Confusing A Panic Attack And Medical Emergency

[Powder]

I went to the ER because I woke up from a nap after feeling very tired suddenly mid-day on a Saturday.

Upon waking, I felt a shortness of breath that I have been feeling and associated with a health problem (I'm female, otherwise sort of healthy, 39).

It progressed to major hyperventilation and almost passing out, shallow breathing. I was taken to the ER and they did EEG and other tests, looking for a blood clot in my lungs. Nothing.

I felt literally no anxiety and it felt purely physical. Can that be an anxiety attack? I had no flashback, no bad dreams, nothing. I am not aware of any anxiety, which is why I went to the ER, plus, I'd been having increasing shortness of breath.

 

[Killashandra]

In my opinion yes, it can be an anxiety attack, I had those particular symptomsbut didn't know what caused them,I thought I was handling things rather well, but I will tell you that your body will override your brain in some circumstances and I know from personal experience this is such. My body was the one who told me things weren't right. And it shut down, hyperventilating, shaking, cold sweats etc. I didn't feel anxious, but clearly I was.

This may not be the case for you but in my case it was an anxiety attack.

 

[mamachick]

It doesn't really sound like a panic attack Muse. I have had 2 scares with blood clots, that ended up being negative both times.
First time I broke a rib then had partially collapsed lung and D Dimer (blood test) showed low probability of clot but lung scan showed high probability. Then they did best test which was ultra sound and I did not have clot.

Second time I had severe ongoing stomach issues. Then got short of breath with chest pain, but thought gas had just moved up to chest. D dimer was elevated and they said they were going to admit me, then CT was negative for blood clot and they said this happens. They concluded that shortness of breath was stomach issue (I think hiatal hernia). I eat very light but if I eat too much it does cause shortness of breath most recently.

Are you still having shortness of breath? Did they have any answers for you?

 

[caligirl03]

Hi Muse,

I'm so sorry you had to experience that! As an occasional panic attack sufferer, I know firsthand how absolutely terrifying they are and also wound up in the ER during my first attack thinking something was seriously wrong.

Unlike anxiety attacks, which are directly tied to an obvious trigger such as immediately before having to take a test or speak in public, etc., panic attacks strike out of the blue, often while relaxing, or as in your case, even sleeping. Basically it just means that your nervous system is overloaded to the point of manifesting as physical symptoms while your guard is down.

Panic attacks also have a lovely way of building on themselves. Being scared about your shortness of breath compounds your anxiety, which further compounds your physical symptoms, and off they both go until you spiral out of control. Check out this article about the correlation between anxiety and shortness of breath: Dead Link Removed.

I'm glad anything physically wrong aside from your preexisting condition was ruled out, which I'm sure is in some sense a relief to you as well. Now you can perhaps focus on effective stress management and making any necessary life changes to help restore your baseline sense of calm.

 

[EmmaOwl]

I went to the ER because I woke up from a nap after feeling very tired suddenly mid-day on a Saturday.

Up...

I'm sorry you had that scary experience.

I feel anxious all the damn time, it seems.... but sometimes, even when I feel calm, I feel physical symptoms that should not belong - like, why on earth would I feel asthma trouble on the left side of my chest feel cramped up and not the right? Because waay in the back of my mind, I happen to know that's where the heart tends? Honestly, I have no idea.

Luckily I have a couple of people I can gut-check with. "I'm feeling such-and-such.... It's just anxiety, right?"
And believe me I have enough health problems - if they thought there was even a tiny possibility, they would have me at the ER as well. Getting medical attention, it sounds like you did the right thing.

BTW as you stated, being a 39-year-old female, your story here, I think the best thing they can look for is a blood clot. Or, the most important/the most immediate. They did a good job for you. I'm sorry for the fright or even plain concern that involves. Life can indeed be scary for the physical and not just mental.... and it can be very difficult to sort out the difference. Feel better.

 

[EmmaOwl]

I have had 2 scares with blood clots, that ended up bei...

you've got a good point. I wanted to make the point in a less-dramatic way, but I would like to address this because I've been through it. Seven years ago, at age 30, I ended up with multiple blood clots in my lungs. (PC me if you want to know the actually name of the diagnosis - it even *sounds* scary!)

It took 8 or 10 hours in the ER for them to diagnose me. The only cause anyone could find was long-term use of birth control pills (which are supposed to be "safe" until age 35, if you're a non-smoker). There are now a lot of class action lawsuits......... it was terrifying. I ended up almost a month in the hospital, bed-bound - I had the use of a luxurious "commode" next to the bed, one step up from a bedpan, and was covered with wires that were being constantly monitored from somewhere outside my room. And darnnit but the monitors always beeped when I went to use it, and the little intercom came on and they would ask if I was all right... "Yeah just using the commode." Fun.)

But I was SICK. It wasn't a little thing. I fainted twice and when I got to the doctor they took one look at me and immediately shuttled me to the ER.

I'm not saying it's always going to be dramatic but even with that in my history, even that I'm 37 now, I'm simply not at risk. I'm not terribly overweight. I don't move around a LOT in general, but if you are going to be on an airplane in a car for a long time, move around as much as possible and possibly invest in some compression socks. And I sure as hell don't take birth control pills anymore. These are things that can help avoid blood clots.

Add PTSD into the equation.... I mean, yes, get it checked out, DEFINITELY BE SAFE. but I have these kinds of things, breathing trouble in particular, happens fairly often, even when I don't feel anxious. It is weird and makes zero sense to me, but I see my doctor and, despite treating me through that health crisis, - and acknowledging that I could have ..well. - she has no concerns over this, these days. My psychiatrist says the same, even with this experience in my past. It varies from person to person. But yeah the ultimate cause can be anxiety or a certain kind of panic, even if you don't know it.

