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Vakul Aren
Vakul Aren, Doctor
Category: Medical
Satisfied Customers: 3372
Experience:  MBBS,DTM&H,30 years of experience
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Hello, thanks for this fine service you all provide here.I

Resolved Question:

Hello, thanks for this fine service you all provide here.

I am in the midst of a medical mystery. I'll chip in first with a bit of a background on my health and lifestyle. I'm a 19 year old male. I'm not physically active at all, and lately this is even more true as I've sent out 20 or so applications by mail, email phone etc. for jobs. I'm not overweight and I do suffer from acid reflux disease at times, my blood cholesterol level is elevated at 220. I've always experienced migraine headaches that come and go with no clear cause, I have had for as long as I remember had several large lymph nodes in the groin area, the back of the head, under the chin etc. and have brought these up several times to my doctors where they either brushed them off as temporarily swollen from infection or sent me for sonogram to look at them and say "yes, they're lymph nodes" on the revisit. (Most of these nodes have been present for years, none have changed size or shape and many are around 3/4" in size.)

Thank you for making it this far, it helps me just to know that you have!

I started noticing symptoms strange and seemingly unrelated, I'll start first with the visual changes. Never getting progressively worse but always coming in short or long flares I was getting changes in peripheral vision, blurry vision and seeing blue spots and increased floaters. I went to the eye doctor on this, she tested my vision, pressure tested my eyes and did all sorts of stuff and said that my eyes are completely healthy.

Yet I still continue to have vision symptoms, always worsening with headaches and sometimes coming without headaches.

A problem that came in afterwards is when I noticed that my pulps on my fingers and toes occasionally hurt, especially when I put pressure on them by using my hands and feet for normal activities. (This still continues now)

These two problems were compounded later when the more recent symptoms set in which were sensations of numbness on my breastbone area of the chest, (no tingling, no pain), pain in the tendons of my arms and random stiff muscles from calf muscles, to biceps to shoulder muscles to abdominal muscles at times. Also with slight weakness in my legs which has mostly resolved now.

I've been to the ER several times and to my general physician of these complaints where they basically mocked me time and time again dismissing checks for more serious as simply not necessary. (maybe they looked at my age group and went no further, I don't know)

Revisit after revisit in attempt to get Doctors to actually listen, I've ended up getting general bloodwork which showed nothing wrong, a cat scan of the head that showed no tumors and an xray of the lumbar area of my lower spine which showed everything as alright.

Time and time again I've been released from visits with diagnosis such as Anxiety which I feel is just another way at saying "I don't know, we have more critical patients to take care of, go home now." which I don't really mind with the thought behind it, but when you skip major tests for coronary function and whatnot simply because of my age group and mock me for being "overly" concerned, it get's very frustrating at times and nerving when the symptoms flare up at their worst.

Thanks again for making it this far with me, it's a tedious and nerving process. You're all the best for doing this on your free time!

During the worst times of these symptoms I sometimes get anxious, reasonably so and end up compounding the symptoms with more symptoms but I can dismiss anxiety as unlikely to be the total cause of these. At nights sometimes I wake up 3 to 4 times with a sweaty back and eye that I can barely see from (this resolves after a few minutes of waking up) and on one morning (the morning after the day that I decided to exercise as an aunt suggested that my problems might be due to poor circulation) on that following morning, I woke up incredibly dizzy before even picking my head up from the pillow, the worst of it lasted 2 minutes and it eased up over the next hour or so when I got up to make breakfast and such. It's become an issue when I began waking up with these symptoms (pointing away from anxiety) as you should be waking up relaxed from your sleep and not with blurred vision, a headache, a weak pulse and a sweaty back.

Lastly, we're almost there! To the end of my "rant" (Sorry!)

My diet has been on an off throughout this episode partly because of acid reflux symptoms at times, partly because of fatigue and lack of energy to do it and partly because of concerns about high sodium and water content as I fear this may be a dragged out episode of Congestive Heart Failure and especially given my adequate background risk factors (try telling that to my physician, he'll scoff, say I'm completely fine!)

