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Avatar universal

*Topic Move* Anxiety or Neurological

I have quite a difficult situation to sort out right now. I am a 22 year old Caucasian male. Last April, I went on a run and by the time I came home I thought I was having a heart attack. I had been to the ER once before for a similar incident but nothing was found and I was told it was a panic attack. I ended up waiting a few days until the symptoms came back worse and I went to the ER again. Again, nothing was found. The first time I went, I felt fine after being checked out. This time, the symptoms never got better. I got a physical from my doctor including an EKG, physical exam, blood work (thyroid, cholesterol, triglycerides, chemical panel, etc.) and urinanalysis. Everything was normal. Blood pressure and blood count normal. I was still having many symptoms: pains in my chest, arms, stomach, and back, panic attacks, occasional muscle spasms, insomnia , gastrointestinal problems, weight loss and sexual dysfunction. I went back to my doctor over the summer and got a referral to a cardiologist. I was given a stress test EKG. Everything was still normal. My symptoms essentially stayed the same throughout the summer. I went back to my doctor a few times asking about possible other medical causes such as fibromyalgia, vitamin deficiency, etc. but he refused to believe it was anything but stress and wanted me to take Zoloft, which I refused. I saw a psychologist for about a month and did a few acupuncture sessions, which seemed to help my circulation a bit but also seemed to cause fasiculations in my legs, so I stopped after 2 sessions. The psychology sessions succeeded in ceasing panic attacks. I had another urinanalysis done which came back normal. I still had most of my symptoms however. I moved to Japan in September for school. I immediately noticed a worsening in symptoms since I arrived, even though my depression symptoms got far better. I weighed about 153 ponds in February. Now after living in Japan for a little more than a month my weight is between 144 and 148 pounds daily (probably not a very accurate scale). I have noticed my fasiculations are much worse now, as is my insomnia. About a week ago, I was eating dinner and felt really weird. I had a strange headache that felt like head was tingling and I couldn't think straight. I suffered from a bad headache all night and eventually took some motrin. The next day I was fine in the morning, but went to a doctor after lunch because my headache returned. The doctor looked at my list of symptoms and gave me some painkillers and anti-cold medication and told me to see a psychiatrist for the rest of the symptoms. The doctor did not take blood pressure, heart rate, nothing. Literally I sat down and talked for five minutes and the doctor never examined anything. I have noticed since I arrived here that my clothes are fitting very loosely and I have needed to go up one notch on my belt. I feel as though my muscles have deteriorated and when I try to exercise them they are quite painful. My hands have now begun to shake a lot and my arms are often painful and burning, and sometimes tingling. My legs are tingling more now too. I have also noticed that since April I will occasionally mis-pronounce words and recently I feel as though my right pupil is larger than my left. I have no numbness, and no issues with balance. I feel as though I can't think sometimes, however I am still able to speak read and write in both English and Japanese, and am able to complete my college work. I have noticed symptoms fluctuate in the last few days. My hands are shaking less, however my eye seems to be getting worse as it is getting blurry at times and painful. The right upper quadrant of my stomach also began to have sharp pains during a run the other day, although I just started a sit up regimen.  

