would you push for something more? (GP)

[doc192]

I've been having these symptoms for a couple of weeks. I will feel fine and then suddenly feel sick and sometimes violently shake with it too (teeth chattering etc..). It feels like I'm going to vomit but I never do. This gradually wears off but can last for a little while before it does. It happens at any time of day or night and has been stopping me sleeping. In between these episodes I feel my usual self and can eat, go about my day etc.. it doesn't feel like a bug to me.

I visited the GP today as its been going on for a couple of weeks and no one else in the house (DH and 3 DC) are ill so thought surely not a bug.

They took BP readings which were apparently a little high but not a concern (180 / 70 - I'm 29) and then said it's probably viral and come back in a few weeks if no change.

I thought I would at least be offered a blood test or something given the symptoms and the fact no one else is unwell.

Aibu if not gone by this time next week to go back and ask for a blood test instead of leaving it for weeks?

A blood test for what though? There isn’t a blood test that will magically say what it is you are actually suffering with.

Hypoglycaemic?

Are you sure you've got those BP readings right? That sounds like very high blood pressure to me! The top reading at least - bottom one is fine.

My first thought was hypoglycaemia. Or an ear issue.

Well I'm not a doctor obviously but I thought given the suddenness of the symptoms and the fact I'm not unwell in-between they may have checked blood sugar, iron levels, blood count I don't know. It just seems a bit worrying to me that I can suddenly be nauseous and shaking, with seemingly higher than normal blood pressure and it just be a case of "give it a few weeks".

I had read about hypoglycaemia, im not diabetic but I understand you don't have to be. I have been trying to nibble on biscuits when the epsidoes happen in case it is something like that and have noticed I feel quite hungry after the sickness has subsided.

I'm not eating any differently than usual though so not sure why my blood sugar would be low if it were that.

And yes they were definitely the BP readings, I made a note of it when she said. She said it's quite high for someone my age but not immediate concern.

Blood tests can tell you all sorts of things

You’re not very bright, are you?

This is how blood tests work- they take some of your blood and check for any abnormalities which can help with a diagnosis. It’s a medical procedure that says ‘what it is you are actually suffering with’. There’s nothing magical about it. I’ve known someone with similar sounding symptoms who had actually been exposed to a toxin. Now have a little guess how the doctors diagnosed it?

Just because you (possibly) have a virus doesn't mean everyone else has to have it, or will react in the same way to it. I think the doctors right to give it a couple of weeks, maybe sure you get 3 square meals and plenty of sleep.

That’s rude. It’s true. Bloods are done with an idea of what you’re hoping to include or exclude. You need a working hypothesis of what you’re looking for. The OPs symptoms are vague, short lived so far and in between episodes she’s fine. A fit healthy young woman, and it’s winter with multiple viruses circulating.

A lot of primary care involves excluding anything serious, watching and waiting and reviewing if things don’t improve or change. If we did bloods on everyone that pitched up with a fortnights worth of slightly odd symptoms that spontaneously resolve you’d have to wait even longer for appointments and the labs would be overwhelmed.

BP needs rechecking in a couple of weeks and if symptoms persist a review is needed. In the meantime she can eat well and regularly, get some fresh air and exercise, avoid alcohol, keep a diary of her symptoms and review if it continues.

You've been told to come back in a few weeks if there's no change, so yes YWBU to go back next week unless there are any changes.

Why have you written me an essay like my one line comment means that I disagree with anything you’ve just written? I agree that the op should wait and keep an eye on her symptoms for now. The pps comment was ‘rude’ in the way she’s implying that the ops suggestion of a blood test for a diagnosis is ridiculous. You don’t always know what you’re hoping to ‘include or exclude’ with a blood test. I’m a hca and it’s interesting to note the other pps suggestion of possible toxin exposure, we’ve had a similar case where there was exposure to what I believe was snail bait.

@doc192 could you be pregnant?

@Peoplemakemedespair my essay was an overall response to the general thread.

You were rude. Calling someone “not very bright” because they have pointed out that there’s no magic single blood test will say yes! You have abcxyz (which is completely correct). If you think there is such a test you are the one that is mistaken. Usually a panel of bloods is needed alongside other investigations to make a firm differential diagnosis.

Do you really think GPs/ANPs see a patient with vague and fleeting symptoms and think yes there’s just the blood test for that?

You don’t always know what you’re hoping to ‘include or exclude’ with a blood test.

Of course you do. Years at medical school and post qualifying training and experience gives you that knowledge.

Why are you repeatedly twisting what the pp is saying? If this does require further investigation, what tests do you think they’ll start with?

@Fiddlerdragon i don’t think I’m twisting anything? I pointed out a PP was rude and suggested that the OP going back and asking for “a blood test” was inappropriate.

If her symptoms persist and her BP remains high she would need some home BP readings, then maybe some baseline bloods, an ECG and then another review.

But as her GP said, wait a bit longer and review if needed.

Typed in ops symptoms in med diagnosis. Possible serious causes (ruling out viruses) include low blood sugar, poisoning (mentioned for the 3rd time), muscle problems, neurological problems, can’t even be arsed to go through the whole list. A lot of which can be determined through a blood test. Of course they won’t know exactly what they’re looking for. A blood test can really be the starting point. As pp said they look for abnormalities and go from there. It’s really not hard

She seems to be looking for a fight some reason so I’ve just left her to argue to herself 🤷🏼‍♀️

I hope your symptoms improve soon op. Keep us updated x

Honestly I would be concerned with your BP. 180 is very high for your age. I wonder if your pharmacy can check your blood glucose…? You would probably have to be symptomatic at the time. I guess you could buy some urinalysis sticks too. I would definitely push for more. Your symptoms are not normal and they’re not going away.

Hypoglycaemia can increase BP.

Rather than biscuits try an immediate sugar boost (sugar/juice) see if it subsides quicker. Also look at when they're occuring. Is if after a big meal? Something very sugary? After exercise? On movement?

Sudden hypos in someone without reason aren't 'normal'. I'd give it more of a days than weeks and then go back. So maybe till Monday. GP's generally get sick enough of you to order some tests. So bother them enough and they'll do it.

I think, personally, that I would feel OK to leave it just a little while to see if it resolves because if it is a virus you will waste a lot of time and worry checking unnecessarily. But if it doesn't resolve you will have to go back and then, yes, surely a blood test is the first starting point.

The NHS page does say to see your GP, which you have done - it gives some self help advice which might help you? Have you kept a diary to see if there is any pattern? https://www.nhs.uk/conditions/feeling-sick-nausea/

The NHS page includes mention of migraines - I did wonder about that myself as you can have migraines without any headache and nausea is a strongly connected symptom.

What is your basic diet, hydration, sleep, exercise and stress situation like?

180 is more than a little high. I'd be buying my own machine and rechecking it at home. Should be 140 or less.