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Having constant migraine, heart burn, acid reflux, depression. Am I suffering from anxiety?

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General & Family Physician
Practicing since : 2005
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I have serious migraines that seem to be constant lately and are fairly debilitating. I have come to the point where i dont know what to do just to get a little relief and be able to see and think while doing my work. I had until recently been trying to search for an answer to all my health problems but i sort of came to the point where i dont care what it is anymore i just would like pain relief. Now dont get me wrong there are some good days everyonce in a while i will have a day or two completley pain free and thats awesome, i hardly know what to do with myself. In that case i am usually very hyper and super playful and wild because it is great to feel normal for a short time. Currently i have been experiencing other symptoms that have be disconcerning. I have had a lot of numbness or tingly in my legs, then followed by heat and extreme pain for multiple hours on end, leaving me wishing i was in the ER with help, but ER is not something that i enjoy nor that i would like to associate myself with always doing, i have already had to do this far too often for the recent migraines. Secondly and this may be anxiety, or thyroid but it really bothering me, i have tight feeling like choking in my throat and kneck, this is something i have experienced off and on for maybe a year or two since on thyroid meds, but usually it only lasts breifly and then goes away entirely but this time i have been dealing with this for three days and my heart is fluttering too which is uncomfortable. Along with the kneck choking i feel like i am having a heart attack but i know it is not my heart and it is just something in my chest but i cant explain how severe the pressure is and how off and on it is. i do not have a history of heartburn or acid reflux in fact i never really experience any kind of burping or burning or pain after eating etc and i am on a bland healthy diet. This may be the panic attack or anxiety attack others mention, it just seems so strange to me because even if i am overlaoded with all this stress of my health, i am even now as i experience this, sitting here calm and happy besides all the pain and that it makes me feel stressed but i dont believe that i was feeling stressed before i felt the pain in my chest and throat. Other things i have been experiencing lately are slurred speech at times comlpetely randomly and loss of good motor function like hands shaking and not able to grip well, or balance or vision things like this, usually breifly and not normally brought on by anything in specific. My questions would be are these things concerning, and why might they be happening, and there is so much more to this story but i dont want to write this any longer than it already is. I dont think i am in denial, all of my friends think that i am fine except for health issues, and my coworkers seem to feel i am normal and not experiencing any depression or panick disorders. The last doctor i asked (turns out he is a psychiatrist) suggests that this may be somatoform and that i am clearly depressed, but without being the classic girl in denial of depression i just dont feel like that is anything i am experiencing. My understanding of most forms of depression lead to the lack of ability to function in everyday life and excell or complete normal tasks and also usually involves some form of sadness and or social withdrawal. I am not sad, i get stressed and angry often but only times i get sad is when i sit in pain for days until it gets so extreme that right then at that moment i cannot function but just from pain not mental ability, because on a regular basis i function through pain like i am now. I play sports, i have friends, i work two fulltime jobs in social services and law enforcement, i laugh all the time and make jokes i work out in the gym i run my dogs for miles ever day and i go out and have diner and drinks occassionally with friends also i still like, i try my very best to always think of others and put others first and that is actually what helps the most even now is remembering that no matter what i am going through there are others who are way worse off and i am blessed to be functioning even if it is hindered at times. Also how can something be somatoform if it is clearly diagnosed that i have at least these other known issues, like the hypothyroidism, i know that this could be a reason for many of my issues but i do experience so seriously many signs and symptoms of MS that it does concern me somewhat that even though i have nothing showing in my brain that i might have something going on. If i dont then that is great! I would just like to know if it is all related to migraine or if it is all just related to combination of different auto immune diseases or if there is something bad going on since it seems like i have had all these very disturbing and somewhat debilitating issues happen in the past six months, also i would like to know if the meds im on is the only help, if those are good and if there is any immediate pain relief i can suggest to my doctor or neurologist that they will be receptive too since all the sumatriptan had not worked and the gabapentin seems to be helping but has not stopped the extreme pain when it happens. I appreciate you taking the time to read and review this and i hope that i can get a regular practicing physician not a psychiatrist to review this. Thank you and have a great day.
Posted Thu, 16 May 2013 in General Health
Answered by Dr. Shanthi.E 8 hours later

Thanks for writing your health concern. I would like to appreciate your style of writing. Amazing.