My question is, is it likely that I have a constellation of symptoms that are born from stress, diet change, lack of exercise, and insomnia, or is there more likely a neurological cause? I assume I should see another doctor and get a neurological exam. However, I have been to the doctor so much in the last 6 months that I no longer trust my judgment on if I should see one or not. My PCP and psychiatrist seemed to think there is nothing seriously wrong. My family tells me it is anxiety and tell me I have nothing wrong. Are there any opinions? I feel as though I am developing very real symptoms now such as possible essential tremors. I have never smoked but I do drink. I drank heavily for a year about 2 years ago. I drink a lot on occasion, usually about once per week (now less). Any input is welcome.
16 Responses
Avatar universal
Many of your symptoms do sound like fibromyalgia. Having had the disorder of 20 years I can tell you that many doctors don't know what it is, how it's tested, or even believe it exists. Also, since it's rare for men to have it, they probably just ignored the posibility. First, get tested for Lupus. It has many of the same symptoms, so rule that out first, as well as a thyroid condition, and a neurological work up. If nothing else turns up, a rhematolologist can check you for fibromyalgia. There are 18 pressure points they test, if you show sensitivity in at least 11 points, it's usually a positive test. Bad news, there is very little treatment for fibro. They treat the symptoms, but there is no magic pill. I hope you don't have it, since you are so young, you'd have a long time to deal with it just as I've had. As far as the antidepessants go, they aren't telling you it's all in your head. Antidepressants alter the chemical balance in your brain that may be responsible for a lot of your symptoms. A chemical imbalance is a real, treatable, physical problem, not just feeling down, or imagining symptoms. Give it a chance to work before you refuse it. A good month or so to reach the proper levels, and see if it doesn't help. If you had been diagnosed with diabietes, you wouldn't refuse insulin, would you?
1291268 tn?1274810922
You should continue with whatever tests you think may be necessary but it sounds to me that you are suffering from anxiety and/or depression.  What does your psychiatrist tell you?
All your symptoms are very, very common to anxiety and depression.  Check out the anxiety and depression forums and you'll see countless people that are going thru exactly what you are.  Let your psych guide you toward the proper treatment and I think you'll see relief from your symptoms fairly quickly.  
Avatar universal
@hppytrails:
I know the signs and symptoms of lupus and fibromyalgia. My thyroid was tested during my physical and came back fine (although I don't know what was tested or to what degree). As far as taking beta blockers, I am not opposed to the idea. I am opposed to taking them for purely psychological issues however. If I get tested to my satisfaction and still have symptoms that are attributed to anxiety, I will work on them on my own and not mask the symptoms under drugs. Taking insulin for diabetes is not comparable to taking beta blockers for anxiety/depression in my mind. If I end up having, say, POTS I would accept beta blockers as a form of medical treatment.

@MMahon:
I hope that it is only psychological. I think you are right and that I should get checked out properly, and, if the medical results indicate no serious disease I will work on the psychological side. This is going to sound like a hypochondriac but this is how I look at it: if I get checked up now and continue to stress until I see the results, I will have let my anxiety perpetuate in the mean time. Conversely, if I work on my stress now and don't get checked out and there IS something wrong, I may have allowed permanent damage to progress. I am more willing to stress and be safe of the two options.

Currently, I have caught a sinus infection or so it feels like. Its funny how a "normal" illness doesn't stress me at all. However, I am going to see the psychiatrist on Friday. I am going to try and explain my situation to him/her and hopefully have him/her agree that I should get checked out and THEN deal with the mental issues.
Avatar universal
Also I wanted to inquire a bit more about my eye. So, it has been going on for several days but less than a week now. Both eyes still react to light; that is both pupils are still able to contract and enlarge. However, once both eyes settle to whatever ambient light level there is, the right one is more dialated (or the left is less dialated). I haven't been having much issue with blurriness lately, but my right eye is painful, as is the area around it. I assume that with my sinuses infected, there is inflammation in the area. However, the eye issue began BEFORE the sinus issue, and this is worrying to me. I will certainly ask about it, but does anyone have an educated guess about it? The only substances I put in my eyes are my contacts and the solutions that go with them, and not everyday. I notice the issue both with contacts and without.
Avatar universal
So, I went to the Doctor today. He listened to me try to explain stuff in Japanese (I suck) and he tried to give me his assessment in English (He *****). Essentially he thinks I'm fine. He looked at my eyes and listened to my heart. I tried to explain the muscle spasms, but unfortunately they weren't happening at the time to show him. He essentially thought it was a matter of stress, insomnia, digestive difficulties, and probably potassium deficiency. I do hate bananas. So at this point unless something really bad happens then I guess that is that for now. Seeing doctors here is difficult, and I have let this ruin my life for long enough now. Its time to move on for better or for worse.
434278 tn?1324706225
I had some similar symptoms and my dr. tested something called C-peptide.  Sometimes a non-cancerous insuline producing tumor can show up somewhere in the intestinal tract and cause intermittant problems w/ insuline levels.  Because it doesn't fuzz up all the time, the insuline level might not reflect the activity, but the C-peptide will.  

