Dear XXXXXXX

I wish you are totally healthy when you are writing this query, but by this age often out of curiosity we tend to feel things as unusual when medically it may be normal.
You have used many medical words.. I hope you are not a medical student.

Palpitations: by literal means we mean as subjective perception of heart beats, which is normal in adolescents, thin people and anxious ones. Often it is normal unless you have a background heart disease. What is more important is when palpitations are associated with chest pain, discomfort and breathlessness, and if the beats are irregular, all this warrants an ECG XRay chest and an examination by cardiologist.

Shortness of breath: If you are feeling shortness of breath while lying down in medical terms, it becomes medical emergency. Again you cant be extremely fit and running when you feel shortness of breath. Often your respirations will be laboured and breathing and talking will be difficult with shortness of breath. And if you do have all of these, its again a medical emergency and you need to visit ER.

Shortness of breath while lying down, after a heavy meal may be normal to some extent, but if you are worried about this and if the problem is persistant on daily basis, it may require a colour doppler echo of heart to rule out a pleural /pericardial effusion, and any other heart issues.
post meal shortness of breath and sleepiness are often observed in hypothyroidism and also in anemia which may need a blood test to confirm it.

If all the above tests and consultations are normal, you may need to accept it as normal if you are extremely fit and healthy.

Feel free to write back, at times mental stress can make one feel many such issues, things wont be clear unless you reveal more details.

Hope this is reassuring and helpful.

Thanks

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Hi,

Good to hear from you again.

What I means by "extremely fit and healthy" is that I exercise 4-5 times per week and eat a healthy diet.
-- You are doing your best to keep yourself healthy. More so, your body is letting you do it. Most illnesses with these complaints have reduced exercise tolerance.

When I say I get short of breath when lying down I don't wheeze or struggle to breathe, it is a mild sensation whereby I feel I cannot get enough air.
== Often its normal, and should disappear when you sit upright.

When I feel my pulse it does feel irregular - it will beat normally, very quickly followed by a "thump". It will then return to normal rhythm after a second or so only to repeat the cycle again.
== This is the normal irregularity with breathing called as sinus arrhythmia, but can only be called normal after seeing an ECG.

Three years ago I also suffered from extreme dizziness and headaches. This quickly subsided but has left me with a constant throbbing sensation in my body, particularly in my head which also gets worse when lying down.
== As per my experience common cause of headache in males at this age is sinus related issues. If it still persists its better to get a CT brain and rule out any chance aneurysm or mass inside.

Since then I have had dozens of blood tests, which were normal apart from unconjugated hyperbilirubin (dx as gilberts)
== This was incidental. The bilirubin level decides the chances of complications including the ones you describe as symptoms.

for which I have had abdominal MRI and thoracic contrast CT for the shortness of breath which were both normal.
== Scans will only help to find any treatable cause for your jaundice, it wasnt there.

I have had EKG, which was normal. No cause was ever found for the dizziness/headaches,
== Do you have any stress? Work job or Business related? Is the headache every day? Does it trouble in sleep? If yes, you may need a CT brain and a BP check.

and so it was put down to anxiety. I feel too ill for this to be anxiety only.
== If the antianxiety drugs dont comfort you, its unlikely to be anxiety alone. Antianxiety drugs taken with less food often cause similar dizziness / giddiness. Why dont you go for counselling with a psychiatrist, he may help you get rid of the anxiety label.

More recently I had a sleep study for my tiredness which I had to remove as the equipment kept me awake. I am yet to receive the results for this.
=== What kind of study was it? Polysomnography? You may benefit for the headache by an EEG though.


One doctor has stated that she believes the tiredness to be post viral fatgue
== Such fatigue should not last more than 3 months.

and wasn't concerned about the dyspnea.
== If you can do exercise without getting stressed, even I would put dyspnea out of question.

However I am not convinced
== I will suggest Colour doppler echo of heart, Xray chest, EEG and CT brain to be on safer side. Get back to me with reports.

Hoping you will say I am healthy soon.

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Hi,

Painless throbbing sensation is surely not a headache but along with dizzi or drowsiness may surely match with symptoms of vertigo, dont worry about blood pressure much, that may respond to anti anxiety medicines.

Try to understand that most such issues may need long term therapy to balance the symptoms and may be long term counselling. Dropping the therapy may worsen the situation.

Keeping yourself busy may help you think of other things than the medically proven normal issues, as you said you have learnt how to manage it. Yoga may help to boost your performance and to keep you away from thinking about the issues. also get the remaining investigations done to call all as normal and close the seriousness with this issue.

Thanks, do not hesitate to write back if you have more queries.

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