DEAR DR. GOTT:
My husband is 70 years old and feels like a dying man. In the last three months he has had a plethora of problems including an unproductive cough (now gone), trembling, lightheadedness, dizziness, fatigue, hiccup spasms, nausea, constipation and occasional inability to urinate. Currently he is taking half an Atenolol (50 mg), one Prilosec and one low dose aspirin (81 mg).
In February 2007, my husband was found to have high blood pressure and was started on lisinopril, hydrochlorothiazide and metoprolol which he took until October 2007 when he developed an unproductive cough, extreme fatigue and lightheadedness. He could sleep 24/7. He saw his doctor who ordered testing but nothing was found.
He then developed dizziness when turning his head or bending over and saw the doctor again after developing a slight fever. He was given amoxicillin. At that time we asked about the possible side effects of the lisinopril and were told he could stop it.
Now fearing medication my husband stopped them all. He then returned back to the physician because his symptoms persisted and was found to have very high blood pressure and a heart rate of 120. His cough had disappeared shortly after stopping the medications but he continued to be dizzy, lightheaded and tired. He was admitted to hospital that day where he had a chest X-ray and was seen by a cardiologist who prescribed atenolol, lisinopril, a low dose aspirin, and Lipitor. His symptoms continued.
We called his primary physician again when he started trembling. At that time he told us to discontinue the lisinopril. The Lipitor was never started because we felt he had enough problems already without taking more medications. My husband then developed a hiccup spasm which is very loud and happens sporadically. He continued to have the extreme tiredness, lightheadedness, dizziness, and trembling so back to the doctor we went. An ultrasound of the carotid artery was ordered and was found to be clear, despite the fact that he nearly fell over after the exam. We were referred to an ear-nose-and-throat specialist to rule out a middle ear infection. Everything appeared to be fine but recommended to our personal physician that a test be done on the inner ear and an MRI of the ear and brain. We decided to hold off on the testing at that point.
In January 2008, our doctor prescribed an antidepressant, fluoxetine. His symptoms improved slightly but two weeks later, my husband couldn’t urinate and was sent to a urologist. He finally was able to go shortly after we arrived for the appointment. During the exam everything was found to be normal but it was recommend that he have an internal exam of his bladder. That test was never done.
Back when my husband had the cough, he felt something happen in his lower torso but didn’t notice anything. He then developed a bulge in late January 2008 that was diagnosed as a hernia. By the time this arrives to you he will probably have had corrective surgery (scheduled for May 2008). He continues to have symptoms despite stopping most of his medications and now has trouble urinating, constipation and a hernia. We don’t know what to do, his doctors cannot find anything wrong and I am worried.
DEAR READER:
Your husband appears to have a series of seemingly unrelated symptoms. Some are similar to adverse effects of his medications, others of vertigo, infection and his hernia.
Your husband’s doctors appear to have done appropriate testing and exams but thus far have failed to find an explanation. Therefore, I recommend your husband get a second opinion from another internist who specializes in ailments of the whole body rather than just this part or that part. You should bring a copy of your husband’s medical record with you to the appointment which will provide an accurate history of symptoms, medications, testing and more. Perhaps having a fresh set of eyes look over the history and do another general examination will reveal something overlooked.
As for holding off on the testing, I urge you to now have that MRI of the ear and brain. The dizziness, lightheadedness and nausea may all stem from vertigo. Vertigo is caused by an abnormality within the ear that can, often upon waking, looking up, bending down and more can cause motion sickness-like symptoms.
The constipation, inability or difficulty to urinate may be part of the hernia which once repaired should stop symptoms. A hernia occurs when part of the intestine slips through an abnormal hole in the abdomen into various areas. Depending on the area of the hernia, symptoms vary. Constipation is fairly common because the stool within the bowel can become blocked in the area that has been “misplaced”. If the intestine is pushing on the tubes leading from the kidneys or the bladder, urination can be affected.
Get a second opinion and follow-up on the recommended testing. Let me know how this turns out.
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