Discussions By Condition: I cannot get a diagnosis.

Dizzy spells, recurring neck pain, hot flashes, choking when drinking fluids

Posted In: I cannot get a diagnosis. 20 Replies
  • Posted By: kramieinc
  • May 4, 2009
  • 10:03 PM

I have had the following symptoms, with little help from doctors, for years.
The first incidence of arm pain was when I was 11. Two years later, I developed pain in my neck - diagnosed as a pinched nerve. This pain recurs every year or two, with it spreading to my back, right arm, and shoulder. This pain always occurs on the right side.
In addition to this, I also suffer from hot flashes at night. When I lie down flat, I get a feeling like I'm being choked gently. I cannot wear high collared shirts or necklaces because I get the same feeling.
At least two to four times per day, I have a major episode of choking when drinking fluids. I always get "the wrong pipe". It's messy and embarrassing.
For as long as I can remember, I have had dizzy spells. I get dizzy when I stand up, on elevators and escalators. I also get dizzy if I look up or down. About every 1-2 years, I go through several days of severe dizziness. Whenever I move, I feel so dizzy I sometimes fall over. This was diagnosed once as benign postural vertigo. I was told not to drive when it happens.
I get hot flashes at night, with no real explanation. They are quick, and usually go away when I do something to cool myself (water, go outside, etc.).
I have been told I have low blood pressure, but I don't know if that means anything, and my allergist told me my thyroid is enlarged and has nodules on it. My doctor said it wasn't anything to be concerned about.
I have had food and environmental allergies all my life.
Everytime I get a cold, I develop bronchitis, and it has been so my entire life.
I am 27 years old, female, with a bmi of 20. I take oral contraceptives, and sometimes take ibuprofen for headaches. When I have neck pain, I tend to take acetaminophen with codeine (tylenol 1), in addition to ibuprofen. I use a steroidal inhaler when I have a cold to calm my cough. I drink alcohol about twice a year, though not in a binge. I do not use recreational drugs. I find that my symptoms seem unimportant to the doctors I've seen.
A recent massage at a physiotherapy clinic caught my attention. They mentioned something about the vagus nerve, and said they couldn't do some sort of traction on it because of my dizzy spells.
I live in Alberta, Canada. If anyone knows of a really great doctor, please let me know. I'd also be interested to find out if anyone else has these symptoms

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20 Replies:

  • I know hot flashes can be caused by the tick born illness Babesia. It also causes "air hunger" a feeling where you are not getting enough air. I saw you said you feel like you are choking sometimes, is it like you are not getting enough air?Also, when I was about 5, I got terrible neck pain for a few years. It will radiate down my arm also. This, for me, turned out to be Lyme disease. Also, the Lyme gave me terrible dizziness. Lyme also can cause the body to become allergic to many things.It might be something to look into. At this point you would look up Late Stage Lyme Disease.Have you ever had a very comprehensive allergy panel done? It is quite possible there is something going on in your diet/environment that could be causing a lot of your symptoms. If you can remove that thing, you might see an improvement.I really hope this gets better for you. Best wishes!
    soltice57 18 Replies Flag this Response
  • first if you are eating sucralose or splenda or aspartame get off of it and check all food labels - do not eat - poison!Then search the internet for these products and see what you find- it may clear things up for you =go to youtube and search those key wordsto google to facebook groupsyou should find that half if not all of your symptoms may disappear- many people are suffering diverse symptoms due to these artificial sweetenersread their testimonials and see what you learn
    founddog 188 Replies Flag this Response
  • Thank you for your input. However, I do not eat processed foods, artificial sweeteners, or large amounts of sugar. I do not drink pop or energy drinks, and I only use organic honey to sweeten my coffee. I follow the Canada food guide, and avoid canned foods as often as possible.
