[40F] Experiencing gastrointestinal, cardiovascular, and neurological symptoms

Patient Description

A 40-year-old female presents with a complex array of symptoms including diarrhea, chest and armpit pain, pain in the lower extremities extending to the groin and lower abdomen, and similar pains near the wrists and hands. The patient also reports lightheadedness, particularly upon standing, which is sometimes accompanied by intense tingling and brief vision distortion. Additionally, she experiences a dull ache in the chest, more pronounced on the left side, which is sensitive to deep breaths. The patient describes feeling generally weak and shaky, with a severity rating of 4 out of 10. This weakness is associated with a tendency to drop objects. The patient has been experiencing these symptoms for a little over 24 hours, with the pain in the lower extremities rated at 5 on the left side and 8 on the right side, worsening upon standing or walking. The patient's bowel movements start out hard then become watery, and are now extremely soft or loose, occurring 10 or more times a day, described as more constant with intermittent stopping. She also reports the presence of mucus in her stools, which has worsened recently. There is no reported blood in the stool. The patient feels flu-like without a temperature and has been experiencing increased heart palpitations, sometimes feeling sluggish. She works night shifts and sleeps in between, and her symptoms began after waking from sleep. She has a history of hypermobility and a rectal prolapse. There is no recent travel, no new medications or supplements, and no recent injuries or accidents reported.

Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

Gastroenteritis: This is an inflammation of the digestive tract, often caused by a viral or bacterial infection. It can cause diarrhea, stomach pain, and mucus in the stool. Dehydration from gastroenteritis can also cause lightheadedness and weakness.
- Treatment typically involves rest, hydration, and over-the-counter remedies. If symptoms persist, a doctor may prescribe antibiotics or other medications.
Orthostatic Hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down. It can cause lightheadedness and fainting.
- Treatment often involves lifestyle changes, such as drinking plenty of fluids and standing up slowly. Medications may be necessary in some cases.
Peripheral Neuropathy: This condition results from damage to the peripheral nerves, often causing weakness, numbness, and pain, usually in your hands and feet. It can be associated with various medical conditions, including infections and metabolic problems.
- Treatment typically involves managing the condition causing the neuropathy. Pain and physical therapy may also be recommended.
Paxil Withdrawal: As you mentioned tapering off Paxil, some of your symptoms could be related to withdrawal from this medication. Paxil is an SSRI antidepressant, and withdrawal can cause a variety of symptoms, including dizziness, fatigue, and flu-like symptoms.
- It's important to taper off Paxil under the supervision of a healthcare provider to minimize withdrawal symptoms.

Please note that these are potential explanations based on the information you've provided, and not a definitive diagnosis.

What you can do

Stay hydrated: Drink plenty of fluids to replace those lost through diarrhea and to help prevent dehydration, which can contribute to lightheadedness and weakness.
Stand up slowly: If you're experiencing lightheadedness when standing up, try standing up slowly to give your body time to adjust and prevent a drop in blood pressure.
Rest: Give your body time to recover. Rest can help your body fight off infections and recover from physical strain.
Consult a healthcare provider: Given the number and complexity of your symptoms, it's important to seek medical attention. They can provide a more accurate diagnosis and appropriate treatment.