Discussions By Condition: I cannot get a diagnosis.


Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: CSMD521
  • September 26, 2011
  • 08:16 AM

Even Drs. can have problems as patients: I am an MD Gen Pract/ER Med for 25 yrs and cannot get a straight answer from Cardiologist/Neurologist/Ortho. I am 54, athletic and an endurance expedition medicine participant always in good shape and never having DM, HTN, Chol>160s, or family histories of such. I passed last treadmill stress test(company req.for all >50y.o) never had heavy labor or long endurance issues at work and expeditions. Two yrs ago I sustained C5/6 disc herniation/extrusion with broad anter cord indentation 10-15% neutral resting MRI & CT Myelogram with foramenal impingements and classic C6 sensory(R>L) radiculopathy, muscle twingings/fasciculations and C6/7 broad disc herniation-thecal indentation and mod foramenal compression with mild C7 sensory intermittent paresthesia; along with bilateral shoulder labral tears and partial cuff tears with a left inferior para labral cyst compressing Ax.Nerve and partial TOS to ulnar trunk. I'm gradually getting joint arthroscopic repairs(right knee also) but also suddenly developed inappropriate sinus tachycrdia as the cervical symptoms worsened to more bilateral C6> C7 symptoms with all but sedentary use. My rate runs 110-130 day and night, with no POTS, dizziness or syncope, but I get BP surges from my normal 110-60s to 140/90s with tense neck and global headache directly corresponding to neck aggravation from mild overuse. The Tachycardia is temporarily being controlled with beta blockers(atenolol 25-50 mg q 24h) but when neck used more, or aggravated symptoms, Breakthrough tachycardia requires atenolol redosing, sometimes within 6-8 hr, directly paralleling neck/upper body usage, and required timing and dose diminishes days later with forced sedentary activity and neck symptom improvement. I see a direct correlation with neck/shoulder structural function causing use-irritation, and presume the disc or environments of vertebral artery or anterior cervical ateries or SANS commuicating branches to vertebral artery, roots or discs may be carrying irritation up, down or across from the inflamed disc indentation in dynamic function(worse than resting MRI) or foramenal encroachment and edema/pressure to vert art. or nerve branches communicationg to SANS,. probably contributing to Cardiac accelerator stimulation,as an irritation, rather than complete compression failure. I have no overt lower tract signs, but do have persistent wax and waning left shoulder and anterior/parasternal and subclavicular ache/pressure/burn paralleling neck irritation, but cannot tell if this is cervical origin or left paralabral cyst origin, even though it was decompressed part way by aspiration. Endocrine screens for thyroid/adrenocort fctn all WNL; EKG, Echo,Holter WNL except IST, and my dynamic correlationwith upper body neck activity induction, vs. isolated leg use not inducing, seems to make the disc and or left paralabral sources evident. But cardiologist simply states it isn't heart, but stay on Beta Blockers, Neurologist doubts it's disc(very very remote-never say never) bad other second opinions seem disinterested, or claim my body/age, though my condition was AAA+ for expeditions at 52yo and family longecvity is to 90s with no chol, heart, DM, and onlt mild HTN in mother at 82yo after undiagnosed Temporal arteritis. My health sudden change from all life HR 60's, BP110/60s all active and strnuous performance up until impact injury causing cervical discs, shoulder injuries. Ockham's razor, and medical elimination of other things should logically lead to neck/shoulder neurol related input from injury tissue changes with activity flaring them. So Why no answer? Shouldn't they at least allow physical performance to induce and document symptom worsening, with reduction after activity withdrawal to confirm? The Insurers(Work.Comp>) are in the usual deny mode, and the specialists aren't helping. Anyone with a better direction to help direct this? I plan to have disc surgery, because I cannot exist with the symptoms of paresthesia, muscle spasm and pain with minor activity, as I wish to return to heavy activity. But the Cardiac overdrive is a big longevity fear that doesn't make sense. I can exert immediately, starting right up with HR to 130---> 180s without problems for hours, until my neck/shoulders get irritated, then the chest left symtoms begin with neck spasm andC6 paresthesias(unless I isolate their use) and the BP may surge if neck irritated, or surge that night/next day for 24-72 hr if neck gets very stiff and symtomatic. MRs and CTs miss alot, and I would bet there's more tissue involvement to go on. Just sitting, typing on laptop here >hr induces surge Tachy/BP paralleling neck/shoulder symptoms..
What to do/say to get direction?

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