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Sorry For Troubling You Again. Owing To My Immigration Status
Question: Sorry for troubling you again. Owing to my immigration status in the United Kingdom, I am not able to access healthcare. Since consulting you some days back I skyped with a local private doctor to get my monthly prescription. He felt I should have a cardiac review and other things soon. He felt should go to A&E if I get chest pains or black stool. I am not getting chest pains but my left side, which feels like a swollen wound all the time becomes limp and weak suddenly. Without cause, as I am sitting at home without exertion. This happens at certain times of day, plus today my dizziness is really awful so I drop things and forget to close the tap. My eyes used to burn but they are burning more.I fainted in January on the road and hit my head and was taken to hospital. Do you think it would be a good idea for me to take that parathyroid blood test, as they have a local company you can pay to do any test you want. What is your honest opinion of this ECG attached -do you agree with the doctor s comment about incomplete RBBB and do you see anything else. You have already told me to have a cardiac ultrasound and I will in due course see if someone can help me. Is my pressure in the head caused by AF
Sorry for troubling you again. Owing to my immigration status in the United Kingdom, I am not able to access healthcare. Since consulting you some days back I skyped with a local private doctor to get my monthly prescription. He felt I should have a cardiac review and other things soon. He felt should go to A&E if I get chest pains or black stool. I am not getting chest pains but my left side, which feels like a swollen wound all the time becomes limp and weak suddenly. Without cause, as I am sitting at home without exertion. This happens at certain times of day, plus today my dizziness is really awful so I drop things and forget to close the tap. My eyes used to burn but they are burning more.I fainted in January on the road and hit my head and was taken to hospital. Do you think it would be a good idea for me to take that parathyroid blood test, as they have a local company you can pay to do any test you want. What is your honest opinion of this ECG attached -do you agree with the doctor s comment about incomplete RBBB and do you see anything else. You have already told me to have a cardiac ultrasound and I will in due course see if someone can help me. Is my pressure in the head caused by AF
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome back to Ask a Doctor service!
I agree with the doctors description of the ECG. I don't see anything else besides the incomplete RBBB.
Your chest discomfort is not typical of coronary artery disease, as it comes even when you are resting. It could be just costo-chondritis, acid reflux or a lung disorder.
Regarding the dizziness, it could be related to low blood flow to the brain. For this reason, I would recommend performing a Doppler ultrasound of the carotid and vertebral arteries.
Another issue to consider would be an inner ear disorder.
For this reason, I would recommend consulting with an ENT specialist and performing labyrinthine tests. If this is not possible, because of your insurance, I would recommend trying dimenhydrinate or meclizine and see if your dizziness improves but such drugs. If this is the case, it would be another argument in favor of an inner ear disorder.
Inner ear disorders can also be related to head trauma (Benign paroxysmal positional vertigo).
Regarding Parathyroid hormone levels, I would recommend checking its levels every 6 months, just to be sure that you are getting the right treatment.
Hope to have been helpful!
If you have any other questions, please don't hesitate to ask me again!
Wishing all the best,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome back to Ask a Doctor service!
I agree with the doctors description of the ECG. I don't see anything else besides the incomplete RBBB.
Your chest discomfort is not typical of coronary artery disease, as it comes even when you are resting. It could be just costo-chondritis, acid reflux or a lung disorder.
Regarding the dizziness, it could be related to low blood flow to the brain. For this reason, I would recommend performing a Doppler ultrasound of the carotid and vertebral arteries.
Another issue to consider would be an inner ear disorder.
For this reason, I would recommend consulting with an ENT specialist and performing labyrinthine tests. If this is not possible, because of your insurance, I would recommend trying dimenhydrinate or meclizine and see if your dizziness improves but such drugs. If this is the case, it would be another argument in favor of an inner ear disorder.
Inner ear disorders can also be related to head trauma (Benign paroxysmal positional vertigo).
Regarding Parathyroid hormone levels, I would recommend checking its levels every 6 months, just to be sure that you are getting the right treatment.
Hope to have been helpful!
If you have any other questions, please don't hesitate to ask me again!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome back to Ask a Doctor service!
I agree with the doctors description of the ECG. I don't see anything else besides the incomplete RBBB.
Your chest discomfort is not typical of coronary artery disease, as it comes even when you are resting. It could be just costo-chondritis, acid reflux or a lung disorder.
Regarding the dizziness, it could be related to low blood flow to the brain. For this reason, I would recommend performing a Doppler ultrasound of the carotid and vertebral arteries.
Another issue to consider would be an inner ear disorder.
For this reason, I would recommend consulting with an ENT specialist and performing labyrinthine tests. If this is not possible, because of your insurance, I would recommend trying dimenhydrinate or meclizine and see if your dizziness improves but such drugs. If this is the case, it would be another argument in favor of an inner ear disorder.
Inner ear disorders can also be related to head trauma (Benign paroxysmal positional vertigo).