    kramieinc 7 Replies Flag this Response
  • Lyme disease is such a remote possibility in the place I live, it's rarely tested. The region in which I live doesn't have ticks that carry this bacteria. I suppose it's possible the bacteria entered my body another way, but I'm sure I wouldn't know how. I would likely discuss this as an absolute last resort with a doctor. It's hard to get doctors to take you seriously.The choking sensation is not like I am getting inadequate air - rather, it feels as though something is pressing on the front of my neck, and I feel as though there is a large lump in my throat. I have been told this sensation is common with enlarged thyroids.Because of the nature of my allergies (I have severe reactions to trees, tree nuts, and tree fruit, and my allergies have changed several times over the years) I get extensive allergy testing (full panel) every five years, and have since I was four years old. My last allergy tests were completed only five months ago. It is unlikely an allergy is the cause of these symptoms, especially considering these symptoms do not resemble in any way my usual allergic responses. I assume, however, that if it was the cause, my allergist would have told me at my last test.I really hope Dr. Cottle responds to this thread.
    kramieinc 7 Replies Flag this Response
  • There is hardly an area in this nation or even most of the world unaffected by tick born illness. Both my mother and I got Lyme and other tick born illnesses in Tampa, Florida (where they say there is no ticks or tick born illness).The lump in your throat definitely makes it sound like something else. It does sound like something to do with your thyroid. I really hope you find some help with this.
    soltice57 18 Replies Flag this Response
  • Perhaps Addisons disease?
    soltice57 18 Replies Flag this Response
  • I live in a city in Canada. There have been only a few cases of lyme disease in my province. All of these were found to have been contracted out of province. I have never travelled outside of my province. If I suggested this to a doctor in Alberta, I'd be laughed out of the office. I do not wish to undermine your condition, as I understand Lyme disease to be a terrible, lifelong affliction. I only mean to explain that I must enter a doctor's office with as much poise and knowledge as possible.
    kramieinc 7 Replies Flag this Response
  • Well, doctors had been telling me I was wrong about Lyme for 17 years, and guess what I had. Just cause the doctors tell you its a small chance does not mean they are right. Our US military reports Lyme/tick born illness is all over the state of Florida and it is ramped, but our state and all our doctors here refuse to believe it. It is our military doing the actual research on this though as it effects so many of our troops. It might not be tick born illness (babesia), but If you can not get a clear answer on anything else, It is worth looking into. It does cause just about all your symptoms specifically.Don't be afraid to approach a doctor with an idea. If they laugh you out of the office, they are never going to help you because they are too stupid to do their job. If they are that close minded, then they will never get an answer for you.
    soltice57 18 Replies Flag this Response
  • Hi, sorry to see of your troubles.If you live in a large city in Alberta, maybe you could go to a university hospital? I know that the Royal Alexandria Hospital in Edmonton has many great specialists in their ranks.If you live in Calgary, there are a few hospitals there that are good also.I understand about the majority of doctors here, they are difficult to deal with at best. I wish you luck.
    riskyd 35 Replies Flag this Response
  • I need to take a moment and make something clear. Although I have had difficulty getting my symptoms diagnosed, I in no way mean to insult doctors in any way. Doctors have a very difficult job, with a large amount of responsibility. They have heavy patient loads in Canada due to a doctor shortage, and some are forced to work insane hours in order to maintain their practices. Doctors are well educated and hard working, and without their front line work, research, and tireless efforts we would still live in a world where minor conditions kill thousands. I have never met a person who is "stupid", or rather, someone with low intelligence, complete university - let alone medical school. I have faith that all doctors are very intelligent, as is proven in their ability to complete a training program as rigorous as medical school, interships and residencies. I did state in my original post that the doctors I've seen so far seem to find my symptoms unimportant, and I believe this to be because they are common symptoms that can be associated with a number of conditions, and that can also be associated with bad luck. It is difficult to find a doctor who is able to put in the extra time for cases such as mine. As patients, it's our responsibility to advocate for ourselves, but to do so in a respectful and understanding manner. If we begin to insult doctors out of our frustration we are lowering ourselves to the level of junior high school students who don't get what they want. I in no way think doctors are anything but overworked and underappreciated professionals. If I am persistent and maintain my dignity and poise - this will all work out for me and I will find a doctor who knows what I have, or will test for a few things before ruling anything out. Like finding a good hairdresser, this all comes down to personal taste, trust, time, and effort. I do not think it is appropriate to allow our frustrations with our situations affect the manner in which we behave. I am interested in finding out if anyone has had the same symptoms - all of them - as I. I am also interested in guidance in figuring out the questions to ask a doctor to help me get the help I need, without being rude, disrespectful, or coming across as a hypochondriac. If anyone can offer information, please let me know.
