Where to go with weakness?

Greg is a handsome man in his early 30's who looks worried. The note on the chart says he is in for recheck of urinary tract infection/fever. But as often is the case, the supposed reason for visiting falls far from the mark of what is on Greg's mind this morning. It starts fairly simply-- he had a urinary tract infection a couple of weeks ago, was treated with an antibiotic, but now has some mild diarrhea and fever again. As I go over the history, the first thing that is puzzling is that he had a urinary tract infection. Men are not supposed to have them. It could indicate an underlying condition of some type. Greg hesitates, and then says, he has actually been having changes in his urination since last summer, when he started having to get up at night numerous times to urinate, and since then his urination has never completely normalized. Asked about his fever, he states that he actually feels weak. Weakness is often interpreted differently by different persons, so I ask him about the weakness in different ways, finally concluding that he has had generalized weakness of his muscles, that worsened with the onset of his infection two weeks ago, and now is worsening again. Weakness is a worrisome symptom if true in a strict sense, and not just merely fatigue or feverishness. Prompted by this detail, I ask him more about his recent history. He's actually had an episode of double vision last November that lasted for a couple of months and required the use of special lenses. Together these symptoms raise a troubing possibility: that he has been struck by atleast 2 epsiodes of loss at different times and locations in his nervous system. One in the part of his brain controlling the coordination of his eye muscles, the other in his spinal cord, controlling the function of his bladder and leading to the current urinary tract infection. Multiple sclerosis causes this sort of pattern, and Greg's cousin has been diagnosed with MS as well. Greg seems relieved that someone is starting to put together his variety of symptoms, and was actually very worried about what was happening to him. He will have an MRI of his brain next week. It is never easy to broach the possibility of a disabling, chronic illness, but never as bad as the fear and loneliness of falling through the cracks and knowing that something is terribly wrong.