Regarding Parathyroid hormone levels, I would recommend checking its levels every 6 months, just to be sure that you are getting the right treatment.
Hope to have been helpful!
If you have any other questions, please don't hesitate to ask me again!
Wishing all the best,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome back to Ask a Doctor service!
I agree with the doctors description of the ECG. I don't see anything else besides the incomplete RBBB.
Your chest discomfort is not typical of coronary artery disease, as it comes even when you are resting. It could be just costo-chondritis, acid reflux or a lung disorder.
Regarding the dizziness, it could be related to low blood flow to the brain. For this reason, I would recommend performing a Doppler ultrasound of the carotid and vertebral arteries.
Another issue to consider would be an inner ear disorder.
For this reason, I would recommend consulting with an ENT specialist and performing labyrinthine tests. If this is not possible, because of your insurance, I would recommend trying dimenhydrinate or meclizine and see if your dizziness improves but such drugs. If this is the case, it would be another argument in favor of an inner ear disorder.
Inner ear disorders can also be related to head trauma (Benign paroxysmal positional vertigo).
Regarding Parathyroid hormone levels, I would recommend checking its levels every 6 months, just to be sure that you are getting the right treatment.
Hope to have been helpful!
If you have any other questions, please don't hesitate to ask me again!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Dr Sharka. I will print your comments and take them to a local doctor. Now you had said RBBB is sometimes found in healthy individuals. Do these individuals (who are healthy) (all or some) end up sick with heart problems a few years down the Road? In other words is RBBB a bad thing in general? In other words in that case RBBB is not a benigh thing.
I have had severe vertigo symptoms in the past at some times. You said " head trauma (Benign paroxysmal positional vertigo" Well I did have a head injury from fainting in XXXXXXX 2020, but my vertigo attacks are older and they came for a period and went away. My hearing was affected in that period but I do need a hearing aid due to cochlear damage. Is that inner ear? Would my fainting also relate to vertigo and if I did not have head injury would I have a head trauma? What is costo-condritis? Where is my carotid artery?
One problem I have is if I put a liquid into my ears or nose it trickles down my throat. I thought that was normal but was told its wrong. I was asked if it takes several minutes to reach my throat and no it is instantaneous. I had ears tested for deafness, and the specialist said I do not have a perforated ear drum. My GP last said that was really weird.
Regarding whether RBBB is ever benign, and not likely to become a genuine condition, do you agree in my case it is not likely to be benign. I know you will be XXXXXXX with me. Can I expect this incomplete RBBB to progress to complete RBBB and LBBB with time? I suppose as you recommend a cardiac ultrasound, will that test show if my stenosis had increased, and show the possible causes of the RBBB? Can they be treated or operated somehow?
As you feel my chest discomfort may not be due to heart disease, I assume it is not that urgent. But the cardiologist said in Dublin in April 2020 he did see some changes from a scan of Feb 2020. The fixed pain point in chest middle (not left) throbs when I am feeling lousy everyday. Do you thing I donlt have AF or v unlikely? I woke up this splitting headache today and chest discomfort but it passes off later in the day-I guess blood isnt going into my brain-hence the headache? You dont think then my circulation is poor due to heart failure which is why blood isnt going into my brain? Are their other reasons for the same?
You said if I have secondary hyperparathyroidism it will disappear when Calcium becomes normal. What is the primary cause of it? Why does my sodium and potassium also go up and down
It gives so much peace of mind to get directions as I need to know whats on with my body. I will print your valuable advice to give me a srart in life. Do I have your permission to print your full advice with your name and show to a local doctor?
I have had severe vertigo symptoms in the past at some times. You said " head trauma (Benign paroxysmal positional vertigo" Well I did have a head injury from fainting in XXXXXXX 2020, but my vertigo attacks are older and they came for a period and went away. My hearing was affected in that period but I do need a hearing aid due to cochlear damage. Is that inner ear? Would my fainting also relate to vertigo and if I did not have head injury would I have a head trauma? What is costo-condritis? Where is my carotid artery?
One problem I have is if I put a liquid into my ears or nose it trickles down my throat. I thought that was normal but was told its wrong. I was asked if it takes several minutes to reach my throat and no it is instantaneous. I had ears tested for deafness, and the specialist said I do not have a perforated ear drum. My GP last said that was really weird.
Regarding whether RBBB is ever benign, and not likely to become a genuine condition, do you agree in my case it is not likely to be benign. I know you will be XXXXXXX with me. Can I expect this incomplete RBBB to progress to complete RBBB and LBBB with time? I suppose as you recommend a cardiac ultrasound, will that test show if my stenosis had increased, and show the possible causes of the RBBB? Can they be treated or operated somehow?
