Thank you for your query at DoctorSpring.com
I understand your concern.
So from your history, you took a vaccine ( Fluzone ) 2 months back, following which you developed symptoms like inability to open eyes, tinnitus, and vibrations and tremors in your limbs. And this developed suddenly after getting the vaccine.
You have already taken Methylprednisolone and Ativan. Methylprednisolone was suggested to rule out viral based inflammatory pathology, and since it has not helped, it does not seem to be due to infection.
I will ask you a few questions to help me better with your case :
1) Apart from the symptoms you mentioned, do you have any difficulty in walking?
2) Any difficulty in perception of sensation?
3) Normal bowel and bladder habits?
4) Any problem with vision?
5) Has an ENT evaluation been done? If so is your middle ear normal?
6) Has any neurologist physically examined you?
If possible can you upload the MRI reports? And alsp when was the blood culture done?
Kindly reply and I will get back to you.
Patient replied :
To answer your questions,
(1) No problems at all walking. I just returned from a 5-day hiking/camping trip where we doing strenuous boulder hopping up and down mountains and I noticed no difference at all from before the Fluzone in either muscle strength or balance.
(2) I notice no difficulty in perception of sensation. The vibrations and tinnitus are completely new but all other sensations seem normal, as they were before the Fluzone.
(3) Bowel and bladder habits completely normal.
(4) No vision problems. Only my left eye feels slightly difficult to open. The right eye is not at all affected.
(5) Have not been to ENT. Hearing is fine except for loud tinnitus. I have never had a middle ear problem and had no problems of any kind in my ears before the Fluzone.
(6) I have been examined by two neurologists. One ruled out Guillain Barre syndrome and the other is currently treating me for tinnitus. He prescribed clonazepam 0.5 mg twice a day but until yesterday I was taking only one pill at night because of the camping trip. I just took a morning pill yesterday, which has made my condition deteriorate so much I am going back to one pill at night so I can at least sleep! He was also the one who prescribed the valacyclovir and the methylprednisolone that didn’t have any effect.
(7) Blood cultures were done a week after the Fluzone. I had no symptoms of any kind before the Fluzone.
(8) I will attach what I was given from the MRI’s but I should mention that I am a 65 year old female and ALL the females in my family have developed dementia which starts to be noticeable at about age 80 but obviously starts developing a lot sooner. The slight pathologies noted in the brain MRI, in my opinion, have nothing to do with the Fluzone but to my advanced age. That was also the conclusion of the radiologist. I have noticed some short term memory loss over the past several years.
Thank you for your detailed replies.
Firstly, the Fluzone high dose vaccine is the vaccine given to people older than 65 because it contains 4 times as much flu antigen. Therefore there is stronger stimulation of your immune system. A high dose vaccine is given because in response to a regular flu shot, older people produce 50 to 75 % fewer antibodies (whose role is to protect against the vaccine antigens) in comparison to younger adults. Therefore, I would like to assure you that you were given the correct vaccine meant for your age.
The only currently known side effects to the fluzone vaccine are as follows: nausea, vomiting, dizziness, runny or stuffy nose, cough, diarrhea, headache and some behavioral side effects. However, these are uncommon.
Additionally, you were prescribed valcyclovir (antiviral) and methyl prednisone (steroid) both of which should have suppressed your symtoms should they have occured in response to the vaccine.
In my opinion, the likelihood that it was the vaccine which was responsible for your symptoms of tremors, tinnitus and vibratory sensations is unlikely but perhaps you came to be more aware of them in relation to the timing of being vaccinated.
I do not understand for which indication clonazepam is being prescribed, it is generally used to treat seizures and panic disorders. It does not treat tinnitus. Therefore my first recommendation to you would be to get an evaluation by an ENT whereby appropriate diagnosis and management can follow.
