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Dr. Amir
Dr. Amir, Doctor
Category: Medical
Satisfied Customers: 8842
Experience:  Master of Internal medicine & Gastroenterology with six years of experience (London). MBBS
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I have episodes of extreme fatigue sometimes to the point of

Resolved Question:

I have episodes of extreme fatigue sometimes to the point of becoming very short of breath at the slightest movement. I have been to 3 cardiologist, 2 pulmonologist, allergy specialist, neurologist. I always have episodes after being sick especially with bronchitis. Chemicals/perfumes will trigger episodes. These episodes last anywhere from a couple of hours to a couple of months. I have been labeled depressed(I am not), anxiety (would be the world's longest anxiety attacks. I have had a couple many years ago. These are not), or chronic fatigue. Steroids, inhalers etc do not help or shorten the attacks. The only thing I can do is stay in bed until they pass. I am normally very athletic but can no longer play sports AJ
Submitted: 7 years ago.
Category: Medical
Expert:  Dr. Amir replied 7 years ago.
Thanks for your question. I can only guide you here. I would like to have few details from you. Any specific tests done for lungs like spirometry, if yes then any positive findings in that? allergy specialist was able to find any aspect of allergies? any thyroid function tests done? history of heart burns in the past or abdominal pains like in acid-reflux? history of diabetes?
Customer: replied 7 years ago.

I have all of the following test run. Each one came back normal.

Lung scan, methocolene challenge, bronchoscopy, heart scan, ekg, tilt test, echo cardiogram, stress test, ENG, sleep study, allergy skin test ( I was told I do not have any allergies and do not have the asthma I had been previously treated for when these episodes started approx 10 years ago and now become more frequent) I have played all the doctors games to make sure I wasn't missing anything. I was put on three different anti depressents ( at different times of course), anti anxiety meds, steroids, inhalers. I do have hypothyroidism but synthroid keeps my levels acceptable. I was walking up to seven miles a day but excercise is more difficult now though I keep trying.

Expert:  Dr. Amir replied 7 years ago.
Thanks for your details. You missed my very important question which I asked above which is history of heart burns? history of abdominal pains like acid-reflux disorders? any tests done to rule out GERD?
Customer: replied 7 years ago.
Sorry. No heart burn. Had an endoscopy done when I was having trouble with my gallbladder. There was no sign of reflux or any other gastro problems. It was removed in March of 2005 making no difference in the episodes. As a matter of fact when I said I usually have them after being sick I had a major episode 5 days after my surgery landing me in the hospital for 3 days. They used gas to put me to sleep. I fought it because as soon as I got a whiff of it I got tight i the chest. I failed to mention that during the episodes my chest doesn't hurt but it does feel as though my breathing space is restricted. My heart also beats so hard I can feel it but it doesn't always beat fast. My normal heart beat is 62 and blood pressure is 110/62. During these attacks I can lay in bed until I am breathing slow but shallow. If I get up and go to the bathroom (or anywhere) by the time I get back to the bed I am as out of breath as if I just ran as hard as I could for a long distance.
Expert:  Dr. Amir replied 7 years ago.
Thanks for your details. You are anemic or not? history of wieght gain or loss? any visible neck swelling due to thyroid? history of joint problems with that? history of any stress or panic attacks in the past? You can relate these episodes with some specific event? what about your sugar levels? I have to ask all these questions in order to guide you well.
Customer: replied 7 years ago.
I have a complete physical every year. All my blood work is completely normal. The neurologist sent 9 vials of my blood to test for everything she could think of. According to every doctor I've been to I am healthy as a horse. I just wish I could always feel that way. The only thing abnormal was on my last visit to the emergency room my arterial gas level showed my Co2 level at 25. They said it was because I was hyperventilating. I know technically that is what I was doing but it couldn't be helped. As I stated any kind of movement during these episodes makes me breath as though I just ran a marathon.
Expert:  Dr. Amir replied 7 years ago.
Thanks for your details and really appreciate that. This is related to my field of specialty which is Internal medicine. I have asked most of the questions from majority of the body systems which can cause your problem. I reviewed your case specifically with much interest and more time because really want to help you. Your symptoms are some what for atopic asthma which is triggered by chemicals, perfumes and for that spirometry lung test is important. Other possibilities are for anxiety attacks and hypothyroidism. Remember most of the people with thryoid dysfunctions do complain of shortness of breath and I will suggest you to have thyroid scan done as well. I will advise you to join YOGA classes, behavior therapy and hypnotherapy will be beneficial for you. There is nothing much can do here because the good news is that your every body function is fine and I am happy for that. Take multivitamins one tablet daily and it will help in reducing the fatigue. I can give the possibilities and show the right direction here.

Best of luck and keep in touch
Dr. Amir Javed

Edited by Dr. Amir on 10/29/2009 at 7:38 PM EST
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