Thank you for you question. Your situation sounds like a very complicated one, as you have obviously been involved with multiple physicians and have attempted many different types of therapies with no real improvement in your symptoms. In this sort of situation, there is often some value in referral to a tertiary care institution, where you may be able to find an explanation for your problem. Tertiary care centers are hospitals that are recognized for treating extremely difficult problems, and have names that are recognized for such across the country. Some of the more common examples would be Johns Hopkins, The Cleveland Clinic, and other similar hospitals. Most regions of the country will have access to this sort of resource, where the most difficult cases present and are able to be treated. While there are many additional questions that I would like to ask, I would anticipate that you may need additional testing before you can have the answer that you are after. Your primary care doctor
, or the doctor that has been managing your complaints, should be able to discuss the next step with you. He or she may also advise if you should see additional specialists. Please speak with your doctor.