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Could This Still Be Dysautonomia/or Heart Problem??


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:P Hi everyone,

I am new to the forums and would like your thoughts. Please be patient - I know this is a long post. I would like your thoughts. I have a sister that was diagnosed a few years ago with dysautnomia. She has pots. I am six years older and have started having some terrible health problems.

My main complaint is(premature ventricular contractions) pvcs/ palpitations. I can feel my heart beat in my throat ,neck and chest pounding. I can feel my heart skip beats and beating erraticlly.

They are every day and are nearly constant. They do not stop when I lay down, and sometimes this makes them worse. (especially on my back or left side.) They often make me short of breath and dizzy /lightheaded. I get really dizzy when walking around the grocery store and have felt like passing out several times. I sometimes have have to squat next to my buggy. One time I had to squat down in line because i feared I might hit the floor. I have never actually passed out , though. I am now afraid to even leave the house because if I am shopping or out long enough, it happens almost every time now. I dont want to drive

I went to my family dr and he brushed it off and kept telling me to calm down. He listed to my heart and could hear them clearly . He ordered a chest x ray and ekg. The ekg was abnormal. They put a holter monitor on me for 24 hours but only had it on about 6 minutes and said it was called in as abnormal, I was having several pvcs.

The doctor would not let me drive. He admitted me to Trinity Hospital in Birmingham immediately. My husband had to pick me up and take me to the hospital. Myheart was pounding and flip flopping constantly.

When I got the the hospital, they did an ekg, nuclear stress test and and echocardiogram. The cardiologist on call saw me that night and explained why might dr had sent me. He showed me the ekg and pointed out places that showed my heart skipped four beat in a row. He said they were pvcs and they would check and see if everything else was o.k. Because my stress test and echo showed normal, he allowed me to come home and take tenormin (atenolol). I am starting on a low 25mg dosage. My palpitations are not as visible in my chest and throat(heartbeat isnt as forceful) but dont they it is really slowing them.

I had my husband drive me to turn in a 24 hour unine catch to a lab and we walked around a little at the store. I shopped at one store for about 20 minutes and although I felt bad, didnt feel faint. We drove to another store and as soon as I got out I got short of breath and my head started hurting. It felt like somone was sqeezing both sides of my throat. My pulse was banging in my head and neck and I got really dizzy and lightheaded. I didnt feel like I would immediately faint, but very close. I had to turn around and leave.

My cardio says pvcs are not dangerous in a normal heart , and my other tests showed nothing wrong. I asked him if the pvcs were causing my dizziness and he said yes. I told him my main concern was feeling like I was going to faint and again asked if that was the cause. He said if I felt faint that it indicated blood flow was not getting to the brain and pvcs would NOT cause that! He says he doesnt know why and may never know why.

Some of these are similar to some types of dysautonomia, but the more I have researched it ,the more it seems like it may not be. If anyone else has had similar symptoms, please let me know. Of course, i realize that it is possible that I do have dysautonomia, and that the symptoms have a wide range. But looking at the manner in which they occur(i.e. NCS- blood pressure changes upon standing) I am just not sure.Mine

never happens just upon standing, but usually walking around. I have almost completely ruled out pots.

My heart never races or goes up upon standing. I have checked my bp at home and standing doesnt change it.

I am really worried. I feel like something is really wrong with me . I am not able to even function. I have Thanksgiving coming up and Christmas to give three kids. I am not able to even shop or drive. We are living off sandwhichs because i cant even cook. I worry that something may be wrong that is life threatening.

I need to go and have dysautonomia ruled out so I at least know to search for something else if i dont have it. I have a sibling with pots, but I feel pretty strong from all my research on the dinet site and boards that POTs can be ruled out. It also really doesnt sound like ncs because my bp and pulse. I also have bad pvcs while laying down.

This is why I have doubts about having it- i dont have high blood pressure. I have always have normal blood pressure. Even when taking my stress test. My pulse does not rise or drop much at all when I stand. Laying at night is even worse sometimes with the pvcs, it certainly doesnt alleviate them. I dont have a racing pulse, or even a slow heart rate. I have arrhythmias and skipped beats, but a pretty normal heart rate.

