In addition to increased nasal congestion and drainage, she also began having generalized fatigue, malaise, and migratory arthralgias involving bilateral wrists, shoulders, elbows, knees, ankles, and finger joints. 
In addition to increased nasal congestion and drainage , she also began having generalized fatigue , malaise , and migratory arthralgias involving bilateral wrists , shoulders , elbows , knees , ankles , and finger joints .