Multiple Medical Problems and Chest Pain

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Did 100 reps with 30 lbs 2 days ago (not sure if its important or not) Have had a sinus infection for almost 3 wks (dr appt in 2 days) I have back problems and have t4 and flexeril for it. I took them last night in hopes of sleeping better since sinus has been keeping me awake and restless sleeps. When meds kicked in, I got bad chest pains that kept me up all night and had a hard time breathing for 1/2 night. Today it's still sore and sensitive. Area is solar plex/between breasts.. Had this before and dr said was acid reflux. If so why does it happen only occasionally (once every 2 or 3 mos) and cause such pain for 24 hrs ?? I am overweight, had pituitary tumor, have hypothyroidism, celiac (found out in jan), low magnesium. I have had 3 kids as well.

 Gender: Female
 How tall are you (feet and inches)?: 5'3
 What is your weight in pounds?: 186
 How old are you?: 31
 How long has this been going on?: More than a year

 Check all symptoms you are currently experiencing:
 Abdominal Pain
 Difficulty Breathing
 Chest Pain

 Describe associated symptoms not listed above: The difficulty breathing part felt like someone was sitting on my chest.. I know it wasn't the side effect of the meds as I have been on them for a while

What have you done so far to remedy this condition? Please include tests and relevant studies here.
 : I was given reflux meds for a couple wks. That seemed to help at that time as I was getting the pains repeatedly. But now 3 mos later it's back.

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): I have a pinched nerve in my lower back as well as arthritis. I can't take anti inflammatories as they caused major weight gain and stomach probs..  I have hypothyroidism, celiac disease, and low magnesium (taking vitamins)Had a pituitary tumor but it seems to be under control, not on meds for it anymore. I have had breast reduction 17 yrs old, surgery on my knee after skiing accident (15yrs), surgery on my armpit as breast tissue left  grew (28yrs),tonsils removed (16yrs), adnoid removed (8yrs)

 Check all conditions present in your immediate family... :
 Asthma / Lung Problems
 Cancer

Please list any medication allergies that you have : : Penicillin - throat swells
Please list any medications you are currently taking (and dosage if known) :: Cytomel 1/3.5 & synthroid 50mcg compounded in one pill .. I take 3.. I also take Tylenol 4 and Flexeril10 mg. I also take daily vitamins, including vitamin b 100 complex, kelp, omega 3-6-9, vitamin c 1000mg, digestive enzymes, vitamin d 25 mcg, magnesium glycinate 600 mg ..and occasionally iron 300mg ( was deficient last yr)

 When was your last menstrual cycle?: 3 weeks ago
 Are you currently using or do you have a history of tobacco use?: Yes
 Are you currently using or do you have a history of illegal drug use?: No
 Please describe your alcohol consumption :: Occasionally

The pain causes, what other things it could be ?
 ______________________________________________________

Ma'am, with respect, you have so many issues going on at once here I can't really tie this up nicely. The fact is that your symptoms could be coming from reflux, could be from gallstones, or it could be your heart. There are other possibilites, but these three are top of the list.

The point I guess I would make with you is that in order to GET the diagnosis more work needs to be done.

For instance, withn the chronicity of this, reflux is a likely cause. But you need to be checked for ulcers and you may need to have an upper endoscopy (camera exam of inside of esophagus and stomach).

You are also at the right age for gallstone disease. An ultrasound of the gall bladder is probably needed in your case.

Finally, even though the odds are against this being your heart, it is certainly worth looking at your heart with an EKG and, perhaps, a stress test.

Your other medical problems DO muddy the waters, so perhaps the best advice I could give would be to make sure your doctor is comfortable AND competent to manage a complicated medical patient such as yourself.

There are many unanswered questions in your case. I wish I could help more, but there is much that is yet to be done.

If you have any questions please do ask them below in the comments section.