But , I do on the other hand have some odd symptoms that some people with dysautonomia have. Strange symptoms like- before I feel faint, I get very flushed and shaky- instant fatique. Its hard to explain but feels like I am very hungry or thirsty. It also makes my chest , hands and arms burning hot. (usually they are very cold) I also have stomach pain, constipation, my face sometimes feels hot and almost sunburned. The other night I could sleep because my arms felt numb, like they were falling asleep. I have heart palps. shortness of breath during dizzy episodes.

Even when I have near fainting episodes, it is never from just standing. It has never happened except when I am standing and walking a while, such as shopping. Even when a sit down after an episode, i still feel lightheaded and s.o.b. Sitting doesnt stop it. These symptoms just started a few weeks ago. I know this is a long post but your support and responses would be very aprreciated. I went from a mom of three playing tennis 3 days a week with my girls to someone who cant even pick then up from school or shop for groceries.

Another reason I want your feedback is so I will know how to proceed. Of course I have an appt. with a dysautonomia clinic after Christmas. But I still need to know how to proceed until then. Should I go to another cardio who is an ep or rhythym specialist? I feel like I am in danger. I feel like my heart is skipping so many beats in a row and having so many pvcs, that I may be having ventricular Tachycardia. That can lead to ventricular afib., which is deadly. For whatever reason, my brain isnt getting oxygen. I feel like my heart doctor wasnt straight with me. I think he thinks Ill be fine because my heart is structually sound. But if the heart is misfiring and having so many skipped beats, maybe that is why I am getting so sick. He is not an ep specialist. I need to know why blood is not getting to my brain.

The cardiolgist also said I did not have mvp. He also said he was writing it in my record as benign pvcs because they were not life threatening. If they dont cause dizziness and nearly fainting though- then I still have a problem. I have done research on the net about pvcs and most drs say they shouldnt cause dizziness , but one article I read said that they rarely can, because the cardiac output is diminished. I feel like my heart is skipping so many beats, that its the same as a very slow pulse, even though the rate is normal when my pulse is measured.

My main dilemma is this: Either I have another serious health problems that is also causing pvcs and dizziness. Or, my heart having pvs and skipping so much is the problem and these other symptoms are incidental. I want to see a rhythm specialist cardiologist at uab, but they make you send records first and decide if they will see you. I know that this is a very long post, but any help would be appreciated. I have never been an anxious person and have not been depressed, but everytime I go somewhere and nearly faint, it makes me anxious and upset. I am only 33 years old and suddenly feel hopeless. Any posts appreciated.

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First of all, I apologize for not being able to give what you expect from our answers, but I could not resist writing to you, at least to give you my support.

I am very sorry for you sufferings and hope you can find the best help to recover as soon as possible.

On the other hand, I hope you do not mind telling you my own experience. It might be of some help.

I suspect that I have POTS but I have no diagnosis yet.

In August 2005, I started having chest discomfort/pain, shortness of breath, dizzyness, lightheaded... No matter if I was standing or sitting. Laying down, sometimes made me feel worse (especially on my back or left side). I had to put 2 pillows to sleep.

When walking or standing for a while and walking around the grocery store the pain was going worse.

My X-Ray showed "Pericarditis" and the EKG was Ok. I started taking meds for the diagnosis and felt better, though when finishing, it started again. My GP recommended to continue with one of the drugs: Inyesprin Oral Forte. (similar to an Aspirin, but also antiinflammatory). Since then, I am feeling better, though I am still feeling bad, at least, I can go to the grocery, etc.

Sometimes, I also feel my pulse banging in my neck, head and chest. And I always feel like someone is squeezing both sides of my throat everytime I bend forward, collect something from the floor (bending), etc. Sometimes, the pain becomes unbearable, even when laying down. But I have some relief when taking the antiinflammatory.

(By the way, thyroid tests were ok).

I also suffered from syncopes. Now only pre-syncopes.

I really do not rule out dysautonomia and POTS. I am 90% sure that I have POTS.

Have you checked the DINET website: what helps and what to avoid? Have your read DINET website STORIES? Some are similar, some are not...

I am looking for someone specialized in POTS and dysautonomia.

You should go to someone specialized too and reject doctors who do not help.

You mentioned:

But , I do on the other hand have some odd symptoms that some people with dysautonomia have. Strange symptoms like- before I feel faint, I get very flushed and shaky- instant fatique. Its hard to explain but feels like I am very hungry or thirsty. It also makes my chest , hands and arms burning hot. (usually they are very cold) I also have stomach pain, constipation, my face sometimes feels hot and almost sunburned. The other night I could sleep because my arms felt numb, like they were falling asleep. I have heart palps. shortness of breath during dizzy episodes.

