About 9 years ago in Dayton, Ohio I experienced my first Panic Attack (I did not realize what it was at the time.). I was relaxing on the couch, watching some television, and drinking some pop, when without warning my heart began to palpitate and beat out of control. I couldn't seem to catch my breath. It was really scary when the attack didn't go away. I thought to myself, "Could this be a heart attack? I am only 22 years old, how could this be happening?" I then went and woke up my wife and asked her to take me to the emergency room. I kept the car window down for fresh air as the attack persisted. The ride to the hospital seemed endless. The attack continued as we arrived at the hospital's main entrance.
In the emergency room the doctors seemed to be at a loss. They thought that maybe I was doing drugs and that this was causing my heart to race out of control. The tests that they ran for drug use all came up negative. They tested my blood to look for muscle damage from my heart which would indicate that I had had a heart attack. An x-ray of my chest was taken to see if there were any abnormalities with my heart or lungs. I was also hooked up to an EKG monitor to see if my heart was beating normally. After being monitored all night I was released and prescribed some pills to help me relax. The Doctors never told me what was wrong. The only thing that they confirmed was that I had Tachycardia, or a fast heart rate.
These attacks became a normal part of my life after that night. Most of the time the attacks struck after work when I was trying to relax. Soon though they started to happen at different times of the day. They even struck when I was on family outings. Sometimes I had trouble while driving since it was so hard to concentrate when my heart was racing. At other times my chest would hurt and pain would shoot down my left arm. Sometimes this pain was so bad that I had trouble lifting objects. I thought for sure that these attacks were the symptoms of a heart attack, yet the attacks always subsided and things would go back to normal.
After living several years with these attacks I decided to go and see my personal Doctor. I now lived in Cleveland and had a new baby son, and I really did not want my son growing up without a dad. Also, my coworkers over the years had suggested that I was experiencing Panic Attacks. I had never heard of Panic Attacks before, so I wanted to find out for sure what exactly was wrong with me and see if I could eliminate these attacks from my life. There were many questions that I wanted the answers to about these attacks. I am sure you would want to know the answers to these questions as well. The questions were as follows:
WHAT ARE THESE ATTACKS?
WHY ARE THEY HAPPENING?
WHAT IS THE SOURCE?
HOW CAN I COPE WITH THEM?
HOW CAN I ELIMINATE THEM?
By reviewing my personal struggle with Panic Attacks this web site will help answer these questions. The first place I went to look for answers was the Medical Profession. Let us see what the professionals had to say about my attacks and see if they could help answer any of the questions I had about these attacks in the next chapter.
AT THE DOCTORS OFFICE:
The symptoms of Panic Attacks (SEE CHART 1) are very similar to the symptoms of many serious physical ailments; therefore, if you have not done so already I strongly urge you to go see a doctor. Did you notice on Chart 1 all of the serious ailments that share the same symptoms of Panic Attacks? The doctor has the difficult job of diagnosing which ailment is causing your symptoms before you can be treated effectively. In order to narrow down the probable causes of your symptoms the doctor will have to do a "diagnosis of exclusion" which requires a lot of questions to be asked and a lot of tests to be performed. You will need a lot of time, patience, and money or insurance to go through this process. Your life is worth the effort though so you should make sure you do follow through and see your doctor. The following summarizes my experiences during my quest to find the answers to the questions I had about these attacks. This should give you a glimpse as to what to expect on your doctor visits during the "diagnosis of exclusion" process. Remember, even though this chapter will DISCUSS many of the tests you would probably have to go through at the doctors office,it is not intended to dissuade you from seeing your doctor and going through these tests yourself.
My first visit was to my personal doctor. The first thing that the doctor did was weigh me in. This was to see if I had lost or gained weight since my last visit. Then the doctor listened to my heart through a stethoscope. The doctor then asked me a series of questions. These questions were intended to help with the diagnosis process. The questions were similar to those that follow: * Note that my answers to the questions are at the end of the questions.
1) WHAT IS THE PROBLEM YOUR EXPERIENCING?...............,Chest Pain
rapid heart rate, difficulty swallowing.
2) WHERE WAS THE PAIN?.... Left lower arm and upper chest.
3) WHEN DID IT HAPPEN?...... Continuous for some time now.
4) WHAT WERE YOU DOING WHEN IT HAPPENED?....Relaxing.
5) WAS IT A SHARP OR DULL PAIN?........Sharp continuous pain.
6) HOW LONG DID IT LAST?..........Varies
7) HAVE YOU EVER HAD THIS HAPPEN BEFORE? IF SO DESCRIBE......Yes
8) HAS ANYONE IN YOUR FAMILY EVER HAVE HEART PROBLEMS BEFORE?..No.
9) DO YOU DO DRUGS?......No.
