Thursday, March 5, 2020

The Diagnosis

Do you research your meds?

If you read this blog often you will recall I've been having a few medical tests due to symptoms that include gastrointestinal problems, swollen abdomen, pins and needles from the waist down, sweats, nausea, higher blood pressure, loss of coordination, feeling flushed, rapid heart rate, confusion and this very odd feeling of standing outside myself.

I've had tests for menopause, diabetes, colon cancer, bowel cancer, ovarian cancer, thyroid, coeliacs, vitamin deficiencies, stomach ulcers.....

You name it, we've tested for it.

Through it all I've felt very strongly there was something foreign in my body.  There was a tumor or an infection that was causing me to change who I am in such a short period of time.  All of this in the course of 8 weeks.

The onset of gastrointestinal issues was first thought to be a virus, but as my stomach continued to expand rapidly and the stomach discomfort turned from cramping to nausea and the rest of the symptoms set in, I was adamant this was no virus.

So I went to the doctor.  My doctor has moved overseas so I saw his colleague.  I was dissatisfied with the flippant prognosis so with a tip from a friend I moved to a new practice.  I found a very patient doctor who listened, wrote notes and agreed that I needed to find the gremlin lurking within.

All tests came back showing me to be fit and fabulous at fifty.  Good news, yes?

Good news, but no.

None of this changed my symptoms.  As I sat at the doctors on Monday afternoon reading through every blood test, pelvic exam, colonoscopy notes and ultrasounds I thought "surely this can't just be age?"  The onset was too rapid.  The feelings too real.  The increase in "episodes" too frequent.

What is an "episode"? I'm glad you asked.

On Sunday I attended my daughter's fashion show.  I was having a lovely time wandering around in my brightly coloured dress, smiling, chatting and proudly participating in my daughter's world (albeit in a strangely surreal fog).  I was on a high which has been happening a lot lately.  High as a kite in the clouds where as I walk, I am not inside my own body but rather walking beside myself as a spectator.  I spent a lot of time tripping, holding onto walls, carefully contemplating stairs - trying to hide my clumsiness and trying to get my feet firmly back on the ground.

Official photo taken at the CBR Fair on Sunday by a photographer employed by Danielle Cleary Events.
As the fashion show finished I became increasingly agitated.  I was floating next to my own body, feeling hot, flushed, sweating and nauseous.  My girl and I went to the shops but I asked her to keep an eye on me. I had this overwhelming sense that if I turned my head too quickly it would be lights out.

By the time we got home I had a sick bag in my hands and I was being guided into the house lest I fall and never wake up again.

Dramatic I know.

We had friends visiting and my fellow fibromyalgia/migraine sufferer took one look at me and said "you're not OK".  I was pale, sweating and vacant. I spent the afternoon on the couch and didn't sleep a wink that night for fear I may never wake up.

So with that "episode" at the forefront of my mind I sat with the doctor on Monday and wondered how I could be deemed to be so fit and fabulous on paper, yet felt like I was about to exit the world in practice.

At the end of our chats we decided to get my scripts up to date for my medications. One to help me manage my fibromyalgia pain and the other for my migraines.

It was at that point, right at the end of the consultation, that a computer diagnosed me.  A major warning flashing in red came up on the screen advising the combination of these two medications could lead to the very rare and very serious condition of Serotonin Syndrome.


The doctor and I read the symptoms together and they are a checklist of my last two months.

Serotonin Syndrome as explained by the Mayo Clinic:

Signs and symptoms may occur within minutes to hours of taking the drugs and may include:
  • Nausea, vomiting and diarrhea
  • Fever
  • Increased heart rate (tachycardia)
  • Changes in blood pressure
  • Overactive reflexes (hyperreflexia)
  • Tremor
  • Extreme agitation or restlessness
  • Hallucinations
  • Loss of coordination
  • Skin flushing
  • Shivering
  • Confusion
  • Seizures
  • Coma
If you experience signs or symptoms of serotonin syndrome, seek immediate medical attention. Left untreated, serotonin syndrome may be fatal.