As you feel my chest discomfort may not be due to heart disease, I assume it is not that urgent. But the cardiologist said in Dublin in April 2020 he did see some changes from a scan of Feb 2020. The fixed pain point in chest middle (not left) throbs when I am feeling lousy everyday. Do you thing I donlt have AF or v unlikely? I woke up this splitting headache today and chest discomfort but it passes off later in the day-I guess blood isnt going into my brain-hence the headache? You dont think then my circulation is poor due to heart failure which is why blood isnt going into my brain? Are their other reasons for the same?
You said if I have secondary hyperparathyroidism it will disappear when Calcium becomes normal. What is the primary cause of it? Why does my sodium and potassium also go up and down
It gives so much peace of mind to get directions as I need to know whats on with my body. I will print your valuable advice to give me a srart in life. Do I have your permission to print your full advice with your name and show to a local doctor?
Thank you Dr Sharka. I will print your comments and take them to a local doctor. Now you had said RBBB is sometimes found in healthy individuals. Do these individuals (who are healthy) (all or some) end up sick with heart problems a few years down the Road? In other words is RBBB a bad thing in general? In other words in that case RBBB is not a benigh thing.
I have had severe vertigo symptoms in the past at some times. You said " head trauma (Benign paroxysmal positional vertigo" Well I did have a head injury from fainting in XXXXXXX 2020, but my vertigo attacks are older and they came for a period and went away. My hearing was affected in that period but I do need a hearing aid due to cochlear damage. Is that inner ear? Would my fainting also relate to vertigo and if I did not have head injury would I have a head trauma? What is costo-condritis? Where is my carotid artery?
One problem I have is if I put a liquid into my ears or nose it trickles down my throat. I thought that was normal but was told its wrong. I was asked if it takes several minutes to reach my throat and no it is instantaneous. I had ears tested for deafness, and the specialist said I do not have a perforated ear drum. My GP last said that was really weird.
Regarding whether RBBB is ever benign, and not likely to become a genuine condition, do you agree in my case it is not likely to be benign. I know you will be XXXXXXX with me. Can I expect this incomplete RBBB to progress to complete RBBB and LBBB with time? I suppose as you recommend a cardiac ultrasound, will that test show if my stenosis had increased, and show the possible causes of the RBBB? Can they be treated or operated somehow?
As you feel my chest discomfort may not be due to heart disease, I assume it is not that urgent. But the cardiologist said in Dublin in April 2020 he did see some changes from a scan of Feb 2020. The fixed pain point in chest middle (not left) throbs when I am feeling lousy everyday. Do you thing I donlt have AF or v unlikely? I woke up this splitting headache today and chest discomfort but it passes off later in the day-I guess blood isnt going into my brain-hence the headache? You dont think then my circulation is poor due to heart failure which is why blood isnt going into my brain? Are their other reasons for the same?
You said if I have secondary hyperparathyroidism it will disappear when Calcium becomes normal. What is the primary cause of it? Why does my sodium and potassium also go up and down
It gives so much peace of mind to get directions as I need to know whats on with my body. I will print your valuable advice to give me a srart in life. Do I have your permission to print your full advice with your name and show to a local doctor?
I have had severe vertigo symptoms in the past at some times. You said " head trauma (Benign paroxysmal positional vertigo" Well I did have a head injury from fainting in XXXXXXX 2020, but my vertigo attacks are older and they came for a period and went away. My hearing was affected in that period but I do need a hearing aid due to cochlear damage. Is that inner ear? Would my fainting also relate to vertigo and if I did not have head injury would I have a head trauma? What is costo-condritis? Where is my carotid artery?
One problem I have is if I put a liquid into my ears or nose it trickles down my throat. I thought that was normal but was told its wrong. I was asked if it takes several minutes to reach my throat and no it is instantaneous. I had ears tested for deafness, and the specialist said I do not have a perforated ear drum. My GP last said that was really weird.
Regarding whether RBBB is ever benign, and not likely to become a genuine condition, do you agree in my case it is not likely to be benign. I know you will be XXXXXXX with me. Can I expect this incomplete RBBB to progress to complete RBBB and LBBB with time? I suppose as you recommend a cardiac ultrasound, will that test show if my stenosis had increased, and show the possible causes of the RBBB? Can they be treated or operated somehow?
As you feel my chest discomfort may not be due to heart disease, I assume it is not that urgent. But the cardiologist said in Dublin in April 2020 he did see some changes from a scan of Feb 2020. The fixed pain point in chest middle (not left) throbs when I am feeling lousy everyday. Do you thing I donlt have AF or v unlikely? I woke up this splitting headache today and chest discomfort but it passes off later in the day-I guess blood isnt going into my brain-hence the headache? You dont think then my circulation is poor due to heart failure which is why blood isnt going into my brain? Are their other reasons for the same?
You said if I have secondary hyperparathyroidism it will disappear when Calcium becomes normal. What is the primary cause of it? Why does my sodium and potassium also go up and down
It gives so much peace of mind to get directions as I need to know whats on with my body. I will print your valuable advice to give me a srart in life. Do I have your permission to print your full advice with your name and show to a local doctor?