Has any doc. varified what is going on w/ your pupil.  W/O researching it, my first thought is MS, but I would think you wold also have vertigo.  The muscle spasms could be caused by a numerous of things.  I would encourage you to try magnesium supplements for a while along w/ the potassium.  

Honestly, you are going through a lot of changes.  Moving to a new country is quit a change!  Stress can do incredable things to your body.  Muscle jerks/spasms are one of them.  I encourage you to read your Bible and pray and allow God to be your peace in the midst of all that you are going through.  And if you need antidepressants to help you get over the hump, I would encourage you to give them a try.

Praying for you :)
Avatar universal
Hi.
After reading your post, it sounds to me like a systematic illness, auto-immune.
I would definately be having some antibody blood tests done , ANA, Anti-DNA. ACA, etc.
What worries me is this has been going on for a while, and while the testing you have had done previous, and i dont know fully what.
I am saying whatever it is might not have been tested for already.

I would say , i dont think the mind can make pupils in the eye to dilate, and i think the weight loss, is connected,
I think you need a fully neurological examination, as dilated pupils can be found in a few neurological diseases, and this with all your other symptoms may be connected, as in a systematic illness.

You are your own judge, as you know your own body, and you sound smart enough, to be in charge,
What you have to do is, make sure you dont get labelled, and fobbed off,
When doctors dont do a full physical, or any tests, to seek a real diagnosis to the cause, then this is the time to run from him, and find one who listens and takes your symptoms seriously.
Im wishing you well,
Nicola
434278 tn?1324706225
I went on the symptom checker (medhelp) and put in ptosis (eye lid dropping).  Please click on this site and feel free to add other symptoms.

http://www.medhelp.org/symptomsearch?subtractterm=Unequal pupils&addterm=Ptosis&addterm=Unequal%20Pupils

We are praying for you.  Most of us have been treated like nut cases at some point.  It is not very fun.  I know some of what you are experiencing "could" be stress related, but other symptoms certainly could not.  

Keep us posted and let me know what you think on the symptom checker.
~Kara
Avatar universal
No doctor has verified anything since I have posted. The doctor at school did a simple light sensitivity test on both of my eyes as I said. He said both pupils appeared to react to light properly. I would love to have a Gastroenterologist take a good look at my insides but it isn't likely for that to happen here. It is very difficult to get much of anything done at the doctor's office here, but thank god its cheap. I can go 60 times for the price of one visit in America. Anyway, don't take this the wrong way but please refrain from posting any religious comments on my topics in the future. I am sure you would want people to respect your religious views on your own topics, and I only ask the same. Thank you. Also, I don't have a dropping eyelid. I have believed for a long time that I have had BOTH psychological issues as well as organic ones, as well as one affects the other. I wish the doctors I encounter would consider this.
Avatar universal
I have feared systemic illness for quite a while, amongst other things. One thing that has stayed consistent about my health through all of this is my poor immune system, which I have had my entire life. Again, it is highly unlikely I will get any answers to these sorts of questions while I am in Japan. Anyhow, as far as the eye thing goes, believe me I have researched it a lot lately. One redeeming quality to my own plight is that both eyes seem to react to light properly still, which is very different from a blown pupil, which does not contract in light. My right eye has certainly gotten worse in terms of visual ability about this, but again neither my optometrist nor my PCP seemed to think anything of it when I brought this up. I have put a lot more work into this than they have, I think.
Avatar universal
So in addition to responding to the previous comments, I wanted to give an update on my feelings, because I still feel like posting here gives me some kind of hope. Anyway, a few things I have noticed lately:
Alcohol is certainly having a pronounced negative effect when I partake. I have thought for about 2 years now that I should modify my drinking habits, but never really did it. I notice now that it seems a day or two after drinking my symptoms seem to be bad. I took a week and a half off and was doing better, then went to a party and drank a lot on Sunday, and have been feeling worse ever since (duh). Nonetheless, these are not normal hangover symptoms. Also, I went running the other day and had a horrible stabbing pain in my lower right abdomen for about an hour. I am sure I would have gone to ER in the past with the kind of pain I was having, but I have been through so much in the last 6 months that I have an insanely high pain tolerance now. It went away after a bit, but the area has been tender ever since. In addition to the general pain I have had in the area for 6 months, I had diarrhea for about 2 weeks straight when I got to Japan in September. I think there is something really wrong with my digestive system. I have also had nausea after eating sometimes, loss of appetite sometimes, floating stools sometimes, pain during urination sometimes, etc. Gallstone? Kidney Stone? Hernia? Ulcer? I have no idea. I guess it will either get better, or bad to the point I need to get it looked at by the doctor. If I don't have a substantial immediate problem, there is little point in going.
Avatar universal
Still having thoughts of gastrointestinal problem. Sorry to describe but I have been having some rather dark stool and diarrhea lately. Not positive if it is blood from high in the intestinal track or not, but it isn't comforting along with the stomach pains. I had asked my PCP about my gastrointestinal system before, but he said that I likely have dyspepsia and just needed some more fiber. He never examined a thing. I know that this should get checked out. Unfortunately it won't be until Monday that I can. I just wonder if what might be going on is some sort of gastro problem causing malabsorbtion that has created a vitamin deficiency or something. I would have thought my initial blood test would have caught that, unless it wasn't a deficiency at that point. Anyway. those are my present thoughts.  
551343 tn?1506830518
Could your diarrhea be related to a new style of diet? I take it you are eating differently in Japan, this could also be why you are loosing weight or have lost weight. When I lived in Hong Kong the weight shifted off me for the first few months and my bowel was all over the place.

