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I have had this several times within the last few months. I…

I have had this several...
I have had this several times within the last few months. I am awakened at 5:00 am with a queasy stomach and feel nausea. Cold sweat on forehead. and heart racing. I then get up out of bed and ususally take my pulse. Today I counted 112 but that is after it slowed down. I think it may have been about 130-140. I do some deep breathing and then it will slow back down. The rest of the day my legs felt like jelly or sea legs and I am very achey tonight, feel like I am running a fever of 100 with the aches, but no fever. I keep getting these symptoms. When I go to dr, basic blood tests always are normal. What do these symptoms sound like to you?
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Answered in 1 hour by:
6/23/2018
Dr. Nina Lim
Dr. Nina Lim, Board Certified MD
Category: Medical
Satisfied Customers: 1,074
Experience: Internal Medicine Physician
Verified

Hello, my name is***** and I am an internist and women's health physician. I am sorry you are having this health concern.

Do you currently take any medications?
I was reading through your symptoms and below are some medical conditions that immediately came to my mind, even before knowing about your past medical history and medication list.

- hypoglycemia (low blood sugar) very early in the morning causing the nausea, queasiness, cold sweats and heart racing - what you would do is try to check your blood sugar as soon as you wake up (you will need a glucometer of course), and this the way to rule this out

- arrhythmia - irregular heart rhythm - you would need to wear a Holter monitor for a few days to see if the machine can detect any significant arrythmias that are causing symptoms

-sleep apnea that would make you more prone to irregular heart rhythms - you would need a sleep study to rule this out

-fibromyalgia - this is for the general achiness, feels like you have the flu

-anxiety/ panic attacks- deep breathing very helpful for this, and you may need to see a psychologist.

I am available for any follow up questions so please feel free to ask. Thank you so much!

If you were satisfied with the service I provided, please consider giving me a 5 star rating as we work for stars, thank you again.

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Customer reply replied 1 month ago
let me give you a little more history of myself. I have a very long history of blood tests that show current activation of Epstein Barr Virus. This blood test always shows current activation during the last 25 years. I was told I have Fibro although I don't have the pain that most people have, but do have have chronic fatigue and exercise intolerance and leg fatigue. When I turned 50 developed high bp and long episodes of sinus tachycardia lasting up to 10 hours. Ended up in ER 3 times from this. They didn't really do anything, but am taking a ccb right no. Also take Losartan. The ccb has helped me from having the long episodes of tachy, but sometimes rarely I wake up like I said above with a racing heart that will settle down within 15 minutes or so. . I am also perimenopausal as I am 53 and having irregular periods. The episodes of nausea and fast heart rate started within the last year. So going back to the original question. I don't have it very often, but basically I wake up around 5:00 AMt to bad nausea cold clammy forehead sweat and then I will notice the heart racing. I have worn heart monitors a few times in the past which reveals pvc/ pac and sinus and atrial tachy. I had one episode 12 years ago of nonsustained vt which cardio doc doesn't seem to concerned about. The episodes I am getting of jelly legs is kind of new. I have had leg fatigue in the past, but not without doing something. I will just wake up and have them. Feels like sea legs. I was reading on menopause blogs of other women complaining of same thing .

Thanks for the detailed information.

Your history of supraventricular tachycardia may not be well controlled so that may be why you are having breakthrough episodes. What CCB are you on and what is the dose? What is your average blood pressure and pulse rate when you check it with your machine?

