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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 63989
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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Hello, please help. Im feeling really spacey unreal and like

Customer Question

Hello, please help. Im feeling really spacey unreal and like im going to die any second. I feel like this 24 hours a day. Ive had blood tests, blood pressure check, balance tests etc and nothing can be found wrong with me but im so certain im about to die.
What can i do?

Please help

I feel like im going mad
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
We have already discussed the options for management of this problem.
What question do you have that has not yet been answered?

Customer: replied 3 years ago.
I was on another website and a doctor said i may have a brain tumour?

Is this true?
Expert:  Dr. D. Love replied 3 years ago.
Is this the only question that you are going to ask? I ask this because the amount that you have said that you are willing to pay with this question would cover this question, but it will not cover 4 hours of discussion of other issues, as you have done on previous questions. I do not want you to have a false impression of what service is offered and want to be sure that you understand this before we proceed.

Customer: replied 3 years ago.
This is the only question
Expert:  Dr. D. Love replied 3 years ago.

Very good.

There is no evidence that there should be any concern that you have a brain tumour. I’m not sure how much information that you gave to the other web site, but a brain tumour would not cause symptoms that have been present since age 13, getting worse recently, and also have a completely normal neurologic examination.

Even if we ignore the presence of symptoms since age 13, there would not be a reason for concern. It is true that early in the course of the growth of a brain tumour, there may be no symptoms or changes on neurologic examination. But as the tumour grows and progresses to the point that it is causing the symptoms that you describe, there would be evidence of neurologic dysfunction on neurologic examination. Since you have a normal neurologic examination, there is no reason for concern that you have a brain tumour.

As we discussed previously, I cannot examine you, so this statement is obviously dependent upon the examination that you say was done by your doctor, and you say that you trust your doctor’s examination. However, what we discussed previously would also apply to this situation – if you do not trust the examination of this doctor, it would be reasonable to consider seeking a second opinion. But if you trust the examination by this doctor, then there is no reason to seek a second opinion and no reason for concern that a brain tumour is causing your symptoms.

If you need any clarification of the answer to this question, please let me know.

Customer: replied 3 years ago.
Yes all of my tests the doctor did were normal.

Ive also had an eye test would it be picked up there?

I told the other doctor everything she said to go for an mri scan as could also be brain lesions or ms
Expert:  Dr. D. Love replied 3 years ago.
An eye test is only one part of a neurologic exam, as it will only detect a brain tumor affecting the part of the brain affecting vision. It is the entirety of the neurologic exam that is meaningful regarding this question.

Customer: replied 3 years ago.
What is the neurological exam? Im not sure what that means?
Expert:  Dr. D. Love replied 3 years ago.
It is a series of portions of the physical examination that test the function of the nervous system. It is similar to the cardiac examination of the heart and the pulmonary exam of the lungs.

Customer: replied 3 years ago.
So is it like balance testing, following finger with eyes etc? I still dont quite understand. Can you give me an example a test?
Expert:  Dr. D. Love replied 3 years ago.
An example is the pupil reaction to light which assesses the third cranial nerve. Yes, balance testing and tracking with the eyes is part of it. If you want to understand the entirety of the neurologic exam, it is an entire chapter of any standard physical examination textbook.

It sounds like you do not trust that your doctor did an appropriate examination, and if so, it is appropriate to seek a second opinion.

Customer: replied 3 years ago.
Yeh the doctor did do this. Would there not be other symptoms aswell tho like headaches, seizures etc?

Can spaciness alone possibly be a brain tumour?
Expert:  Dr. D. Love replied 3 years ago.
There can be many different symptoms from a brain tumour, but any single or combination of symptoms can occur. Yes, a brain tumour can cause all of the symptoms that you describe, but as I noted above, if it has progressed to the point that it is causing your symptoms, it would be causing changes on the neurologic examination. Since there were no changes seen on physical examination, there is no reason for concern about a brain tumour.

Customer: replied 3 years ago.
Another doctor on this website said theres no way my symptoms could be a brain tumour as there would be other symptoms present and he is a tumour specialist.

Im getting different answers from people so just dont know what to believe
Expert:  Dr. D. Love replied 3 years ago.
This is not a question.

I have answered your question, so it is time to provide a positive rating.

Customer: replied 3 years ago.
No im not happy as being told different things so;

Why am i being told different things? I was told previously theres no way i could have this with the symptoms ive got
Expert:  Dr. D. Love replied 3 years ago.
This is now a separate question. If you want me to address additional questions, then you need to first provide a positive answer for the answer to the first question.

If you are not happy with my answers, then there is no reason for me to continue to provide any answers.

Customer: replied 3 years ago.
Yeh im not happy, i find you to be quite rude and unsympathetic which is not nice for a patient who is really struggling and id very scared.

Ill like a different expert to answer my question above
Customer: replied 3 years ago.
I have just spoken to another expert who was very very helpful. Told me no way could have a brain tumour and strongly disagreed that my symptoms could be a cause of this. They said spaciness alone would never cause this. There would be weakness or loss of feeling or headaches etc.

I would like you to take this feedback on board as dont think you are very sympathetic or helpful. You make me feel upset and anxious
Customer: replied 3 years ago.
I have just paid for another answer but nothing is there?
Expert:  DrRussMD replied 3 years ago.
Hello
I provided you with an answer on this question.
And I think the answers are the same.

Since you don't have exam findings, this is not at all likely a brain tumor.

The other thing is, a brain tumor would not just go on and on without having progressive symptoms which you do not have.


So, you can not get a 100% diagnosis on the internet, and I have told you this before.

I also told you that if your doctor has a concern on exam, then an MRI is the test to alleviate your concerns.

I think the main problem is anxiety.

