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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35509
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have asked before but got different answers depending on

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I have asked before but got different answers depending on the doctor. I was feeling faint a few times at work but only a few times. my deputy said the best thing was to walk in the fresh airi fshe hadn't said that I proably would have just run the docotor which would have been my normal practice for anything wrong with me. I was fine after that .. no more feeling faint episodes.i ha d7 years runnin gmy school when I becam eill. some of your doctors think this was because I didn't see the doctor when I felt faint. but tow others think it was a separate issue as it wouldn't have waited 7 years. I am writing now to fin d out exactly what the correct answer is? could I be ill for ten years now because I didn't get checked out or is it a separate issue? ten years ago I was convinced that my back was broken and that I was dying. I hve been sur ethta I ma dying for ten years but don't know what from. I have had ecg's which have been fine. and a whole lot o fblood tests which have been fine except the liver one. I get very sweaty and prone to iut's.
at first I was put in to a mental home and had ect's now I am in a supported living house. I miss my job as a headteacher very much. at first my physriast said I ahd semantic delusional disorder but changed his mind when I didn't respond to the phycotic medication. he now says that I have unspecified neurotic disorder . but when I challenged him said he didn't know what was wrong with me and that I could die. I don't know what of unless it is something that would have been treated when I was feeling faint. but surely i would have felt faint again if it was something life threatening? and perhaps got other symptons too.? if it I not because of feeling faint why have I felt I am dying for ten years? and have been scared to go out? I have tried counsellors and anti anxiety medication. can I have a final answer on this? my life ha sgone down hill. I wa sso happy with my teaching career and bringing my boys up and had no health problems going to the well woman clinics regular smear tests and mammograms. the first time I had a problem was when I felt faint a few only happened at work.
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 2 years ago.
I am Dr. Arun and will be helping you today.
I am sorry that your question was unanswered for long.
Before labeling it to a psychological issue; I would investigate you thoroughly. Chronic issues play on mind and many times mind symptoms may supervene and thus doctors may start believing this to be a psychiatric disorder. Also psychological issues may cause physical manifestations. Still thumb rule is to investigate the physical symptoms thoroughly to exclude any physical ailment.
Having said that; I would advice you to relax, meanwhile you are investigated. As anxiety would complicate the issue and make the diagnosis difficult. Human body and mind have lot of interplay and both of them cannot be taken in isolation. Cognitive behavioral therapy can be tried with yoga, relaxation techniques, deep breathing exercises and mild massage. All of these are considered good aid to relaxation.
You should be evaluated for the following which are the commonest cause for feeling faint or syncope;
1) bradyarrhythmias; this is sudden slowing of the heart. it is mainly due to sinus and atrial node dysfunctions. Sick sinus syndrome is a prototype of these arrhythmias and is a major cause for syncope. 24 hour Holter monitoring, echocardiography etc are the investigations done for it.
2) neurocardiogenic mechanisms; this is fall of the blood pressure suddenly due to a sudden sympathetic failure (failure of the autonomic nervous system).
3) carotid hypersensitivity syndrome is an exaggerated response to carotid sinus stimulation. In some studies almost 50% cognitively normal people who had experienced sudden sensation of fainting were diagnosed with carotid hypersensitivity.
4) orthostatic hypotension is due to failure of autonomic nervous system and related heart regulatory mechanisms.
These are the more frequent causes of syncope.
Following investigations need to be pursued in your case;
1) MRI with gadolinium contrast
2) Magnetic resonance angiography (MRA)
3) Tilt table test
4) Carotid sinus massage
5) Electroencephalography (EEG)
6) Stress cardiac test
7) Total creatine kinase (CK) and heart enzymes; done immediately after the fainting episode and would tell about the abnormal brain or heart activity which caused the sensation of fainting.
8) Following also may be done after the episode; blood electrolytes and blood glucose.
These should be able to zero down the cause.
It is privilege assisting you.
Please let me know if you have further queries or unanswered questions.
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Thank you.
Wishing you all the very best in life.
Expert:  Dr. Arun Phophalia replied 2 years ago.

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