Anxiety attack or not??

[hospitalstaph]

Hi,

I apoligize if anyone is offended that I am asking for professional opinions to a personal problem but we really need an educated opinion.

My husband has been having trouble breathing for the past two months. He just told me on Saturday night so I told him that he should see a dr. this week. Today it became much worse so he went to the ER. He says that he was having a very difficult time breathing and his hands and feet were numb to tingling. In the ER they did a chest X-ray and blood work. I believe from his decription that a blood gas test was done, but no EKG. The Dr told him that he is having an anxiety attack and prescribed Zanex. My hubby told the Dr repeatedly (as well as the nurse) that he was not under any unusual stress. My husband is 31 healthy, works out 4 times a week, is 5' 10", 170 Lbs. He does have ulcerative colitis but it is under control and he is not on meds for it. He has never been diagnosed with asthma but does have allergies.

Does this sound like anxiety to you or should we seek a second opinion? He is home now and is still having a hard time breathing although without the numbness in the extremities.

Thanks so much for any info!

Tracy

[hospitalstaph]

Hi all,

My husband saw my NP today. She ordered an entire series of tests. Please forgive me if I sound stupid, but one was the test where they blow into a tube. I really should know this since I have asthma:) Anyway that was normal. EKG was normal. And oxygen saturation was normal. She ordered blood work to test for thyroid function and strep (although she thought strep was not likely). She also referred him to a heart doctor that he will be seeing monday. She admitted that she was stumped, however, she did not "think" that he was having panic attacks, although she did take him off of the xanex and put him on another anti-anxiety med until we know for sure.

She was very impressed by the amount of information that I recieved from all of you! I cannot thank all of you enough. This has really made a very scary time much more managable:)

Tracy

[hospitalstaph]

Just wanted to answer the questions from above:

He had strep April 6th, it was me that had strep in January (sorry about the confussion)

No he does not currently take supplements (he tried creatine recently and I really let him have it:)

I will try the ice cream thing! He does say that it gets worse after he eats.

Tracy

[NurseFirst]

I will try the ice cream thing! He does say that it gets worse after he eats.

Tracy

Ahhhhh....now we are getting somewhere. Does it always get worse after he eats, or only if he eats certain things or a certain amount. What kind of workup was done in order to determine he has ulcerative colitis--and how long has he had it, what kinds of treatments? Has anyone pushed on his belly? (er, examined, palpated, his abdomen).

Come to think of it, does he remember what he was doing last Saturday when it became "very difficult" for him to breath?

I think someone said something about bloodwork, that certain things would have been picked up--but after re-reading the thread, it doesn't sound like any blood work was done until today... Tracy, has he had a CBC w/differential done?

NurseFirst

[hospitalstaph]

Ahhhhh....now we are getting somewhere. Does it always get worse after he eats, or only if he eats certain things or a certain amount. What kind of workup was done in order to determine he has ulcerative colitis--and how long has he had it, what kinds of treatments? Has anyone pushed on his belly? (er, examined, palpated, his abdomen).

Come to think of it, does he remember what he was doing last Saturday when it became "very difficult" for him to breath?

I think someone said something about bloodwork, that certain things would have been picked up--but after re-reading the thread, it doesn't sound like any blood work was done until today... Tracy, has he had a CBC w/differential done?

NurseFirst

I am not sure about what foods or amount of food makes it worse, I'll ask him tommorow when he wakes up. He was first diagnosed with ulcerative colitis in Jan 03. It started with rectal bleeding and his primary doctor referred him to a gatrointerologist (oh I am sure that is spelled incorrectly:). Anyway, the Dr said, after doing a colonoscopy that it was ulcerative colitis and put him on meds that made him extremely tired and irritable. In April 03 he asked for the meds to be changed and was put on sulfasalazine (sp?). This did not make him tired but bleeding flared up occationally. He also was on Prednisone and gained 25 lbs. (which he has since lost) In November 03 he took himself off of all meds and started taking a mutivitamin and acidopholis everyday. He also watches what he eats. He says that eating excessive amounts of sugar or highly procecced foods causes the colitis to act up. This program of treatment has been working very well.