I also have some of the symptoms you mention.

What is very important: do not feel anxious, try to rest what you feel you need and look for help.

You have friends on the forum who care for you.

You are not alone.

Take your time to find the best person to help you.

And I am sure that some more members on the forum will answer and support you, even with some more helpful information than mine.

Take care,



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Ann, for many, dysautonomia is the diagnosis after other conditions have been ruled out--so rather than "ruling dysautonomia in" you'd first rule out all the other usual suspects: adrenal or pituitary problems, thyroid disorders, structural problems, infections (both viral and bacterial), genetic disorders (I have one called EDS-hypermobility type), etc.

While it may not be hopeful to hear, I think your doc was at least part right: most people, pvc's, alone, probably wouldn't be causing you to feel so sick and exhausted. Pvc's, though, can happen with folks with dysautonomia of various types--everyone here has their own constellation of major symptoms. I've only experienced pvc's a few at a time and usually with days, weeks or even months between episodes. However, I'm in SVT (tachycardia) nearly all day--at least all the time that I'm upright. Every single ekg I've ever had says "SVT with nonspecific s-t-wave changes and possible LVH" starting in my 20's and continuing to the present day, in my 40's--even when lying down.

The flushing and hunger sensation you describe could have a relationship to dysautonomia, but it could also be hormones and/or catecholemines--which can also cause one to feel very tired afterward. If you don't get firm answers from your dysautonomia clinic evaluation, you might want to find an internist to work with you on figuring this all out.

However, if you do have a first degree blood relative with dysautonomia, it's a possibility that you also have a form of it too-- I hope you're able to figure out what's going on in conjunction with your doctors, and that you find treatments that help.


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Hello and welcome. Hope you get some answers and treatments that help. I would also be suspicious of POTS if you have a sibling diagnosed with it. My younger sister and I both have it. It is not uncommon for this to be found in families. Good that you can have a work-up by a specialist. I am sorry that you have to wait so long and that you feel the stress of the holidays when you are feeling so poorly.

I don't think that you can rule out POTS without the evaluation of a specialist, and particularly a tilt table test (which does not always give definitive answers unfortunately).

Is your sister's POTS well-controlled? Have her symptoms been similar? There may be treatments that have worked for her that may work for you that you could start without waiting for this specialist, but you would need to talk to your doctor--e.g. beta blockers, low-dose SSRI, plus things like compression hose, increased fluids. My sister and I respond well to exactly the same treatment.

Finally, perhaps this will ease your mind about the PVCs you are experiencing. Another member posted this on our site a couple years ago. MANY of us with POTS experience scary heartbeats, that are totally benign--this is a popular topic on this board.



Posted by RLR on Dec-17-04, 09:16 PM (CST)

Thought I would visit your site and post a general response for anyone suffering from palpitations, racing heart, pounding heart and similar issues.

It's always a good idea to have your primary care physician or cardiologist examine you for underlying causes if you experience frequent episodes of palpitations. But once an examination has been performed and the sypmtoms are considered benign, then it's important to understand a little about how these occurances come about and what they really mean. Many times as physicians, there simply isn't time to address the more important point of peace of mind for the patient. Sad, but the waiting rooms and the schedule is full and we're slave to time and contemporary practices of medicine.

In the case of benign palpitations, we need to underscore the importance of several things that are occurring, all of which are normal and none of which are life-threatening in any manner.

Think of the central nervous system as a sort of two-lane highway in this instance, signals going both ways. One direction is the sympathetic nervous system, which is responsible in a way for making us alert and responsive, making the heart beat in relation to the demand and even kick things into high gear when we're frightened and need to be on highest alert. The parasympathetic nervous system sort of does the opposite. It tones down those high responses when required and keeps things quiet and balances regulation in a way.

There are many, many nerves responsible for this highway, but the most important for our discussion here is the Vagus nerve. It is called a mixed nerve because it regulates and stimulates many different organs to act, including the bronchi, heart, lungs and intestines. This is very important for you to understand how it relates to your life on a daily basis. First of all, and very importantly, this highway represents the autonomic nervous system, meaning that it runs all by itself without any effort or thought on your part. It is, however, responsive to the environment. Let's use and example to break it down even further for purposes of illustration.