While this revelation is completely crazy and overwhelmingly scary, I have my answer.  It is the combination of two drugs that has caused my problems.  I am one of the rare cases who can have severe (even deadly)  results of mixing Maxalt (for migraines) and Duloxetine (for fibromyalgia and other serotonin related illnesses).

Of course I've had to come off the drugs immediately which means a very slow exit from the Duloxetine and an immediate halt to my migraine remedy.

The resulting headaches are painful and the Serotonin Syndrome symptoms are still presenting in a very mild form, but it won't be long and my health will be back within my control.

I have found the gremlin and we're slowly extinguishing it from my life.

There are still a million questions I have which will require another doctor's visit and perhaps a few "please explain" style communications.

Why did this warning not present itself earlier? My drugs were clearly listed as a major warning on Monday when both drugs were being prescribed at the same time, yet all the times I've had these prescribed in the past, nothing.  All the visits to the chemist to get them made up at the same time, nothing.  How does this happen?

Ultimately our health lies in our own hands, but we all become complacent and just trust in the words and expertise of others.  We should. That's what we pay for.

I strongly believe that on Sunday I was very close to being one of those rare cases where this combination could lead to coma.  Having an out-of-body experience for much of the afternoon, then getting to the point of not being able to walk, vomiting and full sweats.  I felt as though the life was draining from me. 

What if it actually was?

Do you research your meds?

Have you ever had a medication reaction?

Should I be questioning the advice of previous doctors and asking our pharmacist "why"?

Today is Thursday which means it is lovin' life day. Despite the medical challenges of the past two months and the trauma of the last few days, there is still something to love about life.  I love that I've had a full suite of tests that have given me the big thumbs up when it comes to being fit and fabulous at 50. I love that my diagnosis is fixable. I love that I caught it just in time.

What are you lovin' about life this week?

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  1. So glad that you're okay now, Leanne. And so glad that you're on the ball and asking questions.

    SSG xxx

  2. Sometimes we sure do know best about our bodies and you did. Doctors can be complacent (overworked perhaps) so when you find a good one, stick with him/her. Wow. That was one scary time. We both know about meds and side effects (or worse) in this household and one of us (not me) is off to our very good GP this morning. Phew, Leanne, stay well. Denyse x

  3. I had a serotonin overload due to migraine meds mixing with my anti depressants. Not quite as serious as the syndrome because we recognised the symptoms early enough. I have never done speed but that is what it felt like. I was on a huge high, didn’t sleep much, fast talking and fast brain. Sweating, shaking. Went to emergency and they didn’t get the connection but gave me a serotonin blocker. Went to GP next day who realised the link between meds.

  4. Man, you were lucky - and unlucky both at the same time. I'm fortunate that the strongest medication I take at the moment is the occasional nurofen, but I'm sensitive to most medication & do question it. When Grant was going through the nasty bullying divorce from his old employer my blood pressure was through the roof and what she prescribed for me mixed with an underlying asthma condition and had me unable to walk 100m without gasping for breath. So yes, I question...

  5. So glad that you caught the gremlin in time and are on the mend. Hope you feel much better soon. #lovin'life

  6. I don't research my meds at all and just assume the doctor would be conscious of that stuff. I did have a pharmacist once tell me to take two tablets at different times... (though can't remember now what they were!).

  7. Well that was a wake-up call and I bet your doctor was sweating and feeling a bit of an out of body experience when he realized he could have killed you! Glad you got to the bottom of it all (in more ways than one!) and that you're now on the road to getting the meds sorted. I hope things continue to improve from here on out. Doctors are definitely not as infallible as they'd have us believe!

  8. Wow! So glad you persisted in seeking medical advice and the gremlin was diagnosed!


  9. Glad that you are ok. I always to research my meds. Glad that it was diagnosed.

  10. Thankful you got to the bottom of it, and it just goes to show we need to be on top of our own health and wellbeing. After all we are the experts in our own bodies!

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  12. khalid Hassan
    As the fashion show finished I became increasingly agitated. I was floating next to my own body, feeling hot, flushed, sweating and nauseous. My girl and I went to the shops but I asked her to keep an eye on me. I had this overwhelming sense that if I turned my head too quickly it would be lights out.


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