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Dr. Bob
Dr. Bob, Medical Doctor
Category: Medical
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Experience:  20 Years in Internal Medicine, Neurology and Sports Medicine
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I have been to my doctor since my issue began on the 15/02/16

Resolved Question:

Hi,
I have been to my doctor since my issue began on the 15/02/16 and am continuing to seek medical advice while I am still suffering with my symptoms but I am starting to wonder if I should be either seeking advice elsewhere or starting to insist that my doctor sends me for some tests/scans as there isn’t much improvement 7 weeks on.
It all started on the 15/02/16 when I felt very light headed along with sickness feeling and just generally not myself. i.e. struggling to concentrate / felt like i was in a bubble.
I was at work at the time and had been there since 8am, around 11am I suddenly collapsed. I had passed out and i did come round very quickly but instantly had a major panic attack which took a good 15 to 20 minutes to calm down and realise what had happened
The next day my symptoms had not improved, infact they had worsened. Now i was very dizzy whenever I moved and got a major headache whenever I tried to move around which made me feel very sick, even though i wasn’t actually sick. I can’t concentrate on things, I struggle to talk properly as I find myself loosing concentration and just generally feeling lost.
I booked myself in to see my Dr and she was pretty certain that I had Benign Paroxysmal Positional Vertigo but arranged for some blood tests to be complete to rule out any other causes. I had the tests carried out and I took the week to rest and try the exercises that the Dr had said to try (Brandt & Daroff exercise)
I returned to the Dr a week later, still not feeling any better to get my blood test results. All was clear except low folic acid and b12 but not at a worrying level. (I am now taking multi vitamins to help raise these levels). I also had an infection that was on the way out so the Dr believes this could of been the cause to me coming down with benign paroxysmal positional vertigo.
She advised to carry on with the exercises and use otrivine nasal spray with pain killers and ibuprofen.
I was using the nasal spray both morning and evening daily and taking the painkillers with ibuprofen when needed whilst completing the exercises, but nothing seemed to help infact things started to worsen.
My sinuses started to flare up so bad that the headaches were constant and very harsh, I had pain all up my neck, shoulders, all over my head and across my face. This completely knocked me out. All I could do was sleep or I was just sat around really struggling to deal with this along with my dizziness.
This time i had to speak to a different Dr and he was sure my issues were linked to the BPPV but this time stated that I was likely suffering with eustachian tube disfunction. His advice was to carry on with the nasal spray and painkillers.
After a few more days of this I called the Dr again, again I had to speak to another Dr who said she thought I was suffering with acute sinusitis and prescribed me with Beconase nasal spray and 100mg Doxycycline.
I used these for a week and did see a major improvement with the sinus issue. This had pretty much cleared but I still had the issue of severe pressure headaches with dizziness whenever I am in motion and I am still struggling to concentrate and string sentences together.
I have been back to my Dr twice more since and I am just getting the same advice now, just carry on trying exercises and use the nasal spray along with pain killers and ibuprofen. The only change was today when she prescribed me with Fluticasone propionate nasal spray which she says to use for 2 weeks!
This is where I am getting annoyed as i keep getting told to give it another week and see, now i am being told give it 2 weeks and we will see. I don’t understand why I am not being sent for a scan or something as it has been 7 weeks and I am still struggling with everyday activities, I am off work and have been through most of this yet the Dr does not seem to be trying to get answers. I don’t know how much longer I should allow the Dr to continue like this, I really want to insist that I am sent to a specialist as I need to get back to myself and work.
My problem is I tend not to push for things, if I am told to try something then that’s what I do. I just feel that I need to be more assertive now to get things in motion. Thankfully work have been very understanding but I am starting to worry that they will not see how bad my symptoms are if the Dr does not seem to be worried.
More info
I am 33 year old male who is not unfit, I am 5 foot 7 inches and weigh 10 stone.
Medication: 20mg Citalopram which was upped to 40mg a day since these issues started effecting me. Mainly because of the panic attack I suffered after passing out.
My symptoms are probably worse in the mornings and evenings but this can effect me all day from time to time. Every evening my sinuses do tent to block up (Toop of nose) and makes me feel very uncomfortable. I tend to hear a thudding in my right ear which is like a heartbeat. I also get a numbness in my in my right, sometimes left temple.
Submitted: 11 months ago.
Category: Medical
Expert:  Dr. Bob replied 11 months ago.
Hi Shane. This scenario is actually quite common, unfortunately, and while a definitive diagnosis is elusive, the symptoms almost always improve over several months. If you were in good health before all this started, it is possible you contracted a virus for which your body was not prepared. It may have damaged the delicate machinery of your inner ear provoking dizziness, and gotten into your sinuses causing congestion, secondary bacterial infection, even confusion and lightheadedness. When the immune system goes after a difficult virus, it can create symptoms that are vague and non-specific but quite debilitating. This is believed to be the mechanism behind chronic fatigue syndrome, fibromyalgia, multiple chemical sensitivity syndrome and other rheumatologic (autoimmune) conditions. While the prognosis is typically good, you should ask your doctor for a referral to a rheumatologist in the meantime to see if he or she can pinpoint more clearly the underlying problem and manage the symptoms until they slowly resolve.
Customer: replied 11 months ago.
Thank you for your reply. It is good to hear something other than leave it for a week or two. I think I will try the new nasal spray for a week and then go back to the doctor if there is no improvement and ask if they would arrange for me to see a rheumatologic, is this something she is likely to do if she believes I should be waiting at least 2 weeks from today? Also how long would it usually take to actually get the appointment with the rheumatologic?
Expert:  Dr. Bob replied 11 months ago.
If you are not improving, your GP should be willing to get the input of a specialist, at least to make sure she is not missing something that might get worse. The time frame for this will vary depending on how many rheumatologists are available and how busy they are. In the meantime, steady slow improvement may mitigate the need to see them. Steady slow progression should prompt a request for an expedited visit.
Dr. Bob, Medical Doctor
Category: Medical
Satisfied Customers: 5222
Experience: 20 Years in Internal Medicine, Neurology and Sports Medicine
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Customer: replied 11 months ago.
Thank you for your help.

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