[33F] Experiencing chest tightness, chills, and dizziness post-fall

Patient Description

A 33-year-old female reports experiencing chest tightness, chills, dizziness, and numbness in fingers following a fall while taking her son trick-or-treating. The fall resulted in knee and hand pain. The patient works a graveyard shift and noted worsening symptoms after waking up from sleep. She describes the chest tightness as constant for about an hour, exacerbated by deep breaths and physical exertion. She has a history of depression, PTSD, and anxiety. She is currently tapering her methadone dosage, which she takes for recovery, and has experienced mild withdrawal symptoms. The patient started her menstrual period today and has been experiencing nausea after eating, possibly due to her new work schedule and lack of sleep. She occasionally takes ibuprofen and has no known drug allergies except for a reaction to Tylenol with codeine in the past.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations for what you might be experiencing:

  1. Injury from the Fall: The knee and hand pain you're experiencing are likely due to the fall you had while trick-or-treating. Swelling in your feet and ankles could also be related to this injury, especially if you twisted or strained something during the fall.

  2. Viral Infection or Cold: The chills, shivering, and feeling generally unwell could be signs of a viral infection or cold, which can sometimes cause body aches, chills, and fatigue. This might also explain the chest tightness and shortness of breath, although these symptoms should be monitored closely.

  3. Methadone Tapering: The dizziness, numbness in your fingers, and changes in your eating habits could be related to the tapering of your methadone dosage. Withdrawal symptoms can vary and sometimes include these types of symptoms.

  4. Stress and Fatigue: Your new work schedule and lack of sleep could be contributing to your overall feeling of being unwell, including the chest tightness and dizziness. Stress and fatigue can exacerbate physical symptoms and make it harder for your body to recover from injuries or fight off infections.

What you can do

Chest Tightness and Shortness of Breath:

  • Given the seriousness of these symptoms, it's important to seek medical attention as soon as possible, especially if they persist or worsen.
  • Try to stay calm and take slow, deep breaths. Avoid strenuous activities until you can see a healthcare provider.

Knee and Hand Pain:

  • Rest your knee and hand as much as possible.
  • Apply ice to reduce swelling and take over-the-counter pain relief like ibuprofen if needed, but be cautious with dosage.
  • Elevate your leg to help reduce swelling in your knee and ankles.

Chills and General Unwellness:

  • Stay warm and hydrated.
  • Rest as much as possible to help your body recover.
  • Monitor your symptoms, and if you develop a fever or your symptoms worsen, seek medical advice.

Methadone Tapering:

  • Continue to follow your healthcare provider's guidance on tapering your methadone dosage.
  • Report any withdrawal symptoms to your provider, as they may need to adjust your tapering schedule.

General Well-being:

  • Try to maintain a regular sleep schedule, even with your graveyard shifts, to ensure you're getting enough rest.
  • Eat small, frequent meals if you're struggling with nausea, and try to include nutritious foods to support your recovery.

Consider using MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider.

What you should look out for

  • If your chest tightness or shortness of breath worsens, or if you experience new symptoms like chest pain, fainting, or severe dizziness, seek emergency medical care immediately.
  • Watch for signs of infection, such as fever, increased pain, or redness and swelling in your injured areas.
  • If your withdrawal symptoms become unmanageable or you experience severe mood changes, contact your healthcare provider for support.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan.

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3 mo ago

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People Also Ask


What could be causing my chest tightness and shortness of breath after a fall?

Chest tightness and shortness of breath could be due to a variety of factors including injury from the fall, a viral infection, or stress and fatigue. It's important to seek medical attention to rule out serious conditions, especially if these symptoms persist or worsen.


How can I manage withdrawal symptoms while tapering off methadone?

Managing withdrawal symptoms while tapering off methadone involves following your healthcare provider's guidance closely. Report any severe symptoms to your provider, as they may need to adjust your tapering schedule. Staying hydrated, getting enough rest, and maintaining a healthy diet can also help.


What are some ways to alleviate knee and hand pain after an injury?

To alleviate knee and hand pain after an injury, rest the affected areas, apply ice to reduce swelling, and take over-the-counter pain relief like ibuprofen if needed. Elevating the injured limb can also help reduce swelling.


How can working a graveyard shift affect my health and what can I do to mitigate these effects?

Working a graveyard shift can disrupt your sleep schedule and lead to fatigue, which can exacerbate stress and physical symptoms. To mitigate these effects, try to maintain a consistent sleep schedule, create a restful sleep environment, and ensure you're getting adequate nutrition and hydration.


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