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Forum Name: Headaches

Question: Headache, Chest Pain, Tremors that Get Worse at Night


 shumphreys1104 - Fri Jan 16, 2009 12:49 pm

I am a 23 year old female and for the past three months I have had a wide range of symptoms that appear totally unrelated but that continue to get worse. The doctor I am seeing has passed me off to another doctor because he can't figure out what is wrong. Here are the general symptoms: Chest pain on both the left and right side, sometimes sharp and sometimes burning pain that radiates into the shoulders and back, difficulty breathing and swallowing, severe headaches with throbbing, pain behind the right eye, muscle pain and soreness in one leg at the calf, neck pain and nodules, dizziness, body tremors/shocks at night when trying to sleep. The pain is constant systemically and is dull ache during the day, and severe at night. I cannot sleep at all because of the pain and the muscle tremors and inability to breathe. I am seriously at a loss as things continue to get worse.

I have had a chest xray, a CT Scan on my chest, extensive bloodwork, brain MRI, EKG, echo, and have been tested for RH factor, and H pylori bacteria. All of this has come back normal. They attributed the symptoms to stress but Valium, sleeping medication (ambien), and SSRIs do not improve symptoms. Please, any help that can be given would be appreciated. I am truly at a loss.
 John Kenyon, CNA - Sat Jan 24, 2009 11:52 pm

User avatar Hello -

While the tests and exams have all been appropriate and seem to have ruled out the most obvious potential problems, there is still a range of autoimmune stuff that's left to rule out, and which could be narrowed down some by a trial of a pain blocking medication. Since you apparently do not have multiple sclerosis (MS) or any central cause for this, you may have either polyneuritis (a sometimes virally mediated, sometimes autoimmune, system-wide inflammation of nerves throughout the body); it also could be peripheral neuropathy, a similar problem but frequently without a determinable cause. In both cases anti-seizure medications which are also used to block pain sometimes can produce dramatic (or at least significant) relief from symptoms.

This also could, conceivably, be polyarteritis, an inflammation of arteries (sometimes large, sometimes small, sometimes both, sometimes highly localized and sometimes widespread) which can cause lots of pain, organic dysfunction, etc.

There are some other autoimmune diseases which also should be ruled out and which haven't been as yet. While SSRI medication is sometimes helpful with symptoms of this sort, drugs like gabapentin and pregabalin are usually more helpful and might well help narrow down the range of potential disorders to be identified. The relief alone, if one of these meds should help, would be a big step forward.

I hope this is helpful to you. Please follow up with us here and keep us updated.
 shumphreys1104 - Mon Feb 23, 2009 5:29 am

They have tested me more extensively for autoimmune. I had an ANA test come back positive, and they sent me in for more specific tests after that. I haven't heard back yet but I am still in a great deal of pain. I have excruciating leg pain, a rapid heart rate, still the chest tightness and am still unable to sleep. If anyone still has any suggestions please let me know. I will keep this post updated as I continue to seek answers. Is a neurologist perhaps the right kind of specialist to go see?

Oh also, was tested for gall bladder problems and they found small stones and sludge. One doctor has suggested removal. I will consider this but it seems unrelated to the other problems I've been having and thus I am reluctant to have this surgery.

I had surgery approximately one year ago and had half of my thyroid removed because of a 3.5 cm cyst on the left side that was pressing on my airway. Don't know if this could be related to current problems or not, although all my thyroid hormone level tests have come back normal.
 John Kenyon, CNA - Tue Feb 24, 2009 11:48 am

User avatar This ANA result confirms my suspicion of autoimmune problems. This will probably be managed best by a rheumatologist with "tag-teaming" possibly with a neurologist, if the problem is affecting nerves as it seems to be. The pain blocking medication still seems a possible avenue of help, although once the basic problem is identified steroids may be more effective in the short run.

With all this going on it may seem overwhelming to consider having your gallbladder removed, but since this has become such a simple, routine procedure, and since it can really add to your physical woes, it probably would benefit you greatly to have that out of the picture and not clouding the collective symptoms. Also, you'd feel better in general once that's done.

Please do keep us updated. Having a diagnostic direction is a big first step.
 shumphreys1104 - Wed Mar 18, 2009 2:55 pm

I will be seeing a Rheumatologist but cannot get an appointment until Mid-April. Will follow up with results.
 shumphreys1104 - Mon Jun 22, 2009 12:44 am

I'm back and better in some ways and not in others. The rheumatologist sent for xrays from head to toe and A LOT of bloodwork. The only two tests that have come back abnormal is the ANA and D Dimer... both pretty nonspecific findings. Everything else normal- 60 labs, and everything falls in the normal range.

I had the gall bladder surgery, which came with some minor complications, but an overnight stay in the hospital along with extensive testing for clots (because the leg pain seemed to get much worse after surgery) and a few days later I returned to my version of normal.

I saw an allergist as well, which helped determine that I have severe allergies- both indoor and outdoor, including severe dust and mold allergies. I also had lung function tests which determined I have a pretty severe lung deficiency that was improved by bronchodilators. They concluded that I had significant asthma that required treatment.

So now I am on a regiment of inhaler, allergy meds, omeprazole (for GERD), and unfortunately ambien. I don't think I have slept through the night without it in several months now. I get the tremors in the night still when I don't take the ambien. Its like being shocked with an electrical current, but not in the jerky body falling asleep kind of way because its rather painful. Still have leg pain and burning in my feet. I am trying to work on exercising more to see if it helps the legs. But I am not overweight. I am pretty average.

Now that you have my whole story I will conclude by saying I still have chest pain after two months of regular inhaler use, severe headaches, intermittent stomach pain, pretty constant leg pain, feet burning, and insomnia. I have found a new primary care but the doctors don't have much more they can do really.

Any suggestions?

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