Lightheaded - throat tightness - near fainting episodes - help!

Hello everyone,

I am desperate and seriously need help. I had a shoulder surgery (acromion fusion) 10 weeks ago
and one week after the surgery I developed heavy lightheadedness to the point of fainting, a shaky head (I can feel my head moving slightly with the heartbeat) and a very tight feeling around my neck and sternum. Often when I breathe in or move my head, you can hear my spine cracking. Even my girlfriend notices that.

MRI of the neck was fine. Brain MRI still stands out, but the neurologist doubts that it originates from the brain.
ENT didn't find anything. Eye doctor also said I am fine and there aren't any neurological signs except that I have a little bit of a shaky vision, but not to the point of nystagmus. He suspected a cervical problem that could lead to a very mild nystagmus.

The shoulder sling was too tight, pressing on my neck and causing a horrible posture. My scalenes and traps are ultra tight but massages only work for a few minutes and stretching the neck in some directions causes horribly lightheadness.

Now I have following problems. Luckily, I don't have to wear the sling anymore, but I still have horrible episodes of being so lightheaded that I nearly faint. Also, I suffer from derealization.

- VERY lightheaded when driving combined with sternum and throat pressure (bad posture in car)
- lightheaded when shaving and looking up
- lightheaded when sitting with bad posture
- lightheaded when crouching
- lightheaded when standing up too quickly (feel a rush in my chest up my throat and face)
- lightheaded when I expand my chest and push back my shoulder blades (last time I did that, I had heart arrythmas and a drop in blood pressure. Vagal nerve???)
- Tinnitus became worse
- very strong pressure in the sternum when I push my shoulders down
- permanent tightness around the throat

When I have an episode where I nearly faint I have to lay down and wait a few minutes. It's not spinning vertigo, it's more a feeling that the brain doesn't have any blood in it. A collapse like feeling where you think the light goes out in a second.

I have a cardiologist appointment soon but my heart was fine 11 weeks ago when I tested it pre-surgery so I doubt it's the heart. I also have a sore throat every morning I wake up and chronic reflux but I have that for ages and I don't think it's causing the lightheadness because head and thorac movements seems to trigger the faint episodes or make them worse.

I suspect the following:
- subclavian steal syndrome
- neurocardiogenic syncope
- vertebralis insufficiency

I think the cause was definately the bad posture after surgery but I am not sure how to fix it.
No doctor knows about that.

Any advise? I feel like dying.

Hello, thanks for the welcoming post.

I also thought at first that it might be anxiety. But the weird thing is that the feeling of fainting can even happen when I am sitting infront of the TV and being completly distracted from my problems. It's a sudden spell that literally makes me lay on the floor. Also, I suffer from orthostatic hypotension, getting really dizzy after standing up. Doesn't happen everytime, but pretty often. That's why I also considered Adrenal Fatigue.

I am off opioids for 6 weeks now. I was on Targin for 1,5 years due to the shoulder pain. I have heared that opioids can wreck the adrenal glands and could lead to a hormone imbalance. My testosterone levels were checked and are fine. I do not think that I am still feeling withdrawal but maybe being off after more than 1 year on opioids worsens the symptoms due to the lack of euphoria I used to have being on them.

I didn't have a CBC yet but I will get one. The problem is that even doc visits are very difficult for me because the fainting spells do also occur in public. I can't go out with my girlfriend anymore because I am constantly lightheaded and a lot of people around me make the situation worse.

I also tend to yawn and sigh a lot and suspected that I may hyperventilate chronically. This could not explain the fainting spells that are triggered by head or thorac movements though.

When I am crouching down I often feel a big chest rush that travels up my throat. This also happens when I sit down sometimes. I also feel very lightheaded when this happens. Could this be the reflux? I have a mild hiatal hernia. I also notice that I have post nasal drip running down my throat which causes the sore throat in the morning.

My shoulder is fully healed and I can move it in almost all directions again. I would need a second surgery though because the K-wire is a bit lose and needs to be removed because irritates the skin of the shoulder but I can't get it done yet because I feel so lightheaded. I do not want to undergo an anesthesia at the moment. Tomorrow I have a cardiologist appointment just to make sure everything is fine with the heart.

Thanks for your kind words, I will keep you updated.

I have tried to relax, doing gentle stretches, breathing exercises... But nothing really helps.

Hi Abyssos,

I am so sorry to hear about your difficulties post op.

Just to be clear...all of your symptoms started after your surgery?

Have you never previously dealt with anxiety issues before?

If not, then I think you are wise to continue to find a physical reason for the way you are feeling.

Anxiety can certainly present as you describe...and be the result of health issues/sugery...

...however, if your symptoms starting directly after your procedure...I would suspect that there may be more going on here.

If after ruling all else out, you do find that anxiety is the root of how you are feeling....

...come on back and we will be here to encourage and support you in any way we can.

Best wishes on getting the answers you need soon!

Scaredy Cat

I am totally depressed now.

My relaxed ECG was fine, but the stress test ECG showed a negative T-wave. I need to go to the hospital for a heart CT next week for 2 days and I am horribly scared now.

My doctor said it's unlikely that the T-wave becomes negative when exercising and suspects something with the heart arteries. The heart ultrasound didn't show anything.

I have a mild left ventricular hypertrophy (43mm, normal would be 35mm) but I've had that for ages since I was doing martial arts and weightlifting before the surgery. He also said it's nothing to worry about. But the negative T wave seems to worry him. I am terrified!