Let me start with the good things first - You are a happy person, helpful, kind, loves life to the most. Most of the people are not like this. I am glad that you are.

Migraine is a debilitating illness; I know the disturbances it causes in our daily life. I experience it occasionally as well. Triptans did not work for me either. Gabapentin is a very effective drug in Migraine. Recent studies have proved its effectiveness and in fact are being frequently used as the first line drug in migraine now. So, please continue to take it. The dosage is ideal for you.

On reading your query, I saw that on some days you are happy, some are really not good days for you where you suffer a lot. On the happy days, you are very hyper and super playful and wild.

I would also definitely rule out symptoms do not match the diagnosis of MS.

You do get numbness, tingling in the legs along with heat and extreme pain. Gabapentin will definitely take care of this. Continue the medication. Over time, this symptom will vanish for sure.

Your second concern - You are hypothyroid and are on medication. Hypothyroidism, anxiety, and depression coexist. Continue to take Levothyroxine. The choking feeling in the throat may be due to an enlarged thyroid. It would be ideal to get a thyroid ultrasound done to check if it is causing any pressure symptoms on the throat.

The symptoms of slurred speech at times, completely random, and loss of good motor function like hands shaking and not able to grip well, or balance or vision things - all these are concerning. Do you have a plain CT scan of the brain done? Is it normal? Have you discussed about these issues with a Neurologist. It is very important that you do this. If the brain CT scan is normal, then the only other condition where I can fit all your symptoms would be a mood disorder - probably- Bipolar. Your friends, colleagues would not be able to grab these initially. However, going by your history, I could figure out somewhere that you may be in the initial stages of a mood disorder.

Your current health problem is not related to migraine, though migraine is a part of it. Hypothyroidism is also part of the problem. Both these are pre-existing in you.

I do not see a single clue towards an autoimmune process in you. Therefore, I would definitely rule this out. It is not MS as I already said.

Your current medications are your help, they are good, and you should continue taking them.

Gabapentin will take care of the pain; you do not need additional painkillers.

My suggestion for you would be to think on the lines of Bipolar disorder. Definitely, you do not need medicines at this point. Watch over your symptoms. Look for sudden changes in your mood or fluctuations.

You are doing amazing in your life. You should not worry much. It's what your mind thinks. So think good and be happy.

Let me know if I missed out on something. I am sorry if I am offending. Come up with any more issues that you would like to discuss or clarify.

Great day ahead!!

Above answer was peer-reviewed by
Follow-up: Having constant migraine, heart burn, acid reflux, depression. Am I suffering from anxiety? 2 days later
Thank you so very much for the compliment and the time you have taken to read, review and comment on my issues, it is greatly appreciated.

Everything you said seems to makes sense to me, i just hope and pray i have no mood disorders or any form of mental illness in my future. I strive so greatly to just function normally i do not look forward to something else in my brain that i have no control over.

I did forget to mention that in 2006 i was involved in a motor vehicle collision that left me with a TBI and after that for a few years i was in physical therapy and chiropractic therapy constantly three times a week for two years, i also underwent some speech therapy and other types of therapy to help with motor skills and function. I had serious memory loss and never did recover much of it, very sad situation actually because at the time i had lost all of the knowledge i aquired in college and it was embarassing for me to feel so stupid. At one point in time, believe it or not, i actually knew how to write grammatically correct. I still struggle to this day with words and their meanings and spelling is huge for me because i can no longer recall how to spell something and i have to rely on sounding it out which is not always correct especially for the english language.

