[63F] Experiencing dry mouth, vision issues, and ocular migraines

Patient Description

A 63-year-old female reports several weeks of extreme dry mouth, which feels sore, cut up, and hot, without any relief from interventions. Additionally, she experiences shakiness, particularly in the arms, hands, and a strange feeling in the stomach, accompanied by weakness and mild lightheadedness that have been occurring on and off for several weeks. The patient describes a need for sugar during these episodes. She also reports new visual disturbances in the right eye, including zigzag patterns and black string-like obstructions, which she has never experienced before. She experiences ocular migraines triggered by light and visual patterns. There is a family history of diabetes and other metabolic disorders, but the patient has tested negative for Sjögren's syndrome. No slurred speech, confusion, or loss of consciousness has been reported. The patient manages to perform daily activities despite these symptoms.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Sjögren's Syndrome: This is an autoimmune disorder characterized by dry mouth and eyes. However, you mentioned that you were tested for this and the result was negative. It's worth noting that sometimes tests for Sjögren's can be negative early in the disease or in milder cases.

  • Diabetes: Your symptoms of dry mouth, shakiness, and feeling like you need sugar could be signs of high or low blood sugar. Given your family history of diabetes, this could be a possibility.

  • Ocular Migraine: This could explain your vision changes and migraines triggered by light and visual patterns.

  • Vasovagal Syncope: This is a condition that leads to fainting in response to certain triggers, like the sight of blood, intense emotional distress, or standing for long periods. You mentioned experiencing "vaso vegals" which could be referring to this.

What you can do

  1. Stay Hydrated: Drink plenty of water and avoid caffeine and alcohol, which can make dry mouth worse.
  2. Chew Sugar-Free Gum or Suck on Sugar-Free Hard Candy: This can stimulate saliva production and help with dry mouth.
  3. Monitor Your Blood Sugar: If you have a blood glucose meter, check your blood sugar when you're feeling shaky or weak. If you don't have one, consider getting one given your family history of diabetes.
  4. Avoid Migraine Triggers: If certain visual patterns and light trigger your migraines, try to avoid these when possible.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Sudden, severe headache or migraine
  • Sudden loss of vision
  • Slurred speech or difficulty speaking
  • Weakness or numbness on one side of your body
  • Confusion or difficulty understanding speech
  • Loss of balance or coordination

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare professional for a formal diagnosis and treatment.

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9 mo ago

People Also Ask

What are the common symptoms of diabetes that I should be aware of?

Common symptoms of diabetes include increased thirst, frequent urination, extreme hunger, unexplained weight loss, fatigue, irritability, blurred vision, slow-healing sores, and frequent infections. It's important to consult a healthcare provider for proper testing and diagnosis.

How can I differentiate between an ocular migraine and other types of migraines?

Ocular migraines typically involve visual disturbances such as zigzag patterns, flashing lights, or blind spots, often without a headache. These symptoms usually last less than an hour. Other migraines may include severe headache, nausea, and sensitivity to light and sound. A healthcare provider can help differentiate between them.

What are some effective ways to manage dry mouth?

To manage dry mouth, stay hydrated by drinking plenty of water, use a humidifier at night, avoid caffeine and alcohol, chew sugar-free gum, and use saliva substitutes or mouthwashes designed for dry mouth. Consult a healthcare provider for additional treatments if needed.

What should I do if I experience visual disturbances like zigzag patterns or black strings in my vision?

If you experience visual disturbances like zigzag patterns or black strings, it's important to rest your eyes and avoid triggers such as bright lights. If these symptoms persist or worsen, seek medical attention to rule out any serious underlying conditions.

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