- CASE FILE
2018-began having migraines & IBS symptoms.Then,losing time/forgetting basic things/dropping things. Comes and goes. All tests clear. :/
ABOUT THIS CASE FILE
As a young child, I often would have unexplained episodes of violent vomiting of undigested food. These episodes would usually be triggered by bouts of severe stress (tests, sleepovers, etc.). Doctors did not understand the episodes, as they would typically resolve themselves and did not follow the same timeline as most conditions. After visiting all the local physicians, it seemed that it would just be a part of my life. However, when I had my longest episode at 2 weeks and lost 20 pounds, something had to be done. I visited a gastroenterologist who explained the issue as Cyclic Vomiting Syndrome, with a neurological trigger similar to a migraine. He referred me to a specialist whom we went to see. I was prescribed a maintenance medication to suppress the trigger and this worked for the majority of my childhood. Upon reaching puberty, the episodes were so few and far between that I was taken off the maintenance medication, but kept an open prescription for an injection in case of an attack.
At this young age, I also exhibited signs of Obsessive-Compulsive Disorder (repetitive movements, washing hands repeatedly, rechecking locked doors, etc.). These symptoms were aggravated by stress, much like the C.V.S., but were not severe enough to hamper my abilities to participate in activities. The maintenance medication for the C.V.S. also served as a stabilizer for this condition so my symptoms were alleviated for the majority of my youth.
Prior to my current condition, I was a highly productive member of society. I was dual-enrolled in high school and college, graduate high school early and achieved my A.F.A. in Drama by age 20. During this time, I traveled the country working and promoting involvement in the arts. I led a very active social life and was in good health. I also frequently volunteered with nursing home ministries (therapy dogs, entertainment).
In 2013, I began working on cruise ships. I successfully managed the entire theatrical department onboard each ship and passed all management training with little difficulty. However, this new environment brought extreme hazards to my health. I was sexually assaulted repeatedly during my time onboard. I was advised to keep silent in order to keep my position, so I did. My physical, mental and emotional health continued to decline due to the abuse until I was medically evacuated from the ship in St. Thomas for severe lower abdominal pain. When I was found to not have any issues with my appendix, I was flown home. In 2017, a doctor suggested that this was the beginning of Irritable Bowel Syndrome. On my next contract, the pain still plagued me, often causing me to require assistance to perform my duties. I visited doctors when we were in port in Seattle and Miami, to no avail. I was released from my duties for over a year to recuperate.
Upon my return from the high seas, I moved to a new city, acquiring my own apartment, my own car and kept up payments for both. I took a position as head baker at a restaurant not far from my home and spent a year there. My mental and physical health began to rapidly decline at this point. I suffered from incredible bouts of depression and rarely participated in any events. When I did go out, I felt great anxiety for the entirety of the event. As I was still having the lower abdominal pain, I was prescribed an anti-spasmodic, but received no relief from the symptoms.
In an attempt to return to my former position and emotional self, I took another contract with the cruise line. The intense fear and stress immediately took a toll. I slept very little, trusted no one and my hair began falling out. Upon a trip to the senior physician’s office to acquire a new prescription from my physician in the States, I was asked to provide the background of my stress. This was my first allocution to any cruise line officer. I was immediately referred to the director of human resources. Upon my recounting the story, he offered an official reprieve from my contract. I gratefully accepted and began all the necessary arrangements. I was mocked by my immediate supervisor for my involuntary physical and emotional reactions to the stressors, but the senior physician and H.R. director were able to have me medically disembarked yet again.
The severe lower abdominal pain continued and the O.C.D. returned with a vengeance. I was diagnosed with Post-Traumatic Stress Disorder and prescribed anti-anxiety medication and anti-depressants, which did assist with some of the symptoms. However, it became clear that I was unable to maintain a healthy standard of living on my own. I would often have panic attacks that felt like cardiac arrest, often self-harmed and still frequently had suicidal thoughts. At this point, I moved back to my parents’ home.
This helped alleviate the issues for a short time. I visited a therapist who helped me articulate the things that had been done to me and helped me overcome the self-harming. After a few months of recuperation, I took a position at a local diner run by a very trust-worthy woman who became a maternal figure in my life. However, my parents were experiencing marital stressors at the time and the support that I had been looking for at home was simply not there. Most nights I couldn’t sleep in my bed due to panic attacks. During the day, I would have episodes of what I can only describe as “brain zaps”—it was like a powerful electric shock would surge through my head.
