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Family Medicine (Expert Forum)
Anxiety??????
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Anxiety??????
by money1, Nov 27, 2001 12:00AM
It started one day with back/neck aches and stiffness and a "fuzzy" head. Not a true dizziness, but a feeling of fullness in the head/mild lightheadedness. Then came the stomach upset, gas, loose stools, acid reflux and by the end of the first week I was crying on a regular basis, severe insomnia, a constricting throat and the urge to throw up. All of the symptoms would wax and wane over days but the "fuzziness" was constant. March was a terrible month.
I had all of the tests, blood work, sinus x-ray, upper GI, CT Scan of the head, urine work and everything came back normal except for slightly elevated cholesterol and a 9mm cyst in my left temporal lobe.
In April my Doctor gave me 15 mg Paxil and 0.5 mg Klonopin per day. The Klonopin eased some of the symptoms. Once the Paxil kicked in it cleared up most of the symptoms except the fuzziness, although it did get better and I started having days without fuzziness, but not everyday.
A mild tinnitus in both ears (high pitched whistle) started over the summer with a feeling of ear fullness and popping sounds when loader noises occured. The popping only happens when noise happens but the whistle is ALL OF THE TIME. Its quite mild though.
My questions:
I seem to have anxiety symptoms but I have NO WORRY, very little stress; I am very laid back. Don't the two go hand in hand? If I don't worry about anything consciously is it possible to have anxiety problems? What about the cyst, my doctor says they are not uncommon and won't cause the symptoms, is this true? Should I mention the tinnitus to him or is this another symptom of anxiety or a side effect of the Paxil.
I no longer need the Klonopin (haven't taken in a month)and take Valerian Root to sleep once or twice a week.
Thanks.
I had all of the tests, blood work, sinus x-ray, upper GI, CT Scan of the head, urine work and everything came back normal except for slightly elevated cholesterol and a 9mm cyst in my left temporal lobe.
In April my Doctor gave me 15 mg Paxil and 0.5 mg Klonopin per day. The Klonopin eased some of the symptoms. Once the Paxil kicked in it cleared up most of the symptoms except the fuzziness, although it did get better and I started having days without fuzziness, but not everyday.
A mild tinnitus in both ears (high pitched whistle) started over the summer with a feeling of ear fullness and popping sounds when loader noises occured. The popping only happens when noise happens but the whistle is ALL OF THE TIME. Its quite mild though.
My questions:
I seem to have anxiety symptoms but I have NO WORRY, very little stress; I am very laid back. Don't the two go hand in hand? If I don't worry about anything consciously is it possible to have anxiety problems? What about the cyst, my doctor says they are not uncommon and won't cause the symptoms, is this true? Should I mention the tinnitus to him or is this another symptom of anxiety or a side effect of the Paxil.
I no longer need the Klonopin (haven't taken in a month)and take Valerian Root to sleep once or twice a week.
Thanks.
Doctor's Answer
by Forum-M.D.-DT, Nov 28, 2001 12:00AM
Thank you for visiting the Family Practice Forum,
Lets review your symptoms
1. Neck Aches and Neck Stiffness
2. Light-Headed
3. Stomach upset
4. Gas and loose stools
5. Insomnia
6. Nausea
7. Normal blood tests/upper GI/ Sinus Xray
8. 9mm csyt in the temporal lobe.
To begin, Symptoms 1, 2, 3, 4, 5, 6 ... and be present in patients with anxeity and/or depression. Interstingly, many of these symptoms improved when you started taking Paxil. Paxil is used for both anxiety and depression. Maybe your main problem was, in fact, more related to "depression" than "anxiety". In my experience "tinnitus" is not a common side effect of Paxil but the Physicians Desk Reference does state it is a "possible" side effect of this medication.
Secondly, I also want to mention a condition known as "Meniere's disease". Meniere's (pronounced "men-ears") Disease is a problem involving the inner ear. It is caused by fluid in the canals of the inner ear. Although it can be a troublesome condition, Meniere's is not a serious condition and is not contagious. People with Meniere's don't usually have symptoms all the time. When symptoms occur it is called and "attack." It usually affects only one ear but can affect both ears in about 30% of patients. The symptoms present during an attack include dizziness, a feeling of fullness or loss of hearing in the ear, and tinnitus (ringing in the ears).
