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911DOC
911DOC, Board Certified Dr.
Category: Medical
Satisfied Customers: 5094
Experience:  Emergency Medicine Physician
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I have been feeling awful for a long time. Sometimes I am white

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I have been feeling awful for a long time. Sometimes I am white as a sheet, I sweat a lot, have to be in front of a fan, can't tolerate even moderate heat, I feel tremulous and my hands have begun to shake, I do have anxiety, but I am also dizzy, so tired, I am always thirsty, even when my Blood sugar is good, I crave salt, my heart rate is up and down, I have nearly daily headaches, I bloat after eating, and feel full for hours after even a small meal. I do have diabetes and am working with a PharmD to get it under control, but I am tiered of feeling this bad all the time, and feeling like I am just going to fall over. My balance is getting really poor. I have not been hypotensive when checked. but I am often clammy and sweaty, even when laying down. A doctor I wasn't seeing suggested I look into dysautonomia?

911DOC :

This could all be related to poorly contolled diabetes.

911DOC :

however, there are other things that need to be checked if they have not been checked already.

911DOC :

the first is your thyroid.

911DOC :

your thyroid can be normal or be overactive or underactive.

Customer:

Thyroid is normal

911DOC :

Okay, good

Customer:

I am going to see the endocrinologist soon, but when they raise my isnulin I get more exhausted and feel like I'm going to nod off

911DOC :

have they checked you for Addison's disease?

Customer:

no

911DOC :

stand by

911DOC :

standing by

Customer:

I've actually gained weight, but most of the rest sounds like it. But what about the pallor and sweating? I don't get increased pigmentation either. I have lost most of the hair on my legs, tho, I never get low blood glucose. So some is right the rest not so much.

911DOC :

I think it is great that you are going to see an endocrinologist as this is a very complicated case and some endocrine disorders come with others.

Customer:

I will ask the Endo if they think it is a possibility. at first the doctors said I had Menieres, now they say Vestibular migraines. I don't know what to think

911DOC :

even though your initial thyroid test was normal it is still on my list as it is possible to have a problem with the thyroid and have a normal screening lab

911DOC :

I'm sure you don't know what to think

911DOC :

and it sounds like your doctor is calling in help as you do not fit neatly into any one diagnosis

911DOC :

there may be two or three

911DOC :

but endocrine is a good next step for you

Customer:

If the lab is normal how do I find out if I have low thyroid?

911DOC :

as far as dysautonomia

911DOC :

that is a diagnosis that is arrived at after ruling out other problems first

911DOC :

and as to the thyroid there are more specific tests the endocrinologist can order that will nail that diagnosis

Customer:

ok just this whole thing has been going on for years. I am so tired now.

911DOC :

the primary care tests are good at picking up most thyroid disease, but not all

911DOC :

I'm sure you are

911DOC :

i would be very hopeful, if i were you, that the endocrinologist can make some headway here

Customer:

ok so the best thing is to follow up with endocrine, not ask for neuro to eval?

911DOC :

i think endocrine needs to come before neuro... your symptoms are consistent with an endocrine problem. we know you have diabetes, but we do not know if you have addisons or any number of other endocrine conditions that may be playing in to your whole problem

Customer:

ok. Thank you for talking this over with me. It was hard to get answers talking with my doctor face to face.

911DOC :

i understand

911DOC :

these days we don't have very much time to spend face to face with patients

911DOC :

it's why i like this service

Customer:

yes, thank you very much. how do I sign off?

Customer:

Or do you have more info?

911DOC :

if this has been helpful look for the 'rating' button, positive feedback is appreciated.....

911DOC :

as to more

911DOC :

yes

911DOC :

i would list from one to ten your most prominent symptoms and what seems to bring them on

911DOC :

i would have your top five questions written down and ready to ask

911DOC :

as you may not have much time with the endocrinologist either

911DOC :

and it's good to come prepared

911DOC :

standing by

Customer:

ok. I will do that. I get flustered when I see them. do you want me to list my symptoms here or for when I see my Endo?

911DOC :

when you see the doctor... concise list... most bothersome symptoms and what precipitates them

911DOC :

and top five questions

911DOC :

including

911DOC :

the PLAN for diagnosis going forward

Customer:

ok. only the younger doctors seem to share a plan with me! Thanks very much. I'm going to do the rating now.

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