    kramieinc 7 Replies Flag this Response
  • You were given lots of helpful information and dismissed it all. Why would anyone want to try again?
    Anonymous 42789 Replies Flag this Response
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  • To be fair, I have been over many things with my doctor. If you recall, I was asking specifically if anyone had similar symptoms, or could recommend a good doctor. I am not trying to self diagnose, as people who are not doctors are not qualified to offer a diagnosis. I dismissed answers that did not specifically answer the two questions.
    kramieinc 7 Replies Flag this Response
  • 27yo F, BMI 20Hx-Arm pain at age 11-neck pain --'pinched nerve' age 13; recurs every yr or two; spreads to back, right arm, shoulder; right side only-hot flashes at night, brief, relieved with water, going outside-mild choking feeling on lying down-choking feeling with high collar shirts, necklaces-choking sensation like something pressing on neck and like large lump in throat; not like getting inadequate air-choking when drinking fluids 2-4X/d -->"wrong pipe"-dizzy spells "as long as I can remember"; with standing up, elevators, escalators, looking up or down-several days of severe dizziness every 1-2yrs, sometimes falls over-dx with BPPV once, advised not to drive during episode-Low blood pressure (how low? transient or permanent, orthostatic?)-Enlarged thyroid with nodules--evaluation equivocal-H/O food and environmental allergies. Allergies to trees, tree nuts, tree fruit... variable over time-Full allergy panel every 5 yrs since age 4 yrs-Last all. panel 5 mos ago --> does not suggest allergy as cause of symptoms-No processed foods, artificial sweeteners, excess sugar, energy drinks/soda. Honey to sweeten coffee.-Follows Canada food guide, avoids canned food-H/0 colds --> bronchitis "entire life"-Meds: OCPs, ibuprofen for headache, acetaminophen+codeine for neck pain, steroid inhaler for cold-Alcohol 2x/yr (no binges). Recreational drugs (not specified)-Feels "symptoms feel unimportant to drs"-Residence Alberta, Canada. Never traveled out of province P/E General appearance and integumentary systemHEENT (head, eyes, ears, nose, throat)neck and thyroidchest, lungs, heartabdomenneurologicalTests and Investigations-None available Queries:-For good dr-Wants to see dr prepared with "as much poise and knowledge as possible"-not trying to self-diagnose-Anyone else with these symptoms-Hopes Dr Cottle will read and respond I have prepared some rough notes included above to help me prepare an adequate response.(1) I understand that you want JCottleMD to respond to your post. I would suggest you address a post with JCottleMD's name in the header. In the meantime, I hope you will not mind my humble opinion.(2) I respect the fact that you wish to see a good doctor. I do not think it constitutes any insult to doctors. Doctors are human beings like the rest of us, and occasionally do make errors, sometimes terrible errors.(3) If you feel that "your symptoms are unimportant to doctors," do not consider it your fault. It is part of a doctor's duty to address the concerns of their patients, even if they deem them to be "unimportant."(4) It is natural to seek someone with similar problems for support.(5) I respect that you wish to be prepared with "as much poise and knowledge as possible" before seeing a physician. An informed patient can work better with a doctor.(6) It is good that you are not trying to diagnose yourself, which is very different from trying to understand and find information on your problems. Self-diagnosis does have its pitfalls.