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Anyone up for a differential? (LONG)

My current symptoms are:

- (always-present) blurry/double vision,
- headaches/head pain/head pressure
- nausea,
- upper abdominal pain,
- chest pressure,
- "swimming" brain (like I'm about to lose my balance, but never do),
- the feeling of mild hypoxia,
- and more.

I have symptoms of varying severity pretty much every day.

Other than the always-present blurry vision, most symptoms are transient, lasting from just a few minutes, to a few hours.  


HOW IT ALL BEGAN:

It all began 8 months ago with sudden-onset near-fainting (but I have never lost consciousness), heart pounding (but not racing), muscle trembling, headache/head pains, head pressure (usually across back of head), the feeling of mild hypoxia, hot sensation across back of head, scalp numbness, chills leading to whole body shivering, nausea, chest "heaviness", and urgent need for a bowel movement (diarrhea or loose stool).  

The first episode occurred after a relaxing morning with a large, healthy breakfast, and while sitting, relaxed, on my couch.  

The first few episodes occurred within 30 min's of a meal, but with no commonality between the foods in those meals.  Episodes didn't occur after every meal, either.  

"Episodes" only occurred when I was very relaxed, and only when I was sitting or lying down.  

Immediately following all episodes and stronger symptoms, I am massively tired, and usually sleep for 1-2 hrs.  

These "episodes" would last just a few minutes (1-10), with some of the symptoms lingering afterwards.  However, episodes would usually come in waves of varying intensity.  Some days I had only individual symptoms, while other days I had multiple episodes over several hours.

These full-blown "episodes" only occurred for the first 2 weeks.  

It's been 8 months since then and, while individual symptoms are less-severe, overall, I am still somewhat debilitated by those that remain...most notably the blurry vision, which prevents me from driving, thus diminishing my personal freedom.  The frequent nausea and head pain also make it uncomfortable to do many tasks.

When I have strong symptoms, I do my best to take stock of what's happening with my body.  I'll check my pulse, which is usually 50-70 bpm, but could be as high as 120 bpm (never over that, though).  After a few more episodes, I bought a home BP kit.  I have tested it during, and immediately following, severe symptoms, and it is always within normal ranges.  (My normal BP is <100/<60-70.  The highest I've ever seen during symptoms is 133/98.)  Similarly, my temperature is always in the normal range.


MY MEDICAL HISTORY:

I am female, almost 50-years-old, and have always been super-healthy.  I do have Polycystic Ovarian Syndrome (PCOS), but only the anovulation (none of the other symptoms).  I was very thin (BMI 17 naturally), and fit, my whole adult life, up to around age 40, at which time I inexplicably began gaining weight.  This happened even though I was eating a very healthy diet, and exercising regularly.  I cut calories further, and began exercising harder, and at least 6 days per week, yet continued to gain weight for several years (a BMI high nearing 30).  Long story short, I learned of the link between PCOS and insulin resistance (IR), and began including a natural insulin sensitizer (plain ol' cinnamon) in my diet.  It worked and, with continued diet & exercise, my BMI is 23 now.  

I have never smoked, tried illegal drugs, nor taken regular prescription medication.  I can only recall taking one prescription - an antibiotic I took for a few days, due to a UTI about 25 years ago.  I'm not against drinking alcohol, but have rarely done so in the past, and haven't had anything alcoholic since 2009.  I don't even have aspirin in my house.

I have always been wildly heat-intolerant and sensitive to light.  I'm blond with very fair skin & green eyes.

Until these episodes/symptoms began 8 months ago, I had near-perfect normal & distance vision.  I did develop mild presbyopia around age 43.  However, it is so mild I still do not require reading glasses.


ABOUT ME:

I'm a hapoy, confident person, by nature.  I'm very happily married (17th anniversary coming up).  I have a fantastic life (and would like to get back to it).  I lead a virtually stress-free life, too.  I can't think of anything I'm afraid of.  I ran my own business for many years, before essentially retiring.  I love traveling, but love my life at home, too.  

I have a pretty high tolerance for discomfort, and tend to minimize symptoms.  (When it became obvious the first nurse treating me had just assumed I was imagining my symptoms, my husband barked, "LOOK!  SHE'S AS TOUGH AS A HORSE!!!") (Not only does he know me...and yes, I'm kind of proud that I'm not a wuss...but he always has my back.) ;)

I'm kind of the anti-hypochondriac.  My former, long-time GP used to joke with me, before he retired in 2006, that I saw him so seldom, his receptionist always had to get my file from the archives.

I exercise everyday, and eat a disturbingly-healthy diet.  I have been doing relaxation yoga before bed for years, as well.

I like to use humor to keep things light, whenever appropriate.  My husband and I like to laugh...a lot!  :D


TESTS THAT HAVE COME BACK NORMAL, SO FAR:

- standard CBC ("slightly" high hemoglobin & HCT)
- blood cultures
- 5-minute EKG
- stool analysis
- 24hr Holter monitor
- echocardiogram
- 2-week loop monitor
- eye exam & retinal imaging
- complete physical
- pelvic exam & PAP test
- (fasting) serology report (incl. B12, thyroid, etc.)
- breast ultrasound
- ("Neuralite"SP?) CT scan


THEORIES DU JOUR:

X heart-related problems cleared via normal echo., EKG, and heart monitors
X TIA shared a few of my initial symptoms, but not all (esp. the lasting ones)
X brain circulatory problem, tumor etc. excluded via CT scan
X heart attack in women ostencibly cleared with tests & time
X no physical eye abnormalities found in eye exam
X MS - I would be on the higher end of the age of onset, with none of the coordination or cognitive symptoms
X hyperthyroidism is unlikely, due to "normal" blood test results, and only a few, related symptoms

- PERIMENOPAUSE is the current "theory du jour", even though the blurry vision, and chest & head pressure, etc., are not typically associated with it.  I AM at the right age, but have not had any hot flashes or night sweats, the most common perimenopause symptoms.  The "roller-coaster-like" nature of my symptoms could hint at a hormonal cause.  My menstrual cycle has changed since I began gaining weight around age 40, becoming MORE REGULAR.  But I'm told PCOS can have this effect on perimenopause.  (My menstrual cycle has not significantly changed since these symptoms began, back in August 2012.)
4 Responses
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1756321 tn?1547095325
Dysautonomia (autonomic nervous system dysfunction) comes to mind. The symptoms of this condition are extremely long so you would have to do a good search online for all of them. Medhelp has a link with more info....

http://www.medhelp.org/health_pages/Neurological-Disorders/Autonomic-Dysfunction-FAQ/show/181?cid=196



Helpful - 0
1340994 tn?1374193977
I'd have them look at your adrenal function.  It sounds a lot like Addison's disease to me.  

Because you have PCOS, I think you need to make sure you had complete thyroid testing.  I think a trial of hormone replacement might be prudent because lots of people need higher levels than the lab cutoff.  

My other thought is a tick-borne illness.  

Just some ideas.  

Helpful - 0
Avatar universal
Wow!  That IS quite the list!  I'm not sure where to begin!  But I'll be sure to give it a read through.  Thank you.
Helpful - 0
Avatar universal
Thanks.  I plan to see my GP again, to go over the thyroid tests (which ones were done, what exactly were the results) and ask about a referral to a neuro-opthalmologist (at the suggestion of an eye doctor here at MedHelp).  I'll ask him about adrenal function, too.  "Adrenal fatigue" seems to be a growing subject of discussion, these days.  I don't know if it applies to me, but I guess Zi'll find out.  :)
Helpful - 0
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