Beyond Our Scope

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I have had lower abdominal pain since I was 15.  The intensity of it fluctuates.  During periods of great stress, it is severe and constant.  I also have Complex PTSD, Fibromyalgia, Diabetes Type 2, Migraines, and mild osteoarthritis in my knees. I have tried many food allergy, food sensitivity diets over the years.  I have learned and practiced many relaxation exercises. I do not feel like I have control over this at least 50% of the time.  Sometimes I can eat anything I want and have no ill effedts.  Other times I eat as well as is possible...and still have great pain, tension, bloating, fluctuating bowel movements. I have been told that I have IBS.   I have tried to accept this.

I have recently read a new book on women's stomach health and it has led me to ask if there is a missing diagnosis. I am female, 55 years old, in full menopause for 3 years, 5'4", 200 lbs.   From age 15 to 50 had various forms of ED-NOS...mostly anorexia binge-purge type.  I used all forms of purging. (over exercise, vomiting, enemas, laxatives.) Any input would be appreciated.
 I know that my case is "complex"  so maybe there are no clear answers.  More importantly I am looking for help on how to reduce the flare-ups once they have begun. Thank you.

 Gender: Female
 How tall are you (feet and inches)?: 5'4"
 What is your weight in pounds?: 200
 How old are you?: 55
 How long has this been going on?: More than a year

 Check all symptoms you are currently experiencing:
 Abdominal Pain
 Diarrhea
 Genitourinary
 Musculoskeletal Pain
 Neurological
 Psychiatric

Please list any chronic medical problems and also list any prior surgery (lacerations don't count!): polyps on bladder twice, cystoscopies 4 times. tonsils out at 4 years of age.

Check all conditions present in your immediate family... :
 Diabetes
 Psychiatric Disorders

Please list any medication allergies that you have : : mould and sulpha based antibiotics...cause very severe gastrointestinal upset and headaches.

 Please list any medications you are currently taking (and dosage if known) :: seriquel 400 mg
 Nexium 40 mg
 atenolol 50 mg
 zanaflex 8 mg
 Lyrica 225 mg
 Metformin

 When was your last menstrual cycle?: I no longer have a menstrual cycle
 Are you currently using or do you have a history of tobacco use?: No
 Are you currently using or do you have a history of illegal drug use?: No
 Please describe your alcohol consumption :: Never

 How can I lessen the intensity of "IBS" flareups when they occur?
 Do my symptoms really match up with IBS?   Is it possible that there is another condition happenning that is not yet diagnosed?
 Would I maybe also have Endometriosis?
_______________________________________________________

First of all let me give you some good references.

THIS is good on Irritable Bowel Syndrome.

THIS is good on Endometriosis.

Past this, and I say this with kindness, your complicated medical history makes it impossible, without the aid of testing and examination, to try and untangle your problems. Your issues simply do not lend themselves to an online discussion. Again, my apologies.

 

Chronic Bacterial Vaginosis

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I have been diagnosed with bacterial vaginosis.I have taken the medication prescribed which was flagyl. Not only did I take it once but twice. It has not worked both times. They increased the second dosage and still had not worked. I read if you take folic acid that it will work. However, I have been taking this as well and still no luck. I was wondering could there be an underlying cause for this not clearing up.

 How tall are you (feet and inches)?: 5'3
 What is your weight in pounds?: 250
 How old are you?: 36
 How long has this been going on?: More than a month

 Describe associated symptoms not listed above: just a discharge that is a cloudy color . The doc said it is chronic b.v.

 Check all conditions present in your immediate family... : Diabetes

 Please list any medications you are currently taking (and dosage if known) :: folic acid 800 mcg.once aday

 When was your last menstrual cycle?: 4 weeks ago
 Are you currently using or do you have a history of tobacco use?: No
 Are you currently using or do you have a history of illegal drug use?: No
 Please describe your alcohol consumption :: Never

___________________________________________

THIS LINK HERE MAY BE OF SOME HELP TO YOU.

I wish I had more information for you but as you can see from the link above, this CAN become a chronid problem.

If you are not currently under the care of a Gynecologist I would highly recommend this.

