What Specialist Is Appropriate For Syncope?

Question: I am not sure a neurologist is the right specialist. Please suggest what specialist is appropriate, and sorry for the trouble. It's about Syncope. It is my ongoing problem. As such, I feel like this will happen again. It is infrequent, and I get badly hurt when I fall from syncope. Doctors at the hospital here said they are non-stroke events, including events where I just feel dizzy and don't actually fall down. I feel like I will fall, and sensations like a plane landing inside my head happen. I have also had sleepwalking, and confusion more than once, usually after long periods of exertion. Originally told I have vertigo, they said because I don't remember anything it is syncope. Frankly they have not diagnosed or treated the syncope. They are not sure why. Have been asked (only by doctors) if I have a movement disorder. Suspected but cleared of Parkinson's disease. I would like to know which syncope I have, and how to avoid these in the future. I have contradictory heart diagnoses, one where I have diastolic dysfunction, another where I am doing perfectly with results being inconclusive. I question how I can be perfect & inconclusive at the same time?? There is also a mitral valve prolapse and one more valve has a problem which is a secret. They told me the prolapse is mild and "everyone" has it. Right now I feel like i don't even have a heart, which is probably a good thing? but the heart feels as though it is in the center and not on the left. This is strange and only a doctor can explain as I know it wont move. My 2023 bnp score was 150 while it was 91 in 2022, and 40 in 2017. While doctors told me how wonderfully low 150 is, I still feel they are withholding some information as LOGIC tells me BNP is rising slowly and steadily. I have given up hope on getting information from a cardiologist as they say stuff like "doing great" and nothing more. I cannot diagnose myself. I must rely on doctors, and once I feel they are sugar coating- which I feel is to withhold treatment - or they did withhold treatment in the past which could have helped me. I feel cardiologists will give the information when I am in the palliative stage. One cardiac nurse said I had at least two years to the palliative stage, and later changed her story when she realized the cardio did not want her to tell me. Right now I cant even feel my heart but have to walk slowly live as an invalid. Only these head attacks come along with a heart issue. Flutter mild discomfort breathing problem in the middle and "waves" or jolts in the head. I lay down and avoid standing up, passes off in an hour. Is there a way medically to establish, or strongly suspect cardiogenic syncope? As I do seem to have some neuro issues, please comment. I want to tell it all in one question, When shocked on both sides, my right leg feels almost nothing. On their exercise bike about half the strength of the left leg and cannot use right one as primary leg to claim a staircase, The difference in my hands is a bit smaller than in the legs. So I thought this would show up in the nerve conduction test. They said after weeks needed to determine the result that all is okay. I assume they feel it is a life-threatening matter but do not provide much information. I hope you did not find me too annoying and thank you for your expert advice

Thank you Dr. Spaho. A professional evaluation or overview as you provide was exactly what I was seeking. I am going to ask one more thing below closing this question. I will understand if you do not want to answer. and still to me you are five stars. A summary like that is worth its weight in gold.

I understood what you feel needs to be done with someone like me. I am only a patient trying to stay well, and know I must heed doctor diagnoses and follow instructions. I shall use your evaluation as guideline to see what has, and has not been evaluated in my local area,

My last question to you is I am supposed to suffer from Primary Hyperparathyrpoidism. What they have done is a radioactive scan and found according to them a huge parathyroid tumour. Initially they diagnosed me by coincidence when admitted for a car accident in May 2019 through a blood test. There was high PTH hormone in my blood as well as Hypercalcemia.

They decided not to do anything for life after putting on low dose of Cinacalcet for 4 months and deciding it was not good for me.