Brief Answer:
My answer as follows:
Detailed Answer:
Hello again!
Having incomplete RBBB does not mean that you have any cardiac disorders or you will have them in the future. Anyway, you should know that the incomplete RBBB sometimes may progress to complete RBBB and this may be a sign of a cardiac disease. That is why I would recommend follow up with resting ECG every 12 months.
Regarding the cardiac ultrasound, it is necessary performing one in order to examine your heart function and structure.
I don't think that you have AF or VF, because your symptoms are not suggestive of this disorder. Anyway, performing an ambulatory 24-48 hours ECG monitoring would help examine your heart rhythm trends for a prolonged time and exclude cardiac arrhythmia.
Regarding carotid arteries, they are the main arteries in the neck, which supply the brain with blood. They should be checked for possible narrowing (with a Doppler ultrasound), in patients at a higher cardio-vascular risk (arterial hypertension, family history, diabetes, smoking, blocked arteries in legs, etc.). When they are narrow, the brain has a poor circulation.
Anyway, I don't think that your circulation is poor. But checking your carotid arteries by means of Doppler ultrasound would help put your mind to peace.
Regarding the fluid with gets in your throat from your ears, that is very strange, because the eardrum should be ruptured in such case. There is no other way for the throat and the outer ear to communicate besides the eardrum.
Regarding the head trauma and the inner ear, even though there is no visible injury, the head trauma can lead to an inner ear disorder called Benign Paroxysmal Positional vertigo. The coclea is the same thing as the inner ear.
Regarding primary hyperparathyroidism, it occurs due to a disorder affecting the parathyroid glands, which are some small glands near the thyroid glands. The doctor will come into the right conclusion (primary or secondary hyperparathyroidism) based on your blood lab tests.
Hope you will find this information helpful!
It is OK for me to print this information whenever you need or like to!
Wishing all the best,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello again!
Having incomplete RBBB does not mean that you have any cardiac disorders or you will have them in the future. Anyway, you should know that the incomplete RBBB sometimes may progress to complete RBBB and this may be a sign of a cardiac disease. That is why I would recommend follow up with resting ECG every 12 months.
Regarding the cardiac ultrasound, it is necessary performing one in order to examine your heart function and structure.
I don't think that you have AF or VF, because your symptoms are not suggestive of this disorder. Anyway, performing an ambulatory 24-48 hours ECG monitoring would help examine your heart rhythm trends for a prolonged time and exclude cardiac arrhythmia.
Regarding carotid arteries, they are the main arteries in the neck, which supply the brain with blood. They should be checked for possible narrowing (with a Doppler ultrasound), in patients at a higher cardio-vascular risk (arterial hypertension, family history, diabetes, smoking, blocked arteries in legs, etc.). When they are narrow, the brain has a poor circulation.
Anyway, I don't think that your circulation is poor. But checking your carotid arteries by means of Doppler ultrasound would help put your mind to peace.
Regarding the fluid with gets in your throat from your ears, that is very strange, because the eardrum should be ruptured in such case. There is no other way for the throat and the outer ear to communicate besides the eardrum.
Regarding the head trauma and the inner ear, even though there is no visible injury, the head trauma can lead to an inner ear disorder called Benign Paroxysmal Positional vertigo. The coclea is the same thing as the inner ear.
Regarding primary hyperparathyroidism, it occurs due to a disorder affecting the parathyroid glands, which are some small glands near the thyroid glands. The doctor will come into the right conclusion (primary or secondary hyperparathyroidism) based on your blood lab tests.
Hope you will find this information helpful!
It is OK for me to print this information whenever you need or like to!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
My answer as follows:
Detailed Answer:
Hello again!
Having incomplete RBBB does not mean that you have any cardiac disorders or you will have them in the future. Anyway, you should know that the incomplete RBBB sometimes may progress to complete RBBB and this may be a sign of a cardiac disease. That is why I would recommend follow up with resting ECG every 12 months.
Regarding the cardiac ultrasound, it is necessary performing one in order to examine your heart function and structure.
I don't think that you have AF or VF, because your symptoms are not suggestive of this disorder. Anyway, performing an ambulatory 24-48 hours ECG monitoring would help examine your heart rhythm trends for a prolonged time and exclude cardiac arrhythmia.
Regarding carotid arteries, they are the main arteries in the neck, which supply the brain with blood. They should be checked for possible narrowing (with a Doppler ultrasound), in patients at a higher cardio-vascular risk (arterial hypertension, family history, diabetes, smoking, blocked arteries in legs, etc.). When they are narrow, the brain has a poor circulation.
Anyway, I don't think that your circulation is poor. But checking your carotid arteries by means of Doppler ultrasound would help put your mind to peace.
Regarding the fluid with gets in your throat from your ears, that is very strange, because the eardrum should be ruptured in such case. There is no other way for the throat and the outer ear to communicate besides the eardrum.