The doctor examining the patient with possible Meniere's Disease will closely examine the ears and check for problems with balance. He/she may check a hearing test and will possibly order a CT or MRI of the head to rule out other more serious causes for these symptoms.
Treatments for this condition include limiting dietary salt (less salt will likely help reduce the potential for fluid to build up in the canals of the inner ear), also a medicine called a diuretic (water pill) may be prescribed as the best treatment for this condition remains medication which helps reduce the potential for fluid to collect in the inner ear. During episodes of dizziness, a medication called "Antivert" may be prescribed. Additionally, for the nausea which commonly accompanies the "attacks", medicine may be helpful.
This brings me to the third consideration here, that is, the 9mm cyst in the temporal area of the brain as noted on the CT. If you continued to have the symptoms of "fuzziness" and "tinnitus" and it was determined that this was NOT due to Meniere's disease, a Neurology consultation would be in order. The Neurologist, in addition to doing a detailed neurologic exam would likely order an MRI as well as an EEG (brain wave test) to help determine if this "cyst" is in some way contiributing to your symptoms.
I hope this helps you sort through and get this problem solved.
Take care,
Dean M. Tomasello, M.D.
Lets review your symptoms
1. Neck Aches and Neck Stiffness
2. Light-Headed
3. Stomach upset
4. Gas and loose stools
5. Insomnia
6. Nausea
7. Normal blood tests/upper GI/ Sinus Xray
8. 9mm csyt in the temporal lobe.
To begin, Symptoms 1, 2, 3, 4, 5, 6 ... and be present in patients with anxeity and/or depression. Interstingly, many of these symptoms improved when you started taking Paxil. Paxil is used for both anxiety and depression. Maybe your main problem was, in fact, more related to "depression" than "anxiety". In my experience "tinnitus" is not a common side effect of Paxil but the Physicians Desk Reference does state it is a "possible" side effect of this medication.
Secondly, I also want to mention a condition known as "Meniere's disease". Meniere's (pronounced "men-ears") Disease is a problem involving the inner ear. It is caused by fluid in the canals of the inner ear. Although it can be a troublesome condition, Meniere's is not a serious condition and is not contagious. People with Meniere's don't usually have symptoms all the time. When symptoms occur it is called and "attack." It usually affects only one ear but can affect both ears in about 30% of patients. The symptoms present during an attack include dizziness, a feeling of fullness or loss of hearing in the ear, and tinnitus (ringing in the ears).
The doctor examining the patient with possible Meniere's Disease will closely examine the ears and check for problems with balance. He/she may check a hearing test and will possibly order a CT or MRI of the head to rule out other more serious causes for these symptoms.
Treatments for this condition include limiting dietary salt (less salt will likely help reduce the potential for fluid to build up in the canals of the inner ear), also a medicine called a diuretic (water pill) may be prescribed as the best treatment for this condition remains medication which helps reduce the potential for fluid to collect in the inner ear. During episodes of dizziness, a medication called "Antivert" may be prescribed. Additionally, for the nausea which commonly accompanies the "attacks", medicine may be helpful.
This brings me to the third consideration here, that is, the 9mm cyst in the temporal area of the brain as noted on the CT. If you continued to have the symptoms of "fuzziness" and "tinnitus" and it was determined that this was NOT due to Meniere's disease, a Neurology consultation would be in order. The Neurologist, in addition to doing a detailed neurologic exam would likely order an MRI as well as an EEG (brain wave test) to help determine if this "cyst" is in some way contiributing to your symptoms.
I hope this helps you sort through and get this problem solved.
Take care,
Dean M. Tomasello, M.D.
He is beign given Klonopin, nad Dentrium, for hte relaxation of his muscle spasticity.
However he seems to be always sleeping, and has the following side efeects of Klonopin, nystagmus, coughing, facial edema, constipation, coated tongue, urniary retention.
Is there another alternativve to Klonopin?
WIll Valium be suitable?
He has also developed gynacomastea, and hisblood sugar level keeps jumping up and down!
WHat could be the cause of that?