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Customer reply replied 1 month ago
my average resting pulse rate can be 64-74. The break through episodes are not enough to make me switch meds because I can tolerate them. My cardio doc says they normally don't treat sinus tachy. The only reason I was treated because it was distressing when it would last several hours. My bp is normaly 120/ 78 for the most part, sometimes it will be 135 systolic. I was on a beta blocker altenolol and that was causing some strange constricted feeling in my chest. I could hardly walk into a store. So now I take 120 mg of Diltiazem ER. I do better on small doses of meds.
Customer reply replied 1 month ago
I would like to add that I think the nausea may have caused a vagal response, thus the higher heart rate and cold sweat. I have had vagal responses before.
I understand. Would it be possible that the response you are having is from low blood sugar too - have you had the chance to check on that?
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How about a sleep study? Have you ever had one done?
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Customer reply replied 1 month ago
I have checked my blood sugar and it is in the normal range. I have not done a sleep study. I have suffered from severe insomnia and anything at all that is different will cause me not to go to sleep. One time I had insomnia for 21 straight days and developed sleep anxiety, because when I know I have to sleep I just can't. I just know I won't sleep during a sleep study with wired on me etc. I have trouble sleeping in a hotel. I also think a sleep mask woiuld be challenging for me if I did get diagnosed with apnea. I do have daytime sleepiness and can easilty take a 3 hour nap. I always thought that was related to CEBV diagnosis. I am overweight. If I do have apnea it would be related to enlarged tonsils and face structure. What I think makes me the most sleepy is the fact I have so many vivid dreams and storylines I can remember. I recall all of my dreams and dream the entire night. They say if I am dreaming that means I am having deep sleep, but I don't feel like I have slept sometimes. Another strange thing is I dream within 10 minutes of sleeping. As I will wake up and think I have been asleep for awhile because of the length of the dream and I only slept 5 or 10 minutes. I didn't know you can fall into dream state that quickly. Sometimes I wake up at 7:30 AM and should just get out of bed, but when I fall back asleep and keep dreaming more, it just makes me more sleepy. I do have a choking thing going on also. I wake up and feel like I swallowed some object and I am hacking it up, like I am choking to death, but then realize there is nothing there and go back to sleep. I don't do this every night. Sometimes there is a span of time between the episodes. The strangest thing about this phenomenon is it only occurs within the first hour of falling asleep, which I find pretty strange. Someitmes if I have a bad dream, I will wake up and feel nerve pain all over my body, almost like my body tensed up during the dream. So lots of weird sleep situations here going on. I was reading about nocturnal choking syndrome which sounds like it may be a type of parasomnia.

Oh wow! You have such interesting symptoms. You know, sleep studies are now done at home, so you don't have to sleep in a strange environment. And reading your symptoms makes me feel it is important to get this test done. I hope you will consider it.

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Customer reply replied 1 month ago
My husband just had one done at home and that would be easier ,but it is so mental for me. Knowing I have to sleep to do the test will cause me to not sleep. I know it sounds strange. If I can't get to sleep, I have to pay to do the test again. Also not sure if the home one will address the dreaming issues, because the one my husband did was only oxygen and breathing wasn't showing brain activity like the sleep labs do. It is such a process. His was positive, so now he has to go to the lab to get a mask that shows the right level of oxygen and then he will have to back a few more times. Just not sure I would be able to do this more than once. Once I get into insomnia sometimes it takes awhile for me to get back on track. I know I should do it, but just don't know if I can.

I completely understand. I apologize that I cannot help any further as I am out of ideas. Would it be ok if I opt out for now and allow other experts to weight in on your question? I really hope you find the answer to your health concern one way or another.

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Customer reply replied 1 month ago
That is okay. You don't have to refer me to anyone else. I would like to ask you is it possible that perimenopause could be causing the nausea and fast heart rate?

Anything is possible especially with fluctuations of hormones. But I personally feel that other things must be ruled out first before chucking it up to menopause. Too many things are attributed to menopause so other conditions are overlooked.

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And really the only thing you can do to diagnose this is to try hormone replacement therapy and monitor if the symptoms improve or not. There is no other way to test for it.

Dr. Nina Lim
Dr. Nina Lim, Board Certified MD
Category: Medical
Satisfied Customers: 1,074
Experience: Internal Medicine Physician
Verified
Dr. Nina Lim and 87 other Medical Specialists are ready to help you
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Like I said above, I really hope you get some answers. Feel free to update me in the future if you have any additional testing done. Take care always.

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