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Hi. My Son Has Been Experiencing The Following For About
Question: Hi. my son has been experiencing the following for about a year. Chest pain usually starting on the right side and radiating, shortness of breadth, stomach pain, dizziness from vestibular migraine, and fatigue. He has also lost 10 lbs in the last 2 months. he ways only 120lbs. Also blood in the stool. He has had all the scopes for his colon and digestive track. Heart tests, X-rays, MRI, testing for parasites and other diseases. Tested his blood for deficiencies, thyroid, and white blood count etc. He has been in the emergency room and in the hospital twice with no answers. The only thing they said was maybe it was autoimmune. He is going to a ruemotologist soon. He has not traveled outside the country. He has been tested for Lime disease and other tick born illnesses. He has had his lungs reviewed. Not sure what else we can do?
Brief Answer:
should visit medical school and the patient should be taken as a CASE.
Detailed Answer:
Hi,
Thanks for choosing 'Ask A Doctor' service,
As per your query, my opinion is,
There are a number of possibilities as most of the symptoms are overlapping and tests(Basic)almost all are normal.
So hope that you can understand how complex and difficult it can be for an online doctor to make a comment on the diagnosis of your son, however, I would try to relate things with symptoms you have told. Firstly pain in chest with radiation along with shortness of breath can be due to two reasons-
1) Cardiac-though baseline tests are normal. Yet sensitivity of even both 2D-echo and stress test have done together is about 65%. However, as the case is complex a Stress M1B1 gated scan should be done. It's almost 99.6%sensitive and non-invasive. If its normal cardiac causes are ruled out.
For shortness of breath a pulmonary function test if the normal involvement of heart or lung is ruled out. Now if endoscopy is normal even then it could be due to gastritis. For which a proper therapy with strong antacids should be started to see the response.
Stomach pain and shortness of breath could be an aura of a vestibular migraine.
Losing weight is normal as he must be in anxiety losing blood and must not be in a state of mind where he is having full meals.
So if the test suggested by me is normal then go to a quaternary care hospital request management to take up this case where a Gastroenterologist, Rheumatologist, Oncologist and Cardiologist would sit together would discuss the case as a whole.No separate visits one-time discussion in one room with all four specialities.
Hope you can understand the gravity of the problem and it's not easy to give a diagnosis when so many doctors have failed too but I have shared my idea. It would be good if you follow it.
Hope I was helpful.
Any follow-ups are welcome.
should visit medical school and the patient should be taken as a CASE.
Detailed Answer:
Hi,
Thanks for choosing 'Ask A Doctor' service,
As per your query, my opinion is,
There are a number of possibilities as most of the symptoms are overlapping and tests(Basic)almost all are normal.
So hope that you can understand how complex and difficult it can be for an online doctor to make a comment on the diagnosis of your son, however, I would try to relate things with symptoms you have told. Firstly pain in chest with radiation along with shortness of breath can be due to two reasons-
1) Cardiac-though baseline tests are normal. Yet sensitivity of even both 2D-echo and stress test have done together is about 65%. However, as the case is complex a Stress M1B1 gated scan should be done. It's almost 99.6%sensitive and non-invasive. If its normal cardiac causes are ruled out.
For shortness of breath a pulmonary function test if the normal involvement of heart or lung is ruled out. Now if endoscopy is normal even then it could be due to gastritis. For which a proper therapy with strong antacids should be started to see the response.
Stomach pain and shortness of breath could be an aura of a vestibular migraine.
Losing weight is normal as he must be in anxiety losing blood and must not be in a state of mind where he is having full meals.
So if the test suggested by me is normal then go to a quaternary care hospital request management to take up this case where a Gastroenterologist, Rheumatologist, Oncologist and Cardiologist would sit together would discuss the case as a whole.No separate visits one-time discussion in one room with all four specialities.
Hope you can understand the gravity of the problem and it's not easy to give a diagnosis when so many doctors have failed too but I have shared my idea. It would be good if you follow it.
Hope I was helpful.
Any follow-ups are welcome.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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