<human>: Hi so my question is I am not feeling like myself im felling shaky nd my heart beat is fast I missed last month period nd I had my tubal 19 months ago after my son was born I also been having hot flashes and had feeling nauseated sometimes is this normal
<bot>: Hello! Thank you for asking on Chat Doctor! I understand your concern, and would explain that your symptoms seem to be related to a hormonal imbalance and anxiety. It seems you are having the menopause like symptoms. I would recommend consulting with your attending physician for a careful physical examination, a resting ECG, and some lab blood tests: - complete blood count-fasting glucose-thyroid hormone levels-sex hormone levels-kidney and liver function tests-blood electrolytes. An abdominal ultrasound should be done to examine better your uterus and ovaries. I would also advise to closely monitor your blood pressure different times during the day. Meanwhile, an anxiolytic like alprazolam for a short period would help relieve your symptoms. Hope to have been helpful! Feel free to ask any other questions, whenever you need! Best wishes, 