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Family Medicine (Expert Forum)
Strange symptoms, and scared beyond belief! What could this be?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
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Strange symptoms, and scared beyond belief! What could this be?
by mjk216, Mar 12, 2006 12:00AM
Over the past 3 months, I have been having some strange and frightening symptoms. It seems as if I have had every test in the book, and seen every doctor in the book, and no-one has been able to effectively diagnose me. The symptoms are as follows (in order of occurrence):
* Lump-in-the-throat feeling (globus sensation), but there is nothing obstructing my throat. Started with a bad cold last Fall; the cold went away, but the throat problems have stayed. Medication for GERD ineffective; upper GI endoscopy normal.
* Loss-of-balance, often accompanied by disorientation and dizziness. Not a feeling like the room is spinning, but rather, feeling of unsteadiness or inability to place myself correctly in space. Neuro-otologist says it's some sort of vestibular disorder involving my left ear, according to results of balance testing. Prescribed vestibular rehab therapy (not started yet).
* Extreme "brain-fog," i.e., memory loss, "reaching" for words I should easily know, inability to concentrate or perform sophisticated cognitive tasks, stuttering or hesitant speech (when disoriented, see above). Brain fog always accompanied by feeling of pressure and heaviness in the head; often concentrated at my forehead (esp. behind the eyes), may involve entire head. Sometimes, mild/moderate headaches along with the feeling of pressure; most often in the forehead area above my left eye, but also toward the back of my head/base of my skull. Eyes also feel tired and bulgy (although don't look that way in the mirror), esp. at night, as if there is pressure behind them. MRI of the brain (with and without contrast) normal; no sign of tumors, demyelinating disease or sinusitis.
* Chest pressure sensation along my breastbone, but will spread at times to my upper pectorals and under my left arm. Feels as if someone is sitting on my breastbone. Sometimes there is mild pain, but not often. No shortness of breath; just feels like it's hard to breathe sometimes because I am working against a weight on my chest. EKG and stethoscope exam of breathing/lungs are normal.
I've had the above tests, plus a blood tests for anemia, diabetes, high cholesterol, pituitary/thyroid function, inflammation and autoimmune diseases, PPD test for tuberculosis, chest X-ray, and others. Except vestibular problem w/ left ear, nothing else has been diagnosed. GP says possible hyperventilation syndrome, but didn't seem too sure about that, and could offer no suggestions in the way of treatment.
Even if loss-of-balance could be caused by a vestibular disorder, so-far, no-one has been able to account for the globus sensation, brain-fog, or chest pressure. Some doctors seem to want to write this off as anxiety related, but I am absolutely NOT anxious about anything, except their inability to figure out what's wrong with me, and the piecemeal approach to my medical care so far. I'm scared + frustrated.
Any suggestions? Should I get a 2nd opinion or another GP? Thanks so much.
* Lump-in-the-throat feeling (globus sensation), but there is nothing obstructing my throat. Started with a bad cold last Fall; the cold went away, but the throat problems have stayed. Medication for GERD ineffective; upper GI endoscopy normal.
* Loss-of-balance, often accompanied by disorientation and dizziness. Not a feeling like the room is spinning, but rather, feeling of unsteadiness or inability to place myself correctly in space. Neuro-otologist says it's some sort of vestibular disorder involving my left ear, according to results of balance testing. Prescribed vestibular rehab therapy (not started yet).
* Extreme "brain-fog," i.e., memory loss, "reaching" for words I should easily know, inability to concentrate or perform sophisticated cognitive tasks, stuttering or hesitant speech (when disoriented, see above). Brain fog always accompanied by feeling of pressure and heaviness in the head; often concentrated at my forehead (esp. behind the eyes), may involve entire head. Sometimes, mild/moderate headaches along with the feeling of pressure; most often in the forehead area above my left eye, but also toward the back of my head/base of my skull. Eyes also feel tired and bulgy (although don't look that way in the mirror), esp. at night, as if there is pressure behind them. MRI of the brain (with and without contrast) normal; no sign of tumors, demyelinating disease or sinusitis.