Have you ever heard of someone describing a frightening experience and literally say "it made my heart skip a beat!" Well, that's a very accurate statement indeed. You see, when our sensory modalities, eyes, ears, touch, smell and other senses detect a change in our environment, they automatically send signals to the brain and our nervous system swings into action one way or the other, either to calm us or to bring us up to high alert. In order to accomplish high alert for example, our blood pressure is raised, our heart races or pounds, our breathing rate is increased and even our intestines will perform their functions if necessary to prepare us for possible fight or flight. In the case where no threat is present, the parasympathetic nervous system works to bring us back down to normal and the heart slows down, our blood pressure descends, our breathing returns to normal and our intestines calm down. Sound familar? Does the fact that the Vagus nerve being connected to all these organs make you wonder about your responses that seem out of your reach and control?

Here are the facts to know and keep close at times where you feel panicked from a racing heart, palpitations, pounding heart, flushing sensations, dizziness, shortness of breath or tightness in the chest, a lump in your throat, tingling in the hands and other extremities and a whole long list of symptoms.

We are creatures of evolution and regardless of how cultivated and socialized our environment has become, our bodies nevertheless maintain those basic automatic responses to that environment through use of our nervous system. This point is illustrated to show you that many thousands of years ago, threats to safety represented something entirely different that which we experience today, but nevertheless we respond to our environment based upon the way we perceive it. So many things like stress can trick our nervous system into jumping into high gear.

More importantly, the Vagus nerve is responsible to a large extent for causing all the trouble simply by doing its job well. The more we learn about our health and our bodies, the more we can become concerned and even overwhelmed and worried about its ability to do all those marvalous things daily that keep us in good health. So much so, that based upon the complexity we more tend to doubt its precision rather than trust it.

Let me illustrate how easily we can become overly focused on a perfectly normal bodily process and actually make matters worse without justification. If you eat a rather full meal and the intestines begin having difficulty digesting that meal, discomfort and bloating from indigestion can cause stimulation of the intestines in a rather abnormal manner. Guess what nerve responds to this irritation? THAT'S RIGHT! The Vagus nerve. The Vagus nerve fires due to inappropriate stimulation no differently than when we hit our elbow in just the right place and the median nerve sends a shooting pain all the way to our hand, with considerable discomfort. The important difference is that we must remember that the Vagus nerve is a MIXED nerve and it has connections to other areas of the body. Guess which connection is relevant here? RIGHT AGAIN! The heart. The Vagus nerve sends out a signal to the heart which is steadily beating away and doing its job when all of a sudden this wayward electrical impulse arrives. Well, it gets added in with the present stimulation and we feel it as a disruption of the normal sinus rythym of the heart. A PALPITATION! This funny sensation gets our full attention because the heart is our main pump and we don't want anything to even hint at a problem there. But it's not a problem. In fact, it does absolutely no harm. Some people even can feel it in their throat when it occurs. Guess where the Vagus nerve is also a factor. GO TO THE HEAD OF THE CLASS! The throat. We sense it as a lump or tightness and it can often send some folks into a panic because they initially feel like they can't get enough air or that their throat is going to close off. Breathing increases and folks feel that they can't get that deep breath that they need. Again, the lungs are affected too. But it's merely a sensation and will never cause any actual harm. EVER.

As you might guess, the instant worry and panic induced by those sensations only makes matters worse and the nervous system is stimulated even further. So when a palpitation is felt, folks suddenly sit up and give attention, they become scared. Remember what we said happens when we become frightened? RIGHT! The nervous system responds automatically and not necessarily the right way. It only knows to respond to stimulus automatically.

Many people experience palpitations due to indigestion. Once the palpitation occurs, most folks shift their body position and are alerted to the sensation. Indigestion often shifts and the nerve can either be stimulated again or the palpitations may cease due to a lack of inappropriate stimulation. Stress is another even more potent predictor of palpitations. Practically anything we conciously do, and some things that we don't realize that we do out of habit like excessive worry and stress, can cause irritation of the vagus nerve and other nerves for that matter. It's only important for you to realize that inappropriate stimulation of a nerve with subsequent ectopic heartbeats(beats where they don't belong)are as harmless as the instance where we hit our elbow in just the right place. Think about it, we hit the median nerve in our elbow and it causes intense pain to the degree that we often don't know whether to laugh or cry. But we don't suddenly start thinking that it is going to cause impending threat to our lives simply because it's our arm and not our heart that has been irritated by the stimulus. But in reality it is no differnt from a physiological standpoint. A palpitation is the result of an inappropriate stimulation of a nerve. Nothing more.