Regarding the head trauma and the inner ear, even though there is no visible injury, the head trauma can lead to an inner ear disorder called Benign Paroxysmal Positional vertigo. The coclea is the same thing as the inner ear.
Regarding primary hyperparathyroidism, it occurs due to a disorder affecting the parathyroid glands, which are some small glands near the thyroid glands. The doctor will come into the right conclusion (primary or secondary hyperparathyroidism) based on your blood lab tests.
Hope you will find this information helpful!
It is OK for me to print this information whenever you need or like to!
Wishing all the best,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello again!
Having incomplete RBBB does not mean that you have any cardiac disorders or you will have them in the future. Anyway, you should know that the incomplete RBBB sometimes may progress to complete RBBB and this may be a sign of a cardiac disease. That is why I would recommend follow up with resting ECG every 12 months.
Regarding the cardiac ultrasound, it is necessary performing one in order to examine your heart function and structure.
I don't think that you have AF or VF, because your symptoms are not suggestive of this disorder. Anyway, performing an ambulatory 24-48 hours ECG monitoring would help examine your heart rhythm trends for a prolonged time and exclude cardiac arrhythmia.
Regarding carotid arteries, they are the main arteries in the neck, which supply the brain with blood. They should be checked for possible narrowing (with a Doppler ultrasound), in patients at a higher cardio-vascular risk (arterial hypertension, family history, diabetes, smoking, blocked arteries in legs, etc.). When they are narrow, the brain has a poor circulation.
Anyway, I don't think that your circulation is poor. But checking your carotid arteries by means of Doppler ultrasound would help put your mind to peace.
Regarding the fluid with gets in your throat from your ears, that is very strange, because the eardrum should be ruptured in such case. There is no other way for the throat and the outer ear to communicate besides the eardrum.
Regarding the head trauma and the inner ear, even though there is no visible injury, the head trauma can lead to an inner ear disorder called Benign Paroxysmal Positional vertigo. The coclea is the same thing as the inner ear.
Regarding primary hyperparathyroidism, it occurs due to a disorder affecting the parathyroid glands, which are some small glands near the thyroid glands. The doctor will come into the right conclusion (primary or secondary hyperparathyroidism) based on your blood lab tests.
Hope you will find this information helpful!
It is OK for me to print this information whenever you need or like to!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
My answer as follows:
Detailed Answer:
Hello again!
I am sorry for the confusion with my answers!
I don't think that you should perform those tests just to calm your mind.
I think that tests should be done in order to rule in or out any possible disorders.
The cardiac ultrasound should be done in order to rule in or out a possible structural cardiac disorder like :hypertrophy, dilatation, a born defect, etc..
The carotid and vertebral artery Doppler ultrasound should be done in order to examine the blood flow to the brain and rule in or out possible vessel narrowing which may need medication.
There are many other causes underlying the dizziness : like blood pressure fluctuations (as you describe), an inner ear disorder, thyroid gland dysfunction, etc..
Regarding bisoprolol, I think that you should continue it, in order to prevent possible palpitations (extra heart beats). Anyway, an ambulatory ECG Holter monitoring (24-48 hours ECG) would help examine your heart rhythm trends for prolonged time and monitor the number of extra heart beats, and also make the right decision to continue or stop bisoprolol.
To conclude, based on your description of your symptoms I don't think that you are dying of an end stage or serious medical disorder. But, you have some complaints, which may need further investigations, in order to discuss about the possible treatment options.
We can not make a brain or artery or heart transplant, but there are many other ways (drugs) to solve this and help you live a normal life, without suffering.
Hope you will find this information helpful!
If you have any other questions, please don't hesitate to ask me again!
Wishing all the best,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello again!
I am sorry for the confusion with my answers!
I don't think that you should perform those tests just to calm your mind.
I think that tests should be done in order to rule in or out any possible disorders.
The cardiac ultrasound should be done in order to rule in or out a possible structural cardiac disorder like :hypertrophy, dilatation, a born defect, etc..
The carotid and vertebral artery Doppler ultrasound should be done in order to examine the blood flow to the brain and rule in or out possible vessel narrowing which may need medication.
There are many other causes underlying the dizziness : like blood pressure fluctuations (as you describe), an inner ear disorder, thyroid gland dysfunction, etc..
Regarding bisoprolol, I think that you should continue it, in order to prevent possible palpitations (extra heart beats). Anyway, an ambulatory ECG Holter monitoring (24-48 hours ECG) would help examine your heart rhythm trends for prolonged time and monitor the number of extra heart beats, and also make the right decision to continue or stop bisoprolol.
To conclude, based on your description of your symptoms I don't think that you are dying of an end stage or serious medical disorder. But, you have some complaints, which may need further investigations, in order to discuss about the possible treatment options.
We can not make a brain or artery or heart transplant, but there are many other ways (drugs) to solve this and help you live a normal life, without suffering.
Hope you will find this information helpful!
