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Query about stress - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Anxiety and Stress
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3613 Questions
Doctor :   Hi
User :   Hi
Doctor :   How can I help you?
User :   Sir, I seek advise on the following matter: Doctor :   Please explain.
User :   On 3rd Oct, 2010, my son had fallen down from our society boundary wall, leading to a cut on his head. While he was being stitched in the OT, I suffered syncope and fell backwards inside the OT. The cause of the fall was emotional stress upon seeing my son being operated upon. This resulted in head injury and left shoulder trauma, resulting in hospitalization for 24 hours and also being advised strict bed-rest for a week.
Doctor :   Ok
Doctor :   Proceed.
User :   pls gv me one minute. sorry for keeping u on hold...
User :   just 1 minute
Doctor :   No problem.
User :   Really sorry once again
User :   I had an external injury on the backof my head, which got resolved
Doctor :   Ok
User :   One thing which continued was a tingling sensation on my lower neck and upper chest, for which the doctor kept giving me cobalamin & nervijon
Doctor :   Ok
User :   Then, around 1st week of Dec, I started getting numbness in my left hand thumb & index finger
Doctor :   Ok
User :   and some vibration inside on left side of my body, behind abdomen
Doctor :   Ok
User :   this has now aggravated and everytine I tilt my neck, I get strong vibrations in the left part of my body, shoulder, hands, right upto upper leg and groin
User :   itchiness & tingling on my neck, fellings of ants crawling, and hot & cold sensation
User :   I have shown to 2 orthos, 1 spine and am currently undergoing physiotherapy since last 10 days
User :   the relief is minimal
Doctor :   Ok
User :   someone told me to go to a neurologist/neurosurgeon and also get MRI done
User :   Can u pls advise what should be my next steps?
Doctor :   You mentioned about numbness/tingling sensation on the left index and thumb finger - Do you persist to have the same?
User :   Yes
Doctor :   Ok
User :   now I feel it in the lower jaw and cheeks also
Doctor :   Do you have difficulty while holding a pen/spoon with your left hand?
Doctor :   or difficulty in buttoning a shirt using left hand?
User :   no sir, all orthos have checked it, no muscular poblem as of now; except some twitching and loss of sensation during night at times. Also cramps in my hands on some nights
Doctor :   Ok
Doctor :   May I know your age?
User :   35
Doctor :   Do you consume alcohol?
Doctor :   Are you on any regular medications?
User :   no. teetotalar
Doctor :   Do you have diabetes?
User :   yes, on homeopathy medication for same condition
User :   Diabetes - NO
Doctor :   Ok
Doctor :   May I know if you had loss of consciousness/neck pain after the fall?
User :   yes, loss of consciousness for a few seconds. Neck pain was severe on the left side for almost a week
Doctor :   Ok
User :   My left side nect nerves had got badly stretched during the fall
User :   i meant neck nerves
Doctor :   Ok
Doctor :   May i know if Xrays of neck was done?
User :   immediately after the fall, CT for back of head and chest x-ray; it was normal
User :   In dec, neck digital x-ray, where doctors found osteocyte formation in C4, C5, C6 and diagnosed early spondylosis leading to nerve compression which is resulting in these shocks when I tilt my neck
Doctor :   Ok
Doctor :   Let me explain to you.
User :   sorry, i think osteophyte
Doctor :   Based on your description,
Doctor :   neck pain and the numbness /tingling sensations of left thumb and index fingers are explainable.
Doctor :   The cause could be the previous spondylosis, nerve compression which may have worsed by the fall.
User :   ok
Doctor :   The other symptoms that you report aren't explained by spondylosis alone.
User :   do u mean the vibrations when I tilt mu neck at a certain angle?
Doctor :   The fall you had and the subsequent history aren't suggestive of a spine injury too.
Doctor :   Yes.
User :   ok
User :   yes sir, the vibrations are most irritating and scary
Doctor :   Since your symptoms are predominantly sensory (perceived symptoms), there are possible chances that these symptoms are related to psychological factors such as anxiety and stress.
Doctor :   But from this far, without physically examining you,
User :   ok sir, but the vibrations are real and severe
Doctor :   I will not able to conclude op a diagnosis.
User :   ok
Doctor :   I shall hence suggest you few measures that you can follow
Doctor :   1. Anxiety and stressors play a major role in any organic neurological lesions too.
Doctor :   Hence the first step towards treatment is anxiety and stress management
User :   ok
Doctor :   you will need slow breathing exercises, meditation, yoga and physical exercises.
User :   I am scared if this will keep getting aggrated and might result in more severe problems like loss of muscle control or permanent nerve damage
Doctor :   Since your symptoms are following a fall,
Doctor :   such complications happening after such a long time is unusual.
User :   ok
Doctor :   hence you need to stop worrying(which can be contributing to the symptom)
Doctor :   Along with the meditation and breathing exercise, sleep adequately and regularly.
Doctor :   2. Continue with multivitamin supplements and physiotherapy.