Anxiety is often a catch 22, because you want reassurance, but no one can really give you reassurance. The way anxiety works, even if you have the MRI and it is clear, you are likely to worry that the MRI missed something, or worry about what else this problem can be.

So, you need to effectively treat the anxiety.

One thing that might help...go back and ask your doctor to repeat the neurological exam, or send you to a neurologist for exam.

If you get cleared this way, there is really not even much of a reason for an MRI.


Use reply to let me know if you have further questions [click reply to expert].
Please do not forget a positive rating [hopefully you will click an excellent; or come back to ask me more as needed].
Customer: replied 3 years ago.
Thanks for your reply.

So if i was a brain tumour there would be other symptoms by now?

I cant get a scan as the doctor wont refer me due to normal results.

Ive seen 4 different docs who are all saying the same
Expert:  DrRussMD replied 3 years ago.
Yes
Over this period of time you symptoms should have progressed if it were brain tumor.
Use reply to let me know if you have further questions [click reply to expert].
Please do not forget a positive rating [hopefully you will click an excellent; or come back to ask me more as needed].
Customer: replied 3 years ago.
I literally feel like im nearly dead. Its bloody awful.

If i could just reduce this spaced out feeling id be fine
Expert:  DrRussMD replied 3 years ago.
As we discussed before, your meds have not had time to kick in for the anxiety.
So you will have to relax and give it more time.

Please click a positive rating.
Come back as needed.
Customer: replied 3 years ago.
Should it really be this bad though? Where i cant function and get through the day. To feel so bad like im dying?
Expert:  DrRussMD replied 3 years ago.
Yes.
This is classic for both major depressive disorder and anxiety disorder.

Quite common.
Please do not forget a positive rating.
Customer: replied 3 years ago.
Could it be a mixture of anxiety and depression
Expert:  DrRussMD replied 3 years ago.
Yes that is common as well.
Please click a positive rating.
Customer: replied 3 years ago.
I really hope this goes away. I feel stuck with no way out.

How can i get through the weekend?

Expert:  DrRussMD replied 3 years ago.
That is for your doctors to say.
If you actually feel that you can not "get through the weekend" then you need to go to the ER.

Recovery from this is a matter of weeks to months.

It should get gradually better week to week.

I have also mentioned to you before some of the things that your doctor need to be checking and prescrbing.
Therapy
Check magnesium levels, if under 2.5, supplement. Quite important.
Check thyroid studies, and if TSH is over 2.5 this can be considered hypothyroid.

All routine labs.
Iron levels
Lead levels.

I would personally check a heavy metal panel.
I would check a celiac panel and anti-gliadin antibody....to rule out gluten sensitivity as well.

Please click a positive rating.
Customer: replied 3 years ago.
Ive had most of the tests done already that you have mentioned,

I cant see my doctor till next week.

All i want to know theres light at the end of the tunnel
Expert:  DrRussMD replied 3 years ago.
I have already told you there is many times.
And I really doubt your doctor did all of these tests....they are not routine.
But you can easily double check.
Give it some time.
Use reply to let me know if you have further questions [click reply to expert].
Please do not forget a positive rating [hopefully you will click an excellent; or come back to ask me more as needed].
Customer: replied 3 years ago.
What is the heavy metal panel?
Expert:  DrRussMD replied 3 years ago.
It is a 24 hour urine test to measure things like lead, arsenic, cadmium, etc.
Please click a positive rating, come back as needed.
Customer: replied 3 years ago.
Could any of these tests indicate a serious condition?
Expert:  DrRussMD replied 3 years ago.
The tests I have recommended are self explanatory.
Thyroid.
Magnesium for low magnesium, heavy metals to see if you have heavy metal toxicity, and so on.
All abnormal conditions are serious, but not life threatening in most cases.


I apologize, but I have not seen a positive rating for any of my work, and we are only paid PER positive rating by JA.

Please click a positive rating THEN come back as needed.
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 63989
Experience: Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
DrRussMD and 4 other Medical Specialists are ready to help you
Customer: replied 3 years ago.
Well ive had thyroid and iron checked definitely.

What do i do coz the doctor has said they dont need to do anymore tests as they are satisfied its anxiety.

How can i get these tests done if the doctor wont allow it?
Expert:  DrRussMD replied 3 years ago.
Saying you had the thyroid checked tells me nothing. I would need to know the TSH value exactly.
You can find a doctor that does functional medicine.
They are better trained in this type of testing.
See this site.
www.functionalmedicine.org
see the find a practitioner link, upper right of the page.

Use reply to let me know if you have further questions [click reply to expert].
Please do not forget a positive rating [hopefully you will click an excellent; or come back to ask me more as needed].
Customer: replied 3 years ago.
I dont know the doctor said it was fine so if they have said that shouldnt that mean its ok?

Is that type of testing available in the uk?
Expert:  DrRussMD replied 3 years ago.
I am not going to second guess your doctor. Your doctor will gladly tell you what your TSH was.
All of this testing is available in the UK
And if you call the institute of functional medicine, they will give you some names of doctors that the IFM trained in functional medicine about a year or two ago.

Use reply to let me know if you have further questions [click reply to expert].
Please do not forget a positive rating [hopefully you will click an excellent; or come back to ask me more as needed].
Customer: replied 3 years ago.
Why dont general doctors know to do this testing? You would never know what was wrong unless you research.

I always thought a gp would have the training to spot things like this and help
Expert:  DrRussMD replied 3 years ago.
I am sorry, that is not a question for me.
And in fact some general doctor do know this, some don't.
OK
Good luck.
I'll expect to hear from you when you have taken some action; at least call the IFM and find out what your TSH is.
Be sure to let me know.

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