Also, I see that you have a history of diabetes in your family, and I also see that you are overweight.

If you are pre-diabetic or 'borderline' diabetic this could be contributing to this problem.

While the BV is the issue of concern for you here, with your family history and your current weight you are at high risk for developing TYPE 2 DIABETES.

It is quite possible that if you could get close to your ideal weight, THIS IS HELPFUL, that you might find that your BV problem clears up, and that you would avoid becoming diabetic.

Again, I'm sorry that I don't have a better answer for you. If you have comments or questions please make them in the box below.

PCOS and Type 2 DM

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

 Gender: Female
 How tall are you (feet and inches)?: 5'8
 What is your weight in pounds?: 181
 How old are you?: 15
 How long has this been going on?: More than a year

 Check all symptoms you are currently experiencing:
 Fever
 Abdominal Pain

 Describe associated symptoms not listed above: tiredness most of the time.

What have you done so far to remedy this condition?

I am doing this fro my 15 yr old daughter. she has been recently diagnosed with type 2 diabetes and PCOS. However, my concern is the everyday abdominal pain with headaches and tiredness. Also frequent low grade fevers ranging from 99-100. She has only had an ultra sound for the stomace and it showed that she was constipated. She is also anemic, and they took her off of her iron pills. She has had h-pylori tests done , amalyse and other tests as well.

 No surgeries.

 Check all conditions present in your immediate family... : Diabetes
 Please list any medications you are currently taking (and dosage if known) :: she takes metformin xlr. was on reg metformin but caused stomach problems on top of the stomach problems she already has.
What could possibly causing this. What can reduce the pain and sleepiness. What other tests could be done. And does she need to be referred to a specialist?

_____________________________________________________________

First of all, if all she has had is an abdominal ultrasound that showed 'constipation', then it did not acheive the results intended, which were to visualize her ovaries. The fact that they said it showed 'constipation' means that the study was sub-optimal.

Unfortunately, PCOS is not in MY particular area of expertise.My gut reaction was that PCOS is poorly understood, and about this I was correct. I did not remember that Type 2 DM was associated with this disorder.

In fact, what I have linked HERE is a very good reference for you to print out and have at hand.

From what you are telling me she is getting a slow workup for her issues. With the H pylori esting and the focus on the stomach and abdomen they are looking for a source of blood loss which could cause her anemia. It sounds as if they have not found it yet.

As you can see from the link, increased or abnormal uterine bleeding uheavy menstrual cycles) can go with this syndrome and may be the source of the anemia. But if they took her off iron pills they are thinking that this is NOT an anemia based on iron deficiency... there ARE other causes.

I do not have any magic answers to her low grade fever, tiredness, and headaches, but would say the following.

If her thyroid function has not been checked it needs to be.

If she does not have a primary care manager that is WELL versed in treating PCOS then she either needs an endocrinologist or a family practitioaer with a concentration endocrine disorders.

The headaches may or may not be related to her PCOS, and doctors always look for a 'unifying diagnosis'... a single diagnosis that explains all symtoms. That being said, the headaches may need an evaluation by a neurologist.

And finally, as hard as this will be for her, she absolutely needs to become VERY aggressive in managing her weight and in maintaining her health. The habits she forms now will either see her thgough a long and healthy life or will set her up for failure.
 
As you can see from the reference, people with PCOS often develop 'metabolic syndrome', as of now a poorly understood cluster of medical problems (including DM) that make heart disease and heart attack a big risk, not now, and not in ten years, but as your daughter gets into her late thirties and onwwards.  
 
It is not clear from your question, but it would seem that things are moving along slowly. If you are not satisfied with the progress so far, do not hesitate to get a second opiniion. A pediatric endocrinologist might be a good place to go for a second opinion.
 
I hope this helps some. Again, this problem is complicated and poorly understood at present. Your daughter is being treated reasonably, but there are unanswered questions. I hope you will drop back by in the comment section and update us on her progress. The comment section is also where you can ask questions about this answer.
 
Thank you and good luck .