Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Sudden unilateral ptosis + sudden frozen back (needed wheelchair briefly)If you fancy yourself a diagnostician, have I got a case for you. 39 yo female; US; 5'3" 179lbs; Grave's, Hashimoto's, Celiac (Celiac just diagnosed in fall, others well managed with meds for ~6 years).9 days ago - sudden moderate unilateral ptosisMonday was sitting at my desk (no exertion, no recent falls/trauma etc) and back locked in place, confined to wheelchair upon arrival at hospital. Went to ER and got an acid reducer injection which did enable ambulation again, albeit with altered, ginger gait2 steroid injections Tuesday helped a little bit, still walking very gingerly. Can't bend down. Hurts to sit for long, can't get comfortable, prefer fetal position on my side laying down or in recliner - agony yesterday to lie flat for MRI and x-raysRecent appointments:Emergency eye doctor appointment 8 days ago, nothing identified --> refer to opthalmologist, apt. in 1 monthUrgent care Sunday - no tests performed, referred back to primaryMonday primary referred me to ER where x-rays performed (after identifying it as a muscular issue)Orthopedic doctor Tuesday - ordered lower back MRI. Came back showing moderate disc bulge but nothing that should be causing my 10/10 pain level, nothing surgery worthyRheumatology Wednesday (yesterday). Ordered blood work (partial results below) referral to neurologistBlood work results:High Rheumatoid factor (15.6 - ref rate up to 14)High alkaline phosphatase (134 - normal up to 121) (this has been chronically high over last 9 months, up in the 150s)High Neutrophils to Lymphocytes Ratio (NLR) - (3.89 - normal should be under 2 or 3 I'm reading a few different things here so any insight is helpful)I had a 23 and Me done recently so I have a ton of information there (positive for DQ and homozygous for HLA-DQB1:02, etc)Persistent symptoms since ~July 2022 -Extreme fatigue and malaiseExtreme brain fogWinded easily (i.e. climbing stairs)Have not taken stairs in 2023 because of weakness and how out of breath it makes meExtreme difficulty getting up from seated positionNeck/shoulder/back weakness and pain (diagnosed spinal osteoarthritis and degenerative discs in January 2023 but pain and weakness in neck and shoulders too)Vitamin D deficiencyAnemia (was barely not anemic in the blood work yesterday but was anemic in 3 other blood workups in this period)"Polyarthritis" diagnosis in February (additional subsequent Rheumatoid Arthritis diagnosis by Orthopedic doctor but Rheumatologist this week said no)Some headaches, blurry vision, confusion (not necessarily trouble speaking but trouble remembering words occasionally. I typically can't remember the $.50 word so I use the $2 one instead - using bigger vocabulary words more often - I used to be able to "mask" this better)Some dysautonomia in that I've had some Raynaud's attacks (been happening ~15 years) just sitting in my living room and sometimes if I get hot I can't regulate my body temp very easily. I will get randomly sweaty (especially on my upper lip it seems?)My most educated guesses: Either myasthenia gravis or Lambert-Eaton, considering the eyelid drooping, muscle weakness especially in trunk and legs, weird sweating, etc. Plus I seem to have every gene on the planet that predisposes you to these conditions.My biggest concern is that those two conditions pop up when your body is trying to fight off an as yet undiagnosed cancer (often SCLC and lymphomas). I am a never smoker but my husband smokes. Originally smoked cigarettes indoors for ~5 years and now has vaped indoors for ~5 years. I also have the double dose of DQB1:02 giving me Celiac. But it also predisposes me to Enteropathy Associated T-cell Lymphoma. I have an eating disorder (ARFID) that is getting in the way of proper management of my Celiac.Please ask me any follow up questions you may have and give me your best guesses. Doctor after doctor is sending me down the line to someone else and I'm afraid of running out of time. I have a 4 year old I would like to spend a little more time with. Thank you so much for even reading this far. I look forward to any replies.. ### Response: I dont think you are dying!!The back complaint sounds like a classic musculoskeletal injury. Unfortunately as we get older this is more likely, it can be incredibly painful and can linger. None of these other entities happen quickly like this and you had an MRI.Myasthenia and lambert eaton are not typically painful conditions. I wouldnt diagnose one of these from ptosis, which is more often a local issue with the facial nerve. So i wouldnt go on and say you have cancer, though Dr. Google tends to give this diagnosis with any search.I highly doubt all of these things are tied together by one underlying diagnosis. You are very in tune with your body and human nature is to try to assign a unifying cause..