User :   I do that, I also do pranayaam
Doctor :   This will have a gradual effect on your symptoms.
User :   I take a nutrilite daily and am regularly undergoing physiotherapy
Doctor :   You need to patiently continue with it.
User :   ok sir
Doctor :   3. Avoid any unnecessary lifting of weight, sudden turning of neck and any activity
Doctor :   that involves over usage of neck muscles.
User :   ok sir
Doctor :   4. A physical consultation with a neurologist will boost your confidence and aid in the treatment.
User :   ok sir
User :   a neurologist or a neuro-surgeon?
Doctor :   5. A neurologist will be more appropriate.
User :   ok
Doctor :   You will need neurosurgeon's help if any localising factor is seen on evaluation.
User :   Ok, also will he decide if I need an MRI?
Doctor :   yes, the need for MRI and other investigations such as nerveconduction studies/EMG studies will be decided after the neurology consult.
Doctor :   According to my previous experiences in Neurology,
User :   ok sir
Doctor :   the chance that you will need them and the chance that you suffer from a serious neurological condition is very unlikely.
Doctor :   Hence do not worry.
Doctor :   You should be fine.
User :   ok sir
Doctor :   Have you followed what I have suggested?
User :   one more question; i will really try and relax as per your advise but the vibrations which were very minimal just 2 weeksago have really increased, even though I am undergoing physiotherapy. this aspect is contributing to my biggest stress...
Doctor :   I can understand that.
Doctor :   Physiotherapy sessions help in treating cervical spondylosis which may have aggravated during the fall.
Doctor :   Since the vibration sensation that you describe isn't contributed by physiotherapy,
Doctor :   anxiety and stress is probably the reason for the present exacerabation.
User :   yes, that is another thing. I feel that while the exercises suggested by the physiotherapist are meant to strengthen the neck muscles, they are also inflaming my nerves further
Doctor :   The main motto of your treatment hence is stress and anxiety management.
User :   like yesterday (after talking to my physio), I did not exercise much and I felt better, but by the time the day nears the end, this vibration really increases
Doctor :   Absence of pain is a feature against inflammation.
User :   ok sir
User :   i do hae some pain on my left nck side
Doctor :   If you feel that your symptoms are getting worsened after physiotherapy,
Doctor :   stopping physiotherapy for a few days is a good treatment plan.
User :   ok
Doctor :   you can hence withdraw from physiotherapy exercise,
User :   ok
Doctor :   continue with the yoga, pranayama's, meditation, multivitamin supplements and good sleep.
Doctor :   meet a neurologist in person.
Doctor :   Have you followed what I have suggested?
User :   ok sir
User :   yes, i have
Doctor :   Do you have any other query?
User :   Pls gv me a half minute to think...
User :   is this vibration thing normal?
Doctor :   Instead of answering this question, I shall answer it in this way.
Doctor :   Vibration (which is a sensory symptoms) alone with no motor dysfunction is probably secondary to somatic causes - anxiety and stress.
Doctor :   This is a benign and non serious concern.
Doctor :   which can be treated with proper anxiety and stress treatment.
User :   ok, that information definitely relieves me...
Doctor :   So though it is an abnormal symptoms, it isn't a serious one.
Doctor :   You should be fine.
Doctor :   Do you have any other query?
Doctor :   Are you there?
User :   yes sir, since u have been so helpful and u know this exactly, i was thinking hard if there is anything else (related) that i should ask...
User :   when i chat on this, will i always meet you
Doctor :   You are free to ask me any question you have.
Doctor :   I am Dr XXXXXXXX here, and will be available between 8 to 5 on most weekdays.
User :   If needed, can I also talk to you over phone?
Doctor :   Yes,
User :   only if I need advise after I have shown to a Neuro?
Doctor :   You can request for get a call from a doctor instead of clicking on the live chat.
User :   One more: who should be a good neurologist in mumbai, only if you know?
User :   or can I just visit a neuro near my home?
Doctor :   My exposure to Mumbai is restricted.
Doctor :   I can help you in providing you with a list of neurologist practising at Mumbai, if it can be helpful to you.
Doctor :   You can visit any neurologist available at your location, alternatively I shall mail you the list of neurologist practising at Mumbai who can help you.
User :   ok, i think u can skip that as of now. i will probably visit the one being recommended by my physio as of now
User :   That was great help Doctor, how long have you been practicing medicine?
Doctor :   That will be fine.
User :   Can I know more about your experience and credentials?
Doctor :   I have been practicing medicine for a period of 6 years,
Doctor :   and neurology field for 3 and half years.
Doctor :   I am a general physician.
User :   ok sir
Doctor :   Do you have any other query?
User :   Dr I might cal u after having shown to the neurologist.
Doctor :   You are welcome any time.
User :   You have been really helpful and I feel more clarity on this now..
Doctor :   Do you have any other query?
User :   Thank you and bye.
Doctor :   Thanks for consulting me.
Doctor :   Bye for now.
Doctor :   Have a nice day!!
User :   Same to you Sir!
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