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    What do my lab test reports indicate?

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Posted on Mon, 30 May 2016 in Ear, Nose and Throat Problems
Question: Hi doctor...i have these chronic symptoms of vertigo for 2 yrs now...i feel like i am going to fall but nver fall..i feel movement inside me...pulling on one side..always have to hold something to stand still..cannot concentrate or pay attention in lectures coz i feel i am going to fall if i stare at something and pay attention..i have to keep looking at different things to keep myself stable..my feet are tired..if i try to walk a lot or run i feel like i am going to fall as my feet will loose its stability on ground and i am going to fall..due to these symtpoms my heart beat raises and i kinda get palpitations...all my blood reports are normal except high triglycerides and normal mri and ct scan..i dont know what to do i am tired of going from doctor to doctor with no help...my rheumatoid factor is 15 always...all other rheumatic tests are negative..ccp is bordeline


Followed up with cardio too,,,all reports are within normal limits..including stress test,holter,ecg and ekg..this is like a mystery problem..i am considering vestibular rehab therapy..i dont know if thats a good idea..they even suspected lupus..but my reports are normal...finally my doc wanted me to be on zoloft..i refused since i think its a real problem that needs a solution...i still feel in 2011 i had a minor head injury in office cabinets..since my head scn is normal they r not even bothered abt that injury...but all the problems started around that time....briefing abt my problems on and off since 2011:
Dry eyes
Hairloss
Palpitation
Occasional chest pains
Fatigue
Tired when i wake up
Vertigo...my biggest problem and its bothering me when i am working since i am dentist and i have to talk to ppl counsel them...unable to stare at people and talk since i feel i fall right infront of them..i have to look at the ground when i am taking or somewhere else..
When i walk or do tread mill i feel floating sensation in my feet...

Please help and advise


My reports since 2011

Cbc-normal
Wbc rbc hb normal
Glucose normal
Thyroid normal
Female hormones normal
Rheumatoid factor 15 instead of 14 or less
Vit d was severly low but i am taking supplements now
Lupus lymes negative
Sjogrens negative
Mri ct normal
doctor
Answered by Dr. Sumit Bhatti 7 hours later
Brief Answer:
This will require further investigation.

Detailed Answer:
Hi,

Thank you for your query.

1. Your symptoms are suggestive of a problem with the VOR (Vestibular Ocular Reflex) and the smooth pursuit system.

2. This will require further investigation. There are many causes for this type of dizziness, mostly central and functional. Investigations including scans are usually normal.

3. You should consult Dr. XXXXXXX Newman Toker at the XXXXXXX XXXXXXX Hospital, XXXXXXX

4. Upload your test and examination notes for further discussion on treatment options.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Sumit Bhatti 7 hours later
Thank you for ur prompt response doctor i really appreciate it..i will try to see if i can go to XXXXXXX since i live in XXXXXXX and i work full time..i will also get my reports from various doctors and upload it to u..
But my question is could this be related to head injury that happened in2011..it was pretty severe though it was just office cabinet but the injury was right on the crown of my head with full force ..i was sitting down and then stood up unknowingly with full force...i never fell unconscious but right after the hit i felt blood gushing down and felt like i will fall but never fell ..then in one month i started getting severe dry eyes..feel like sand under my upper eyelid...then i had severe hairloss..i thought i will eventually turn bald....then the dizziness started in 2014 XXXXXXX ..i try to do yoga..even with deep breathing i feel movement inside me..also cant meditate closing eyes but i still try and do everyday..it feels like i am working too hard to attain simple things in life.
Forgot to tell i also tried getting eng..when they blow cold air inside ear i felt so bad like i was floating in air that they had to stop doing it..never went back to get that test again:(
If its concluded that the problems are beacuse of my injury i can apply for workers comp and then do all kinds of vestibular rehab..do u think i should also see a physical therapist here for vestibular rehab before i go to XXXXXXX .
doctor
Answered by Dr. Sumit Bhatti 6 hours later
Brief Answer:
You should get examined before starting vestibular rehabilitation exercises

Detailed Answer:
Hi,

Thank you for writing back.

1. Labyrinthine concussion is a possibility. However there may be no sign to prove it. High resolution scanning of the temporal bones can be done to look for any dehiscence of bone around the labyrinth. Other tests can be used to check for decreased balance system function.

2. Your symptoms can have many other causes such as auto-immune, hormonal and so on.

3. You should get examined before starting vestibular rehabilitation exercises.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti 1 hour later
Hey Doc Thank you so much again for the response..

Ok with autoimmune..all my reports are normal ...except for rheumatoid factor which is 15 instead of under 14..all hormones are normal...

What kind of testing are u talking about..can u please name them since i got most of the tests done already..dont know which way to go..i am confused and tired so stopped going to all the doctors..please let me know what tests are u talking about so i can talk about it to my primary doctor so he can order those tests for me..

Could this be also vestibular neuritis..how can i test for it and tx options

And doc even if its say autoimmune which is undiagnosed...wont the vestibular rehab help with my vertigo kinda symptoms...
doctor
Answered by Dr. Sumit Bhatti 9 hours later
Brief Answer:
These are specialized tests done at a vertigo clinic.

Detailed Answer:
Hi,

Thank you for writing back.

1. Vestibular neuritis is self limiting, recovers within weeks and will not last for two years.

2. The tests are specialized tests possible only by a vertigo specialist and in a clinic where special tests for vertigo are available. For example, a VNG (VideoNystagmoGraphy).

3. A General Medicine doctor will be able to screen you for a full auto-immune work-up.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti 44 hours later
Hey Doc I saw a physical therapist today and he did lot of work up on me and he said its definitely his field and he thinks its vestibular and more of a ocular reflex issue..he asked me for six weeks time and he guaranteed i will see a change..i guess theres no harm in trying before i go to any other doctor runnng around ...please advise if i can continue and try it when the physical therapist is so confident givenall other tests are normal..
doctor
Answered by Dr. Sumit Bhatti 3 hours later
Brief Answer:
Get the diagnostic work-up done first.

Detailed Answer:
Hi,

Thank you for writing back.

1. There is no doubt that vestibular rehabilitation exercises will benefit you in the long run.

2. However, I recommend that you get the diagnostic work-up first.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2593 Questions

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