(7) Unfortunately, I cannot help you locate a good doctor in your region. But I am sure with some searching you will be able to find someone who can help you. That being said, let's turn to your symptoms and see if we can make any sense of them. It would be better to know which problem is bothering you the most, but, for lack of that let's consider all of them in turn. Your neck pain and right extremity problems seem to be related to a "pinched nerve" and if these are bothering you, you may want to get evaluated by a neurologist. Hot flashes: These could be due to hormonal factors (involving sex hormones -- estrogen, progesterone, or LH/FSH) or possibly may be due to thyroid overactivity (more on that later). The choking feeling in your neck on lying down and with high-collar shirts is puzzling, but could be due to an enlarged thyroid or some other factor (although I can't think of any at this time). The choking feeling you have when drinking fluids is due to aspiration of fluid into the trachea. The question is, why may this be happening? It may be due to problems with nerves involved in swallowing (glossopharyngeal, vagus) or due to a problem with the muscles of swallowing. Your dizziness seems to be due to a condition called benign paroxysmal positional vertigo (BPPV). This may sometimes be relieved by the Epley maneuver. Orthostatic hypotension may also contribute to dizziness. You mention thyroid enlargement with nodules. Assuming you don't have a solitary throid nodule, this may indicate a multinodular goiter. Multinodular goiter may be nontoxic (not secreting excess thyroid hormone) or toxic (secreting excess throid hormone and causing symptoms of hyperthyroidism). Allergy is probably not related to your symptomatology, so let's ignore it here. To what extent your recreational drug use may contribute to symptoms is unclear. Now, putting it all together: let's assume that your neck pain and right extremity symptoms can be attributed to neurological causes, and that you vertigo/dizziness can be attributed to BPPV and/or orthostatic hypotension. That leaves the following: hot flashes, choking sensation in the neck, aspiration of fluids, and a possible multinodular goiter. I think you might see a pattern emerging that might pinpoint the likely culprit. It is possible that your symptoms may be accounted for by a multinodular goiter (MNG). A toxic MNG may account for most symptoms above, whereas a nontoxic MNG may account at least for the choking sensation. Other factors may be involved, but this is a starting point. So what should be the next step. Well, you would need a complete physical examination, or at least the components of the examination listed above. Once the physical examination is complete, the next step would be to get tests based on the findings. These may include CBC, electrolytes, BUN, creatinine, LFTs, and TFTs (thyroid function tests) as a start. Other tests may be added based on specific findings. An evaluation of the thyroid gland will probably also be indicated. Once your initial tests are done, it would narrow down the differential diagnoses and lead to one or a few provisional diagnoses which can be further narrowed by specific tests. At this point rational management can be instituted. Caveat: I have included this speculative analysis of your problem not to say this this is the definitive or correct approach. That would be determined by your doctor. The purpose is to give you an idea of how doctors think. With this understanding you will be better equipped to understand what your doctor is doing and why and ask good questions, so as to have a better understanding of the whole diagnostic process.I understand that I have not given you a clear-cut answer for your problems, but I hope I have provided some kind of a road-map to finding a solution for your problem in cooperation with your physician. I wish you all the best with your health.
    m3dh31p 69 Replies Flag this Response
  • I have that choking sensation as well and it is particularly bad with seatbelts. I have several swollen lymph nodes in the cervical region of my neck...a few cm's above the collarbone and that is what I have attributed the choking feeling to. Have you checked for swollen lymph nodes in your neck around your collarbone farther over from your thyroid gland? just a thought. I am in canada as well . I wish you luck, please keep us posted on what you find out.
    Anonymous 42789 Replies Flag this Response
  • For m3d: That was a very informative post. Thank you. It's interesting to me how you posted an analysis. Do you work in the medical field? As far as my bp, I don't know how low. I do know that once while I was waiting for a surgery unrelated to my symptoms, it got down to 80.
