Brief Answer:
Unlikely to be an EMERGENCY

Detailed Answer:
Good evening. My name is Dr. Dariush Saghafi and I am a neurologist who would like to briefly respond to your question.

You are asking if it is an emergency medical situation given your symptoms of blurry vision, lightheadedness when standing or sitting, tingling toes, and the recent onset of urinary incontinence.

I've also read the notes and responses from other physicians. It would appear that you are being treated for a urinary tract infection and also have been on a good solid dose of paracetamol from what it sounds like.

Given the fact that in other notes you mentioned having low blood pressures as well as mild tachycardia.

I believe that many of your symptoms can be explained by way of a mechanism known as ORTHOSTATIC HYPOTENSION which means that your blood pressure is going excessively low when sitting or standing. This could be brought on my dehydration, low blood sugar (hypoglycemia) due to lack of adequate meals over the past several days or weeks, or an infectious cause such as an incompletely bladder infection.

Since multiple rounds of antibiotics have not seemed to quell the UTI then, I'd like to see some emphasis now put on getting 2 imaging studies (MRI's with gadolinium contrast. One would be of the head and the other of the lower back in the thoracolumbar region. I'd like to see if there is something related to the brain that may be causing these symptoms of paresthesias while the other should be an MRI of the thoracolumbar region. I believe both studies would want to be done with gadolinium contrast to be sure that kidney function is not a contraindication.

Also, I'd like to see a small battery of lab tests which are the following:

1. Vit. B12
2. Vit. D, D3, D2
4. serum folate
5. serum ANA panel
6. serum TSH, FT4,
7. ESR, and CRP
8. Urinalysis with Culture and Sensitivity
9. BUN and creatinine (EGFR; in case you decide to go for the MRI with contrast).

And so bottom line is "NO." This is unlikely an emergency but you should strive to get the testing done as soon as possible.

My best to you and if you've been able to learn a bit more information of your condition based upon what I've presented then, a little written feedback as well as a STAR RATING would be greatly appreciated.

This query required 42 minutes of physician specific time for review, research, and final documentation for envoy.

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