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    justanonlooker posted:
    I am a 29 year old woman with some concerns over my health. Over the last 6 years I have a number of problems which have never been considered together by any one GP.

    2009 saw a brief psychotic breakdown, noticing retched smells and nightmares, extreme mood changes and paranoia. Recovered well after 4 weeks on low dose of antipsychotics.

    2010, further disruption of mood without psychosis - noticing a smell of coffee which was not present, confusion, feeling lost in familiar places, not being able to read maps, feeling detached, not remembering which key to use to get in the door etc.

    Also short spells of not being able to move - e.g. sitting up in bed and seeing friends enter the room, being aware of their presence but not being able to respond. Not feeling able to speak/respond to people at times.

    At the same time, diagnosed with papilloedema and drusen - patterns in the eyes, clear blob centre of vision, wonky straight lines. A lumbar puncture was attempted at the time to measure the pressure but not completed.

    Psychiatric clinician at the time noted he thought I was not suffering from psychosis but wanted to investigate possible brain infection. This was not followed up.

    Mood remained relatively stable thereafter, with some problems with confusion and thinking problems. Health seemed to recover in stable environment with support from close friends on a day to day basis.

    2012, during a period of stress/change - noticed extreme fatigue - often needing to sleep for 1 -2 days at a time with a sense of needing to completely stop, switch off. Had periods of time off work to accommodate this tiredness.

    Began to notice any major disruption to my day to day routine such as drinking much alcohol, or having a romantic night with a partner, would leave me tired for days or a week after. Generally now, have to manage myself quite carefully - needing a lot more rest than I used to and only working part time.

    Sought therapy to help find ways to deal with relationships - feeling different to my peers and addressing concerned. Also noticed problems with arousal during 2012/13. Health seemed to stay stable/improve to better than evert this year.

    Late 2013 - another period of tiredness without real cause resulting in lateness to work, confusion making decisions and time off again. Noticed I felt like I was asleep in the swimming pool at one point - felt it was dangerous and had to get out.

    Recovered but shortly after sent to A&E with swollen optical disc. Grey blob in centre of vision. Problems with colour - thought tree trunks in forest were black, could not tell coloured paper notes apart in my purse in low light. A&E found one pupil bigger than the other but sent away - told due to drusen.

    Symptoms came back, and went again, went to A&E with a severe migraine leaving right side of face feeling numb, but not numb, nausea. Referred to eye neurologist in May.

    Shortly after, another fluctuation in mood - total of sleep and sudden change in appetite, not psychiatric - recovered with sleeping tablets and rest.

    I wondered if this could paint a larger picture of a developing problem, if you could please point me in the right direction with any advice of who to seek advice from or how to approach a GP?

    Many Thanks

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    hackwriter responded:
    Dear just,

    The brain infection suggestion and lumbar puncture sound like good avenues to investigate. Why not go to your GP and discuss the psych clinician's opinion and try to get an order for a lumbar puncture? That way you could at least rule out a Central Nervous System infection.

    If you had a traditional LP that wasn't successful, ask for it to be done in radiology under fluoroscopy. After numerous painful and unsuccessful LPs, I discovered that the fluoro procedure is fool-proof and painless.

    Have you had a test for Lyme disease? That requires a blood test. People can be bitten by infected ticks and then years later develop latent symptoms.

    If you suspect you have MS, you would need to see a neurologist to get the battery of diagnostic tests. In order for your GP to refer you, s/he would perform a neurologic exam that tests your reflexes, balance, coordination, strength, and vision, as well as review your history of symptoms. If MS is suspected, you would then be referred to a neuro and you would undergo brain and spine MRIs, a lumbar puncture, and evoked potentials tests.

    Hope you get some answers soon.

    justanonlooker replied to hackwriter's response:
    Hello Kim,

    Thanks so much for the message and the response. I have now an appointment in May with my eye neurologist at the hospital I was seen many years ago. I have gathered a list of my concerns for him as outlined above, and will collate this all with my GP soon. I will definitely take on board the suggestions to have the tests carried out again (LP) - I have moved many times and have broken medical records which is not helping the situation. I think my next step is to see my GP ASAP and stress to him that the cause of my mood change was not psychiatric and to investigate from there. Thanks.

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