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Swelling, Dizziness, ear ringing

  : : : : : : : : I have no idea what topic area to post this to.
  : : : : : : : : Some time in January I experienced a bout of dizziness....more like lightheadedness. More of a floating, than a spinning. It left after a few minutes, but continued to come and go over the next few weeks. I went to an ENT and my inner ear seemed fine. Then, on March 1, I experienced some swelling above both my collar bones. Suddenly. It came on in one day. Both sides, equal in size (would fill a cupped hand). My dr. yelled MRI and XRAY's. All came back stating nothing to worry about, appears to be fatty tissue. To say the least I was relieved. The lightheadedness is persisting. Will last for a couple of hours some times. Now, I'm noticing frequent stiff neck. I've got all these things going on, and nobody seems to have a clue. All the Dr.'s say they've never seen swelling like this (so suddenly, and equal to both sides), and just say "ignore it, it's not related to the lightheadedness". So, at this point, my symptoms are: frequent stiff neck, lightheadedness, swelling above both collar bones, elevated blood pressure, and frequent feelings of head pressure. My Dr. has put me on 2.5 mil of a Calcium Channel blocker (been on it a week), and it hasn't changed my blood pressure a bit. Prior to January, by the way, my blood pressure was always very nice and low. Now, it seems to hold around 125/91. The lower number is anywhere from 85 to 101. Anyone ever hear of anything like this? I just wish I had a direction to take to get this resolved. Also, my left ear is ringing all the time.  I must look like a mess, but actually I am able to go to work.  I push myself on my treadmill for 30 mintues, and I feel no shortness of breath or chest pain. The treadmill seems to not change my condition at all.  They've taken tons of blood from me, and run a battery of blood test, and everything looks excellent. Same with urine. I sleep just fine. I've been to a neurologist in addition to my regular MD, and he said my nervous system is just fine. I am 40, male, do not drink or smoke. I don't know whether to ignore the swelling, or where to turn next... Any help would be so much appreciated. ***@**** Please feel free to email me.
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  : : : : : : : Dear Dirk:
  : : : : : : : I do not know what is causing your symptoms.  No cardiac diagnosis comes to mind that would explain all your symptoms.  I would have suggested a comprehensive exam by an internist, neurologist and ENT doctor, but it sounds like this has been done.  
  : : : : : : : I am not convinced that there is a unifying disorder for your varied complaints.  It could just be that you are getting older and have developed high blood pressure and other medical ailments.  A rare cause of high blood pressure and fatty deposits is steroid excess, either from a disease in your body causing overproduction of steroids or from taking steroids [in a gym, for example].  It would definitely be worthwhile having your thyroid level checked.  Aspirin, in high doses, can cause ringing in the ears.
  : : : : : : : It may also be a good idea to reconsult with your neurologist.  Let him know that your symptoms are persisting.
  : : : : : : : Good luck with your medical conditions.  Let us know if your doctors come up with any answers.
  : : : : : : : Information provided here is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15.
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  : : : : : : Thank you so much for the reply.  When I saw my local cardiologist, he really didn't see any sense in putting me thru all kinds of heart tests, because he didn't see anything that may be heart related.  Interesting mention of the steroids, but I am, and always have been steroid free.  My thyroid has been checked, and is fine. I do not take any asprin.  Would you say at this point, my best bet would be to go in and see a neurologist?  Would that be the specialist to see at this point?  I'm just so sick and tired of the head-pressure (or head fullness), and dizziness.
  : : : : : Dear Dirk:
  : : : : : At this point I think you should see a neurologist.  Make sure to tell him about all your symptoms.  An MRI scan of the brain and a lumbar puncture (spinal tap) are two procedures that may be useful in providing a diagnosis.
  : : : : : Good luck.
  : : : : : If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at desk F15.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.
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  : : : : Well, if we ignored all the symptoms that I am having, except the one: Swelling above both clavecles (sp?), what would you make of that?  That one, seems to have all of my doctors puzzled. Nobody seems to have seen it before. Equal swelling on both sides. No pain, very soft...and MRI shows it as Fatty Tissue. Quite significant...you can cup your hand over them.
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  : : : Dear Dirk:
  : : : Again, steroid excess can cause such fatty deposits; you stated that you do not take steroids, but certain diseases can cause the body to produce an excess of steroids.  Blood tests could detect this.  An endocrinologist could evaluate you for such a condition.
  : : : Certain medications used to treat HIV/AIDS can cause a dramatic build-up of fatty tissues as a side effect.  Of course, this is not a consideration if you are not on those medicines.
  : : : Another possibility is to undergo a biopsy of the tissue to see if it really is just fatty tissue as the MRI suggests.
  : : : Let me know if your doctors figure out what is causing the swelling.  Good luck.
  : : : Information provided here is for general purposes only.  Only your doctor can provide specific diagnoses and treatments.  If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment at Desk F15 with a cardiologist.
  : : They have run me through many, many, blood tests, and all have come back fine. Steroid level was checked. I am on no medications.  My doctors are reluctant to undergo a biopsy, since they cause me no problems.  They are visible, and that's it. No pain associated.  I find it so odd that I can find nobody that has ever had this condition, no heard of it before.  Woe is me....
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  : Dear Dirk:
  : I have no other ideas, other than the biopsy.  I agree with your doctors that it probably would not influence what is done with you, but it would definitively answer the question of whether it is just fatty tissue or whether it is something else (some sort of infection or tumor).  I assume someone has tested you for tuberculosis along the way.
  : If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
  : Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).

  Well, I had an MRI performed as you suggested, and they performed it and spent extra time looking at the rear portion of my brain (balance?), and my inner ear. Everything looked completely normal. So, here I sit. Lightheaded, head feeling full, left ear with moderate ring, and a stiff neck. I guess I'll go to a new local hospital, and start all over. I've gotta find some Dr. that's seen this all before, and has something to try. With my stiff neck, could it possibly be Meningitis? Or shouldn't the MRI have found that? Or, would Meningitis not go this long without progressing to something more severe? Woe is me....
Dear Dirk:
I doubt you have bacterial meningitis; untreated, you would likely be dead by now.  However, there are other rarer causes of meningitis that can be indolent.  A neurologist could perform a spinal tap (a lumbar puncture) to definitively rule out such a process. I had mentioned the possible utility of this test in a previous letter.
Though your symptoms are distressing to you, the multitude of normal tests and physician evaluations, as well as the passage of time with nothing catastrophic happening to your health, all argue that you do not have a serious underlying medical disorder that has remained undiscovered.  
I still do feel a biopsy of the fatty deposits seen on MRI would be useful.  If it is just fatty tissue, and nothing more esoteric, it again provides reassurance that you do not have some bizarre medical disorder.
Good luck.  I certainly hope you find some answers, though that does not always happen in medicine.  You mention going to a new local hospital.  I would instead suggest going to a large university medical center with all your medical records.  Let the specialists there ( who are more likely to have seen rare cases) decide if you would benefit from further testing.
If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at desk F15.  Information provided in the Heart Forum is for general purposes only.  Specific diagnoses and therapies can only be provided by your doctor.

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