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Jef Burk
Jef Burk, Doctor
Category: Medical
Satisfied Customers: 2639
Experience:  MBBS. I've been teaching,practicing and learning since 1985.
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I am a 53 year old female who up to 2 years had no health problems

Customer Question

I am a 53 year old female who up to 2 years had no health problems at all. I am fit and healthy and run, cycle, swim do pilates and am a non smoker. I had a sudden onset of frightening symtoms of dizziness, nausea a feeling of anxiety and impending doom which have not resolved despite referrals to cardiology (heart palpitations), ENT (for nausea and dizziness) gynaecology(trial of HRT which did not alleviate symptoms) and endocrynology where nothing abnormal was detected. I have never had either mental health or health problems but 2 years on without any resolution I am struggling with normal everyday activities. Is this all menopausal or can you suggest anything which maybe causing these distressing symptoms as not knowing makes it even harder to manage? Many thanks.

Fiona Grant
Submitted: 4 years ago.
Category: Medical
Expert:  Jef Burk replied 4 years ago.

Hi

 

I am sorry to hear about your problems.

 

May I ask if your symptoms are intermittent or constant?

 

Dr Jef

Customer: replied 4 years ago.
I have periods when symptoms alleviate and had a period of three months where I was felt virtually symptom free but had sudden onset three weeks ago and experiencing symptoms on a daily basis.
Expert:  Jef Burk replied 4 years ago.

Thanks

 

Do the symptoms last all day or do they come and go?

 

If they come and go can you tell me how long they last for?

 

Dr Jef

Customer: replied 4 years ago.
they come and go but can experience sudden onset of fuzzy head/dizziness that can last for 10-15 seconds and dissapear or can leave me with an extreme feeling of nausea when I am unable to eat or drink for a few days
Expert:  Jef Burk replied 4 years ago.

Hi

 

Thanks

 

When you have the dizzy sensation do you feel like the room is spinning around you?

 

Dr Jef

Customer: replied 4 years ago.
no not spinning very unpleasant sensation, was admitted to hospital when having particularly extreme symtoms and was given brainscan, nothing abnormal detected.
Expert:  Jef Burk replied 4 years ago.

Thanks

 

You have palpations as well with these?

 

Your 24 hour EKG and cardiac echo has been normal?

 

Dr Jef

Customer: replied 4 years ago.
I do experience palpations not always at the same time as other symtoms, have had 24 hr ekg and cardiac echo and was told everything was ok I just have ectopic heartbeats but nothing to worry about
Expert:  Jef Burk replied 4 years ago.

Hi

 

Good.

 

How do you feel emotionally during these episodes and in the hours after?

 

Dr Jef

Customer: replied 4 years ago.
struggling, feelings of impeding doom and anxiety are hard to manage, having never experienced anything like this before and not knowing if and when these symtons will resolve makes it difficult and trying to maintain some sense of normality when symptoms ease is waring, I stll run, cycle and swim when I feel ok, I can't understand when I feel so awful no-one seems to know what is wrong with me.
Expert:  Jef Burk replied 4 years ago.

Hi

 

Has the possibility of a primary anxiety disorder been discussed?

 

Dr Jef

Customer: replied 4 years ago.
no, never what's that?
Expert:  Jef Burk replied 4 years ago.

Hi

 

Read the link below.

 

Get back to me with your thoughts.

 

Dr Jef

 

 

http://www.patient.co.uk/health/Panic-Attack.htm

 

 

 

 

Customer: replied 4 years ago.

have looked into this but am unconvinced this is the problem given that I can feel unwell for days with nausea and feeling generally feeling grim. I have checked into symptoms of the menopause and these symptoms are the only ones that seem to fit into mine.

 

 

Expert:  Jef Burk replied 4 years ago.

Hi

 

"Grim"?

 

Dr Jef

 

 

Customer: replied 4 years ago.
sorry obviously a scottish work means awful+++
Expert:  Jef Burk replied 4 years ago.

Hi

 

LOL!

 

No can you specify what you feel wrong???

 

Where in Scotland are you?

 

Dr Jef

Customer: replied 4 years ago.
fuzzyheaded with extreme nausea can have sudden onset, legs feel weak and wobbly, waves of feelings of dread impending doom with no logical explanation initally lost 1/2 stone in weight as unable to eat or drink. Live in the Highlands of Scotland
Expert:  Jef Burk replied 4 years ago.

Hi

 

Thanks

 

Do the waves of dread and doom last for hours?

 

Dr Jef

 

I'm just outside Glasgow BTW

 

PS - I need to log off right now but I will get back to you

Customer: replied 4 years ago.
no never hours, they are severe but on average last from seconds to a couple of minutes at most but can occur several times a day
Expert:  Jef Burk replied 4 years ago.

