How to calm an individual after being diagnosed with hiatal hernia with pain and tremors?

Question

Hello doctor,

Two months ago, I was diagnosed with a very tiny hiatal hernia. My chiropractor found my stomach pushed up very high, next to my esophagus. He was able to push it back down but with a lot of painful force and manipulation. Ever since I have been getting sicker and sicker with "episodes" that are so debilitating that I can no longer work. They happened occasionally at first, but now three to four times each day (always upon weakening) and last for hours at a time. It begins in my mid-abdomen. I feel and see pulsating in my abdomen and get a "wet" sensation as though the fluid is leaking out of my chest or belly. If I push on that area (or usually all by itself), I get an instant rush of blood to my head and start to feel "fuzzy". My face turns bright red and becomes so hot that I get nauseous. The redness sometimes stays, sometimes goes away. But what always follows immediately is intense heat throughout my whole body, like my spine, muscles, and nerves are on fire - everywhere from my head to my palms to my mouth to the soles of my feet. Then I start to shake uncontrollably, with the shakes progressing into worse "tremors" in my left thigh and right bicep. The shaking seems to start from the abdomen or groin area. If I press my thighs or groin or even touch them lightly, my legs increase in spasticity. When these episodes end, I feel completely wiped out (blurry vision and hard, tired muscles), but I never return to "normal." I always feel shaky and not myself. I have been at the doctor's twice when these episodes were happening. The first time my blood pressure was a TAD high at 130 (usually I am spot on at 120/80 mm/Hg) and the other time my vitals did not change at all during the episode. Other info, possibly related, my left thigh and knee are filled with fluid, but my orthopedist attributes that to a popliteal cyst (is that the same as an aneurysm) he found behind my knee. He gave me a cortisone injection four days ago, but so far the swelling in the front of my thigh, my knee, and my calf has not gone down. I was also told that I have an umbilical hernia and two inguinal hernias. I also have a history of localized scleroderma, which, I understand, can weaken connective tissue and blood vessels. I am very scared! Any idea what is happening to me or what tests I should have done? Not sure if this is G.I.-related, vascular, or rheumatologic. But I need to find a way to calm these spells so I can work again.

Answer 1

Hello,

Welcome to icliniq.com

I read your query and understand your concern. Some of the common causes of palpitation in young females are-

1. Strong emotional responses, such as stress or anxiety-Extracardiac stimulation of the sympathetic nervous system (inappropriate stimulation of the parasympathetic nervous system, particularly the vagus nerve (which innervates the heart), can be caused by anxiety and stress due to acute or chronic elevations in glucocorticoids and catecholamines hormones.

2. Overuse of nicotine and caffeine.

3. Overactive thyroid gland (hyperthyroidism).

4. An abnormal heart rhythm (arrhythmia)- Arrhythmias may include very fast heart rates (tachycardia), unusually slow heart rates (bradycardia), or an irregular heart rhythm. Common abnormal heart rhythms are ectopic beat, premature atrial contraction, junctional escape beat, premature ventricular contraction, atrial fibrillation, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation, and heart block.

5. Palpitation may be associated with electrolyte imbalances of magnesium, potassium, and other salts in serum.

6. Gastrointestinal distress such as bloating or indigestion, along with muscular imbalances and poor posture, can also irritate the vagus nerve causing palpitations). Above mentioned reasons can be a cause of palpitation with lightheadedness in your case.

Yes, you should be concerned about it, a thorough investigation should be done to rule out the exact cause of palpitation in your case. I would suggest you following tests

1. Thyroid profile- to rule out hyperthyroidism.

2. 24-hour Holter monitoring- will record the ECG (electrocardiogram) continuously during a 24-hour or 48-hour period. If palpitation occurs during this period it will be recorded in ECG recording and we can rule out the cardiac rhythm at the time. For this type of monitoring to be helpful, palpitation must have occurred at least once a day. If they are less frequent(you have not mentioned the frequency of palpitations) the chances of detecting anything with continuous 24, or even 48-hour monitoring, are substantially lowered. More recent technology such as the LOOP recorder allows continuous recording for up to seven days. This is a very important and basic test for someone who presents with palpitation as the main symptom. It will rule out the possibility of arrhythmia which are the most dangerous cause of palpitations and can be sometimes fatal also.

3. Serum electrolytes - a disturbance in serum electrolytes can cause palpitations, and they can be corrected easily.

4. If you are a smoker, give up smoking. Do not take alcohol in excess.

5. Try to do 45 minutes of exercise daily. If you are an anxious person with elevated anxiety levels, a cardiologist will suggest Benzodiazepine lower your anxiety.

6. Do not eat oily, fatty, or spicy food for some days. Add fibers to your diet.

The above-mentioned investigations are the basic test that can help find out the cause of palpitations. As prevention is always better than cure, I would suggest you take the problem seriously. In case you need more details or have any other queries, feel free to ask, I would be happy to help you.

Thank you.

How to calm an individual after being diagnosed with hiatal hernia with pain and tremors?

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