress.

I had TB for around a year and a half but it presented in my pleura, so doctors didn't catch it until I was hospitalized due to sepsis and a pleural effusion in 2018. I was tested for everything under the sun before they figured out it was TB. I reviewed the records today, there were few test results that could not have been explained by TB (note that I admit there was way too many test results to go through and this is what I focused on). These were:

• low CD3 (636), CD4 (381), CD16 CD56 (61)
• negative ANA but positive RNP (1.2)
• high IgG subclass 4 (116mg/dL)

The following tests have been done this year. Bloodwork (usually looks totally fine other than low vitamin D). Hormone, thyroid, metabolic, liver panels look fine. Holter test came back unremarkable other than some SVTs. Tested negative for pheochromocytoma. No STIs. Pap is fine. Tryptase is fine. ECGs are fine. Never been pregnant. I haven't repeated any autoimmune panels since the hospitalization for TB.

My gynecologist had me do an ultrasound two weeks ago. Nothing was observed, but the tech did mention to me that my bowels looked very inflamed. So my gyno didn't really offer any solutions for my worsening abdominal/pelvic pain other than pelvic floor therapy, more birth control, and an antibiotic for the cysts and discharge. I presented the same symptoms to my dermatologist after I was unable to sleep due to the cyst pain. She could not identify the cysts, and she said she suspects I have an autoimmune disease or Crohn's as these are gynecological symptoms of Crohn's. She referred me to gastro and said she'd consult with other dermatologists on the cysts.

I've made appointments to see a geneticist to assess for EDS next summer, and to be triaged by a gastroenterology clinic in November (only option available).

I'm at my wit's end with the abdominal/pelvic pain, especially because it does not respond to ibuprofen or acetaminophen. Generally I'm tired of everything! I'm tired of being tired!
I'd really appreciate any other steps I should take at this point, including tests I can ask for while I wait to see the geneticist and potentially be seen by a gastroenterologist, specialists I should also be seeing, and literally anything else. Thanks for reading.