In all my clinical experience, I have never once, even once, witnessed or even heard of an occasion where benign palpitations have brought about the slightest degree of bodily harm. Never. So it's very critical for you to understand that your body will react to stressors and palpitations are a likely event to be dealt with, but you shouldn't worry that it means impending doom at all. Sure, they scare the **** out of some folks, but because they don't understand what is happening to them, they panic.

The key to knowing the causes and prevention is important. Hormone dysregulation can cause them. Just ask a pregnant mother or menopausal woman. Over-eating can cause them. Stress can cause them. Lack of exercise and the liberal use of caffeine, chocolate and other stimulants can cause them. Anxiety and depression can cause them. And yes, illicit drugs like marijuana and cocaine can certainly cause them. There are many causes and these are just a few. Your body will work just fine. In your lifetime, your heart will beat several million times. The fact that it skips a beat or two in that entire time should not worry you in the least. The human body is a marvelous and wonderful complex system that works incredibly well. It is true that some folks get sick, some even die, from diseases. That's a fact. But palpitations simply don't even reach anywhere on the list. All that we're exposed to about cardiovascular disease makes us overly vigilant about how our own hearts are working. You need to relax and use this information in a careful and prudent fashion. If your doctor defines your palpitations as benign, then jump for joy and get on with your life. I work in a tremendously large complex where patients who are truly ill get far worse news. Never take your life and health for granted. Cast aside your worries about those silly and annoying palpitations. They are indeed a nusiance, but you needn't ever worry that they indicate impending harm.

So take a deep breath and sigh of relief, grab those car keys, head for the mall and do some shopping and smile. You've got the whole rest of your life ahead of you to plan and focus upon. Let your body do its job. It won't let you down. And if you do happen to get a pesky palpitation or two from time to time, just relax and get on with it. They're harmless and that's a fact.


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Hi and welcome.

Sorry to hear how you are feeling. I too have suffered and do still suffer from pac/pvc's. Yes they can be very frightening especially when they occur so frequently and forecully, takes your breath away.

I also would not rule out dysautonomia, any form, until everything else is eliminated. Everyone has some similiar symptoms to others and then some that they seem to have that no one else has. How many people really fit the "perfect" diagnosis? Not many. So many of us are all over the map, from one extreme to another.

Getting an endocrine workup for thyroid etc, adrenals like taking the 24 hr urine to check for pheochromocytoma, complete electrolyte panel,(mag or potassium being low can cause them too) and all the rest that everyone else stated can help to narrow down the cause. In a structurally normal heart pvc's and pac's are considered benign, pesky, annoying and sometimes downright painful, but benign. After 15 years of having them, I'm still not used to them. When they occur, they still make me jump, and more than one in a row,,puts me over the edge B)

I also sometimes get the fullness in my neck and head, even feels like I am choking,,(I can't wear a hooded sweatshirt or turtlenecks for that reasons).

Try reading through the medhelp.org forum on pvc's,, you will really see how common it is, and how the dr's 99.9% of the time reply that they are benign.

Give the tenormin some time to work. Try some of the self help measures on here, you may notice a difference too. :lol:

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I have no useful information to add......I just wanted to say that whether or not dysautonomia is your issue, that a lot of people here have been down the path that it looks like you're about to take. The exams, tests, medicine trials, etc. It's not fun and I'm sorry you have to go through all that but you're not alone.