I was interested in why you were against beta blockers. I was started on 1 tablet a day when sat in my GPs office about 10 years ago now and my blood pressure was quite high. He put me on beta blocker immediately. I am still on tablet. The strange thing is a lot of neurologists actually prescribe a beta blocker for fasciculations as they help with the muscle jumping. They are not just for anxiety...

Auto immune problems well they seem not to like alcohol. The more alcohol consumed, the more the immune system becomes out of whack. Besides being pro-inflammatory and addictive, alcohol breaks down to a toxin in the body called aldehyde. Toxins are dangerous chemicals that the liver does not recognize as useful. Toxins attack and destroy cells and attract germs. Aldehyde accumulates in the brain, spinal cord, joints, muscles and tissues, where it causes muscle weakness, irritation, and pain.

I used to love red meat now I cant tolerate it and avoid it.

You should start a diary. Record everything you do and eat and drink. Then you can see if any of that is making you worse......

Its a long waiting game for diagnosis tell me about it I have been 4 years trying to find out what is wrong, and finally now things are starting to show up in my blood....

Try not to be obsessed with every little pain or twitch. I have so many it would take me all day to wsrite them down.

Write down the worse things that happen to you. A lot of the little stuff could be spin offs to the real problems if that makes sense.

EAT healthy make sure you have the right amount of minerals in your body.

Lots of auto immune problems can mess up your grastrointestinal system.

Oh and may I say how exciting for you to be in Japan learning what a great thing.
Avatar universal
I certainly agree that my dietary change is partially to blame for gastrointestinal disturbances, however I think the pains and symptoms I am experiencing are a bit extreme for simple dietary change.

I am not against beta blockers. If you read my earlier post, you will see that I specifically said I would use them to combat an organic problem such as POTS or a nerve disorder. What I said was that I did not want to use beta blockers as a means to cope with purely psychological or anxiety issues, because I think that is creating a drug dependency to mask over a problem that is truly solved in an other manner.

Alcohol is an interesting variable at this time. In smaller quantities it truly seems to help my symptoms, though that isn't a viable solution. It does have the effect of dehydrating my body, leeching away vitamins, and irritating my gastrointestinal system as well as being a temporary vaso-dilator. Its probably best for me to limit my use to a small amount in one day at this point if I'm gonna use it. But honestly, I doubt that I will be following that sort of regimen while I'm in college in Japan. I know myself better than that.