If you have any other questions, please don't hesitate to ask me again!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
My answer as follows:
Detailed Answer:
Hello again!
I am sorry for the confusion with my answers!
I don't think that you should perform those tests just to calm your mind.
I think that tests should be done in order to rule in or out any possible disorders.
The cardiac ultrasound should be done in order to rule in or out a possible structural cardiac disorder like :hypertrophy, dilatation, a born defect, etc..
The carotid and vertebral artery Doppler ultrasound should be done in order to examine the blood flow to the brain and rule in or out possible vessel narrowing which may need medication.
There are many other causes underlying the dizziness : like blood pressure fluctuations (as you describe), an inner ear disorder, thyroid gland dysfunction, etc..
Regarding bisoprolol, I think that you should continue it, in order to prevent possible palpitations (extra heart beats). Anyway, an ambulatory ECG Holter monitoring (24-48 hours ECG) would help examine your heart rhythm trends for prolonged time and monitor the number of extra heart beats, and also make the right decision to continue or stop bisoprolol.
To conclude, based on your description of your symptoms I don't think that you are dying of an end stage or serious medical disorder. But, you have some complaints, which may need further investigations, in order to discuss about the possible treatment options.
We can not make a brain or artery or heart transplant, but there are many other ways (drugs) to solve this and help you live a normal life, without suffering.
Hope you will find this information helpful!
If you have any other questions, please don't hesitate to ask me again!
Wishing all the best,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello again!
I am sorry for the confusion with my answers!
I don't think that you should perform those tests just to calm your mind.
I think that tests should be done in order to rule in or out any possible disorders.
The cardiac ultrasound should be done in order to rule in or out a possible structural cardiac disorder like :hypertrophy, dilatation, a born defect, etc..
The carotid and vertebral artery Doppler ultrasound should be done in order to examine the blood flow to the brain and rule in or out possible vessel narrowing which may need medication.
There are many other causes underlying the dizziness : like blood pressure fluctuations (as you describe), an inner ear disorder, thyroid gland dysfunction, etc..
Regarding bisoprolol, I think that you should continue it, in order to prevent possible palpitations (extra heart beats). Anyway, an ambulatory ECG Holter monitoring (24-48 hours ECG) would help examine your heart rhythm trends for prolonged time and monitor the number of extra heart beats, and also make the right decision to continue or stop bisoprolol.
To conclude, based on your description of your symptoms I don't think that you are dying of an end stage or serious medical disorder. But, you have some complaints, which may need further investigations, in order to discuss about the possible treatment options.
We can not make a brain or artery or heart transplant, but there are many other ways (drugs) to solve this and help you live a normal life, without suffering.
Hope you will find this information helpful!
If you have any other questions, please don't hesitate to ask me again!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am sorry to have taken up your time, when you are so busy.
I also understand you are not the doctor doing my tests and
have no control over that process. I have a problem though.
If I must have ECG once in 12 months can I skip that as well as just not see a doctor unless I am sick?
I have been going to A&E every 1-2 months and feel unwell every single day, although not heart attack.
Just because incomplete RBBB is found in healthy people is not a confirmation I am healthy people.
What makes you feel I do not have poor circulation?
You said my dizziness can be due to carotid arteries being blocked but you feel this cannot be the case. You want me to take that ultrasound test just to put my mind at rest
Unless I know, usually I would not know what test is needed, as
I am not a doctor. If you think I do not need a test I wont bother to take it.
If I did take that carotid ultrasound and it did come out normal that will not put my mind at rest. I am feeling will non stop and not getting well, and tests that come out normal are not likely to bring me any comfort
I am not an irresponsible adult. I would not want to waste doctor time and waste hospital tests for a non-existent illness
just to put my mind at rest.
If I have an illness is anything but imaginary, the illness will live even if you put my mind at rest.
I have been lied to on more than one occasion with abnormal results when the doctor says they are excellent. Even the doctor who wrote RBBB on the ECG I have attached told me the
ECG was excellent. She was confident I could not read English.
She XXXXXXX wrote my Troponin was excellent without doing a troponin test. Previously my GP was confident I wouldn't know
when I saw my systolic was 200. Another time I was vomiting blood my systolic was like 250 and I was delirious in A&E and they discharged me as having a stomach infection. A special one?
Thats why reassurance will have no effect on me when it comes from a doctor. Reassurance does not have to be truthful. I want a coherent honest diagnosis. I dont care if its minor or I am terminally ill. I must have honesty without attitude about my mind. Some panic more than others. So what?
Patients panic is not your responsibility. Mind is not body.
I am asking for honest opinions and if you think I am 100% fit
or terminally ill why not spill the secret.
I am not going to take some test for my body if a doctor says I am normal but to take it for my mind.
So why am I dizzy and is that in my mind too?
Why dont I get a brain transplant?
I have been so ill so long and
So why would I bother with them tests unless I knew they were needed?
