Stones, hypertension, ovarian cyst.

Over the past 5 months I have had chronic fatigue, nauseous and pain in back that comes and goes.  All of June had diarhea (diarrhea).  Late June hospitalized with kidney stones.  August hospital same symptoms, dehydration, low potassium, flank pain, infection, fatigue, nauseous, blood in urine.  No stones. Ultra sound showed mass right ovary. Left ovary small cyst. Not removed.  Right ovary and mass removed in Sept. Mass diagnosed as hemoratic cyst? Size of tennis ball.  August, Sept Oct. protein in urine and kidney infection then bladder infection.  Hospitalized week after surgery, late Sept (ovary removed) with tachycardia.  Cardiac EKG, Echo, Angio showed 30% blockage and small leakage, slight murmur.  Essentially normal?  Stomach seems big and bladder infection now again in November. Referred to endocrinologist because of high hormones levels and protein in urine.  Continued uncontrolled hypertension.  Range 170/110 to 140/90.  Heart rate 100-130.  Medication Cartia 180, Teveten 600 and Amitriptaline for chronic headaches (had since 18 years old, now 43) Prior to June was also taking topomax (topamax) took off thought caused stones.  Suggested stop Amitriptaline contributing to rapid heart beat.  Headaches all life almost daily, amitriptaline has eliminated.  Now only 1-2 a month.  Have not stopped taking amitriptalyne.  Neurologist suggested taking beta blocker with to slow down heart rate.  Waiting for endocrinologist recommendation.  I have had hypertension since pre-eclamptic with two pregnancies, Then also had protein in urine. Have had two strokes in left eye, one during delivery of first child (1996) and 6 years later after migraine in which blood pressure was high.  Hypertension has never been controlled continue to see primary care giver for this.  Have tried all different medications and hypertension persists.  Some days normal for me 140/90 and other days not. Heart rate the same. Normal for me is around 100.  Gets as high as 135 then after I rest for a few hours goes back to 100.  Endocrinolgist now checking adrenal gland and kidney functions with additional blood work. Typically very active. Since June not been as active because of chronic fatigue and one thing after another.  Would like to know what is causing all of the above. Have been referred from one doctor to another. Primary Care to Gyn, cardiologist, cardiologist specializing in electric waves, and now an endocrinologist. Medication seems to be making all of the above worse except the headaches.   Tired of doctors, drugs and tests.  Prior to June had never had any of the above infections etc. Had pancreatitis at 18, only time remember being sick.   Can the mass on the ovary, the kidney stones, chronic headaches, fatigue, nauseousness, high blood pressure, and rapid heart beat all be related?
Respectfully, grace

[Kevin Pho, MD]

These are certainly a complex set of problems - and impossible to answer without evaluation.

Can they be related?  Although possible, I cannot think of a unifying diagnosis.  I'll address the symptoms individually.  

Headaches have been evaluated by a neurologist.  It may be possible that it may be related to the blood pressure.  If they persist despite adequate hypertension control, you can consider an MRI and MRA to further evaluate for a neurologic cause.  The amitriptyline, topamax or a beta-blocker can all be considered for preventative measures if migraine is suspected.

Regarding the back pain, a non-contrast helical CT can be considered if stones are suspected.  A negative test would make stones unlikely.  If the ovaries are in question, a transvaginal ultrasound would provide comprehensive imaging of these organs.

Regarding the rapid heart rate - the electrophysiologist (cardiologist specializing in heart rhythms) - would diagnose any arrhythmia that may be present.  Further testing with thyroid tests as well as imaging with an echocardiogram can be considered as well.  

There are many symptoms that are being described here - further discussion with your personal physician should be done to coordinate all the tests and labs you are receiving.  

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.
http://www.straightfromthedoc.com

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