Question: December of 2010 I was ill with viral infection (fatigue, extreme neck ache that ice application helped with, and generalized aches/pain). I work as a school nurse and throughout XXXXXXX and Feb of 2011 I had numerous strep throat infections that were treated with antibiotics. I attributed strep to work. March of 2011 I began with episodes that last from 4 weeks ranging to 9 weeks at its longest periodically. These episodes start immediately without warning with a sense of impending doom- oh my god here it comes feeling, vertigo, hot feeling starting at my feet and radiating into my chest, uncontrollable breathing at a rate of 50-60 per minute, radial heart rate unobtainable due to an extremely fast pulse, tingling of my extremities especially my buttocks, and inability to walk due to unbelievable unbalanced coordination. This lasts approximately 3-5 minutes initially but continue for 4-9 weeks. The symptoms that continue consist of extreme head pain (not a headache, but sharp intense pain like a brain freeze) that come and go, narrow tunnel vision, floaters in my vision particularly my right eye, extreme right eye pain x 1 again feeling like a brain freeze that I had to hold my head down and apply pressure to the eye (lasted 10 minutes), extreme fatigue - sleeping 12-16 hours per day and I can barely wake up, balance difficulties, neck pain that extends down into my shoulder blades and back. Once these episodes end, I ALWAYS have neck, shoulder, and back pain like I was hit with a baseball bat, my right hip clicks and catches to the point of pain when walking approximately 3-7 times per week, weak and tired. I am 38 and have 3 children. I went to the zoo with them and could not tolerate more than 1 and half hours. I was so exhausted I felt heavy. My legs hurt and felt very heavy. Everyday I become short of breath with any activity especially going up and down stairs. I have gained 20 pounds over the past 2 years. I have always been thin and weigh on an average 135 pounds (5'8") and now weigh 155. I went to my pcp and had a neurologist. The neurologist wanted to put me on Amitriptyline for Anxiety and I refused. I do not normally take any medication at all. I have a high pain tolerance and would rather be in pain that medication. (I delivered naturally my son 10 pounds 7 ounces without medication). I had a CT, MRI, EEG of head and all negative except MRI that shows a clump on the right frontal vein of my head the neurologist is not concerned with. I had some blood work that again is all negative except for a slightly elevated d dimer. (268). I have a 24 holter monitor showed 1 bout of A. Fib and several SVT's even at rest. I then had a 30 day holter that showed 14 episodes of increased heart rate of up to 147 beats per minute at rest. My heart rate races with any activity even showering but low heart rate when doing nothing usually. I was started on Toprol XL 25 mg per day. I cannot take more Toprol due to low heart rate at times. I have had 2 full blown episodes since December and have called my doctor since. I requested a cardiology referral and my pcp states she doesn't have a reason to send me. She says she doesn't remember telling me about the A. Fib or SVT. I then questioned why I was on Toprol XL. She states for my symptoms. Your thoughts..... do you think this could be cardiac related? My thoughts... could this have started with that viral illness I had December of 2010? Could this be something more that is triggering rapid heart rate or questionable A. Fib... like fibromyalgia or MS. Since my CT and MRI's were somewhat normal (if you can explain that clump that would help) but since they were normal can you still have MS and it not show? Should a CT or MRI or Xray be done of my spine? Where should I turn to at this point? Thanks for thoughts.

Dr. XXXXXXX

I see that you didn't receive my reply so I will re-submit. Other things I forgot to mention was that I had an experience this past October/November x1 with lock jaw upon waking. I couldn't move any of my extremities and was gasping for air. My jaw was in a locked position.... I forgot to mention this along with x1 an episode while shopping in which my vision was clouded with white patches. I did have a basic thyroid panel done, c-reactive protein, and B12 level drawn. I did have placenta previa with abruption in 2009 and my iron stores are slightly low but not enough to be concerned about according to my pcp. Thanks for getting back to me. XXXXXXX