It's been hard for me to accept. I haven't always been able to let these pains go. I always wanted them to MRI my chest but honestly.... They told me no, the radiation is more of a risk factor. And now I can deal - I've listened to my doctors, psychiatric, general medical, plumonology, and they agree. It's some sort of panic or anxiety that I am not conscious of.
If you want to be sure you could see a pulmonologist to assess your risk factors.
Ok I think that's it. Sorry for going on and on.

PULMonology, not PLUM. Sheesh. Sorry.

 

[Powder]

I had eaten and then felt suddenly very tired. I don't usually feel that tired or need to lie down. But I did, and I fell asleep, also very not me.

I cannot nap unless I am sick, usually I have to have a fever to nap. I am very tightly wound all day until dark, then I'm a lazy girl, then I go to bed before 11 pm, my whole life. My body clock doesn't work with day time naps.

It was very sudden upon waking that this happened.

I got no information from the hospital other than their one (non-contrast, since I'm allergic) CT scan could easily miss a blood clot. They wanted to admit and do the same tests repeatedly. :( I didn't want to pay for that or stay any more hours in the hallway being coughed on, so I left.

They simply thought it could be a blood clot and had no other explanations since my heart was fine.

 

[Powder]

My sister has the same symptoms, and we all test positive for an autoimmune disease but which we don't know yet. One of them that my test leads to includes shortness of breath as pulmonary hypertension, and can lead to death. So I was pretty freaked out in case that was "coming for me." But I now don't know.

I have to wait 4 more months for a rheumatologist appointment to track down which Autoimmune disease I have. I hope to get answers then as to if this is part of it or something else.

 

[EmmaOwl]

I'm sorry, Muse. It's scary. I have so many health problems that "should" be looked at...someday...when the more immediate crises are over...but they are never over! I understand worrying about pulmonary hypertension.

But your hospital visit.... Did you sign out against medical advice? AMA?
They would not have let you go easily if they really thought you were at risk of a clot. They would've made a big fuss, I can tell you that.

However, I DO understand being afraid, and I know I (and you!, and we all!) have to be careful and tread lightly. I wish things weren't so scary. I'm glad you are getting checked out - and I'm sorry you have to wait! I guess I try to work it out backwards...if one doctor was worried, they would not have you wait so long to see a specialist.

These are things I tell myself sometimes, but it's difficult, frustrating, and frightening when you've got all kinds of health problems going on at the same time.

I worried when I napped last week... and then I slept through the night... anytime I sleep without being sedated, I worry! I had a sinus infection and my body truly needed the rest, I guess.
I am posting too much and making myself anxious! I am sorry.

 

[mamachick]

I agree that the hospital would not have discharged you if they were not pretty certain. I remember how scary it was when they misdiagnosed me.(my pain increased and breathing decreased for over a week as the ER missed the broken rib which punctured the lung) I can only imagine the anxiety it is causing you not having a reasonable diagnosis. I hope you are able to stay calm. Many others do report panic without other symptoms, so that is a good sign here. Is there any way you can get into the specialist sooner?

 

[Powder]

Thank you, there are other doctors I can get into sooner, but not ones that would likely be able to diagnosis my autoimmune condition, or its severity.

I am most curious about that since my abusive father is dying of an autoimmune disease that he never had diagnosed. He got some Dx's such as severe psoriasis, and he chalked it all up to that, rather than pursuing the "could be lupus or similar" bloodwork that I also have had as a result of prelim tests.

I also got Lupus or similar as the pattern of my positive test. Since Lupus can be fatal, and since it would be extremely hard to treat since I also have a compromised immune system, I am between a rock and a hard place (need to slow the immune system from attacking my body, but my immune system is not fully function and leaves me prone to all kinds of infection, so I cannot take the steroids and such they would give me.)

I need to deal with this before I end up having annual surgeries just trying to stay alive, like my abuser. My sister also has the same bloodwork. I also want to know what this thing is so my kids can be screened. Perhaps by the time they'd need to know, there would be better options available.

I guess watching my abusive father be so ill in life, I feel like "I'm next" and since he seems to be suffering from not dealing with it directly, but more of a reactionary to the outcomes kind of way, I feel it would be best to know what I'm dealing with and try to be more careful.

 

[Friday]

I did the reverse last spring... So damn used to anxiety attacks, my heart racing, not being able to breathe properly, and feeling shit that I was in acute pulmonary failure before I schlepped myself to the ER. My affect was so "fine" (like I said! used to this nonsense) that they almost sent me home... Before a nurse noticed my SpO2 was in the 70s & 80s. Whoopsies. Was in the ICU for 12 days. I didn't really even think I was sick, when I went. Figured I needed a few diazapam for the anxiety I clearly wasn't managing well, and some antibiotics for the pneumonia. (I get pneumonia all the time, it's no biggie). And then I'd be right as rain once the Valium reset my brain, so I could stop overreacting about this stupid little cold. Nope. Sick as hell. Spent the next several months on bed rest and hooked up to machines to breathe &/or o2 tanks. Joy. (Not exactly sarcastic, there. Bottled air is a godsend).

It's easy to blow off physical ailments when we've been dealing with neurological fun & excitement for years. I try really hard not to (get my ticker checked annually, etc.) but I still almost missed this one.

So do-do-do follow up with pulmonology, rhemutology, etc. We'd like ya to be around for awhile, hey? :)