instruction: hello doctor I had a problem with lower left abdominal pain for years which is diagnosed in 2017 as an umbilical hernia I subsequently did the surgery in january 2018 and I was diagnosed with moderate fatty liver during the test prior to the surgery but I was given liv 52 to take for three months and lipitor 20 my but when I reported to work I started noticing mild pain in my heels and imbalance which I thought was due to the drugs side effects somewhere in march I panicked out of sleep and started sweating with my heart beating very fast I rushed to the hospital and they did a brain it and kidney function test which was normal and the gave me some anxiety tablets lexotamil 5 my afterward I noticed that my heel pain was aggravating with flashes of dizziness and minor headaches which I could manage I reported to the hospital and was referred to an orthopedic specialist there I was asked to do and mri of the brain neck and spine with magnesium phosphate calcium and sodium test which were all normal the doctor then gave me reserve and stugeron for the dizziness but still the issue persisted so I reported back to focus and was asked to see and ent specialist and eye specialist I went to an eye center but they all proved negative so I was referred to see a neurologist who asked for an mri of the thoracic and lumbar spines and also test for folate and vitamin b12 but again they were all negative and he said my situation might be idiomatic so he did not give anything but in all these I realized my energy levels were coming down I easily get tired and occasionally my heart rate will go up with a feeling of uneasiness and confusion all coupled with balancing disorders associated with cluster headaches I went back to my hospital and was advised to see a cardiologist he also did his relevant test which all proved negative and he declared me safe but he advised if I am still not normal I should see his boys at the executive heart center which I did they have been working on me since and nothing has come up although the symptoms still persist so just last week I was not feeling very well and had to go for a check up when I was told of the micro pulmonary embolism and was admitted I currently have serious heel pain without swelling in the legs dizziness without spinning chest discomfort unsteady gait muscle weakness and extreme fatigue diminished vision issues with acid reflux and indigestion occasional heart palpitations insomnia and pressure and discomfort in the chest after standing for about minutes or while walking with extreme dizziness I currently take xarelto 15 my motilium once daily stugeron 25 my maalox plus suspension 150 my pariet 20 my carvedilol 25 my and lexotanil 5 my once daily at night
output: hello welcome to icliniq com I can imagine how difficult time you have doing all these visit to doctors well I have gone through your history I could not see you have any specific gastrointestinal issues at this moment your main concerns are related to the neurological department not a gastroenterology department I urge you to seek help from a neurology team well some of your concerns like fatty liver and indigestion are related to my field hence I would like to give you some suggestion regarding that so I see you already on some medicine for indigestion such as maalox syearup and pariet which is an acid suppressant medication they are relatively safe and can be taken regularly or intermittently based on symptoms the second concern from gi perspective are fatty liver you did not mention your weight so I could not estimate the body mass index which is a direct tool to assess the level of fat one has over the liver and other body tissues atorvastatin lipitor can reduce some fat from liver but they are not the preferred treatment for fatty liver disease they can control lipids however if elevated atorvastatin can cause myopathy means muscle damage and can cause severe cramps over legs and throughout the body I want you to check your creatine phosphokinase cpu levels to confirm this if you have recently stopped your atorvastatin the preferred therapy for fatty liver disease if you are not diabetes is vitamin 400 my twice daily for at least three months the other recommendation is to reduce your weight by to 10 of current body weight in the coming six months walk 150 minutes week and dieting which is all required I am sorry I could not answer the rest of your concern but I want that should contact a neurologist available online on icliniq to be given proper suggestions regarding your health I hope this helps fatty liver disease indigestion creatine phosphokinase drug induced indigestion capsule vitamin 400 my twice daily for three months you can follow up with me for your gi related issues and discuss long term management of your fatty liver disease