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Feel extreme fatigue, anxiety and pain in abdomen. Suffered depression. Had total hysterectomy and catheter ablation. Suggestions?

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General & Family Physician
Practicing since : 2009
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Hi, I have been out of breath when I exert myself, extreme fatigue, slight pains in abdomen, and an increase in anxiety. I have also lost about 7lbs in the last 3 weeks without trying. I have suffered depression in the past and take medication for that-I dont believe that this is generalised anxiety etc. I had a catheter heart ablation in 2011, and a total hysterectomy in XXXXXXX 2012. I dont feel myself - very hard to explain! I am female 62 years of age, generally fairly well and still working. I am also a smoker of about 10 cigarettes a day. I am due to go for a chest xray on monday. I am quite firghtened as I now worried I have something sinister, I go to the gym and keep active but I just dont feel myself. What is your best advice

I would really appreicate an answer in the quickest possible time as all of this is impacting on my day to day living, thank you
Posted Sat, 17 Aug 2013 in Hypertension and Heart Disease
Answered by Dr. Rene Gerard Cruz Galera Jr 1 hour later
Hi XXXXX ! Thank you for your question and welcome to our site.

I can tell from your medical history and your life stories that you mentioned above that you have managed to survive so many life challenges already. Thank you for sharing these with me.

First and foremost, although your fatigue and pain in the abdomen may just as well be caused by stress, we have to check everything that can be caused by existing conditions - your SVT and cervical cancer.

To help me understand your case better, may I know the following:
1) please tell me more about your SVT and Cervical cancer:
a) Are regular checkups also being done? If so, when were the last check ups for these two?
b) do you have any current results of diagnostic tests related to the conditions?
c) Are you currently taking medications for these? Were there any changes in the doses or types of medications as prescribed by your physician?
2) Can you describe the abdominal pain - is it intermittent, stabbing, dull, bloatedness, gassy? From 1 to 10 (most painful), can you rate how painful it is? Is it triggered by something? What relieves the pain?
3) do you notice any other symptoms - fever, headaches, difficulty breathing, appetite and weight changes, bowel movement changes? Others?
4) does the fatigue go away? what do you do for relief?

I am glad that you are keeping fit and remain active in your work. I do hope that you can minimize the smoking - it is hard, I know - but it will really matter a lot in the long run.

I hope to hear from you soon!

Dr. Galera
Above answer was peer-reviewed by
Follow-up: Feel extreme fatigue, anxiety and pain in abdomen. Suffered depression. Had total hysterectomy and catheter ablation. Suggestions? 22 hours later
Good evening Dr Galera,

Thank you so much for the reply it was reassuring to hear from you.

I will try to be concise as I can with my answers;

SVT started out of the blue in 2010, when my heart rate would go very fast between 180-250. I usually ended up in A and E where they gave me adenosine injection which worked at the time. There was never any pattern as to when my heart rate would go into overtime. I had a catheter (cyroablation) at St Georges London in October 2011 and the consultant zapped the faulty bits!! My last follow up was last March 2012 and I was signed off - no medications used.

I had a total hysterectomy (including ovaries) XXXXXXX 2012 as I was told that I was very high risk of developing full blown cervical cancer in the very near future. I went back to my consultant in december 2012 and was told I was 'all clear' and would never have to have a smear again. I am currently on HRT hormonin tablets (biodentical) and Utrogestan capsules. I am not convinced if this make me feel ok or not to be honest. I even wonder if the hrt makes me feel worse or all the symtoms I have had over the last 6 months or so is as a result of the op, but even at 62 I am more anxious and tense than before.
My weight has dropped by 6 - 7 lbs over the last few weeks, my appetitie is generally good however if I am feeling more anxious than usual I find it hard to eat. I get occasional headaches but no pattern.. I suffer from consitpation from time to time. The abdominal pains are not exactly a pain but I notice I get a dull ache (under the breast bone like a sort of burning but not indegestion) especially when I have been feeling breathless (not at the gym!). In short I have very little respite from the breathlessness, anxiety tenseness and a general feeling of being unwell at times. I am aware that major life style changes can contribute to ill health but I do try to get on with my life as normal. The smoking is not good and I intend to go to a one day course (alan carr) in september. I often have a muzzy head, get mood swings where I cant think properly. Sometimes when im not working I just have to accept that I dont feel right and do very little, I do enjoy gardening so that takes my mind off things. Occasionally (today being one of them) I feel 'normal' a bit breathless but ok and, not too tired which is great but doesnt happen that often. I explained in my first email about the medication which I have been taking for many years, I dont wish to change this or, take a higher dose. I am not manic depressive either. Apart from the above I take a 200mg nurofen which helps with tension. I realise the above is possibly a collection of vague symptoms but definitely not all in my mind! regards Angela Richardson
Answered by Dr. Rene Gerard Cruz Galera Jr 23 minutes later
Hi XXXXX! Thank you for getting back to me so quickly!

I really appreciate all the details you provided, thank you for sharing them.

As you said, it really is a collection of general symptoms and I cannot really pinpoint a specific health problem at this point especially without me physically examining you. But I am glad that you are able to notice them and acted on it - some people just let them pass but, for them, these symptoms were actually the early warning signs of a problem that could have been cured if caught early.

Now, we cannot dismiss what you are feeling and experiencing to anxiety problems without clearing all possible medical causes. Based on the information I was able to get from you, they may all point to 1) a mild respiratory infection that is entirely subclinical - the fatigue, the pain that may be actually coming from the lungs, and breathlessness which may all contribute to anxiety, or 2) a beginning heart or lung problem (I cannot get more specific here because there really are a lot of possible disease entities presenting with the general symptoms).

For these possible problems, I agree that you do need at least an chest xray (this will help us visualize the lungs and see any possible infections too). It might also be prudent to include a complete blood count (to see if there is any ongoing infection) and an ECG (to check the heart). I suggest that you talk to your GP and also share with him these vague symptoms. Just be sincere and honest - I believe that you may just need to communicate with your GP - and I am sure that he/she will be there to listen and is more than capable of managing your care.

I hope I was able to help you out. If you have any further or future queries, you know how to reach me. You may opt to close this discussion and rate it if you do not have any more questions on this matter.

I wish you the best of health!

Take care, Angela!

Dr. Galera
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