Unexplained Health Issues: Seeking Answers for Persistent Dizziness and Pain

Many health issues with no identifiable cause?

Hello Dr.
Jiang: I would like to ask about my condition.
About a year or two ago, I underwent tooth extraction for orthodontic treatment and had bone grafting done at the same time.
The next day, I experienced severe dizziness and nearly lost consciousness, requiring an emergency visit.
Since that severe episode of dizziness, I have been prone to occasional dizziness (for example, when lying on my side and changing positions) as well as headaches and occasional shoulder pain.
My physical condition has changed significantly from before, and I have seen specialists in neurology and otolaryngology, even undergoing an Epley maneuver, but there has been no improvement.
Due to concerns about the pandemic, I received the High-End vaccine, which is considered to have fewer side effects.
After receiving a dose of High-End on August 27, 2021, I again experienced dizziness, cold sweats, and chest tightness and pain, leading to three emergency visits.
However, no cause was found.
My blood pressure typically ranges between 118-121/85-92.
During this time, I also consulted a cardiologist and was diagnosed with autonomic nervous system dysregulation, for which I have been prescribed medication.
I have also sought treatment from traditional Chinese medicine, but there has been no improvement.
Currently, I still experience occasional chest pain, dizziness, and headaches.
What could be the underlying issue with my health? Do you have any recommendations? Thank you.
🙏

Xiao Kang, 30~39 year old female. Ask Date: 2022/05/09

Dr. Jiang Junyi reply Neurology

Dear Mr.
Hsiao-Kang,
You mentioned that "lying down and changing positions causes dizziness," which may initially suggest benign paroxysmal positional vertigo (BPPV).
The symptoms are characterized by brief episodes of vertigo related to changes in head position, such as bending over, leaning back, lying down, getting up, rolling over, or suddenly turning the head.
These episodes may be accompanied by symptoms such as nausea, vomiting, palpitations, cold sweats, and feelings of weakness.
Additionally, regarding "cardiology, autonomic nervous system dysregulation, and medication...
experiencing occasional chest pain, dizziness, and headaches," it is generally understood that the autonomic nervous system is regulated by the sympathetic and parasympathetic nervous systems.
The sympathetic nervous system acts as the accelerator, while the parasympathetic nervous system serves as the brake.
The sympathetic nervous system is activated during physical activity, leading to increased heart rate, faster breathing, and increased sweating.
Once the activity ceases, the parasympathetic nervous system takes over, slowing the heart rate, reducing breathing rate, and decreasing sweating.
The most common medical assessment of the autonomic nervous system is measuring heart rate variability (HRV).
HRV refers to the variation in time intervals between heartbeats, serving as an indirect indicator of autonomic nervous system activity.
However, due to the recent COVID-19 pandemic, it is advisable to wait until the situation stabilizes before visiting a hospital for examination.
In the meantime, you might consider using a smartwatch with blood oxygen and heart rate monitoring capabilities, such as the Apple S6, to track your sleep, heart rate variability, and blood oxygen levels.
Thank you for your inquiry.
If you have any related questions, feel free to discuss further!
Wishing you good health and peace,
Dr.
Chuan-Yi Jiang

Reply Date: 2022/05/09

More Info

It sounds like you have been experiencing a range of distressing symptoms for quite some time, including dizziness, headaches, and chest discomfort. These symptoms can be quite alarming, especially when they persist despite multiple medical evaluations and treatments. Let's break down your situation and explore some potential avenues for understanding and addressing your health concerns.

First, it's important to acknowledge that the body and mind are interconnected. Your history of dental procedures, particularly the extraction and bone grafting, followed by the severe dizziness, suggests that there may have been an initial trigger that set off a cascade of symptoms. Dizziness can arise from various causes, including vestibular disorders, neurological issues, or even anxiety. The fact that you have experienced episodes of dizziness when changing positions (like lying down) could indicate a vestibular issue, but since you've already undergone an ear stone repositioning procedure without improvement, it may be worth considering other factors.

Your symptoms of chest pain and discomfort, along with episodes of cold sweats and palpitations after receiving the vaccine, are also concerning. While vaccines can cause transient side effects, persistent symptoms warrant further investigation. It's good that you've consulted with cardiologists and neurologists, as they can rule out serious conditions such as arrhythmias or neurological disorders. However, if these specialists have not found any definitive issues, it may be time to explore other possibilities.

One potential avenue to consider is the role of anxiety and stress in your symptoms. Chronic anxiety can manifest physically in various ways, including dizziness, chest pain, and muscle tension. If you have been under significant stress or have developed anxiety about your health, this could exacerbate your symptoms. Cognitive-behavioral therapy (CBT) or other forms of psychological support could be beneficial in managing anxiety and its physical manifestations.

Additionally, it may be helpful to keep a detailed symptom diary. Documenting when your symptoms occur, their duration, and any potential triggers can provide valuable insights for your healthcare providers. This information can help identify patterns or correlations that may not be immediately apparent.

Another consideration is the possibility of a functional disorder, where physical symptoms arise without a clear organic cause. Conditions such as fibromyalgia or chronic fatigue syndrome can present with widespread pain, fatigue, and cognitive difficulties. These conditions often require a multidisciplinary approach for management, including physical therapy, lifestyle modifications, and sometimes medication.

In terms of immediate steps, I recommend the following:
1. Follow-Up with Specialists: If you haven't already, consider revisiting the specialists you've seen, armed with your symptom diary. This may help them reassess your situation with a fresh perspective.

2. Explore Mental Health Support: Engaging with a mental health professional can help address any underlying anxiety or stress that may be contributing to your physical symptoms.

3. Lifestyle Modifications: Focus on maintaining a healthy lifestyle, including regular exercise, a balanced diet, and adequate sleep. These factors can significantly impact both physical and mental health.

4. Consider Alternative Therapies: Some individuals find relief through complementary therapies such as acupuncture, yoga, or mindfulness meditation. These approaches can help reduce stress and improve overall well-being.

5. Stay Informed and Advocate for Yourself: Continue to seek answers and advocate for your health. If you feel that your concerns are not being addressed, don't hesitate to seek a second opinion.

In conclusion, while your symptoms are undoubtedly distressing, there are various avenues to explore for relief and understanding. By taking a comprehensive approach that includes both physical and mental health considerations, you can work towards regaining your health and peace of mind. Remember, you are not alone in this journey, and support is available.

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