ongoing weird symptoms

[jess990]

for almost 3 years although some began 7 years ago after the birth of my 3rd child. dizziness, unstable feeling, off balance, feelings of almost passing out, waves of naseau, heart palps, intense fear feelings, fuzzy head for hours at a time like I don't know where I am. shakinees, legs, stomach shakes, headaches. low blood sugar sometimes, heavy blankets of fatigue that just hit me. worse during my cycle! Tests: numerous blood panels, thyroid, Lupus, Hepatitis, AIDS, MRI 2 years ago, all Nero tests, sleep study, all ENT tests, cardio stress test/halter monitor for 24 hours, C Peptide, Vit B deff, iron deff, horomone panel, EPV, allergy food and airborne, several chest x rays, several EKGs. Here is what I know: I had Epstein Barr at some point in my life. I have Herpes Zoster that breaks out on my knee 2-3 times per year in times of heavy stress, I have low estrogen and progesterone, My MRI was clear with the exception of this: esentially negative enhanced MRI of the brain and internal auditory canals - a few non specific foci of increased signal are present within the brain parenchyma - what does that mean??? My chest xrays were clear except this: incidentally noted is aberrant right subclavian artery coursing posteriorly to the trachea - what does this mean and could it cause the symptoms I am having????? I have had 2 D-dimer tests done and one came back slightly elevated at 279 - that was in Dec 2008, not retested since. This is like a puzzle I cannot seem to put togehter but I know that is destroying my life because I don't feel well. I am 33 years old, 2 c sections, 1 natural birth, I weigh 135 pounds, 5'5". Past 2 years, not very active, I mean I don't exercise, I am going all day long and on my feet and never sit, but I don't exercise vigourosly. I can walk for days but as far as aerobics, I get dizzy and feel weird. Also, I should note that I don't sweat from my head, I sweat on my chest and stomach, a small bit, but not from my head.

[jess990]

Also, wanted to add, all these feelings are more intense in the morning when I wake and go away by 10-11am, then sometimes and most times back around 3-7, then fine again, usually. I have issues where I feel like I can't breath but it is not in my chest, it is more at the top of my stomach and it is sore to touch there when I get this feeling. It doesn't happen all the time, just every now and then, when I burp, it feels better. I know this is a lot, but I am trying to figure it all out and not sure how to/where to go next. Also, When this first happened 7 years ago, I was good for 2 years by changing my diet to allow no carbs and took vitamins daily.

[jess990]

I have been seen by both a neurologist and a cardiologist, all normal. The d dimer test in Dec 2008 was followed by a chest x ray and then I was released. I am not sure where to go from here and was hoping you could suggest a certain type of doctor or something. What about the MRI results, are those normal and should it be followed up?

[Kevin Pho, MD]

It's difficult to say without examination, and you certainly had a thorough workup for your symptoms.

A positive D-dimer test can be indicative of a clot, and if it continues to be positive, a chest CT-PA can be done to exclude a pulmonary embolism, or ultrasound of the leg veins can rule out a clot in the legs.

I am not aware of an aberrant subclavian artery leading to your symptoms.  This may be a normal anatomical variant, and if your doctor agrees, can be safely observed.  Again, a chest CT scan can be done to further evaluate this finding.

The feeling of passing out and headaches should be evaluated by a neurologist, while the heart palpitations and stomach pains can be evaluated by a cardiologist and gastroenterologist respectively.  Regarding the latter symptom, an upper endoscopy should be considered to evaluate the upper digestive tract.  

These options can be discussed with your personal physician.

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 Pho, M.D.
www.kevinmd.com
www.twitter.com/kevinmd