10) DO YOU DRINK ALCOHOL?.....Once in awhile.
11) DO YOU SMOKE?............No.
12) DO YOU HAVE ALLERGIES TO ANY MEDICATIONS?..No
..ETC............ETC...........ETC.........
After these questions were answered the doctor listened to my heart again. The doctor did not hear anything abnormal with my heart when listening to it. Next, the doctor took my blood pressure. My blood pressure was normal so the doctor decided to hook me up to an EKG Monitor or Electrocardiogram. This process involved taping tiny electrodes to my chest and upper abdomen. The electrodes measured electrical impulses from my heart beats and translated this information onto a graph. By looking at the pattern produced by the electrical impulses on the graph the doctor was able to determine whether or not my heart was beating or contracting normally. This was the last test that my doctor performed during this visit. All of the tests that were done indicated that I was in good health and none of the questions I had about my attacks were answered.
My doctor did not have enough information to make a diagnosis at this visit. Based on the answers to the questions that were asked about my symptoms my doctor decided that I should go see some specialists. The specialists the doctor wanted me to see were a Cardiologist and a Gastroenterologist. At the Cardiologist my doctor wanted me to get a Chest x-ray,complete blood work-up, stress test, and an echocardiograph with Doppler mapping. At the Gastroenterologist I was to have an Upper G.I. performed. Hoping that I would not have to go through all of those tests, I suggested to my doctor that I was probably just having Panic Attacks. The doctor really did not respond to my suggestion but did go on to prescribe some anxiety related medicines for me. These medicines were Pepcid and Lorazepam. These might be some of the medicines you are prescribed during your doctor visits, so before I go any further let me tell you a little bit about these medicines, as well as another medicine you may be prescribed during your visit.
PEPCID: ,
Is a FAMOTIDINE that is used to treat ulcers and ESOPHIGITIS ( inflammation of the Esophagus). Pepcid basically stops acid production in the stomach and allows ulcers to heal. I guess the Doctor prescribed this medicine because he thought I might have an Acid Reflux problem. In any case the Pepcid did not prevent my panic attacks from happening. Note: PEPCID was also prescribed to me in Dayton after I had my first Panic Attack.
LORAZAPAM: or ATIVAN
Is a BENZODIAZEPINE( The same family as XANAX ) and it is given to treat INSOMNIA or MILD ANXIETY. It works by suppressing brain activity and is like a tranquilizer. This drug did not help prevent my attacks either, in fact it made them worse since at the same time my heart was racing out of control the drug made me sleepy, yet I couldn't sleep because my heart was PALPITATING so much. That is one feeling I do not wish upon anybody!
VISTARIL:
Which is a HYDROXYZINE. This is a ANTIHISTAMINE drug used to treat hives or motion sickness, and in some cases mild anxiety. This drug made my mouth dry and made me drowsy but did not help prevent my panic attacks.
CHART 1
SYMPTOMS
a racing or pounding heartbeat
dizziness and lightheadedness
a feeling that you can’t catch your breath
chest pains or a smothering "heaviness" in the chest
flushes or chills
tingling in the hands, feet, legs, or arms
jumpiness, trembling, or twitching muscles
sweaty palms
or
a feeling of detachment from oneself
Some of these symptoms are also associated with more serious medical conditions such as:
HEART ATTACKS
ULCERS
MITRAL VALVE PROLAPSE
MUSCLE PULLS
TACHYCARDIA ARRHYTHMIAS
HERNIAS
ACID REFLUX
ASTHMA
PERICARDITIS
SHINGLES
ANGINA
NERVE ROOT PRESSURE
After the doctors visit I went and got my anxiety medicines from the pharmacy. I tried these medicines and found that they were not effective. So I decided that I had better set up appointments with the specialists that my doctor wanted me to see. Since I thought that the heart was more vital than the digestive system, the first specialist I thought that I should see was the Cardiologist. The Cardiologist could diagnose any heart related ailments that could have been causing my attacks. See Chart 1
My Initial visit to the cardiologist was much like the visit I had with my personal doctor. I was weighed, asked a series of questions, my heart was listened to, and my blood pressure was taken again. All of this indicated that I was in good health. At the end of the visit the cardiologist set up appointments to have all of the different tests prescribed by my doctor performed.
The first procedure I had done was the chest x-ray. This was done at the hospitals outpatient center. By looking at the x-ray the doctor could see any abnormalities in the size,shape or appearance of my heart. Also, the doctor could check for Pulmonary Edema (CALCIFICATION(CALCIUM DEPOSITS) IN THE ARTERIES). The doctor could also check for engorgement of vessels which could indicate previous heart failure.This procedure took about five to ten minutes to complete.The results came back in a couple of days and did not indicate anything abnormal with my heart.(Still no answers to my questions.)