First you seem to have reverted to that stance where I have no heart disease. Please confirm you feel I have no heart disease.
And why so? Do you recommend I stop taking bisoprolol?
The Dublin cardio said in April 2020 on the phone I am excellent, I then told him the doctor found RBBB in April 2020, and I dont feel excellent either,. He then admitted he noticed a change in the conduction of my heart when he looked at my scan of Feb 2020. He then said it was going to be okay. I said I feel lousy and feel it wont be okay as time goes by. He said that it true, he would do tests when lockdown was over.
I HAVE BEEN SICK 4 YEARS LISTENING TO LIES AND HAVE MORE THAN ONE REASON TO TAKE MY LIFE, WHICH I PREFER TO DO PUBLICLY, I NEED HONEST SPEAKING BY DOCTORS EVEN IF I AM TERMINALLY ILL. THIS IS YOUR JOB
I also understand you are not the doctor doing my tests and
have no control over that process. I have a problem though.
If I must have ECG once in 12 months can I skip that as well as just not see a doctor unless I am sick?
I have been going to A&E every 1-2 months and feel unwell every single day, although not heart attack.
Just because incomplete RBBB is found in healthy people is not a confirmation I am healthy people.
What makes you feel I do not have poor circulation?
You said my dizziness can be due to carotid arteries being blocked but you feel this cannot be the case. You want me to take that ultrasound test just to put my mind at rest
Unless I know, usually I would not know what test is needed, as
I am not a doctor. If you think I do not need a test I wont bother to take it.
If I did take that carotid ultrasound and it did come out normal that will not put my mind at rest. I am feeling will non stop and not getting well, and tests that come out normal are not likely to bring me any comfort
I am not an irresponsible adult. I would not want to waste doctor time and waste hospital tests for a non-existent illness
just to put my mind at rest.
If I have an illness is anything but imaginary, the illness will live even if you put my mind at rest.
I have been lied to on more than one occasion with abnormal results when the doctor says they are excellent. Even the doctor who wrote RBBB on the ECG I have attached told me the
ECG was excellent. She was confident I could not read English.
She XXXXXXX wrote my Troponin was excellent without doing a troponin test. Previously my GP was confident I wouldn't know
when I saw my systolic was 200. Another time I was vomiting blood my systolic was like 250 and I was delirious in A&E and they discharged me as having a stomach infection. A special one?
Thats why reassurance will have no effect on me when it comes from a doctor. Reassurance does not have to be truthful. I want a coherent honest diagnosis. I dont care if its minor or I am terminally ill. I must have honesty without attitude about my mind. Some panic more than others. So what?
Patients panic is not your responsibility. Mind is not body.
I am asking for honest opinions and if you think I am 100% fit
or terminally ill why not spill the secret.
I am not going to take some test for my body if a doctor says I am normal but to take it for my mind.
So why am I dizzy and is that in my mind too?
Why dont I get a brain transplant?
I have been so ill so long and
So why would I bother with them tests unless I knew they were needed?
First you seem to have reverted to that stance where I have no heart disease. Please confirm you feel I have no heart disease.
And why so? Do you recommend I stop taking bisoprolol?
The Dublin cardio said in April 2020 on the phone I am excellent, I then told him the doctor found RBBB in April 2020, and I dont feel excellent either,. He then admitted he noticed a change in the conduction of my heart when he looked at my scan of Feb 2020. He then said it was going to be okay. I said I feel lousy and feel it wont be okay as time goes by. He said that it true, he would do tests when lockdown was over.
I HAVE BEEN SICK 4 YEARS LISTENING TO LIES AND HAVE MORE THAN ONE REASON TO TAKE MY LIFE, WHICH I PREFER TO DO PUBLICLY, I NEED HONEST SPEAKING BY DOCTORS EVEN IF I AM TERMINALLY ILL. THIS IS YOUR JOB
I am sorry to have taken up your time, when you are so busy.
I also understand you are not the doctor doing my tests and
have no control over that process. I have a problem though.
If I must have ECG once in 12 months can I skip that as well as just not see a doctor unless I am sick?
I have been going to A&E every 1-2 months and feel unwell every single day, although not heart attack.
Just because incomplete RBBB is found in healthy people is not a confirmation I am healthy people.
What makes you feel I do not have poor circulation?
You said my dizziness can be due to carotid arteries being blocked but you feel this cannot be the case. You want me to take that ultrasound test just to put my mind at rest
Unless I know, usually I would not know what test is needed, as
I am not a doctor. If you think I do not need a test I wont bother to take it.
If I did take that carotid ultrasound and it did come out normal that will not put my mind at rest. I am feeling will non stop and not getting well, and tests that come out normal are not likely to bring me any comfort
I am not an irresponsible adult. I would not want to waste doctor time and waste hospital tests for a non-existent illness
just to put my mind at rest.
If I have an illness is anything but imaginary, the illness will live even if you put my mind at rest.