They said we operate if there are symptoms. The internet says hyperparathyroidism brings on a host of bizarre symptoms and i have that all right. I have also developed osteoporosis perhaps as side effect of hypercalcemia. I have also heard hypercalcemia can affect the heart. According to the internet, all parathyroid tumors should be seen as pre-cancerous, they can move around in your body, once they become malignant they blow up your calcium and drugs to lower calcium will increase the cancer. I also found a graph which says what the normal range is for Calcium versus PTH - my PTH fluctuates 100-220 whereas they operate from 65 upwards. Moreover the chart shows not even 1% or 0.1% maybe of people have my position (Ca, PTH) value in that chart. Most people would die of hypercalcemia if they had my PTH which corresponds to calcium above the lethal concentration. I am a freak and it says such people exist but are so rare the prognosis o such people is not understood. But one doctor in Belfast said it is not safe since there is no guarantee surges of calcium wont occur, with the average Calcium being mild hypercalcemia.

Please do not be angry i asked such a technically oriented question. I have a degree in Physics, and have not studied biology,

It may be their policy not to operate on people over 60. My Daddy did get a triple bypass heart at 83 in the UK and is 90 now. However, I think his heart failure is advanced and he does not have long to go.. I am registered disabled and get free treatment in XXXXXXX But there are nice private GPs who always write a prescription that helps me feel much better. There are a lot of delays in getting consultant appointments, I am seeking other ways

THANK YOU THANK YOU for not being angry

thank you so much doctor. They said the tumor meant it was primary hyperparathyroidism. They said it was secondary if caused by kidney failure, and even tertiary if something else. They put me on a low dose of cinacalcet for a few months then decided it does me no good. Since 5 years nothing has been done. I've got osteoporosis now and they said it would cause that and kidney stones - not yet., I feel chronically ill currently my throat and neck have a problem and can hardly open my eyes so cannot study or read. Is it possible to request this tumor to be removed? You see I have just seen a local doctor by phone who said to see an ENt specialist . DOES YOUR CLINIC HAVE DOCTORS IN THE EU?thanks you are so kind

Yes I'll be very grateful pleasegive me suggestions on where I can be re-evaluated and treated. I am allowed to travel without a visa in the EU but not allowed to travel to XXXXXXX THANKS A MILLION

I hope it did not worry you that I cannot come to XXXXXXX as you have not replied.

The fact I cannot come to XXXXXXX is not due to XXXXXXX banning or restricting in any way. I can even show
you my XXXXXXX passport (digital only) which has not expired, but I have voluntarily given it up to XXXXXXX after getting refugee status there. While it is not normal to award Indians refugee status, nowadays it is mostly a goodwill gesture, very few countries/people meet those high risk standards.

Giving up my XXXXXXX passport gives an Irish travel document, with identical visa rights as an Irish passport (which it is not)except for XXXXXXX It is a fairly new thing. I would have otherwise possibly gone to XXXXXXX for treatment, but have no family left there.

Actually my questions were finished. Since you said you can suggest somewhere I can get re-evaluated and treated in the EU, I am waiting for the suggestion. I wont bother you after that and you can also see my Irish Ids and verify or make enquiries if they are legal if that is of relevance

This morning, I phoned your customer service and he said he will ask you to answer my question. Surely you do not need to answer any question you dont want. But when you are so kind and helpful and suddenly go silent, I do not feel you want to be unhelpful. I feel something has gone wrong. I have had a lot of hate incidents here where people-not medical- suddenly disappear and I have connected it with shunning. I would not wlike to wasite your time with non-medical matters. I would only like to acknowledge I have both non-medical and medical problems in XXXXXXX and seek to leave it. I have entertained a fear of telling doctors I feel medically neglected in this country lest the foreign country doctors would start disliking me. I am also able to seek without a referral- it is nice and gives you a headstart. A local doctor cannot give a referral to go to another country which is understandable, as they do that only in cases where the treatment is locally unavailable. I may want to go somewhere with less waiting time but thats outside their policy to refer me out. I have to make private arrangements.. I am also familiar with that thing about paid listening. That is not one of the things doctors say to me locally even when i am an inpatient. It is a political opinion of some women here, it is not suggested by doctors. It is terrifying to be shunned again and again without explanation. I am considering euthanasia. But that is not a matter for medical intervention. I apologise for taking up you time and respect your need to hold your silence

Thanks a ton Doctor. I am feeling much reassured that you replied., esp as my throat is getting worse. Yes please tell me about treatment in TURKEY. I am serious about going.