[36F] Experiencing sudden dizziness, blurred vision, and weakness
Patient Description
A 36-year-old female presents with sudden onset dizziness, blurred vision, and weakness that started this morning. The dizziness is described as an unusual sense of expansion, causing blurred vision, nausea, and a headache. It is exacerbated by standing or moving too quickly and is alleviated by lying down or propping up. The patient also reports mild shortness of breath, which has been ongoing since experiencing sunburn and heat exhaustion a week ago. She feels weak and fatigued with moderate muscle weakness and achiness. The blurred vision occurs with upright movement and requires her to stand still before walking slowly. She has been experiencing mild daily headaches for about a month, which are mostly a dull ache but can become sharp with sensory triggers. The patient occasionally experiences random racing heart rates and random chest pain near the sternum. She has noticed fluid retention around her wrists and hands, with indentations that stay for extended periods. Her diet and hydration have been irregular, but she has started drinking more water and electrolyte drinks recently. Her past medical history includes mental illness, stomach issues, frequent UTIs/kidney/bladder infections, degenerative bone disease, polycystic ovarian disease, gallbladder removal, and recently diagnosed fibroid tumors on her ovaries and uterus. She has allergies to levaquin, ceclor, niacin, and latex, and an IV sensitivity to levaquin. She is not currently taking any medications and has not been able to see an OBGYN since her diagnosis of fibroid tumors. The patient has constant lower abdomen pain, which varies in intensity and has been present since the end of May. She has IBS with chronic diarrhea, experiencing 2 or more bowel movements daily, which are usually very soft or watery. She has regular neuropathy pain from carpal tunnel and arthritis in all her joints, occasional loss of feeling in her legs, and a herniated disc at L4-S1. She has a history of drug dependency, specifically meth, but not consistent use in the past 5 years.
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Arora's Assessment
What might be happening
Based on the symptoms and history you've provided, here are some possible explanations:
Dizziness, Blurred Vision, and Nausea
- Orthostatic Hypotension: This condition occurs when your blood pressure drops significantly upon standing, leading to dizziness, blurred vision, and nausea. It can be exacerbated by dehydration, which you mentioned might be an issue.
- Dehydration and Electrolyte Imbalance: Given your recent heat exhaustion and increased fluid intake, it's possible that your body is still recovering from dehydration and electrolyte imbalances.
- Anxiety and Panic Attacks: Your history of anxiety and panic attacks could also contribute to these symptoms, especially under stress.
Shortness of Breath and Fatigue
- Asthma and COPD: Your pre-existing conditions like bronchial asthma and early-stage COPD can cause shortness of breath and fatigue, especially after a recent episode of overexertion.
- Heat Exhaustion Aftereffects: The lingering effects of heat exhaustion can include fatigue and shortness of breath.
Muscle Weakness and Achiness
- Dehydration and Electrolyte Imbalance: These can also cause muscle weakness and achiness.
- Fibromyalgia: Given your history of chronic pain conditions, fibromyalgia could be a contributing factor.
Lower Abdominal Pain
- Fibroid Tumors: The pain could be related to the fibroid tumors on your ovaries and uterus.
- IBS: Your history of IBS could also contribute to lower abdominal pain.
Random Chest Pain and Racing Heart
- Anxiety and Panic Attacks: These can cause chest pain and a racing heart.
- Cardiac Issues: Although less likely given your age, it's important to rule out any cardiac issues.
Fluid Retention
- Dehydration and Electrolyte Imbalance: These can cause fluid retention.
- Kidney Issues: Given your history of frequent UTIs and kidney infections, kidney function should be evaluated.
What you can do
Dizziness, Blurred Vision, and Nausea
- Stay Hydrated: Continue drinking water and electrolyte drinks like Gatorade.
- Move Slowly: When standing up, do so slowly to give your body time to adjust.
- Monitor Symptoms: Use MDandMe to journal your symptoms and track any patterns.
Shortness of Breath and Fatigue
- Rest: Ensure you get adequate rest and avoid overexertion.
- Use Inhalers: If you have prescribed inhalers for asthma or COPD, use them as directed.
- Consult a Doctor: Seek medical advice to ensure your respiratory conditions are well-managed.
Muscle Weakness and Achiness
- Stay Hydrated: Continue to drink fluids to help with muscle function.
- Gentle Exercise: Engage in gentle stretching and low-impact exercises to keep your muscles active.
- Pain Relief: Over-the-counter pain relievers like ibuprofen can help, but consult a doctor for long-term management.
Lower Abdominal Pain
- Consult an OBGYN: It's important to follow up with an OBGYN for your fibroid tumors.
- Pain Management: Over-the-counter pain relievers can help manage the pain.
Random Chest Pain and Racing Heart
- Relaxation Techniques: Practice deep breathing and relaxation techniques to manage anxiety.
- Seek Medical Advice: Consult a doctor to rule out any cardiac issues.
Fluid Retention
- Stay Hydrated: Continue drinking fluids to help your body balance electrolytes.
- Monitor Symptoms: Use MDandMe to track your fluid retention and any related symptoms.
What you should look out for
Given the complexity of your symptoms, it's important to seek medical care as soon as possible. Reasons to seek care even more urgently include:
- Severe Dizziness or Fainting: If your dizziness becomes severe or you faint, seek immediate medical attention.
- Severe Shortness of Breath: If you experience severe shortness of breath, go to the emergency room.
- Severe Chest Pain: If your chest pain becomes severe or is accompanied by other symptoms like sweating or nausea, seek immediate medical attention.
- Severe Abdominal Pain: If your abdominal pain becomes severe, seek medical care.
Remember, while I can provide some guidance, it's crucial to consult with a healthcare professional for a formal diagnosis and treatment plan. You can use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.
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4 mo ago