I developed severe diarrhea and frequent, severe cramping. I was diagnosed with Irritable Bowel Syndrome in early 2018. I also began to develop hives. As stress was clearly the trigger, I realized that something needed to change. A friend recommended a new therapist, whom I began to visit. She talked me through both the old and new stressors in my life, but my home environment was still the same. As the stress increased, so did all the symptoms of all my diagnoses. The O.C.D. came back even stronger than it had left, leaving me nearly neurotic with very dry skin from washing my hands so frequently. The C.V.S. also returned, but in a slightly different form. I still had the vomiting of undiagnosed food, but severe migraines and short, stabbing headaches joined in. I was often ill and sometimes had to leave work early or missed days altogether due to these episodes. I always tried to do my best work, but by the end of summer 2018, it was clear that something was very wrong.
The hives became chronic and debilitating, often leaving me in tears and bloody scratch marks. The migraines were chronic and I resumed using the injection provided for me as a child. My I.B.S. also began flaring up and I would have 4-6 bouts of diarrhea per four hour shift (if I was able to make it to the bathroom). The “brain zaps” returned and more frequently. I lived in a mental and emotional fog. Then, I started dropping things regularly, suddenly losing motor skills. Then, as soon as they disappeared, they came back and I was fine. It was simply annoying at first, but then other symptoms began to rear their ugly heads. I began forgetting basic things. One day, at work, I forgot how to give change. Another time, I forgot who my parents were. The confusion seemed to occur randomly and encompassed everything from forgetting a conversation topic mid-sentence to not knowing where I was. The most concerning was one evening in mid-January 2019 when I was unsure of who or what I was. I began to have even more frequent and intense panic attacks and became so anxious in social settings that even driving would push me over the edge.
Due to the symptoms taking over my life, I continued to miss hours or days of work. When I did make it in to work, I would be so physically and emotionally exhausted that I would immediately go to bed after a four hour shift. I visited several physicians who didn’t seem to know what was going on. As the symptoms were increasing, my employer and I made the mutual decision that I should resign and take some time to sort out my health problems in October 2018. I began having black-out moments where I would have no memory of what had just occurred in the middle of conversations or performing simple tasks. I also began having odd tremor-like symptoms, where my eyes would blink rapidly for a short period followed by a state of confusion. In November 2018, I saw a gastroenterology specialist who confirmed that a portion of the problem was C.V.S., but was concerned that there may be neurological problems, as well. I was referred to a neurologist in April 2019. There were no immediate findings of concern, so I was instructed to continue seeing my counselor and attempt to regulate my sleep schedule. As I continue to have the fluttering and black-out moments, I have a follow up in July 2019. I was also prescribed medication for the chronic hives. I am seeing a moderate alleviation of symptoms.
I joined the patient list of a new psycho-pharmacologist, who determined that the medications I had been put on for O.C.D., anxiety, depression and P.T.S.D. were at incorrect dosages. These changes were made in December 2018 and I am seeing improvement in the O.C.D. symptoms. I also suffer from severe anxiety when attending any public function. The stress from going out, even to church or to dinner with a friend, will exhaust me to the point of having to spend the rest of the day in bed. I also now have the added symptom of hot flashes in the palms of my hands and soles of my feet, especially at night. It is as cruel and debilitating as the hives were at their peak.
Some symptoms have been lessened by the removed physical toll of work, but the majority still persists. This is such an altered state from my old self. I was a contributing member of society, active in many different fields. I cannot remember a time when I was so drained of energy on a daily basis. I have been tested for thyroid issues, but everything came back negative. I had an EEG to test for seizures, but did not have an episode during the test, so it is inconclusive. I had a neuro-psych exam, as well, which came back without any concerning biological red flags. As there is a history of M.S. in our family, that is also a concern, but an MRI also came back clear. I have been referred to multiple neurologists, a gastroenterologist and had many tests done. My primary physician admits that she is unable to find the answer at this time. If there is anything that you can do to assist me in finding an answer, I would be forever grateful.