Sarah,

Since you mentioned lower back, maybe it's ankylosing spondylitis which is also outlined on the Sondylitis Association's (SA) website. That version typically appears at first in the low back. That said, I have always had back pain, but I generally attributed it to scoliosis. Many of the diseases in the spondylitis family bleed together, so-to-speak, involving similar symptoms. Given enough time an individual will display enough symptoms to fall into a specific diagnosis, yey.

One thing the two of you might consider is starting a journal describing how she's feeling. I'm not talking about spouting poetry here, but more of a record of what's going on in her body and how she's treating it. I try to do that, in a more limited sense, but maybe write down energy levels, what physical activities she participated in and for how long, what she eats, any stressful events of note. This may help pinpoint any triggers for her episodes.

Some things that might help, vitamins. I know it sounds hokey, but they may be able to help especially with the fatigue. According to the SA, "Varying levels of fatigue may also result from the inflammation caused by AS. The body must expend energy to deal with the inflammation, thus causing fatigue. Also, mild to moderate anemia, which may also result from the inflammation, can contribute to an overall feeling of tiredness." So maybe a multivitamin? Either that or maybe she can become addicted to broccoli I take a B-complex vitamin and a B-12 specific vitamin which helps a bit. Stress is huge though, so see about ways to alleviate/cope with that - definitely something to talk with the psychologist about.

One last thing I want to mention, it's wonderful that you're being proactive with all of this. While there are great doctors out there, there's nothing quite like doing your own research. If she ever gets a final diagnosis and medication, I strongly recommend doing research on both. I also have rosacea and had a BAD reaction to the antibiotic I was given for it involving drug-induced lupus, liver damage and depersonalization episodes. Granted I was one out of twenty thousand patients who ended up with that reaction, but if I had left it up to the Rheumy I saw for the inflammation issues I thought were due to my own reactive arthritis (but turned out were due to drug-induced lupus) I would've ended up on a liver transplant waiting list.

I wish you both the best of luck. I know what she is going through, and it's not easy. I too know what you are going through with depression, and that is a heavy enough burden on its own, so my heart goes out to you.

Take care