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I just wanted to thank everyone for their support. I am really terrified that something may be life theatening. Last night I couldnt sleep. It felt like someone was sqeezing my arms. They felt like I fell aseep on them. They felt kind of numb and then throbbed, like the circulation was cut off both of them .My stomach started burning too. I know the stomach part is not just stress because it is the same pain I had over two years ago. I am trying not to worry, but the whole picture is looking really bad. Knowing that I am not getting enough oxygen to my brain and am shaky and faint really scares me with these other symptoms. I have to raise my kids and it is a huge burden knowing I could get terrible news. I have such a bad feeling and dread about this. I worry that they wont be able to find what it is, or when they do, that there wont be anything that can help me. I go to the dr today. I have no idea what he will do or where he will send me. If I just had a clue of what direction to go in and strart fighting, then I would feel better, but I dont. The last time I had a dizzy -lighthead episode, I could feel my heart pounding and was sob, but I am not convinced that I had pvcs. This makes me wonder if going back to an ep cardiologist would even help. Maybe the pvc arent causing this, maybe something else that is causing the other symptoms and is causing the pvcs, too. I only live about 1 1/2 hours from the dys/mvp clinic in Birmingham. And although I really dont think this is what I have, I feel like I need to rule it out. If I do have it then I dont have to look for cancers or vascular problems, because it causes such a range of symptoms. I still plan on searching every other avenue with my dr. but I just dont know how far that will take me. In the meantime I scheduled with dr. moore on dec 27th. I can always cancel if I find out it is something else before then. I am so upset that this has happened right before the Holidays and I am unable to do anything. I feel so guilty. We are huge Christmas fanatics and it takes us days to decorate. I cook a huge amount of food. I definitely wont be able to do any shopping much. I think I am starting to really feel the anxiety. Thanks everyone for your support.

Ann B)

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Hi again--Try not to fear anything life-threatening at this time. I know, easier said than done. But, truly, a good number of us with autonomic dysfunction before diagnosis were convinced or scared we were dying. The symptoms can be quite severe. If you have so farbeen given a clean bill of health, then feel confident in that. It sounds like you had a great cardio work-up and all they found were benign symptoms. That is GOOD. Keep pursuing answers, but try to stay as positive as you can. A positive attitude is really important to health--and to getting better when you ARE sick. Again, easier said than done. Something that helped me was learning simple meditation techniques and breathing exercises. You might take a look at the book *Spontaneous Healing* by Dr. Andrew Weil. I found it helpful during the long time I went undiagnosed and feeling very ill.

Allow yourself to give up some holiday traditions this year if it is too much. Remember the core reasons for your celebration--too often we get caught up in the hyper-consumption and the fast pace of all we are expected or expect to participate in for the holiday season. I was sick and disabled with POTS during Christmas of 2002. I couldn't do anything except breastfeed my baby--almost literally. But Christmas I was with family and those who cared most about me and who I cared most for, and that was all that was important at that time.

Take care,


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Thanks for the encouragment. It is really odd that I may not even have dysautonomia but I am getting support from so many people here. I went to the Dr. today. He again seemed to constantly tell me to calm down as if it was no big deal. He did finally put me on an event monitor for 28 days. He also upped the dosage of tenormin to 50mg. I have blood pressure on the lower end, so a big dose wouldnt be good. He also wrote me an rx for valium. We live in small town. I would love to have a woman dr. who I feel like I could communicate with more, but at this point I dont have a lot of options. I cant even drive. The closest Docs out of town are an hour away in Huntsville or 2 hours away in Bham. My husband is taking off work to take me, so right now I am just gonna try to keep him until I see that I am getting no better/ or he doesnt seem to look for more answers. He said he does not think anything is wrong with me. I assume he means other than the pvcs. He says to just up the dose and all will be o.k. He kept saying I need to stay calm. I told him I was not even thinking about my health problems yesterday when I nearly collapsed at the store. I told him that as soon as it was off my mind, another event like that reminded me. I also told him it is ruining my life. I feel like he is just assuming it is the pvcs and i can see why . It is the main symptom besides the dizziness, fatigue. I told him the cardio told me that the pvcs are not causing the dizziness. I told him although I had many pvcs during the testing, I did not have a dizzy /fainting spell. I told him that usually the faint feeling comes when I have been standing and moving a while. Like when shopping. He did agree that the event monitor was the only way to catch it. I told him my fear was that many pvcs in a row are maybe causing v tachycardia-- which can lead to v-afib. That is very worrisome to me. There is something going on besides just the normal pvs when I feel dizzy. The only bad part is the event monitor will not be able to record if I have a drop in blood pressure- which is maybe why I am having these. Hopefully increasing my medicine will help me. I will update soon. Thanks everyone for your replies


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Our members know what it feels like to be in the middle of a diagnostic quest...and they also fully understand how hard it is to KNOW there is really something wrong and feel like you're not being heard.

You might want to be consider being more forceful in telling your doctor what you've said here in various ways:

"I am calm and I don't appreciate you chalking all this up to stress; there's something wrong and I feel like you're not taking me seriously and not really listening."

given that you're in a small town, trying to work with your doctor might be an advantage over trying to find a new one far away...especially if your current doc is repsonsive if you give him DIRECT feedback from your perspective.


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