after 13 years of fatigue complaints that have been associated with the 4 cancers I had from 2007-2011, I have been prescribed methotrexate to go with hydrochloroquine. It is the 4th week today. I think I feel better on day 2 and 3 after the dose. By the next dose, I'm back in bed. I get up for an hour or 3, get stuff done or spend an hour doing makeup etc because the last thing to go will certainly be whether or not how I look to myself in the mirror says I'm sick. I've read about paraneoplastic syndrome and that seems to look like what might be happening here. This is for data. I get empathy from an amazing family and friends. Have you learned of this paraneoplastic syndrome (peripheral neuropathy) and MCTD or lupus. What outcome regarding ocular melanoma and autoimmune disorders? I was a "zebra" with OM 3 times, but this PNS is also a zebra. It's frustrating for those unlikely diagnoses to be left out, even if these are unlikely. For me, idiopathic leaves me to myself to think it's just something that can't be helped and to go away and quit giving providers difficult things to do. Is this common in autoimmune diseases or is it indigenous to a few who also have mental illness?