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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7815
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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Around mid January I I had trouble putting my left contact

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Around mid January I I had trouble putting my left contact lens in for a weekend, then I was able to wear it for a day. The next day, my left pupil was extremely dilated. I went to a local clinic, where the doctor was very concerned and said I needed to see my eye doctor first, and if he couldn't find a reason, I needed a CT scan. I went to my eye doctor, but by this time my eye was back to normal. He did diagnose an infection in both eyes and prescribed some drops. Not long after this, I began having "blackout" spells. I wouldn't completely lose consciousness, but I would faint and take a minute to come to. Also around this time, I started suffering a headache I cannot even describe. It progressively got worse. My left eye would dilate off and on. My moods changed frequently and drastically from happy to harpy with no notice. My boyfriend never knew how to approach me. I started getting a very bad taste in my mouth and was dizzy most of the time. The last Friday of January, I was driving home from my boyfriend's, blacked out and drove my car into a ditch. My parents say I completely flipped out and accused them of not caring and not wanting to get me any help and cursed them and behaved completely out of character. I have no memory of this. They took me to a hospital, where they did a pregnancy test, blood work and CT scan. They treated it like a routine migraine and I refused the shot of Toradol and said they had to do something better because I was getting worse and I was blacking out. They kept saying I was fine and to follow up with my regular doctor. When I got home, I text my boyfriend that I was feeling suicidal and was going to sleep, so if he couldn't reach me, call my mom. I have no memory of sending that text, either. I didn't wake up until the next morning around 11 when b/f called my mom and said I was texting him jibberish. Mom came to make me eat some toaster strudel and found an empty bottle of Klonopin on my nightstand. I have no memory of taking it, but apparently I did. Later, my dad came and walked me down the hall to the kitchen to eat something else. I walked back to my room, but never made it to the bed. That was the first time I really lost consciousness. My 150lb English Mastiff was standing on me and I never responded. Mom took me to a different hospital where they did another CT scan and more blood work. I was transferred by ambulance to a Level IV hospital about 45 mins away. I have no memory of being in the ER, of answering questions or anything else it says I did on the medical records. I was admitted and underwent an MRI the next day. I also had an EEG, EKG and was on telemetry. I was released after 23 hour observation with the diagnosis of depression, anxiety disorder and atypical migraines.

It is now March. I have since spent a week in a behavior health clinic because the symptoms would not go away and my doctor was of the opinion that it was psychological. They determined I am not bipolar, manic, psychotic or schizophrenic. They said I suffer depression and anxiety disorder and increased the dosage on the medicine I was already taking (Celexa from 20mg to 40mg once per day and Klonopin from .5 mg prn 3x/day to 1mg 2x daily) and prescribed a sleeping pill.

I have only been allowed to work half days and that is being reevaluated this week. The headache pretty much went away while I was in the clinic, after 5 7.5mg percocets. I still have the dizzy and woozy spells, I still have the bad taste in my mouth. There is an are on my left leg that extends just to my pelvic area that will itch, tingle and then go completely numb. I cut myself shaving and never knew it because it was numb. Occasionally, my fingertips go numb. My left eye still dilates from time to time and now it seems like the muscles in my right eye are affected. If I turn my head to the left, I'm okay, but if I turn it to the right, it takes 1-3 seconds for my eyes to follow the motion, it's always accompanied by a sharp pain and wave of dizziness. Sometimes I have blurry and/or double vision.

But all the CT scans and the MRI and all the other tests revealed nothing abnormal.

What's wrong with me?????
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Rick, MD replied 2 years ago.
Well, that is an excellent question. The amount of testing, hospital admissions, behavioral health clinic admissions etc have ruled out the vast majority of the common and serious causes for your pain, blackouts, behavioral changes etc. It actually sounds like you have been getting excellent medical care. At this point it is possible that you have just what the doctors say you have: depression and anxiety disorder. Could you be suffering from some rare and exotic condition that the doctors have not yet been able to find? Perhaps. What can you do to make sure that this is not the case?

Well, at this point I think the best thing you can do to rule out this possibility would be to gather up copies of all your medical records and travel to a large University Teaching hospital. At an institution like that you could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.

The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this. That being said there are many excellent teaching hospitals all across the country and I am sure that there is one near you.

If you could tell me what large city you live near and how far it would be possible for you to travel in seeking treatment I would be happy to give you some names. Of course, you could also ask friends and associated or check the internet yourself. Let me know what you would like to do.

Does this make sense to you?

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Customer: replied 2 years ago.
The hospital I was admitted to for 23 hour observation actually IS a teaching hospital. The mood swings have gone away and the headache is gone. A lot of the stress is work related and I have been applying for new jobs like crazy. My main concern at this point is my eye issue. That's been going on for almost 2 months.

Is it possible I suffered a mini-stroke?
Expert:  Dr. Rick, MD replied 2 years ago.
I'm glad, on one hand, that it was a teaching hospital....but sorry that you are still having unresolved issues.

It is possible that you had a mini stroke but, if this were the case, I just can't imagine with all the excellent care you've gotten that the doctors would miss something like that....

Like you have been told ocular migraines, which many times can occur without a headache, are a very common -- and benign -- cause of a unilateral dilated pupil. If the pupil thing happens again you could try to get in right away to an ophthalmologist so she could have a look at you while it was going on.

I'm sorry that I don't have any wonderful new insight for you but one thing I can say for sure is that you are getting excellent medical care and, should this turn out to be some weird and rare condition, with time,it will declare itself and your doc's will be all over it like white on rice ;)

I wish you the very best and, if you have a chance, drop me a line and let me know how things are going. Have a good evening.
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7815
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
Dr. Rick, MD and 10 other Medical Specialists are ready to help you
Customer: replied 2 years ago.
I saw a neuro-ophthamologist Friday and he prescribed Topamax and some prn meds for headache and muscle spams. The pain is now all up and down my spine. He was quite concerned since there is no history of migraines in my family. He is ordering more scans, this time of my neck and spinal chord to check for aneurysm, rupture, injury or anything that could be causing fluid or any other pressure on my brain. He also did blood work to check for auto-immune diseases and said if the next series of scans come up clean, he may order a spinal tap just to be sure. I know something is going on and I feel very safe in his hands. Btw, he said my eyes are very responsive, so those issues are just more side-effects.
Expert:  Dr. Rick, MD replied 2 years ago.
Thanks for the update. I'm sorry that the root cause hasn't been figured out for all your issues yet but I'm very glad to hear that you are in excellent hands and making real progress toward finding a solution. Looks like there just might, finally, be a light at the end of the tunnel :)

I look forward to your next report.....hang in there and don't let the dogs git 'cha down....
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7815
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
Dr. Rick, MD and 10 other Medical Specialists are ready to help you

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