I bring up the vehicle collision just because i wonder sometimes if maybe i am having some underlying issue with that previous TBI. I dont know what it feels like to have a seizure or stroke but at times, that is the only way that i can describe what feels like is going on inside my head. When i had my first optic neuritis event in 2008 it was the strangest thing i had ever experienced. I was sleeping holding my cell phone in my hand. I woke up suddenly when my phone rang and i went to look at the screen and i felt like i couldnt see it so well and the right side of my face felt fuzzy or numb and tingly almost like the feeling you get when your foot falls asleep. My initial thought was, ah my face fell asleep because i must have been sleeping on it wrong. I never stopped to relieve that faces dont really fall nor does our eyes. Then i covered my left eye and tried to look at my phone, it was pitch black nothing at all. I stood up ran out of the room and into the bathroom in a bit of a panic. I looked in the mirror and my face looked frozen on one side but normal on the other, and i did the same test in the bathroom with the bright light on. I covered my left eye and looked straight into the mirror. I could see nothing. At that point i was very scared and ten minutes had passed so i went for help. The ER said that i was ok except for the elevated bp which was high but no higher than it gets when i am in distress. They sent me to the opthalmologist who at the time was the one who came up with the diagnosis of optic neuritis. Then the neuropthalmologist later confirmed saying that he did not know why my face was experiencing numbness etc but that i was lucky to have not gone blind and that my optic nerve had returned back to normal.

Later, here about four months ago, i had what i thought to be another attack of optic neuritis i called my doctor who i saw for it the previous time in 2008 and he stated that it was possible and he asked what eye it was, i mentioned, without rememberiing what eye it was before, that it was my right eye and he said that was the same one that had the issue before. Again with this event there was numbness and tingly in my face and then i had some brief extreme pain in my head like something was exploding. Keep in mind at this time four months ago everything was going pretty well, i hadnt really been having so many migraines and i was feeling pretty healthy, i actually had been out on the shooting range that day and it was a beautiful XXXXXXX relaxing day, i was on my drive home when this occurred and i had to pull over and wait while the vision slowly came back and my chest relaxed (stress). Then the next day the same thing happened and then again three days later, there was no known trigger only that my face felt funny and then bam the vision was gone, completely in my right eye anywhere from periods of six hours to twenty minutes, when it returns it was slow going and fuzzy but seems to have returned to normal, and i have no other vision problems i have extremely healthy eyes and amazing like, way better than normal vision I can easily read the bottom line on all the vision tests with one eye. So with all this what i am letting you know is that it wasnt until that serious of events with my eye that the migraines returned and have since remained constant.

I was wondering what you thought of that and if there could be something happening from the old TBI. I use to be extremely smart, I was the girl who knew everything, who could remember anyone and anything upon first contact, and who always researched and knew the facts, I could read quickly, write perfectly speak three languages fairly fluently and translate for others. I use to pride myself in my intelligence and how focused i was on that, now i pride myself in the fact that i work extra extra hard to just be normal and not appear but that doesnt always work out. I have come to deal with it and i am happy finally with where i am, mostly because im not around the people anymore who use to know me and know how smart i once was, but still i have gotten use to it and i do feel smarter now that i dont have speech problems as much and ive learned to keep my mouth shut when i cant find the words to say or the vocabulary appropriate for the situation. I have relearned a lot of things like reading and writing, but not with the skill i once had, and I will eventually be able to speak other languages fluently it just seems awfully hard to retain when learning or relearning things it seems my brain only allows me to hold onto so much anymore, if i try to learn new things it feels like i lose old ones or just start forgetting unimportant things. I was somehow blessed to have not lost my ability to remember law enforcement and the skills that i have learned there and my natural ability to just be good with people and emergency situations. My reaction time and cognitive processing speed are slower than they use to be by a great measure, however not in the field of law enforcement its the one place where somehow i have remained normal, that itself is an amazing thing.

So as it stands I would love to hear your thoughts on if there is anyway that the TBI could be bothering me again somehow or if it is all just something silly. I am doing my best and even again today with this migraine i will wait and hope it fades away. Thank you so much for reviewing this and i am sorry for all the blabbing it is not too often i get to talk about the things that have happened knowing the person on the other end will be able to understand what i am talking about. Have a great day!