I am now seeing a Neurologist and a Gastrologist but there's no focus on my Cardiovascular health and my general physician keeps mocking me when I come in to describe symptoms.
Submitted: 1 year ago.
Category: Medical
Expert:  Vakul Aren replied 1 year ago.

Your symptoms are suggestive of those of Generalised Anxiety Disorder(GAD).This disorder usually has a variety of clinical symptoms which come and go with all investigations being usually found normal.The illness is very common and begins around the early twenties,having a family history of depression or anxiety may be there.The worry about various symptoms ,irritability,headaches,muscle pains,abdominal pains,sleep disturbances,dizziness,autonomic symptoms like sweating,palpitations may be secondary to GAD .You may need to visit the restroom a lot,you may also find it difficult to concentrate.It would be prudent to seek help from a mental health professional,preferably a psychiatrist who can take a detailed history , examine and investigate you.Ruling out thyroid disorders is essential.Lifestyle modification,increased physical activity and exercise,medication,counselling and Cognitive Behavioural Therapy(CBT) are all used for treating GADS.Usually a combination of antidepressant and antianxiety medication and counselling gives the best results.Reducing stress,spending time with family and friends ,yoga/prayer/meditation usually help.A Patient normally visits many doctors before the diagnosis is made.

Customer: replied 1 year ago.

Hi, I've had tests for thyroid function along with my bloodwork for when my cholesterol was checked. The thyroid function was shown to be normal.

I'm concerned that the vision changes, pain at fingertips and quick muscle fatigue could possibly be due to a heart or circulatory problem, would it be wise to get tests like BNP bloodwork to rule those out before getting psychiatric help?

Thanks for your concern, understandably so I wouldn't want to be receiving treatment for something less threatening, even more so considering I have high cholesterol and am not very active..

Expert:  Vakul Aren replied 1 year ago.

Since repeated physical examination have been found normal,I suggest that you take the opinion of a Psychiatrist rather than go in for more investigations.Stress,anxiety and worry has been responsible for a whole gamut of symptoms which settle down with therapy.Increased physical activity and other life style modification and a healthy diet will help settle your elevated cholesterol values gradually.Therapy for GAD if diagnosed and treated can help settle your problems and symptoms .

Customer: replied 1 year ago.

I feel that the examinations done to date were very general in assumption that someone of my age group would most likely be experiencing these symptoms due to infection or something else. That conditions were ruled out based on the small proportion of individuals in my age group with heart related conditions rather than though actual testing.

I'm certainly not denying that I have an anxiety problem, I do, and I've seen therapists and psychiatrists in the past and plan to revisit soon. Yet upon my repeated visits to care providers often times the attending physicians diagnosed me by word alone. Some people are asymptomatic and some are symptomatic with certain problems, maybe I'm over thinking my situation.


I was bothered by the delayed process of being referred for specialists waiting weeks in-between but ER visits proved to not be as helpful. I probably started freaking out about the cardiovascular interests when I realized that my Gastrologist prescribed me Omeprazole as a stomach acid reducer and have not taken it yet as I was concerned a potentially dodged diagnosis on a heart condition might be exacerbated on by the side effects of this course of acid reflux relief medication, assuming I have a condition as a precaution.


So are you of the opinion from my symptoms and my story that anxiety is more of an interest than further debilitating myself with my concerns over what I think my symptoms could mean? Should I check out my heart health as well?


Customer: replied 1 year ago.
Relist: Incomplete answer.
I really don't mind waiting but a second opinion is always worthy.
Expert:  Vakul Aren replied 1 year ago.
Sorry for the delay,I had to go to the hospital for an emergency.The Omeprazole will help settle your GERD and acid reflux,it would probably do no harm.Ruling out any associated heart condition by an Echocardiography,a tread mill test or a cardiac stress test,and a Holter ECG monitoring(home monitoring for arrhythmias) will probably help relieve your anxiety about it being a heart related condition.
You should realise that symptoms from different organ systems like heart,CVS,Eye would probably be anxiety related.Further worry and stress would only aggravate your symptoms.
Vakul Aren, Doctor
Category: Medical
Satisfied Customers: 3372
Experience: MBBS,DTM&H,30 years of experience
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