The next procedure I had performed was a complete blood work-up.This procedure was also done at the hospital's outpatient center.The hospital labs were able to check just about everything in my blood from white blood cell count to thyroid production, and from sugar levels to phosphorus counts. They compared my results with those of normal blood counts to see if there were any abnormalities in my blood. When the results came back, the only irregularity found was a high phosphorus count. The cardiologist did not know how to interpret this and thought it to be of little significance.
The third procedure I had done was the echocardiograph. This basically was an ultrasound picture of my heart. It was very similar to the ultrasound my wife had when she was pregnant. A gel was put on my upper abdominal area and a transducer was moved over my chest area. The transducer emitted inaudible sound waves into my body. These sound waves were echoed back and translated by a computer to form a picture of my heart.This picture would reveal any structural defects my heart or surrounding blood vessels might have. The cardiologist could also measure blood flow and valve efficiency through Doppler mapping. Overall this test was the most interesting, since I was able to actually see and hear my own heart beat. The results from this procedure showed no abnormalities in my heart or surrounding vessels, except for a mild tricuspid insufficiency, which according to the doctor was of no clinical significance.
The last test I had to do for the cardiologist was the stress test. In this test I had to get on a treadmill and walk against increasingly harder resistance with an EKG monitor hooked up to me. During this process my heart rate and blood pressure were measured while under stress. The doctor did not find any irregularities with my heart during the course of this test. I did work up a sweat during this test and strongly recommend that you wear comfortable clothing if your doctor prescribes a stress test. I would also like to note that if you decide to do this test that it is done at your own risk.
Through all of these tests the cardiologist concluded that from the standpoint of my heart and cardiovascular system that I was in good health. After I suggested I was probably just having Panic Attacks the cardiologist recommended that I avoid caffeine, chocolate, and alcohol to help prevent future attacks. Since I didn't drink much and was already watching my caffeine intake this advice was not much help. After all of those tests I still did not have any answers. The good news was that my heart was okay and that I was not going to have a heart attack anytime soon, so I decided to make an appointment to see the other specialist my doctor wanted me to see, the gastroenterologist.
On my visit to the gastroenterologist I was weighed, asked the questions, and my heart was listened to again.(This process sounds familiar?) This time though, the doctor heard my heart skipping beats when he listened to it. Since my cardiologist did not mention anything about my heart skipping beats the gastroenterologist did not pay much heed to it. I was supposed to get an upper G.I. on this visit but that didn't happen. Remember from CHART 1 that Ulcers and Esophigitis have the same symptoms as panic attacks. Also, if you recall, along with my panic attacks I was having difficulty in swallowing. An upper G.I. would help the doctor see whether or not a digestive problem such as an ulcer was causing these symptoms and attacks. The upper G.I. would have given the doctor an x-ray of my digestive tract. Since the Barium used in this process reflects x-rays, a good picture of any abnormalities in the digestive tract can be seen. The gastroenterologist did not think this test was necessary because he thought another "test" would be better. This "test" , a rectal exam, was rather quick and was performed right in the office. Basically, it checked for blood in my feces which could indicate if I had an ulcer or another digestive tract problem. The test results showed no indications of any problems with my digestive tract. Since, the doctor felt confident that I did not have any digestive tract problems hedid not see a need to proceed with the upper G.I..
The doctor wasn't finished though, and wanted to try another procedure with an endoscope or gastroscope. This device is a flexible fiberoptic tool that allows the doctor to look at the esophagus close up. The doctor would place the device down the esophagus to do this.Once done, he could check for signs of inflammation caused by acid reflux from the stomach. Acid reflux could have accounted for my chest pains and difficulty in swallowing. After talking with the doctor, I opted not to do this test because even if I had esophigitis it wouldn't explain away my rapid heart rate and heart palpitations. Also, from what I understood there was not much in the way of a cure for esophigitis. To cure esophigitis I would have to change my eating habits and I did not see myself realistically doing that, thus I saw no need to proceed with the test. After I made that decision a brief check was made by the doctor for signs of a hernia. No signs of a hernia were found so I was given a clean bill of health by the gastroenterologist and my visit with him came to an end.
From anxiety drugs, to stress tests, to digestive tract examinations, I still had no answers to my questions about my attacks. Therefore, I concluded that my attacks were not a result of some serious physical ailment but must be from PANIC, as my coworkers had previously suggested. The good news was that I was not going to have a heart attack or die from stomach cancer and you probably aren't going to either. The bad news was that I had no idea what a Panic Attack actually was or what caused it. Through my personal experience with these attacks though, I have been able to come to an understanding of what I think these attacks really are and why they happen. The next chapter discusses these ideas and helps to answer some of the questions we had about these attacks.
No comments:
Post a Comment