* Chest pressure sensation along my breastbone, but will spread at times to my upper pectorals and under my left arm. Feels as if someone is sitting on my breastbone. Sometimes there is mild pain, but not often. No shortness of breath; just feels like it's hard to breathe sometimes because I am working against a weight on my chest. EKG and stethoscope exam of breathing/lungs are normal.
I've had the above tests, plus a blood tests for anemia, diabetes, high cholesterol, pituitary/thyroid function, inflammation and autoimmune diseases, PPD test for tuberculosis, chest X-ray, and others. Except vestibular problem w/ left ear, nothing else has been diagnosed. GP says possible hyperventilation syndrome, but didn't seem too sure about that, and could offer no suggestions in the way of treatment.
Even if loss-of-balance could be caused by a vestibular disorder, so-far, no-one has been able to account for the globus sensation, brain-fog, or chest pressure. Some doctors seem to want to write this off as anxiety related, but I am absolutely NOT anxious about anything, except their inability to figure out what's wrong with me, and the piecemeal approach to my medical care so far. I'm scared + frustrated.
Any suggestions? Should I get a 2nd opinion or another GP? Thanks so much.
Doctor's Answer
by Kevin Pho, MD, Mar 13, 2006 12:00AM
, Mar 13, 2006 12:00AM
There has been a pretty comprehensive evaluation done. Anxiety certainly is possible, but should be considered if all the other conditions have been ruled out.
Regarding the globus sensation, GERD is indeed the most common cause. Other possibilities can include post-nasal drip or sinusitis. A sinus CT scan can be considered to evaluate this. I would also consider an ENT evaluation for this - for possible laryngoscopy.
Regarding the loss of balance, you can consider further neurological workup. This can include metabolic diseases like B-12 deficiency, thyroid disorders or diabetes. The MRI would rule out many of the major neurologic disorders.
I would evaluate the cardiac causes of chest pain before attributing it to anxiety. A stress test with echocardiogram can be considered to evaluate this.
These options can be discussed with your personal physician, or another physician opinion.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
Regarding the globus sensation, GERD is indeed the most common cause. Other possibilities can include post-nasal drip or sinusitis. A sinus CT scan can be considered to evaluate this. I would also consider an ENT evaluation for this - for possible laryngoscopy.
Regarding the loss of balance, you can consider further neurological workup. This can include metabolic diseases like B-12 deficiency, thyroid disorders or diabetes. The MRI would rule out many of the major neurologic disorders.
I would evaluate the cardiac causes of chest pain before attributing it to anxiety. A stress test with echocardiogram can be considered to evaluate this.
These options can be discussed with your personal physician, or another physician opinion.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
Low potassium can set off a large chain of ailments,
from muscles to psychology.
im not a doctor :)
im ***@****
Low Potassium Symptoms
Usually the symptoms of low potassium are mild. At times they can be vague. Sometimes you may have more than one symptom involving the gastrointestinal (GI) tract, kidneys, muscles, heart, and nerves.
Weakness, tiredness, or cramping in arm or leg muscles, sometimes severe enough to cause inability to move arms or legs due to weakness (much like a paralysis)
Tingling or numbness
Nausea or vomiting
Abdominal cramping, bloating
Constipation
Palpitations (feeling your heart beat irregularly)
Passing large amounts of urine or feeling very thirsty most of the time
Fainting due to low blood pressure
Abnormal psychological behavior (depression, psychosis, delirium), confusion, or seeing or hearing things (hallucinations)
I’m 21, I have a regular life style, active and social able, nothing extreme....but about 7months ago my ex ‘JAY’ told me he had cancer. I am leading up to hopefully a helpful story, sorry it's long winded. I had left him in July 05 and was so happy! There was nothing I didn't want to do, but he was not as happy and was going through the scariest thing ever, I have always had a phobia of illness/death plus although I left him, I still loved him with all my heart, so I went back to him in sept 05 very scared that he wasn't going to pull through, but to my amazement he was still well and working and going out, he hadn't changed his life style at all!! I was battling my fears trying to bring up the cancer