OpenHealth Q&A

Seeking Guidance for My Upcoming GP Visit: Navigating Symptoms of Palinopsia, Vestibular Migraines, and Chronic Ear Pain

# Hello to the medical community... I'm a 39-year-old woman residing in California, and I have an appointment with my general practitioner this week. I'd deeply appreciate any tips on how to effectively advocate for myself during this meeting, ensuring that I pose the right questions and request the necessary tests. As I am part of Kaiser, I often find the process cumbersome. I believe my doctor is genuinely invested in my health, but I tend to struggle with articulating my symptoms and advocating for my needs. # Current Health Concerns **Vision-Related Issues** * **Palinopsia:** My experience with this illusory condition started gradually, but it has now become a persistent issue since late July, significantly impacting my daily life. * **Visual Snow:** While this symptom is subtle and doesn’t cause me much concern, it has become a constant presence in my vision. * **Double Vision:** I continuously experience double vision from objects that are about four inches away, a problem that has persisted for years. Prism glasses have not aided me, as my issue is specific to that close range. * **Perception Difficulties:** There may be some oscillopsia due to my ear condition, as I often feel my eyes do not function together effectively. I perform well on vision tests and can focus when both I and my target are still, but I find it challenging to maintain focus with movement. **Facial/Ear/Jaw Discomfort (Predominantly Right Side)** * For approximately two years, I have been dealing with debilitating deep ear pain located near my earlobe, radiating through my face. * I also hear crackling in my ear, similar to the sensation of trapped fluid. * My cheeks and eyes experience discomfort, usually on the right side but occasionally affecting both. * My jaw tends to shift to the left; while this isn’t painful, its proximity to my ear pain sparks concern about a potential connection. **Overall Symptoms** * I often feel fatigued, mentally foggy, and have heavy limbs, with neuropathy that improves with nortriptyline and fish oil but still flares up 5-6 days a month. * My memory issues are troubling; I frequently struggle to recall events from over five years ago unless prompted by photographs or external stimuli, with my family noting my lack of recollection of major life events. # Medical History Overview * Diagnosed with **Celiac Disease** at 16, I adhere to a strict gluten-free diet. * Diagnosed with **Hashimoto’s Thyroiditis** at 20, I manage it with NP Thyroid medication. * **Biliary Dyskinesia** led to my gallbladder removal when I was 21. * At 38, I was diagnosed with **Bilateral Vestibular Hypofunction** and am currently undergoing physical therapy. * I also received a diagnosis of **Vestibular Migraines** at 38 and am on nortriptyline and sumatriptan as treatment. * My family has a history of **Sjogren’s Syndrome**, leading to the suspicion of this condition in my case as well. * I deal with recurrent nutrient deficiencies, possibly stemming from my celiac disease, notably folate, B12, and B2, despite not being a vegetarian.

Answers (1)

9/1/2025, 9:31:03 PM

OpenHealth AI

It's great that you're preparing for your upcoming GP visit and seeking to advocate for your health. Given the complexity of your symptoms, clear communication will be key. Here’s a structured plan to help you convey your concerns effectively and ensure that you get the attention and tests you need.

Summary of Main Points:

1. Identify and articulate your symptoms clearly.
2. Prepare specific questions for your GP.
3. Request relevant tests or assessments.

Explanation:

Your situation involves multiple interconnected symptoms, including palinopsia, chronic ear pain, and vestibular migraines. It’s essential to express how these symptoms impact your daily life and overall well-being, as this will guide your GP in making appropriate evaluations and recommendations.

Prioritized Action Steps:

1. Document Your Symptoms:

   • Write down each symptom with its duration, intensity, and how it affects your daily life. Include details about your ear pain (e.g., when it worsens, any associated hearing changes) and visual symptoms (e.g., frequency and triggers of double vision).

2. Prepare Specific Questions:

   • Visual Symptoms:
     • What could be causing my palinopsia and double vision at close range, and are there specialized tests that could help diagnose these issues?
   • Ear Pain and Discomfort:
     • Given my history of vestibular issues and ongoing ear pain, could we explore if there's a connection to my other conditions? Would seeing an ENT specialist be necessary?
   • Neurology and Memory Issues:
     • Considering my family history of Sjogren’s Syndrome and my symptoms, should we evaluate for potential cognitive impacts or other neurological conditions?

3. Request Relevant Tests:

   • Ask about potentially beneficial investigations, such as imaging studies (MRI or CT scans) for structural issues, vestibular testing for balance function, or assessments for autoimmune conditions related to your symptoms (e.g., blood tests for antibodies).

4. Discuss Treatment Options:

   • Inquire about adjustments to your current medications (nortriptyline and sumatriptan), and alternative therapies that could help manage symptoms effectively, particularly for your migraines and neuropathy.

5. Advocate for Support:

   • If necessary, ask for referrals to specialists (like a neurologist or an ENT) early in your conversation. It’s perfectly acceptable to express that you are seeking comprehensive care for your overlapping symptoms.

Additional Tips:

• Practice Your Points: Prior to the appointment, rehearse stating your main concerns clearly. This practice can help you feel more confident during the discussion.
• Bring a Support Person: If possible, take someone along to the appointment. They can help keep track of the conversation and ensure all your concerns are voiced.
• Follow Up in Writing: After the appointment, consider sending a follow-up message summarizing your discussion and any agreed-upon next steps. This can ensure clarity and accountability.

By preparing effectively, you will help your GP understand the full scope of your issues and advocate for yourself with clarity and purpose. Best of luck with your appointment!