I love to sing and one thing that has been bothering me for years is that i lose my voice on a regular basis, like all the time maybe one week a month i have no voice, completely gone and then when it returns it is still raspy and scrathcy like it always is. I like my raspy voice but the problem is its so hit and miss when it comes to singing. Sometimes i can have a clear voice and reach all the notes that i want and sometimes it just stops or falls flatt when i know that it shouldnt, i cannot scream and i cannot yell like normal people, it has been years since i could, and that is not an exaggeration, my friends think its funny because if we are all out doing somoething and someone yells something from far away and i try and yell back with a response, my voice starts to make noise than it just squeaks or cracks and stops just nothing just air comes out it is the strangest thing. I sing karaoke and i like to do singing competitions because when my voice is working well it is beautiful, but its rare when i have enough of a voice to do it. Everyone says i have a very deep singing voice which surprises them becaue they say my speaking voice is much higher pitch but i cant sing with the same voice i speak or again i will have no sound come out. My nose bothers me sometimes or my nasal i guess i dont know what it would be considered, i do not have allergies to anything i have been tested for everything and nothing seems to get a response. But i feel like i never can breath out of my nose, i do not have snot or boogers or dry or wet nose. It seems clean and looks clear but i just cant get air out of it too well, i never can get air out of both sides at the same time but sometmies i can squeak air out of one side. What might this be and when i have mentioned it to regular doctors before they say that its probably just allergies but again my immunologist said its not allergies. I would be so much happier if i could have my voice back and be able to sing like i use to, knowing that it will actually work. My voice is trained so that is not the issue this is something wierd and i dont like it at all. It jut wont do it, comlpetely odd, i dont know anyone else who experiences this, i know some people whos voice cracks and who get hoarse if they overwork thier voice and i know people who just cant but this is not the case either. Let me know if you have any ideas Thank you so much!
Answered by Dr. Shanthi.E 6 hours later

Thanks for writing back. It is disheartening to hear that you had a TBI and have come a long way. It takes guts for a person to overcome all this and still love life to the fullest. You are blessed.

I have read through the lines when you were in physical and chiropractic therapy, must have been hard for you. The TBI has had its impact on you; you know the brain is such an intricate and delicate organ with millions of neurons in it. What has been washed out of your brain with the TBI is difficult to get back. The minute areas of brain associated with memory and learning, the hippocampus and the frontal gyrus, might have been damaged in the TBI with a possible impact on the optic nerve as well.

With so much having occurred and lost, it is a wonder that you have gotten back most of your life.

I still see that your English grammar and the spellings are perfect. Believe me; very few of them in this world get the lost things back. You are such a miracle re-born. Kudos.

The optic neuritis is concerning me. Even though the ophthalmologist says that, your eyes are fine. I would suggest you to go for quarterly reivew examinations of your eyes. Oh yes, how did the blood pressure shoot high? Do you routinely have a high blood pressure?

You love to sing, that is a good thing to hear. You have come a long way until now. You are able to function normally now. You have had speech therapy as well. Everyone has a problem with voice occasionally. Just hope that one day you would sing amazingly well again.

However, I would like to say you a few things here:

- Please take life easily. Do not strain your brain much. It is coping with all the stuff that you want to do. It has helped you re-learn, some of the learnt behavior have still not vanished....touch wood!

- Do new activities and learn new things but do not put too much pressure on your brain.

- Try singing daily; do not be disheartened if you unable to sing the way you wish to.

- Do your daily chores that you normally do, do not tax your brain overtly.

You are a Winner, which need not be proven again. With so much of life still left for you, you must be merrier by the day and move on.

Relax; I do not think you have a mood disorder. Take life as it comes. Would love to see you happy and helpful as always.

Medically, I do not think you need further investigations or treatment.

You can write to me anytime.

Take care!
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