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Cause of fatigue and pressure sensation in head.

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Background: I'm a nationally certified emergency medica technician and have transported 100's if not 1000's of patients to the hospital over the few years I''ve been working on an ambulance. I have no hx of any medical conditions or disease.

I have been feeling fatigued / tired for the last 7 days. It began with a pressure/hypoxic sensation intracranially in the pariatel region of my head when I woke up. This then was accompanied by general nausea feeing. The first day this came on I vomited twice later that night. The pressure was relieved after vomiting, but came back within 20-30 Minutes. The first day I checked my own vitals, and they were:

HR: 68/Min BP 130/64 (*Slightly higher than normal) Pupils - Equal, round and reactive to light
Skin- Pink, Warm, and slightly sweaty.

The fatigue and intracranial pressure continued on the next day, and I in the evening I began to feel nausea again and vomited once again, with the head pressure temporarily being relieved for another 20-30 minutes.

On the third day, I decided to visit my local prompt care clinic in order to get a professionals' opinion on what was going on. The ARNP who saw me instantly told me it was anxiety, but decided to run a few separate tests. (I have NO history of anxiety or psychological disorder/issues)

The test results are attached, but were UNR. Nothing abnormal was found.

The ARNP told me to just relax and go home, and although I found it hard to believe it is anxiety, I decided to take her advice and just go home and try to relax.

It is currently on day 7 and I have not had much of an improvement other than the vomiting stopped, up until 20 minutes ago when I vomited again.

I still have the pressure in my head with normal vx, and nausea that comes and goes. I feel relaxed and am in no way hyperventilating, anxious, or panicked. I am just curious to hear an opinion of another medical professional on any other possibilities that this could be?

Thank you very much for your time. Any advice would be greatly appreciated.


Update as of 2248 PST

The vomiting has continued to dry heaving.


Category: Family Physician-GP

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello. Thank you for posting your query at DoctorSpring.com
I understand your concern.
I went through your reports and the good thing is that it shows no electrolyte imbalance no anemia. Since you hace persistent fatigue with vomitting feeling, it can point towards vertigo, where the patient manifests with slight dizziness, constant fatigue, head spinning ( not all the time ), and vomitting. It is possible that you're too stressed from work too, and that can also be causing your symptoms. Do you have any history of migraine?
Do you have any history of any ear infection recently? Because at times inflammation of the inner ear can also lead to such symptoms. Just to be sure, you can go for a routine Ear examination just to rule out any such inflammation. Also since your systole is slightly on the higher side, i will advise you to get your BP monitored to check its level. As you know, three values have to be taken to be certain of your BP values.
I advise you take some time off and rest for a few days. Your job is stressful and it can have an impact on your health. However, it is better you get your Ear examined just to rule out any inflammation. Also get a CBC done, which will give us a better picture of any sub clinical infection. If it doesn't settle in another 3-4 days time, it is advisable to get a CT SCAN done to rule out any intra cranial hypertension, which seems unlikely in absence of other symptoms like visual disturbances.
You can take the following medicine to control your nausea and vomiting :
Tab. Ondansetron, can be taken 30 minutes before food. ( up to twice a day ).
Hope this is helpful,

Dr. Deepu Sebin Sebastian
Category: Select Speciality
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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