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Suggest Treatment For Persistent Sweating And Vomiting After A Fainting Episode

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Posted on Thu, 3 Nov 2016
Question: Hello, I am a 52 yo male, on July 10th I had an episode while mowing, that I got this strobe light effect in my eyes and then sort of blacked out and fell forward, got back up then fell backwards which I landed so hard I bruised my tailbone. I then went in the house and sat, sweating up a storm and throwing up. Went to the ER and they could not find anything wrong that would of caused that. went for 3 months with nothing ever happening again, then on Wednesday of last week, I was at a clients house blowing tree trimmings and it happened again, the strobe light effect. I said to myself, " get on the ground" and that is the last thing I remember. When I woke up I was being loaded into an ambulance, was taken to ER and all the test were done, I started the sweating and throwing up in the ambulance and that continued during the ER treatment, was given a room to stay in, was there till friday evening. Thursday morning the doctor came in and said there was no sign of heart attack, stroke but I had no b12, d3 and thyroid was extremely low. He ordered a stress test and c scans along with a brain wave. Brain wave came back normal, c scan;s also came back normal. What got him is that when I did the treadmill test with ultra sound before and after test, well the ultra sound of the heart came back normal but during the treadmill test, I was doing fine, until my blood pressure immediately dropped 30 points, that is why they stopped me and threw me back on the table to get the second ultra sound...... So I am on supplements and he raised the thyroid from 25mg to 50mg...... Oh and they say I was extremely dehydrated, which does not make since since I was drinking water and gatoraid and my potassium was depleated also...... So the only thing else he did was remove me from taking prilosec, he thinks after 20 plus years of being on that that my stomach has stopped even taken in nutrients, so now I am on Pantoprazole....... Just not sure what to do, looking for a new doctor as I am on Medicaid, always have felt like cattle being herded by the old doctor. Has anyone ever come across something like this and if you have, what should I be looking at for treatment and or in a new doctor/specialist?
doctor
Answered by Dr. Ishu Bishnoi (4 hours later)
Brief Answer:
Explanation of symptomatology and approach

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your concern. It is good that you have provided me a through history of your symptoms. It helped me a lot to make some differential diagnosis and possible explanation of your symptoms.

As you had episodes of sudden blackout and your heart, brain came to be normal, which is good. You are having
: Low vitamin B12 - The reason could be your diet (deficient in vitamin B12) and persistent use of Prilosec.

Low vitamin B12 can cause
balance difficulty
anaemia and weakness, poor concentration
spinal cord and nerve damage manifesting as tingling, loss of position sense/vibration, autonomic disturbance (Like sudden fall in BP as happened in you).

: Low vitamin D3 - The cause could be poor diet and less exposure to sunlight or excessive use of sunscreen.

It's deficiency can cause
-Bone pain
-fracture due to trivial trauma
-fatiguability
-depression

: Hypothyroidism - It can be due to genetics, familial, diet.

It can cause
-cold intolerance
-constipation
-low BP and vertigo
-weight gain
-poor appetite, constipation
-depression
-fatiguability, episodes of blackout, anaemia

I have explained to you all these symptoms so that you can make out that you are having severe metabolic alteration in your body. That is the reason behind your episodes of blackout, sudden fall in BP. The dehydration and low potassium after this episode was most probably due to severe sweating along with loss of electrolytes.

You can consult neurologist and endocrinologist to treat your condition. Once your metabolic values (B12, vitamin D3, thyroid function test) will normalise, you will see definite improvement.

There is one more thing, you should ask your doctor to rule out "transient ischemic attack" of brain along with anaemia. The doctor can advise
: Ultrasound doppler of neck vessels to know about status of carotid and vertebral arteries.
: Complete blood analysis with peripheral smear to know about "megaloblastic anaemia".
These tests are must for complete evaluation.

Hope you got my point. Hope it will help you. If still in doubt, do let me know.
Thanks. Take care.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
Answered by
Dr.
Dr. Ishu Bishnoi

Neurologist, Surgical

Practicing since :2007

Answered : 901 Questions

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Suggest Treatment For Persistent Sweating And Vomiting After A Fainting Episode

Brief Answer: Explanation of symptomatology and approach Detailed Answer: Hi XXXX, thanks for asking from HCM. I can understand your concern. It is good that you have provided me a through history of your symptoms. It helped me a lot to make some differential diagnosis and possible explanation of your symptoms. As you had episodes of sudden blackout and your heart, brain came to be normal, which is good. You are having : Low vitamin B12 - The reason could be your diet (deficient in vitamin B12) and persistent use of Prilosec. Low vitamin B12 can cause balance difficulty anaemia and weakness, poor concentration spinal cord and nerve damage manifesting as tingling, loss of position sense/vibration, autonomic disturbance (Like sudden fall in BP as happened in you). : Low vitamin D3 - The cause could be poor diet and less exposure to sunlight or excessive use of sunscreen. It's deficiency can cause -Bone pain -fracture due to trivial trauma -fatiguability -depression : Hypothyroidism - It can be due to genetics, familial, diet. It can cause -cold intolerance -constipation -low BP and vertigo -weight gain -poor appetite, constipation -depression -fatiguability, episodes of blackout, anaemia I have explained to you all these symptoms so that you can make out that you are having severe metabolic alteration in your body. That is the reason behind your episodes of blackout, sudden fall in BP. The dehydration and low potassium after this episode was most probably due to severe sweating along with loss of electrolytes. You can consult neurologist and endocrinologist to treat your condition. Once your metabolic values (B12, vitamin D3, thyroid function test) will normalise, you will see definite improvement. There is one more thing, you should ask your doctor to rule out "transient ischemic attack" of brain along with anaemia. The doctor can advise : Ultrasound doppler of neck vessels to know about status of carotid and vertebral arteries. : Complete blood analysis with peripheral smear to know about "megaloblastic anaemia". These tests are must for complete evaluation. Hope you got my point. Hope it will help you. If still in doubt, do let me know. Thanks. Take care.