I am so worried now that I might have coronary heart disease.

Oh boy....

Thanks for your uplifting words. I am distracting myself very well. It really helps to have a forum like this.

I do have a question: As I mentioned, I have a slightly shaky vision. For example, if I try to fixate a point with my eyes, I can't hold them 100% still - there is always slight movement. I don't know if it's the eyes themselves that cause this slightly shaky vision or if it's the micro tremor of my head/neck. I always have the feeling that my head slightly vibrates. Maybe from the tight neck muscles? Anyone of you have the same symptoms?
I am afraid this could be a brain tumor because I also have tinnitus. But then again I have TMJ and tense neck muscles that can also cause tinnitus...

I am looking forward for your answers!

Hello everyone,

the brain MRI came back fine, just like the neck MRI. Heart ECG was as I said not good, but I guess it's due to my hyperventilation. I felt so dizzy when I did the stress ECG because I was sighing way too often and I have read that hyperventilation can cause ST segment and T-wave changes.

Heart MRI is next week. Hopefully everything comes back fine.

Now what I notice is that I have horrible heartburn at the moment, combined with burning and pressure behind the sternum and like I mentioned before, throat tightness. Also post-nasal drip. The ENT didn't find anything, so I will see a doctor to check my esophagus and stomach next week aswell.

Today I had a panic attack again. I didn't drink much throughout the day which may worsened it. It started in the kitchen at my mothers house. She was talking nonstop with my girlfriend which totally stressed me because they couldn't keep quiet for a second. I've noticed that I I hear their voices kinda "muffled"... Also, everything around me suddenly started to look so unreal. I guess I had a heavy episode of derealization again. Anyways, due to this weird vision and hearing I became so lightheaded I thought I am going to pass out. It was accompanied with a lot of chest tightness and I felt so weak and nauseas. I took an alprazolam to calm me down which worked after 1 hour. But I am still totally derealized and fatigued now. I can't explain this feeling. Just before an episode of lightheadness hits me, my vision becomes so weird. Everything looks disconnected and the voices of others are so disorientating that you have to leave the room to reduce the dizzyness/faint feeling. I have no idea what that is. I feel so lost when this happens and am scared that I have some horrible disease or to lose my mind.

Could this be migraine? Or is it typical for anxiety that you can't deal with a lot of people around you talking sometimes? I wasn't thinking of anything bad today when this happened. It hit me out of nowhere when we were having dinner. I had to lay down almost 1 hour to function again. I also noticed that certain lights trigger this episodes.

Sorry for my bad English, I am German. But I think you get what I mean.

Hello Scaredy Cat,

I have improved my breathing a lot, thanks!

I was prescriped Sertraline and Xanax. The xanax was helping me because I cared less about being dizzy so I didn't get panic attacks that often anymore. However, the sertraline worsened my state of derealization and I also had increased visual snow. I am now tappering off the xanax again since I do have to take oxycodone again due to pain.

I have noticed that my problems don't have one origin. The throat and sternum tightness comes from a bad neck posture due to the shoulder surgery. When I drift my chin towards my chest I can provoke the throat tightness and when I push down my shoulders slightly, my sternum hurts very bad (possible a costochondritis...). I also have horrible loud cracking sounds in my neck area when i turn my neck in bed or breath in too deply.

What I have noticed is that my derealization, panic attacks (especially in malls and crowded places with a lot of movement) is purely a vision problem. I think I suffer from motion sickness. I found a video that resembles TV static (https://www.youtube.com/watch?v=800f9UNiF4Y) When I watch the 5 minutes video and look at the movements of my own hands or walk around and observe my apartment, everything is 100% clear to me and the derealization and anxiety is gone. My movements are smooth like they are used to be. Also, my lost depth perception is gone and I can see everything in 3D again. I almost cried because I was so happy to see the world real for a few minutes. Even my visual snow was completly gone for a very short time. After a few minutes the vision returns back to the DR/DP state though and everything looks so unreal again which causes anxiety due to motion dizzyness.

Why does the video relief all my symptoms? I am now 100% sure that my whole anxiety, dizzyness, panic attacks and inability to go to grocery stores is a problem of visual perception.

How can I fix that problem permanently? Neurologist and eye doctor said everything is fine. Is there some sort of rehab training I can do from home to retrain my eyes to view the world normal again?
I want to get rid of this unreal motion.

Regards!

Hello!

Thanks for your post.

I have seen an opthamologist, yes. Everything is fine. I have found the video when I searched in a German forum about the treatment of visual snow and someone posted that video and said it helps temporarily.
I didn't suspect though that it completly frees me of derealization for a short time after watching it.

I am looking forward for your answer! ;)

Regards
Marcus

Hello Scaredy Cat,

thanks for looking for information. That's so kind of you!

I have chronic tension in my upper back and neck and a very bad head posture (forward head posture).
Also, due to bruxism at night, I have horrible jaw tension and clicking when moving my head or mouth.

I have tried exercises, stretches, deep neck massages, but nothing helps because I always wake up with very stiff muscles again. I used to do powerlifting before the surgery and since I have lost some muscle mass post surgery, my posture became very bad.

I was also diagnosed with CMD, so I probably need to get that treated to bring my body back to balance.

I would appreciate the link and try out the PMR.

Thanks again. You are a very big help.

Regards
Marcus