    kramieinc 7 Replies Flag this Response
  • The "questions" regarding low bp in parentheses were just my way of "thinking out loud" but since you bring it up, low blood pressure by itself is not a clincal entity. The JNC-7 criteria define categories of hypertension, and state that a normal blood pressure is anthing below 120/80. Blood pressure is a complex factor determined by cardiac output and peripheral resistance of blood vessels. The cardiac output is itself determined by stroke volume and heart rate. So, very well-conditioned athletes may have a low resting heart rate and "low" bp, for example. This is not a problem. Low blood pressure is a concern in clinical states of shock, which is a serious condition and can be due to various causes such as: severe allergic reaction (anaphylaxis), sepsis, and cardiac causes. Orthostatic hypotension, on the other hand, is due to the body not responding to a change in posture (e.g. from lying down to standing). In this, a person experiences transient low blood pressure which may cause dizziness or syncope. I also want to add that posts by other members on the forum tend to be helpful as they elicit more information which may help with understanding a problem. Obviously, in a message board format, it is not possible to elicit a history by asking one question at a time, and asking the next question based on the response, as that may take days or months and would probably exhaust/frustrate both the questioner and, more likely, the responder (e.g. "why don't you ask me all your questions at once, rather than one at a time?"). This is an obvious limitation with a forum that must be recognized, as an analysis is based only on the information that is posted rather than on H&P, which is a two-way process. Wish you all the best.
    m3dh31p 69 Replies Flag this Response
  • Your symptoms could be related to a number of things; an endocrine disorder or an autoimmune disorder are possibilities. I have the same symptoms as you do, and I was diagnosed with sarcoidosis, an autoimmune disorder. One of the locations I have it is in the lungs, so I cough a lot, especially in very hot or cold conditions.Autoimmune disorders make it difficult to regulate your body temperature; hence, the hotflashes and chills. The neck pain may be due to something else, like too many hours spent looking at a computer screen. I would get a second opinion on that thyroid gland if I were you, since you are having choking sensations. Could be the growth is affecting your swallowing somehow, since that gland is on the neck. Low blood pressure causes dizzy spells, but it could be something else too. Good luck !
    Anonymous 42789 Replies Flag this Response
  • I am replying late to your post and hope you get this. I have thyroid problems--both hyper and hypo--and Myofacial Pain Syndrome. I have hot flashes, chronic sinus infection, TMJ, and a lot of other symptoms--I experience all the things you mention. I have been diagnosed with an unspecified auto immune disease. Since my ANA and sed rates are normal, the docs won't call it Lupus but everyone agrees these health issues are all symptoms of my auto immune dysfunction. Perhaps a rheumatologist can help you. Good luck.
    Anonymous 42789 Replies Flag this Response
  • I feel as though you have completely described me. I am 20 years old and also get hot flashes. It just started not too long ago. If you have any idea why, please let me know. The dizziness you are describing is something I am very familiar with. I have Vasovagal Syncope. You may also have this. it is caused by low blood pressure and the dizzy spells can be triggered by MANY different things. The most common are standing up too quickly, going upside down, feeling pain, or feeling sick to your stomach. The most severe cases can be triggered by little things such as pulling your hair, touching the throat area, or doing any exercise. Ask your doctor about Vasovagal. I also cannot get a cold without getting Bronchitis. I have frequent headaches, and also have no explanation for those. I get stabbing and throbbing pain in my left arm suddenly for no reason and that is still unexplained. I have bad back and neck pain. These things are unrelated to Vasovagal but it is strange that we have the same random problems. Hope I helped!
    Anonymous 42789 Replies
    • February 8, 2011
    • 05:38 AM
    • 0
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  • I too get a similar pain that comes from my jaw goes into my neck and shoulders, sometimes I feel the lump in the throat sort of deal and have on occasion had my gag reflex act up out of nowhere. I have been told it was my wisdom teeth and had them removed to no success, then was told TMJ which still could be my case but unfortunately its really hard to treat effectively. Have also been told by my chriopractor that he feels I may have nerves trapped under my neck vertabrae. Its been a long battle for me and I am in constant pain for the last two years. posture I hear could play an important part especially if you have a forward head posture. Hope this helped a bit and good luck
    Anonymous 1 Replies
    • October 23, 2015
    • 09:41 PM
    • 0
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