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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Dull Pain In Chest Area While Exercising And Sleeplessness?

Here are my case details. Currently, I have been experiencing some very strange symptoms for quite some time which has been quite distressing for me. So, I thought I would check with you again for your valuable advice. I am a non-smoker (have smoked for a year a few years back through), eat a very big serving of fruits everyday (papaya, apple, pomegranate, , orange, pears, etc., but no mangoes, cheekus, or bananas), prefer vegetarian food, drink once a week, and stay off cereals and sweets (except fruit). I also do yogasana three-four times a week. I have sleeping issues (get up 3-4 times during the night) and also an obsession for eating something sweet in the middle of the night (biscuits, cake, ice cream, chocolate, honey, anything). I have been this way for the past 3 years. Symptom 1: Chest pain In June last year, I had not been exercising for a month and also was spending late nights in office for a 2-3 weeks owing to a project. One fine day, I went rock climbing with Anuj. It was a beginner-level climb and while I was climbing and exerting my muscles (pulling myself up), I felt a dull pain run the center of my chest all the way to my jaw. The pain became intense and I had to sit for a while to let it go. It seemed like a heart attack. I ignored it and again tried to climb and the same sensation happened gain. There was no breathlessness, exhaustion, or nausea though. So, I immediately went to the doctor and got an ECG done in 3-4 hours. The ECG was normal. However, the doctor told me to also get a treadmill test and an echo test done. I got them done the next day and both were normal. The doctor said that it was probably a pulled muscle or gastric pain. However, I would still feel the pain on exertion, say for example, when I would: 1.     Pull a heavy object, such as a motorcycle 2.     Bend sideways 3.     Run up the stairs (usually I can run up 6 floors and there is no pain, now s lot of times I have experienced pain on running up even three floors) I have even gotten a stress ECHO done and that was also normal. I consulted a chest specialist and when I shared my symptoms, he also noticed that I have tendency to clear my throat and a bit of a cough. He wanted me to get a chest X-Ray and a CT scan done. The chest X-ray showed some scars in my lungs and a bit of haziness. However, the CT scan was clear. The chest specialist diagnosed me with gastritis and gave me some vitamin, iron, calcium, and antacids. I kept taking the medicine. I also noticed that I was also suffering from a bloated stomach, flatulence, and constipation. However, after a course of 2 weeks, the chest pain on exertion would come and go. I then consulted a homeopath, who evaluated my personality and other aspects and concluded that I have dyspepsia. I took his medicine for three weeks and could not conclude if there had been any improvement because the pain would come and go on exertions (Sometimes there was pain, and sometimes there was no pain. Symptom 2: Extreme lethargy, dryness in eyes, weakness, with mild pain in thighs and lower back In Septembber 2014, I have also started experiencing extreme lethargy, drowsiness, and a dull pain in my legs and lower back, which would be on for 4 days, then off for 2 days, again come back for 3 days, and not be there for 4 days. So, this symptom comes for a few days and then goes away. Doing some exercises does help me feel better, but not all the time. I recently got a blood test done (CBC, Lipid profile, sugar, Liver , Kidney, Thyroid, Electrolyte, Vitamin B12, and Vitamin D). Everything was normal except the fact that my Vitamin D levels were a bit deficient, (a value of 18). The doc said that this was nothing major and I started taking calciferol once a week. I also got an urine test done and the results were normal there as well. In Sep-Oct my lethargy (symptom 2) goes off and on once a week, and symptom 1 (chest pain/upper chest pain/jaw pain) seems to happen once in two weeks. Also, I had chronic insomnia, craving for sweets at night, and constipation. I was extremely confused because I have already consulted 3-4 doctors, gotten a lot of test done, and still had symptoms that persist. The doctors had pointed to: 1.     Gastritis (however, I do not have acidity attacks, do have mild heartburn sometimes) 2.     