Also I try very hard to not obsess over small sensations. I feel like if I found SOMETHING legitimately wrong it would help ease my mind a bit (as weird as that sounds) but I realize that is due to hypochondriasis. One last interesting point I want to make: Since this has begun, I have noticed that when I am in excessively crowded areas for a long time, or I'm doing something intense like dancing in a crowd or physically exerting myself, or singing karaoke, I get very light-headed and flushed, and feel like I might faint. It hasn't happened and I don't at all avoid these situations. I don't feel any social anxiety that I am consciously aware of. On the contrary I have several times put myself in these situations because the busyness keeps my mind occupied. But it makes all my other symptoms worse, including my shaking hands and my fasciculations. Is this helpful to anyone in making any guesses. I tried to explain it to my PCP back in the States and he told me I need Zoloft because its entirely social anxiety. In my own analysis of other options, would this have to do with adrenals or thyroid or some deficiency?
Avatar universal
Hi Chopper,

Well, I will tell you what I have had tingly sensations in my right shin & right side of my head when I would have migraines this was off and on, never constant and had serious digestive issues (and Im in the states), pain in my right side occassionally. My GP could find no reason for it said it was attributed to stress and IBS. That was fine for me except the tingly sensation never subsided with stress decreased. I recently started having blurry vision by my optomotrist and was sent to an opthomologist which found neovascularization in my eye due to an occlussion, which is a blockage basically a stroke. So now finally Im getting some help but before that I started noticing pattern to my symptoms which happen more than not in warmer months plus I have now joint pain, serious fatigue (mostly in long periods in the sun or summer time), and muscle twitching which my son noticed in my face that I wasn't even aware was happening although I could feel it else where. The opthomologist then sent me to a Rhuemotologist which did ALOT of blood tests. He is ruling out Lupus but is more concerned that my problem is nuerological rather than Rhuemetological. So, he wants them to rule out MS. In the downtime wating for my appointments I did get my blood tests back and it just so happens that my blood sugar was dangerously low at one point 47 and Im Vitamin D deficent and a few other things of which Im not even going to try to interpret myself, I'll let the MD do that for me. I would say do yourself a favor, dont worry so much but be proactive. Yes stress does cause lots of wierd effects on the body, but what you need to do to make yourself feel comfortable is go to the opthomologist and get your eyes checked out, they are the ones to tell you if something is wrong with your eye....it is a very good pathway at detecting other illness in the body....Yes the eyes do tell all! And then get yourself to a Rheumatologist and a Nuerologist and get those symptoms checked out and make sure they check your vit & min levels. As far as your stabbing pain after running I can tell you I get that ALL the time. I learned a trick of how to get rid of it, what happens to me in particularly if I run and I am not breathing correctly an air bubble gets stuck in the lung and yes it creates a horrible stabbing pain. So what I suggest you try is blowing out very long and as much as out can while pushing your abdomen. Do this a few times, it even helps while you do it when your running. You migh not realize your breathing may just but the culprate there.

Be easy, in the mean I suggest you stop drinking its not good for you anyway mentally or physically. It mentally alters you by not allowing yourself do deal with any kind of social or enviornmental pressures by making you repress any anxiety and it physically alters you in that your body functions less efficently and it can and will eventually tear down your bodys defenses. If you must have a drink, do a small glass of wine once a night with dinner. Try some mediation after your runs it really does help releave any type of stress you may be experiencing at a subconcious & concious level. You really have been through alot of shock moving to a whole new culture, but you learn to make your way slowly but surely. If the specialist (the opthomologist, rhuemotologist, & nuerologist) cant find anything wrong after the billion and one tests the will give you (of course that is an exaggerated number) I would suggest you listen to your PCP.

God Bless
Avatar universal
Hi,
I have the same symptoms, like exactly the same from pain when running to floating stools, join pain, tingling and even to other people relating it to hypochondria.. I am a 24 year old Caucasian male, now you have described this I really feel it is not stress and I do feel it is autoimmune related, plan to get further tested within next few months.. If you have had any progress please notify me, would love to finally know what is going on! Thanks!
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