Hypovolemic or Neurological or Immunological or all?

I am a 38-year-old female who is in apparent good health and have exercised regularly for at least ten years now.  However, within the past week I've had the problem of my heart racing just before I fall asleep and when I awake.  I've clocked it at 30 beats within 15 seconds.  I have never had heart problems before.  I'm wondering if I'm having seizures or cardiac arrest or what?  I function okay during the day, but I'm worried how long this rapid beating occurs while I'm asleep and why.  The first time this happened was months ago after I drank a cooler.  This is the first problem where a vital was affected. The second part of my question addresses the symptoms that occured prior to this problem.  You can treat the two as one or separately -- however you deem best.  I have gone to doctors with observations of red, swollen fingertips.  I generally have elegant, slender fingers.  Red hands and soles like Kawasaki disease, but no peeling.  Ears red when wiped (relapsing polychondritis)?  Red imprints on skin when pressed.  Burning sensation. Continuous flatulence and belching which was embarassingly loud.  Something else new.  Joints cracking.  Occasional cracking sound in head. Burning sensation on rectum and staining.  Caused by acid? Never had problems with gas although years ago diagnosed with IBS, of late it had not been a problem.  Period early by three days about a year ago.  Both urine and blood had odor. Stopped using tampons. Happened again last period about the time of the racing heart.  I was initially told its because I am 38. Muscles twitching: eyelid, later lower lip, then bridge of nose.  Is it normal while standing in front of a mirror to see pulsating in the neck?  Also, I'm NOT urinating 3000ml per day.  And does urobilinogen moving from 0.2 to 1.0 signify anything?  Known conditions sickle cell trait, Gilbert's disease, general populace viruses.  My eyes used to become red when I drank or cried, now they are clear? I received vaccinations for hep B and C a few months before these symptoms.  Physicians tend to look right past this as though of no significance. Doctors have done CBCs,urinalysis, C-Reactive protein which fall generally within range, except the urobilinogen which has moved and the WBC slightly under. I internalize stress to the point where I don't have a problem with high blood pressure, but I do grind my teeth in my sleep.  Awareness of all these symptoms certainly does not help.  Maybe my system is just super sensitive?  I have had a doctor become totally frustrated with me over this and I didn't even tell him ALL the symptoms because of embarrassment. Thank goodness for the internet. He put me on Doxycycline and Biaxin and Prevacid. It pretty much relieved me of the skin burning sensation, odors and dental plaque.  But, still had the gas. Any accurate insight will be appreciated.  Please don't tell me this is all psychological.  That's what people used to say about menstrual pain.

[Kevin Pho, MD]

Hello - thanks for asking your question.

You describe a wide spectrum of symptoms.  Please understand that without examining you or your studies, it is impossible to say what is going on.  

Regarding your palpitations - you note a HR at times of 120.  This should be evaluated - at minimum with an EKG and thyroid panel.  If those tests are negative, one test that should be considered would be an event or Holter monitor.  This is a device that can record your heart rhythm whenever you have these episodes of palpitations.  

You also note symptoms of bloating and gas.  IBS is a possibility you have mentioned - it is certainly possible since IBS causes an increased sensitivity within the colon.  However, endoscopy should be considered (both upper and lower) since a variety of other conditions (i.e. dyspepsia, inflammatory bowel disease etc.) can also cause an increase in gas.  Malabsorption syndromes can also increase gas - this can be tested via fecal fat tests and blood tests (i.e. antibodies for celiac disease).

As for your joint discomfort and rashes - I would pursue an ANA, sed rate and rheumatoid factor as a screen for rheumatological conditions that can manifest (i.e lupus, rheumatoid arthritis etc.).

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.

Thanks,
Kevin, M.D.