Chronic Discomfort: A Year of Neurological Challenges

It has been a year, and recently, my daily routine has been affected by discomfort during waking hours?

Hello, doctor.
I have been experiencing discomfort for over a year.
Initially, I felt unusually unwell at home on weekends, with persistent dizziness and chest tightness throughout the day.
My memory and concentration have also worsened.
One eye has blurred vision, ranging from 0.1 to 0.7 (the ophthalmologist said it is pseudomyopia).
However, my discomfort is increasingly affecting my daily life.
This year, I have had two severe headaches that did not improve even after sleeping, and the next day, I still felt pain when moving my head.
I often feel drowsy, experience chest tightness, head pressure, and back pain, and the area where my vision is blurred also hurts.
I have a significant sensation of hypoxia, and although I used to avoid napping, I now find myself falling asleep due to dizziness (but I still feel the same after waking up).
Lying in bed, I never feel relaxed; my body feels extremely fatigued.
I wake up wanting to sleep again, with headaches that are not just due to sleepiness.
I cannot focus on tasks because I feel too uncomfortable.
Recently, I have also experienced palpitations upon waking.
I have consulted a psychosomatic specialist (and have been off medication for a while) and tried exercising, but even moderate treadmill workouts have made me feel nauseous several times.
It’s all quite complicated, and I’m unsure where to seek further evaluation, so I wanted to consult with a doctor online.
Thank you!

Jin, 10~19 year old female. Ask Date: 2020/02/07

Dr. Jiang Junyi reply Neurology

Hello, based on your description and age, it may be necessary to first consider the symptoms of migraine.
Common aura symptoms of migraine include visual disturbances such as seeing bright lights resembling stars or lightning, as well as blurred or distorted vision.
These are all precursors to a migraine.
A few minutes after the aura appears, you may experience tingling, weakness, or numbness in the face, hands, or legs.
During the attack, symptoms may be accompanied by nausea, vomiting, photophobia, phonophobia, and pallor.
After the aura subsides, you may experience severe, unilateral throbbing pain in the head.
These migraine symptoms typically last for several hours, and can even extend up to 2-3 days.
However, if the headache symptoms change or worsen, it may be necessary to undergo brain imaging studies.
It is advisable to consult a neurologist to discuss examination and treatment options.
Wishing you good health, peace, and happiness.
Dr.
Jiang from Taoyuan Hospital cares about you.

Reply Date: 2020/02/07

More Info

It sounds like you have been experiencing a range of distressing symptoms for over a year, which is understandably affecting your daily life. Your symptoms, including persistent dizziness, chest tightness, memory and concentration issues, visual disturbances, and feelings of fatigue, suggest a complex interplay of physical and psychological factors.
First, it’s important to recognize that chronic discomfort and neurological challenges can stem from various causes, including anxiety disorders, depression, or even somatic symptom disorders. These conditions can manifest physically, leading to symptoms like headaches, fatigue, and cognitive difficulties. Your mention of "假性近視" (pseudomyopia) indicates that your visual disturbances may not be purely physical but could also be exacerbated by stress or anxiety.
Given the duration and complexity of your symptoms, it is crucial to approach this situation holistically. Here are some steps you might consider:
1. Comprehensive Evaluation: Since you have already consulted with a mental health professional and have stopped medication, it may be beneficial to revisit a healthcare provider for a comprehensive evaluation. This should include a thorough medical history, physical examination, and possibly imaging studies (like an MRI or CT scan) to rule out any underlying neurological conditions.
2. Neurological Assessment: Given your symptoms of persistent headaches and dizziness, a consultation with a neurologist may be warranted. They can assess for conditions such as migraines, tension-type headaches, or other neurological disorders that could be contributing to your symptoms.

3. Psychological Support: If anxiety or depression is a contributing factor, cognitive-behavioral therapy (CBT) can be particularly effective. CBT helps individuals identify and change negative thought patterns and behaviors that contribute to their distress. Additionally, mindfulness practices and relaxation techniques can help manage anxiety and improve your overall sense of well-being.

4. Lifestyle Modifications: Regular physical activity, even if it feels challenging, can significantly improve mood and reduce anxiety. Start with low-impact exercises, such as walking or gentle yoga, and gradually increase intensity as tolerated. Ensure you are also maintaining a balanced diet, staying hydrated, and getting adequate sleep, as these factors can greatly influence your physical and mental health.

5. Medication Review: If you previously found relief with medication, it may be worth discussing with your healthcare provider the possibility of reintroducing or adjusting your medication regimen. Some individuals benefit from a combination of medication and therapy for optimal results.

6. Support Systems: Engaging with support groups or talking to friends and family about your experiences can provide emotional support and reduce feelings of isolation. Sharing your struggles can also help others understand what you’re going through.

7. Monitor Symptoms: Keeping a symptom diary can help you and your healthcare provider identify patterns or triggers related to your discomfort. Note when symptoms occur, their intensity, and any potential contributing factors (like stress levels, diet, or sleep quality).

In conclusion, while your symptoms are undoubtedly challenging, there are multiple avenues for support and treatment. It’s essential to take a proactive approach by seeking comprehensive evaluations and engaging in both physical and psychological care. Remember, recovery is often a gradual process, and it’s important to be patient with yourself as you navigate this journey.

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