Experiencing Persistent Dizziness and Breath Regulation — Seeking Insights
Hello everyone, I am in my 30s and reside in India. Despite being active and having no history of alcohol or smoking, I've been grappling with a perplexing health condition for several months now, and the medical professionals I've consulted have been unable to clarify my situation. Here’s a brief overview of what I am facing: I experience a nearly constant sensation of dizziness; however, it does not resemble the typical spinning vertigo. Rather, it manifests as a feeling of mental fogginess, a lack of balance, or a disoriented state, particularly when I am walking or in motion. Alongside this, I am acutely aware of my breathing, almost as if I need to remind myself to take deep breaths or concentrate on inhaling and exhaling. There are times when it feels as if my breath is hindered or that I need to exert effort to breathe properly. I have undergone various tests, including an ECG, an echocardiogram (with an ejection fraction of 60%), regular blood pressure checks (typically between 105–117 systolic), complete blood tests, and maintained normal oxygen saturation levels (97–99%), even during episodes of breathlessness. All these assessments have returned normal results. In addition, I occasionally experience symptoms while standing or moving, such as mild chest discomfort, neck tension, lightheadedness, and a peculiar sensation in my head. Multiple doctors have ruled out significant cardiac issues, with one suggesting it could be linked to an imbalance in the autonomic nervous system or early signs akin to POTS (Postural Orthostatic Tachycardia Syndrome). Unfortunately, I have not yet had the opportunity to undergo a tilt-table test. I’ve attempted various remedies including breathing exercises, staying adequately hydrated, increasing my salt intake, and practicing yoga, which provide some relief, albeit not complete. To share a bit more about my routine: I typically enjoy three balanced Indian meals each day, manage to get about 6 to 7 hours of sleep nightly, and drink roughly 2.5 liters of water daily. While I don’t suffer from severe anxiety, I do occasionally experience mild panic sensations, particularly when I’m standing for extended periods or walking outdoors. I am finding myself both mentally and physically drained, and this ongoing situation is impacting my work and personal life. Despite what doctors claim is “nothing serious,” I am aware that this feeling is not typical for me. --- Has anyone here gone through something similar? Could this potentially be related to POTS or some form of dysautonomia? How can one manage such a persistent focus on breathing and the sensation of being off-balance? Is there a possibility that this is anxiety-related, even if I do not consciously feel anxious? Any insights or shared experiences would be incredibly valuable to me as I navigate this difficult time. Thank you for your help!
Answers (1)
8/8/2025, 5:31:22 AM
OpenHealth AI
You're experiencing persistent dizziness and a heightened awareness of your breathing, which can be distressing and impact your daily life. While you've ruled out significant cardiac issues and normal test results are reassuring, your symptoms may be linked to autonomic nervous system imbalances, potentially resembling conditions like POTS (Postural Orthostatic Tachycardia Syndrome).
Explanation:
Dizziness that feels like mental fogginess or disorientation can occur for various reasons, including issues with blood circulation, hydration, or even autonomic nervous system functioning. The sensation of needing to focus on your breathing and occasional lightheadedness could relate to how your body is regulating itself, especially during movement or when standing.
Mild anxiety and panic sensations can also contribute to how you perceive these symptoms, leading to a cycle where physical sensations increase anxiety, and anxiety makes those physical sensations feel worse—sometimes known as a "feedback loop."
Next Steps:
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Stay Hydrated & Maintain Diet: Continue your current hydration levels and balanced diet. You might want to incorporate foods rich in potassium (like bananas) and electrolytes to support circulation.
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Breathing Techniques: Since you find some relief with breathing exercises, practice techniques such as diaphragmatic breathing or paced breathing, which can help regulate your respiratory awareness. Aim for 5-10 minutes daily.
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Physical Activity: Gradually increase your physical activity, focusing on gentle exercises like walking or yoga, especially that doesn't require sudden movements. This can help your body adapt to changes in position and improve balance.
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Monitoring Symptoms: Consider keeping a symptom diary to track when these feelings occur (times of day, activities, duration), which can help identify triggers or patterns.
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Tilt-Table Test: If possible, discuss scheduling a tilt-table test with your healthcare provider to further investigate autonomic function, as this may help clarify your condition and guide more targeted management options.
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Coping with Anxiety: Even mild anxiety can exacerbate physical sensations. Techniques such as mindfulness meditation or guided relaxation can aid in improving your overall sense of well-being.
While navigating these symptoms can be challenging, taking proactive steps can help you feel more in control. If symptoms worsen or new ones arise, continue to consult your healthcare providers for support. You're not alone in this, and it's okay to seek help as you manage these complex sensations while ensuring the best care for yourself.
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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.