Hope this helps, feel free to discuss further
Patient replied :
I am so sick and tired of doctors telling me that I'm lying. I am NOT lying. I was healthy, happy and extremely active before the Fluzone shot. Fluzone 4X is for immune suppressed people and this year is the first year it has ever been used. I was very healthy and had no diseases or symptoms of any kind. I have an annual checkup and have always been found 100% healthy. The negative results of all my tests so far should attest to that fact. The fact that I went to bed healthy and happy with no symptoms AT ALL and woke up the next morning with horrible tinnitus and vibrations and tremors that I have NEVER, EVER had before in my 65 years makes it obvious to me as a scientist (Ph.D, physics) that the Fluzone somehow caused these symptoms. I think it is very arrogant of you to tell me I had all these symptoms before but never noticed them until after the flu shot. I NEVER, EVER HAD ANY OF THESE SYMPTOMS BEFORE. I would lie in bed at night listening to the night sounds and enjoying the lovely peacefulness. Now all I hear at night is screaming in my ears, so don't you dare tell me "Oh, you just didn't notice you had loud screaming in your ears before." I used to read, but I can’t read anymore because of the loud screaming in my ears and dizziness in my head. So, you say, I just didn’t notice the loud screaming and dizziness before?? I would lie peacefully in bed with my body wonderfully relaxed but now all I feel is tremors, shaking and waves of vibrations, so don't you dare tell me "Oh, you had tremors, shaking and waves of vibrations in your body before but you just didn't notice them." I was happy and excited about my future but now I don’t care about anything anymore and would just as soon be dead. Oh, you say, you were always suicidal but just didn’t realize it until after you got the Fluzone shot. OK, so why would the Fluzone shot make me realize I was suicidal all along when I was so happy and full of life and hope the night before? Please explain that. You insult both my intelligence and my logic as a scientist by denying that Fluzone had anything to do with my symptoms. My PCP sent me to my present neurologist because he is supposedly an expert in treating tinnitus and he says the clonazepam will help. So far it hasn't helped; it has just made me feel sicker. I will go to ENT but when I tell them I have tremors and waves of vibrations in my arms, legs, spine, back and chest, what on earth are they going to do about that?? These symptoms are obviously related to the tinnitus. BTW, a piece of advice: you would be very misguided to believe everything that comes out of the CDC.
I apologize if your sentiments were offended. It was not my intention to offend your feelings or intelligence
The best way, I can offer to help you is to follow up with you once you have seen an ENT to evaluate the tinnitus which keeps you awake at night. Let’s approach each symptom individually and treat them symptomatically to provide you relief.
Ultimately, we both have a shared goal of wanting for you to return to your happy healthy self.
Patient replied :
I too apologize for being a bit upset since I know you are giving your honest and expert opinion and I very much appreciate that. My point is that doctors keep telling me “You were sick before but didn’t know it.” However, if I were sick before, why do all my tests come out negative and why wasn’t any pathology detected during my MANY annual physicals? And why was I healthy, happy and symptomless before the Fluzone 4X shot? If I am sick, then someone please tell me, what sickness do I have? How can you treat a patient if you don’t know what sickness they have? The neurologist who specializes in tinnitus – in fact, that’s all he does – has given me three different treatments for “symptoms”, none of which have worked. They have not worked presumably because he has not diagnosed the problem and is not treating me for the right sickness. The Fluzone did something bad to my system, but I don’t pretend to know what. That’s what I am trying to find out but no one seems to care. If we knew what the Fluzone did, then maybe the doctors could give me the appropriate treatment but they don’t care to find out and so I will never get the right treatment because they keep giving me useless treatments for illnesses I do not have. It seemed as if you were feeding me the official CDC line, which we all know is sometimes a lot of BS. Do not trust everything they tell you.
It is evident that you have been through a hard time trying to get a diagnosis which fits your constellation of symptoms.
I also agree the only information about the side effects of the Fluzone vaccine I know of are the ones which have been reported to the CDC. Because no-one has reported your set of symptoms, it is probably why no-one can provide you with a satisfactory explaination of why these symptoms appeared or why they haven't responded to medications or why all your imaging tests have come back normal.
Therefore I would like to request your participation in attempting to reduce each of your symtoms individually. Beginning with your most troublesome symptom, tinnitus. You mentioned that you have been prescribed 3 different treatments for your symptoms: can you provide me with the names and dosages and duration of each one. Once I have that information, I can have our ENT physician consult on the next step rather than repeat previously used medication which was ineffective on you.
Hope this helps, I will attempt my very best to help you