I have too many signs and symptoms. What could be wrong with me?

Dear Ask The Doctor: I have a lot of problems I want to go over, but I don't really know where to start. My symptoms have been going on for so long, I can't really remember every single thing that bothers me. I guess I'll start from my head and work my way down. 1) I've been having moderate to severe brain fog for the last year. It first started when I started working on overnights, and it would usually only happen in the car. I'd been driving, see a sign I drive by every night, and not recognize it. It'd turn a corner to a road I drive every day and the street wouldn't look familiar. I'd be thinking two thoughts at one time, and they would collide and almost spin around each other in my head so that I couldn't think straight. I try to think of something and my brain just shuts off. My words have been getting tangled when I speak. I've been having problems spelling and doing simple math. Talking is a challenge when I'm in a fog, because once the fog starts, the words get twisted and sound wrong to me. After having a bought of difficulty, I'm always left with a headache. These problems aren't all the time. They come and go, and over the last two weeks have gotten significantly worse. 2) Ear problems (wax buildup, loss of hearing, ringing, pain) 3) Eye problems (dry, itchy, with a white muccus coming out. I thought it was an allergy to my make up, so I haven't worn any makeup for almost four months now, and it still hadn't gone away) 4) Problems swallowing. When I go to swallow, it feels like the food hits a wall, almost like my throat walls are swollen and not big enough to let the food pass. I had a Modified Barium Swallow done, which showed no problems. I asked my GP if it could be a food allergy and he said no. I suggested I get therapy to relearn how to swallow. 5) I've had six (different) swollen, painful lymph nodes in my neck in two months with no flu-like symptoms to accompany them. Over the last two weeks, probably five to six different points on my neck that would swell and be painful for a minute or two, then go down again. The same swelling-pain is occuring in my armpits. 6) Chest pain. I had a bought of lung pain right before the first swollen lymph node. I couldn't take a deep breath for two days because my lungs hurt so bad. Now, it's a deep pain, feels like my ribs. It moves from the lower left of my ribs to my upper right (or anywhere in between). Just a sharp, but dull pain that I try to massage out (even though it never works). 7) Heartburn. Mostly after tomatoe-based foods, but sometimes very randomly also. Accompanied by a bad taste in my mouth, like I just ate a bell pepper. 8) Rotating diarrhea and constipation. 9) Vaginal dryness and recurring yeast infections. I switched body wash (as recommended by my Gyno) two separate times, to no avail. I've also suffered from a decreasing interest in sex and difficulty getting aroused. 10) Rashes. I have small bumps on my elbows that have white centers, almost like my hair follicle is infected, but there is no pain. They rarely itch. Sometimes they look like they are about to go away, then flare up again and start to spread. It used to be on my knees as well, but no longer. I also have six different spots of rashes on my feet. The sections are no larger than a nickle. The skin is dry, with red-brown spots in them. They itch often, but not intensely. It started with two on the top of my left foot (with a brown discoloration of the skin surrounding it), then two more appeared on the bottom of my right foot, then one on the bottom of my left and my left ankle. I put some anti-rash cream on it twice, and it seemed to dull it down, but it didn't go away completely. The problem I'm having now is that my doctor seems very dismissive of me. I've had problems with my ears for a very long time, and he's aware of it. He recommended drops for my ears to remove the wax and it only made it worse. He makes a comment on my wax buildup every time I go to his office, yet he does nothing about it. When I went to him for the results of the swallow, he was very quick to tell me it was all in my head, even when I told him it felt like my throat was actually swollen, like it was reacting to something. He told me to look into anxiety medication and contact a motility expert to teach me how to swallow. I was deeply offended that he didn't try any other means to figure out the source of my problem. I could have a neurological disorder causing my problems swallowing and he would never know. Anyway.. I found an allergist that also specialises in Celiac Disease, Adrenal Fatigue, IBS, Anxiety and Depression, Hypoglysemia, and Auto-Immune diseases. So my question is, what is your best guess at what my problem could be, and should I see the allergist or find a new doctor all together? Thank you for your time, Beth

Dear Beth:

Since you have several problems, let’s deal with them one by one.

1.      With regards to your visual changes especially at night, I think you should try seeing a neurologist for this. It sounds really unusual not recognizing signs, having speech difficulties and not being able to do simple math. If these bouts happen when you are too stressed out or too sleepy, that is not unusual. But if these bouts happen randomly, even if you are not stressed and not drowsy, then it is something that should get checked out as soon as possible to rule out serious underlying conditions.

2.      Wax buildup is a common problem. You can continue applying the eardrops and wait for it to fall off. If it doesn’t then you may see an ENT specialist to remove the softened earwax. Sometimes, too much earwax can cause dizziness so this should not be ignored as well. This can be the least of your priorities but have it treated as well.

3.      Allergy symptoms, sometimes to pollen, ragweed, can cause itchy and watery eyes. Avoiding the eye makeup is a wise idea. Other causes of watery eyes are blocked tear ducts. Again, this is also one of the lesser priorities.

4.      It is possible that the difficulty in swallowing could be related to your heartburn. Sometimes, heartburn can irritate the oesophagus to the extent that swallowing can be affected. Try avoiding coffee pop and tea (and in your case, tomato-based foods), elevate the head of the bed up to 30 degrees using bricks or a plank of wood, and have small frequent meals. This will help prevent heartburn. If you do all these and you would still have heartburn, then you may need prescription antacids. It is common for those with heartburn to have some difficulty in swallowing. Try dealing with the heartburn first; if you have done everything right and the difficulty in swallowing persists, then there would be enough reason to believe you do have a neurologic problem that involves your swallowing mechanism.

5.      Again, a doctor should see the swollen glands you are having on your neck and armpits. It seems unusual and you should be evaluated for that. You may need further blood tests and procedures to make sure it is nothing serious.

6.      A sharp chest pain that is worse when taking a deep breath is usually caused by a pulled muscle or costochondritis (costo = ribs, chondro = cartilage, -itis = inflammation). This may resolve on its own in a few weeks but if the pain is really bothering you, you may have Ibuprofen (Advil) to help. Make sure you take this with food since this can irritate the stomach and your heartburn may worsen.

7.      See no. 4

8.      Alternating diarrhea and constipation is suggestive of irritable bowel syndrome. The diagnostic criteria for IBS is having abdominal pain or discomfort for the past 12 weeks, accompanied with at least 2 of the following features: relieved by defecation (moving bowels), onset associated with changes in stool frequency, and/or onset associated with changes in stool form (hard/soft/watery/etc). If you think your symptoms have fulfilled these criteria, it is likely you have IBS. Lowering stress levels can help with IBS, and also decreasing caffeine intake.

9.      Vaginal dryness is not uncommon among women, even in those within the reproductive age group. You can use mild soaps (Dove, Ivory) instead of a feminine wash. If this would still not help, you can ask for prescription vaginal estrogen creams from your OB Gyn.

10.  With your description, it would still be difficult for me to conclude what kind of rashes you are having. It will be better if a dermatologist or an allergist can see that.

I am also suspecting you do have anxiety issues, and possibly depression. Try having a daily exercise regimen or do yoga to help decrease your anxiety level. I think you should also see a psychologist so you can be completely assessed and evaluated. You should not disregard your anxiety issues (and possibly depresseion) since if it is left untreated, it will significantly affect your daily living. I do hope I have appeased you and have enlightened you somehow. Take care always.