I have been lied to on more than one occasion with abnormal results when the doctor says they are excellent. Even the doctor who wrote RBBB on the ECG I have attached told me the
ECG was excellent. She was confident I could not read English.
She XXXXXXX wrote my Troponin was excellent without doing a troponin test. Previously my GP was confident I wouldn't know
when I saw my systolic was 200. Another time I was vomiting blood my systolic was like 250 and I was delirious in A&E and they discharged me as having a stomach infection. A special one?
Thats why reassurance will have no effect on me when it comes from a doctor. Reassurance does not have to be truthful. I want a coherent honest diagnosis. I dont care if its minor or I am terminally ill. I must have honesty without attitude about my mind. Some panic more than others. So what?
Patients panic is not your responsibility. Mind is not body.
I am asking for honest opinions and if you think I am 100% fit
or terminally ill why not spill the secret.
I am not going to take some test for my body if a doctor says I am normal but to take it for my mind.
So why am I dizzy and is that in my mind too?
Why dont I get a brain transplant?
I have been so ill so long and
So why would I bother with them tests unless I knew they were needed?
First you seem to have reverted to that stance where I have no heart disease. Please confirm you feel I have no heart disease.
And why so? Do you recommend I stop taking bisoprolol?
The Dublin cardio said in April 2020 on the phone I am excellent, I then told him the doctor found RBBB in April 2020, and I dont feel excellent either,. He then admitted he noticed a change in the conduction of my heart when he looked at my scan of Feb 2020. He then said it was going to be okay. I said I feel lousy and feel it wont be okay as time goes by. He said that it true, he would do tests when lockdown was over.
I HAVE BEEN SICK 4 YEARS LISTENING TO LIES AND HAVE MORE THAN ONE REASON TO TAKE MY LIFE, WHICH I PREFER TO DO PUBLICLY, I NEED HONEST SPEAKING BY DOCTORS EVEN IF I AM TERMINALLY ILL. THIS IS YOUR JOB
I also understand you are not the doctor doing my tests and
have no control over that process. I have a problem though.
If I must have ECG once in 12 months can I skip that as well as just not see a doctor unless I am sick?
I have been going to A&E every 1-2 months and feel unwell every single day, although not heart attack.
Just because incomplete RBBB is found in healthy people is not a confirmation I am healthy people.
What makes you feel I do not have poor circulation?
You said my dizziness can be due to carotid arteries being blocked but you feel this cannot be the case. You want me to take that ultrasound test just to put my mind at rest
Unless I know, usually I would not know what test is needed, as
I am not a doctor. If you think I do not need a test I wont bother to take it.
If I did take that carotid ultrasound and it did come out normal that will not put my mind at rest. I am feeling will non stop and not getting well, and tests that come out normal are not likely to bring me any comfort
I am not an irresponsible adult. I would not want to waste doctor time and waste hospital tests for a non-existent illness
just to put my mind at rest.
If I have an illness is anything but imaginary, the illness will live even if you put my mind at rest.
I have been lied to on more than one occasion with abnormal results when the doctor says they are excellent. Even the doctor who wrote RBBB on the ECG I have attached told me the
ECG was excellent. She was confident I could not read English.
She XXXXXXX wrote my Troponin was excellent without doing a troponin test. Previously my GP was confident I wouldn't know
when I saw my systolic was 200. Another time I was vomiting blood my systolic was like 250 and I was delirious in A&E and they discharged me as having a stomach infection. A special one?
Thats why reassurance will have no effect on me when it comes from a doctor. Reassurance does not have to be truthful. I want a coherent honest diagnosis. I dont care if its minor or I am terminally ill. I must have honesty without attitude about my mind. Some panic more than others. So what?
Patients panic is not your responsibility. Mind is not body.
I am asking for honest opinions and if you think I am 100% fit
or terminally ill why not spill the secret.
I am not going to take some test for my body if a doctor says I am normal but to take it for my mind.
So why am I dizzy and is that in my mind too?
Why dont I get a brain transplant?
I have been so ill so long and
So why would I bother with them tests unless I knew they were needed?
First you seem to have reverted to that stance where I have no heart disease. Please confirm you feel I have no heart disease.
And why so? Do you recommend I stop taking bisoprolol?
The Dublin cardio said in April 2020 on the phone I am excellent, I then told him the doctor found RBBB in April 2020, and I dont feel excellent either,. He then admitted he noticed a change in the conduction of my heart when he looked at my scan of Feb 2020. He then said it was going to be okay. I said I feel lousy and feel it wont be okay as time goes by. He said that it true, he would do tests when lockdown was over.
I HAVE BEEN SICK 4 YEARS LISTENING TO LIES AND HAVE MORE THAN ONE REASON TO TAKE MY LIFE, WHICH I PREFER TO DO PUBLICLY, I NEED HONEST SPEAKING BY DOCTORS EVEN IF I AM TERMINALLY ILL. THIS IS YOUR JOB
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