OpenHealth Q&A

Seeking Clarity on Ongoing Health Issues: A Call for Guidance

I'm a 27-year-old woman weighing around 120 pounds, diagnosed with gastroparesis confirmed through a gastric emptying study and further testing a couple of years later. I also have an Atrial Septal Defect (ASD). My current medications include Venlafaxine and Gabapentin. For several years, I have struggled with persistent gastrointestinal problems characterized by severe constipation needing medical intervention, alternating with bouts of diarrhea. I frequently experience constant nausea, vomiting several times weekly, as well as dizziness. My blood pressure has fallen quite low—recorded at 77/43 last month—accompanied by symptoms of orthostatic hypotension. Holter monitor tests have revealed episodes of tachycardia, and I often face abnormal sodium levels each time my blood is tested. Despite drinking an adequate amount of water, I continue to deal with dehydration, even during hospital stays where my oral intake is monitored. I also void large volumes of urine and struggle to maintain a stable weight, evidenced by a low hemoglobin A1C of 4.3, worsening fatigue, and recently, increasing joint pain. I'm at a point of frustration and despair with my ongoing symptoms. Both my physician and dietitian have recommended that I gain some weight due to muscle wasting and overall weakness, but despite their encouragement, I’m just managing to stay within a normal weight range due to my persistent lack of appetite and the pain and nausea I often experience. As a teaching academic librarian, I find it challenging to concentrate at work, struggling to process information while reading and often feeling overwhelmed by exhaustion. I'm in a position where I haven't had to stand much recently, but with the academic year starting, I’m worried about my ability to manage my responsibilities. I have experienced consistently low sodium levels, which typically provoke suggestions to increase my salt intake; however, I have been advised to take electrolyte supplements by both my primary care provider and a cardiologist I consulted a few months back, which makes me doubt that this is the core issue. I wake up almost nightly feeling starving and excessively sweaty. Being in constant pain, fatigue, and illness leaves me feeling miserable and depleted—I’m not sure how much longer I can endure this. My sick leave at work has nearly depleted because I tend to use every bit of time I gain for days when symptoms flare up or when getting out of bed feels impossible. Working in a medical library exposes me to a variety of academic literature while I conduct research for students and faculty or teach information literacy. Recently, while undertaking research for an article, I stumbled upon Addison’s disease and noted that many of the associated symptoms resonate with my own. However, I am also aware that a lot of symptoms can be quite general and ambiguous. Should I pursue this line of inquiry further with my doctor and consider testing? Just recently, I had a completely normal EGD and colonoscopy, which have ruled out any common issues typically found through these procedures. A vascular CT scan has also ruled out Superior Mesenteric Artery (SMA) syndrome and Median Arcuate Ligament Syndrome (MALS). I feel lost and uncertain about the next steps to take regarding my health concerns.

Answers (1)

8/20/2025, 3:21:47 AM

OpenHealth AI

I'm sorry to hear that you’re dealing with such complex health challenges. It sounds incredibly overwhelming, especially with your ongoing symptoms impacting your daily life and work. Addressing these concerns thoughtfully, while prioritizing your immediate needs, is essential to help you navigate your health situation.

Main Points:

1. Your symptoms could be complex but warrant thorough exploration.
2. Consider investigating conditions like Addison’s disease further with your healthcare provider.
3. Focus on immediate strategies for symptom management and support.

Explanation:

Gastroparesis, combined with your other symptoms (like persistent nausea, low blood pressure, and electrolyte imbalances), indicates a multifaceted health issue. The severe constipation alternating with diarrhea, dizziness, and challenges in weight management can significantly hinder your quality of life. Feeling exhausted and experiencing cognitive difficulties at work are understandably frustrating.

While Addison’s disease is a possibility connected to the symptoms you've described, it requires your provider’s evaluation for proper diagnosis. Testing can determine if adrenal insufficiency is an issue, especially since low sodium levels and fatigue fit within its symptom profile.

Next Steps:

1. Document Symptoms: Keep a detailed diary of your symptoms, noting their frequency, triggers, and any potential patterns. This can help your healthcare provider identify correlations and recommend appropriate tests or adjustments.

2. Discuss Addison’s Disease: Schedule a consultation specifically to discuss your concerns about Addison’s disease. Be prepared to share your symptom diary, which will inform the doctor’s assessments. Request testing for adrenal function if deemed appropriate.

3. Hydration and Electrolytes: Since dehydration persists, evaluate your hydration strategy:

   • Oral Rehydration Solutions: Try electrolyte drinks that contain balanced sodium and potassium ratios, under your doctor's guidance.
   • Compression Stockings: Consider wearing these, as they can help with orthostatic hypotension by improving blood flow and blood pressure.

4. Nutritional Management: Consult with a dietitian again to create a high-calorie, easy-to-digest meal plan. Focus on nutrient-dense foods you can tolerate and consider appetite stimulants if recommended by your doctor.

5. Pacing Yourself at Work: As you return to your academic responsibilities:

   • Prioritize tasks and break them into smaller, manageable parts.
   • Allow time for breaks and consider remote work options if possible, giving you flexibility.

6. Pain Management and Fatigue: Talk to your healthcare provider about a plan for managing joint pain and fatigue, which may include medication adjustments or referral to a specialist, such as a rheumatologist.

Remember, you're not alone in this. Reach out to supportive communities or groups for individuals with chronic health issues, which can offer both emotional and practical support. You're taking important steps forward by seeking clarity and guidance—keep advocating for yourself. Let me know if you have further questions or need more specifics!