Costochondritis (but can this feel like a heart attack pain and can this be brought on upon running up the stairs?) 3.     Irritable Bowel Syndrome and GERD I do read about these symptoms and get boggled by these complex diseases, such as Chronic Fatigue Syndrome, Lupus, Fibromalgia, Gluten introlerance, Adrenal Fatigue. I underwent two Cortisol tests in Dec 2014 and my morning cortisol levels are higher (like 23 and 28). My ACTH is within range. I consulted a gastro in Dec and he gave me a proton pump inhibitor. Although that did minimize the chest pains, it gave my tachycardia (palpitstyions), so I discontinued the meds after a week. He then put me on zinetac (Ranitidine) but that also gave me palpitations (although lesser). So, I stopped taking that as well. Update as on Feb 2014 After I started eating moderate carbs in November, I continued with that change in diet. Now, my sleep has improved. I still feel fatigued off an on. I have this strange symptom of fatigue (accompanied with dry eyes) and normal energy with wet eyes. Fro mthe beginning of Feb, here is my diet and routine. Currently I am avoiding gluten and have banned legumes. My current diet and routine is like this: 1.     I wake up at 8: 30 AM. 2.     Have a spoon of honey with black cumin seeds (kala jeera) on an empty stomach 3.     Do kapalbhati, agnisar, ujjayi, bahrya, and anulom vilom pranayama for 30 min 4.     I then have a cup of black tea with ginger 5.     Go to the toilet to clear my bowels. I face constipation on and off. Sometimes, during the process of defecation, I emit a lot of gas and also get that dreaded chest and throat pain. 6.     I freshen up and have a breakfast at 9:30 AM of curd with a little papaya, banana, apple, dry goji berries, and flax seeds, dry fruits,with amanranth or ragi flakes 7.     I also take a spirulina and moringa capsule 8.     I take a liv 52 capsule 9.     I go to office by 10:30 and have around 2 cups of green tea/black tea/chamomile tea 10.     Lunch is usually brown rice and dal and veggies at 1:30 PM 11.      I have another 1-2 cups of green tea/black tea/chamomile tea 12.     I have recently starte taking a herbal supplement for stress that contains Rhodiola Rosea, Ashwagandha, L-Theanine, and Bacopa 13.     I reach home by 7:30 and either do one hour of yoga if I have energy and am not suffering from chest pain 14.     I typically have dinner of brown rice, dal, veggies, and fish by 8:30 PM 15.     I go to bed by 11:30 or 12: 00 PM I avoid white sugar (I take honey). I have also reduced my fruit intake. Symtoms these days (as in Jan 2015 onwards) Chest Pain My chest pain happens on and off. I will get triggered one day suddenly and then continue for around 3-4 days. Then, there will be no pain for another 3-4 days. The cycle repeats. I am trying to discover the trigger, but am not sure what it is. Fatigue Similarly, my fatigue varies on a day to day basis. My evenings are usually lazy wherein I feel simply like lying in bed and reading or watching something. Typically, I used to go out partying and am a physical person, but these days, evenings (except the occasional yoga) are mostly sedentary. Gastric issues I belch several times a day and my stomach also gets bloated very quickly. Otherwise, my appetite is decent and I have not lost weight. Pain on the side of ribs I also feel a dull pain just below my ribs, especially on the right side. Dry skin ans dandruff The skin between my thumb and forefinger has been dry and cracked for years. I also suffer from a fungal infection in my scrotal area and dandruff (something like seboric dermatitis) in my scalp. These skin problems have been ongoing for years. Stress Obviously after suffering for almost 9 months, I am quite stressed and think about the worst at times. I also have a background of a dissociative disorder. I have been suffering from disassociative disorders (Depersonalization/Derealization) for 14 years now and am able to cope very well, without medication). I am quite confident that I am not imagining my symptoms, they are real. Yes, I do admit that I have health anxiety, especially because the symptoms are strange and I have not received any conclusive treatment. March 14: I got an endoscopy done and it was completely normal. My Gastro has prescribed esomeprazole (proton-pump inhibitor) for acide reflux and normaxin for IBS. Let’s ee if that helps. I would be grateful if you could go through my case and offer me your insights into the matter.
posted on Fri, 20 Mar 2015
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