I don't know what to do next - I'm tired

@lewin I live in rural PA and the closest big city to me is Pittsburgh. Even then, it's an hour away.

Some doctors are asses; only a few really care! You ARE NOT WRONG for feeling unheard and dismissed! It is amazing that you have lost so much weight! You should be celebrated for that incredible accomplishment!
(not important, BUT it makes it relative...to explain my opinion)
I've been dealing with severe abdominal pain AND lower back pain (sitting/laying) for YEARS; no doctor could diagnose thus help me. I kept on...
Years later, during a CT scan for my stomach; they noted my lower spine has crushed vertebrae; hence the lower back pain that a doctor didn't notice from their prior x ray nor the xray reader see it. My stomach issues took years and a dedicated gastrointestinal to diagnose, thus cure. I have been abdominal-pain free to almost one year now!
Prove that A-HOLE wrong! I'm sorry for you, but let that be the STRENGTH to motivate you!
I got great pleasure telling the "previous doctors" what the professional doctors found!

@ktp keep going to Drs. Use Chat GPT to help. I have been to 5 Rheumatologists, 5 dermatologists, oral medicine specialist, oral surgeon, 4 dentists etc in the last 3 years. Finally found a dr who did a biopsy of my tongue to tell me I had OLP and not crazy. Keep trying to get answers. The only person who cares about you is you. I had a neuro dr just tell me this 6 weeks ago and it has stuck!!!

I feel for you! I had a journey where doctors kept prescribing the same med over and over! And no results that helped. I switched to a functional medicine doctor and finally found relief. I was tested for so many causes based on my symptoms. That’s where most doctors go wrong - they treat the symptoms and NOT the CAUSE! You can find one by city and state at this website: ifm.org if you’re interested.
Best to you.

Please don’t give up! Perhaps a functional medicine MD Doctor, would be of help to you! Your situation reminds me of how frustrated I was, when my heart kept beating at 170 to 225 beats per minute for hours ( like 10 ), before it went back into normal rhythm. I got in to see my primary care Doc. right away! He thought that symptom, which was recorded and documented, on my smart watch, warranted further investigation. So, he referred me to a cardiologist. The cardiologist took an EKG, and ultrasound of my heart, and said everything looked perfectly normal, so he could do nothing to help me. i was so flustered. I felt like crying and when I had another episode like that, it was, also, upsetting, but, I thought, what’s the use, even calling the Doctor! I had been made to feel like I was a ‘turkey’ by that Doc, so I let that episode go, and did not report it! That was several years ago! I would have occasional episodes, again, that didn’t last so long. I did report them to my primary Doc.
He seemed uninterested too! So just this last year, I had one of those fast heart episodes, and, at 223 beats per minute, according to my smartwatch, after about 10 minutes, into the episode, I had this horrible feeling in my chest, where I actually felt like my heart moved, a flip flop sensation! Then, what scared the wits out of me, is that I couldn’t feel my heartbeat, and I started feeling light-headed. At the same time, my smartwatch flashed a red light, and a notice came up on the face screen! YOUR HEART BEAT IS IN ATRIAL FIBRILLATION! CALL YOUR DR. RIGHT AWAY, AND PRESS STEM OF WATCH, HOLD FOR 10 SECONDS, AND 911 WILL BE CALLED TO YOUR ADDRESS! So, I woke my wife up, and heard the ambulance sirens approaching! EMT Ambulance service is only 2 miles from my home. Anyway, my smartwatch recorded that ECG, and I sent it to the Cardiologist’s office the next day. Meanwhile, my heart had gone back into sinus rhythm. So, I was sent to a heart rhythm Doctor, an Electrophysiologist Cardiologist, who had a monitor put on me for several weeks, where several other A-Fib. episodes were recorded, and I was officially diagnosed with A-Fib. So, the lesson that I learned, was stop crying and feeling hopeless, because my body was trying to tell me something, and eventually, something happened, symptom wise, where the Doctor’s could see that something definitely was wrong, and that I needed help! Please try and be patient, and keep trying to find an answer for your symptoms, and concerns! I can tell you of several other instances, in my lifetime, where I’ve run into uncaring, or unconcerned, or overworked medical providers! Due to my perseverance, I have met Doctor’s that cared enough to truly investigate my symptoms, and, actually, those Doctor’s, who cared, about me, and thoroughly investigated my symptoms, all came up with my, unfortunately, having very serious disorders! Over the years, I have been diagnosed with Parkinson’s Disease, Gammaglobulin anemia, Supra ventricular Tachycardia, Ataxia, Tonic/Clonic Seizures, Pancreatitis, Fatty liver disease etc. So, please do not give up! Sometimes, caring, investigative, low patient load Medical Professionals are hard to find, especially in larger populated areas, where there is only one hospital, and the Doctor’s patient load is determined by non medically trained administrators, as I have found out, concerning my experiences! Good luck to you!