Thanks

 

Do your symptoms not fit with the description of panic attacks that I sent you?

 

Dr Jef

Customer: replied 4 years ago.
no, have had bad day today, nausea pressure feeling in head unable to eat comes in waves am finding it distressing
Expert:  Jef Burk replied 4 years ago.

Hello Fiona

 

How are you this morning?

 

Dr Jef

Customer: replied 4 years ago.
Feeling better this morning, horrible evening yesterday took 2 stugeron but had nothing to eat since lunchtime yesterday, at work and coping ok just a few 'turns'. Lifestyle is being compromised unable to run or swim last couple of weeks have phoned GP for appointment on 12th April but know from experience she is unable to give a diagnosis but I don't know what else to do
Expert:  Jef Burk replied 4 years ago.

Hi

 

When you have these bad days do you get a "spinning" sensation?

 

Dr Jef

Customer: replied 4 years ago.

having bad days seem to always consist of dizzy, pressure in head, nausea and dreadful feelings of dread and anxiety onset can be sudden or come in waves.

Expert:  Jef Burk replied 4 years ago.

Hi

 

Very strange....

 

Stugeron will only help if you have vertigo - a spinning sensation.

 

Have you ever suffered from migraine?

 

Dr Jef

Customer: replied 4 years ago.
no I have had rude health up to 2 years ago! I know Stugeron doesn't really help, just a placebo.
Expert:  Jef Burk replied 4 years ago.

Hi

 

It's worth considering an atypical migraine ( aka silent migraine)- intermittent symptoms are typical and there are numerous migraine variants that are not associated with headache.

 

May be worth trying a months course of a migraine preventer to see how you respond.

 

Dr Jef

 

http://www.relieve-migraine-headache.com/silent-migraine.html

Customer: replied 4 years ago.
would this account for the distressing feelings of dread and anxiety, which in many ways are harder to cope with than the physical symptoms? Can I just reiterate that I have never experienced any anxiety, mental health problems
Expert:  Jef Burk replied 4 years ago.

Hi

 

Silent migraine can be associated with emotional symptoms.

 

I'm just throwing this in as a possibility.

 

Your symptoms are intermittent - that is the biggest clue - only so may things will do that and one of the most common is migraine and its variants.

 

You seemed pretty sure that you were not suffering from a panic disorder???

 

Dr Jef

Customer: replied 4 years ago.
yes I do the symptoms do not seem to fit at all, you still think it's a possibility? I don't want to close my mind to anything but when I feel so ill over a period of time, surely any attacks of this nature wouldn't last that long or make me feel so ill for days
Expert:  Jef Burk replied 4 years ago.

Hi

 

Migraine symptoms can last for several days.

 

Panic attacks - typically 20mins.

 

Dr jef

Customer: replied 4 years ago.
Do you think hormones are playing any part at all in this?
Expert:  Jef Burk replied 4 years ago.

Hi

 

Nope - your symptoms are not menopausal and you tried HRT already and it did not help?

 

Dr Jef

Customer: replied 4 years ago.

Am feeling slightly confused, when I check for the symtoms of the menopause I can relate to many of them and I know HRT can give similar symptoms, but if you're convinced they are not related then I will go with that!

Expert:  Jef Burk replied 4 years ago.
Hi

The most pertinent symptoms of the menopause are hot flushes and night sweats.

Any symptoms caused by low levels of oestrogen improve promptly after starting HRT - if it made no difference then we can be 100% confident that this is not the cause.

Sincerely XXXXX XXXXX that a tentative diagnosis of silent migraine is a good one and is worthy of discussion with your own doctor.

Dr Jef
Customer: replied 4 years ago.
If this might be the cause is there anything you can recommend for these distressing symtoms of anxiety/dread which I am finding increasingly difficult to cope with
Expert:  Jef Burk replied 4 years ago.
Hi

I would suggest a month of anti migraine prophylaxis - such as propranolol 40mg twice per day.

I would then choose to assess your response and take things from there.

Dr Jef

Propranolol as it happens is also a good treatment for the physical symptoms of anxiety - such as palpitations.
Jef Burk, Doctor
Category: Medical
Satisfied Customers: 2639
Experience: MBBS. I've been teaching,practicing and learning since 1985.
Jef Burk and 4 other Medical Specialists are ready to help you
Customer: replied 4 years ago.
Not convinced but nothing to lose I will certainly give it a try, many thanks for your help I've found the last couple of years very challenging and its been nice offloading to you and receiving some practical advice. Fiona
Expert:  Jef Burk replied 4 years ago.

Hi

 

Seriously I think its a very reasonable option to try the propranolol.

 

Feel free to get back to me to let me know how you are getting on.

 

Regards

 

JB

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