Seeking Support for Ongoing Health Issues
My girlfriend has been struggling immensely with temperatures above 75°F, leading to a frustrating cycle of switching doctors without receiving any clear answers. The waiting time for specialist appointments stretches to over six months. Meanwhile, what can we do with her primary care provider in the meantime? **Background Information**: - **Gender**: Female - **Age**: 27 - **Height**: 5'4" - **Weight**: 145 lbs **Health Conditions**: She has been diagnosed with several conditions including spondyloarthropathy (not limited to Ankylosing Spondylitis, as it impacts all axial bones), celiac disease, and various allergies, specifically to corn, stevia, and chamomile. She also experiences episodes resembling Oral Allergy Syndrome (OAS), along with a history of ulcers, migraines, TMJ dysfunction, post-concussion syndrome, idiopathic hypersomnia, and gastrointestinal issues that require antispasmodics for her gallbladder. Chronic constipation and hyperhidrosis are also notable, alongside anxiety issues. **Medication List**: - Methylphenidate HCl 10 mg (for hypersomnia) - Glycopyrrolate 1 mg (purpose unclear) - Low-dose naltrexone (for pain management) - Dysport 300 units (for migraines) - Dicyclomine 10 mg (for abdominal spasms) - Linzess 145 mcg (gastrointestinal) - Omeprazole 20 mg (for ulcer prevention) - Tizanidine 2 mg (for pain relief) - Secukinumab 150 mg/mL (for spondyloarthritis) - Montelukast 10 mg (for allergies) - Ondansetron 4 mg (for nausea) - Gabapentin 300 mg (for pain) - Clonidine HCl 0.1 mg (for anxiety) - Cymbalta (Duloxetine) 60 mg (purpose unclear) - Zomig (Zolmitriptan) 5 mg (for migraines) - Pamelor (Nortriptyline) 10 mg (purpose unclear) If any of these medications are aimed specifically at hyperhidrosis, that's their indication. **Current Management Strategies**: She has explored various conservative treatments to address her dizziness and tendency for blood pooling upon standing. These include: - Vestibular and vision therapy, including the use of prism lenses for her post-concussive syndrome, although it yielded only modest improvements. After experiencing balance issues, her physical therapy was discontinued as the therapists felt they could not help further. - Pool therapy, primarily aimed at pain relief due to her need for consistent physical activity related to her spondyloarthritis, done twice weekly. - Hand therapy was also attempted for pain and functionality but was stopped for similar reasons. - Both knee-high and abdominal compression garments have been used. - Maintaining hydration at 4 liters of water daily, along with an adequate salt intake, as lesser amounts exacerbate her symptoms. - Strict avoidance of corn, chamomile, and stevia due to joint issues that respond positively to Benadryl. - Additionally, she refrains from dairy, caffeine, and chocolate to manage migraines and TMJ issues. I may have overlooked a few aspects. **Ongoing Concerns**: One pressing issue is the notable purple discoloration of her legs when she stands, often accompanied by dizziness. At times, I have had to support her when she tries to stand. Basic home monitoring reveals her pulse racing and fluctuating blood pressure. The pooling of blood has been quite painful, having begun in her hands approximately seven years ago, later progressing to her legs about four years back. This condition appears to worsen in her lower extremities. She has experienced a decline in fine motor skills, and describes a painful sensation of her hands and legs feeling like they might explode. This discomfort, combined with constant dizziness, leads to significant fatigue, often limiting her ability to work over four hours a day. Just last week, she consulted a specialist who seemed dismissive of her struggles and was only willing to consider thigh compression as a remedy. With another appointment with an electrophysiologist over six months away and a lack of symptom improvement after years of attempts to manage her condition, I am eager for any suggestions regarding possible medical interventions to pursue while we await her upcoming consultation for POTS. Furthermore, I would appreciate any alternative approaches as well as effective conservative treatments beyond thigh compression that could help her in the interim.
Answers (1)
7/8/2025, 5:02:09 PM
OpenHealth AI
It seems that your girlfriend is experiencing a complex array of symptoms that relate significantly to her underlying health conditions. I understand how frustrating this can be, especially while waiting for further specialist consultations. Your concerns about her symptoms, particularly the discoloration and blood pooling in her legs, as well as dizziness, are valid and important.
Main Points
Your girlfriend’s symptoms may suggest a condition like Postural Orthostatic Tachycardia Syndrome (POTS), which can be exacerbated by her existing health issues. In the meantime, there are several strategies you can explore to help manage her symptoms effectively.
Explanation
POTS often results in blood pooling in the extremities, leading to dizziness and discomfort when upright. Given her history of secondary conditions such as spondyloarthropathy and gastrointestinal issues, it's essential to approach her management holistically. The focus should be on mitigating symptoms and improving her daily function while awaiting further specialist care.
Prioritized Next Steps
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Increase Fluid and Salt Intake: Continue ensuring she stays well-hydrated (4 liters/day) and consider consulting with her primary care provider about increasing her salt intake (where appropriate), as this can help to improve blood volume and circulation.
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Compression Garments: Explore the use of abdominal and knee-high compression garments as they help to encourage blood flow and may reduce pooling. If thigh compression was suggested, a full-leg compression option could also be evaluated.
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Posture Management: Encourage her to change positions slowly to avoid dizziness. When standing, she can try tensing her leg muscles to promote blood flow or moving her legs while sitting to prevent pooling.
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Physical Activity: Since pool therapy seemed beneficial, continue with it as it can help reduce load on her joints while improving circulation and strength.
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Cognitive Behavioral Therapy (CBT): If accessible, CBT may help address her anxiety surrounding her condition and improve her coping strategies, which could affect her overall well-being.
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Monitoring and Documentation: Keep a detailed journal of her symptoms, medications, and triggers. This information can be invaluable for future consultations with specialists.
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Consider Nutritional Supplements: Consult with her primary care provider regarding the possibility of supplements such as electrolytes or specific vitamins that might support her overall health.
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Explore Additional Therapeutics: You might want to investigate other supportive therapies such as acupuncture, massage, or yoga that can provide relief from pain and tension, although these should complement her main treatment plan rather than replace medical interventions.
Supportive Environment
During this time, it’s important to nurture a supportive environment for her emotional well-being. Being there for her as she navigates these challenges can make a significant difference.
I understand that waiting for specialist appointments can be incredibly trying. Continuing to actively engage with her primary care provider and advocating for her is essential. If her symptoms sharply worsen, re-evaluating her current approach or considering seeking urgent care may also be warranted.
Let me know if you need more specific guidance on implementing any of these suggestions.
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