Morbid obesity

Resolved question:
Hi, My name is Aasim Pathan,i am from India & 26 years old, I am Morbidly Obese, I way over 160Kgs (i don't know my exact

weight). I have been having a few issues with me for a while now, mostly related to my heart like I am unable to sleep

properly, If i try to fall asleep i am usually woken up unable to breath like my heart has stopped beating. So i watch

videos on my phone usually funny videos that helps me fall asleep. I also can hear like my heart beat in my right ear when

there is silence, when i look straight or left but it goes away if I press my fingers below my right ear.

I had got myself a health checkup for the following things, this was done 5 months ago
CBC, ESR, BlooD Sugar F/PP, Liver SGOT / SGPT / GGT Bilirubin / Alk. PO4, Total Proteins (A/G/A.g)
heart - T. Chol / HDL LDL / VLDL /TB Kidney - BUN / S. Cr Uric Acid S. Calcium.
Stool & Urine Routine Digital Chest X-Ray, USG Abdomen & Pelvis, Resting &Stress ECG
I have the reports

The doctors said i had Grade 2 Fatty liver, apart from that everything was normal. I did not discuss my issues i was

having with the doctor because i wanted to know what he found since he said it was normal i didn't tell him my issue. But

I have started to develop new symptoms for the past few days. I have numbness on top of my head from my forehead to the

top of the head sometimes i feel it on my face too. I now have a slight pain at the center of my chest and back as well.
I am scared to go to sleep fearing that i will not wake up next day.

But during morning i don't have any issues and feel Normal but as the evening comes I start feeling tired and then the

numbness starts and so does the slight chest pain. I don't have any excersie in my daily routine, I walk inside my house

only for like 20 mins, sometimes i go out on a drive for chores. I work from home only.

Is there any pressing issue here that should concern me?

Submitted: 4 Days
Category: Cardiologist

Expert:  Dr. Vivek Mahajan replied 4 Days.

Hello
Thank you for your query at DoctorSpring.com.

There are many pressing issues here.
First is your morbid obesity.
Second is your lack of movement and exercise.
You should exercise at least 30 min a day and also lead an active life. Calorie control is essential.

If calorie control is a problem you could go for a bariatric surgery.
Regarding your sleeping problem. It could possibly be obstructive sleep apnea associated with snoring and obesity. After how many hours does this breathlessness at night occur. Do you have to move around to feel better after being breathless at night?

As far as the chest pain is concerned I would like to know whether your stress test report was normal. Also have you got a 2D echo done? Please replyso that we may decide if your pain is of cardiac origin.

The ear problem can be best tackled by a ear nose and throat doctor. Also the numbness in head needs neurologist opinion.

Hope this helps, please feel free to discuss further.

Regards
Dr Vivek Mahajan
DM Cardiology

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Patient replied :

Hi,

I have uploaded my test that was done, No i don't think 2D echo was done.

I work as a Tech support technician from Home my clients have offices in Australia, UK, US & Canada, So I have to be up at 8 AM for Australia & Sleep at 12 midnight for US & Canada. It does not matter whether i get work or not during that time frame, but if i do I cannot make excuses that I am out. I have to solve those issues that come up asap. Hence I only walk for a few minutes at a time in my house.

Going back to the issue, it starts in the evening only around 6 - 7 pm and it stays till i fall asleep, when i wake up i don't feel those issues anymore. before you can say that it can be stress related to my work, I am not stressed at all. I watch movies & TV shows, surf the internet all day.
also atleast I don't think i eat a lot, its just that i don't exercise and since my work is at home I don't get a lot of movement.

I never felt so uncomfortable that i had to get out off bed and walk around. Like i said if i distract myself by watching videos I stop feeling those problem and i fall asleep.

Last night while i was still sitting at my table and feeling chest pains and numbness on my head, I started deep breathing within a few minutes both of those problems disappeared.

I also have this issue where if i am on a higher altitude or the weather is low like 10 - 15 C I have shortness of breath as well.

Can Gas also be a cause of Chest pains? because I have a digestion issue for the past few weeks. I have been taking Dulcolax every alternate day to regularize my stool routine. Last night when i went to sleep after doing deep breathing exercises I had a lot of Burps while i laid flat on my back.

I don't know if i snore but my parents do tell me that i snore sometimes.

Thank you


Expert:  Dr. Vivek Mahajan replied 3 Days.

Hello,
Thank you for the detailed information.

You have deranged cholesterol levels.

Given your risk profile I would advise you to be started on aspirin and rosuvastatin.

Your stress test is negative.
So the likelihood of you having coronary artery disease is low.
Also you could exercise to a moderate level of stress.
That is encouraging.
But still a 2D echo is warranted to rule out any structural abnormality.
Anxiety couLd still be a cause of these symptoms.

I would still recommend you to see a ear specialist for the sounds and neurologist for the numbness.
If your 2D echo is normal then we have effectively ruled out noth structural and coronary heart disease.

As for lifestyle is concerned work should only be a part of the broader concept of life. You have to somehow find time for yourself and your body. Otherwise what are we working for.

Hope this helps, I would be glad to answer any follow-up queries.

Regards
Dr Vivek Mahajan
DM Cardiology

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Patient replied :

Thank you for your time, I believe it was nothing but because of gas/acidity.

I went to a Cardiologist at a local hospital he gave me a 5 day course of a pain killer & a 15 day course of a tablet for acidity, within 5 days all my aches were gone and even after staying off the pain killer i don't get those heart aches any more at night. I am about to finish my 15 day course of the acidity pills too and my bowl movements are back to normal.



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