We were at an indoor pool when this initially became much worse, but he had been having problems for the previous 7 weeks. The NP today wondered about a chlorine sensitivity, but since we use that same pool atleast once a week that seemed unlikely. I do not believe that anyone has pushed on his belly. I KNOW that no one did at today's visit since I was there. There was blood work done at the ER but I do not know what it was. What would a CBC with differential be looking for?

I think I answered all the ? let me know what you think,

Tracy

[UM Review RN, ASN, RN]

So glad you're getting somewhere and the NP is ordering tests.

The test where the patient blows into the tube is called a PFT or Pulmonary Function Test.

As far as the CBC and other tests are concerned, I highly recommend that you bookmark this site. It's very good. Scroll down past the pictures for a wealth of information about the CBC:

http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm

[askater11]

I had numbness down one side of my body. It totally freaked me out. I was at the gym doing an elliptical machine when it happened. Than I came home and noticed I was not walking straight lines at times. I had a 6-7 years of SOB--being diagnosed as asthma or anxiety.

I was under stress at the time of the numbness. I went the the neurologist and she felt it was seizure vs. somatic. (I have a history of childhood seizures) I knew it wasn't seizures.

My parents started helping out with my little ones. Once I caught up with my sleep all the neurological problems went away. I did start an anti-depressant that did wonders. I found the psychologist dosed and found the best drug the quickest. My family Dr. went through 3 drugs and still couldn't find one that worked well. (kept getting bad SE from the drugs)

Still the SOB went on. Finally one of the Dr.'s sent me to a gastro Dr. I started belching--which would relieve the SOB. Started on Prevacid--no difference. Zelnorm is my wonder drug. All and all I'm SOB free!!!! It has been a long time to get all my answers. Hope your husband finds out whats wrong faster!!!

[lisaow]

I would DEFINITELY go for a second opinion. I suffer from panic attacks, and although they feel physically awful, one has an inside sense that its "psychological" (does that make sense). I believe your husband would know, given time to mull over a diagnosis of "panic attack", if, indeed, his symptoms could be traced back to anxiety.

He needs to have a thorough work up by a good internist (or cardiologist, etc) to rull out all possible cardiac, respiratory, other issues. Sometimes, the ER isn't the place to go for a diagnosis, just to be used in acute situations for stabilization, you know?

Make an appointment with a good, thorough doctor.:uhoh21:

[rjflyn, ASN, RN]

L&D,

I was rereading this thread at something just hit me, you know one of those duh moments. In one of your posts you mentioned what he does for work- heating and cooling. If thats correct one more test they might want to add is for Legionella. It is the cause of Legionnares Pneumonia. This bug likes to live in poorly kept ie poorly drained AC systems. He may have come in contact with it there. Have seen it present a couple times in the ER, symptoms run from vauge to pneumonia's on xray. There is a urine antigen test for it, tx is with antibiotics.

Rj

[NurseFirst]

I am not sure about what foods or amount of food makes it worse, I'll ask him tommorow when he wakes up. He was first diagnosed with ulcerative colitis in Jan 03. It started with rectal bleeding and his primary doctor referred him to a gatrointerologist (oh I am sure that is spelled incorrectly:). Anyway, the Dr said, after doing a colonoscopy that it was ulcerative colitis and put him on meds that made him extremely tired and irritable. In April 03 he asked for the meds to be changed and was put on sulfasalazine (sp?). This did not make him tired but bleeding flared up occationally. He also was on Prednisone and gained 25 lbs. (which he has since lost) In November 03 he took himself off of all meds and started taking a mutivitamin and acidopholis everyday. He also watches what he eats. He says that eating excessive amounts of sugar or highly procecced foods causes the colitis to act up. This program of treatment has been working very well.

We were at an indoor pool when this initially became much worse, but he had been having problems for the previous 7 weeks. The NP today wondered about a chlorine sensitivity, but since we use that same pool atleast once a week that seemed unlikely. I do not believe that anyone has pushed on his belly. I KNOW that no one did at today's visit since I was there. There was blood work done at the ER but I do not know what it was. What would a CBC with differential be looking for?

I think I answered all the ? let me know what you think,

Tracy

First, a couple of comments:

1) Angie O'Plasty--When I blew into one of those tubes the other day, my doc called it a peak flow meter. And he has referred me for pulmonary function tests (so, I don't know what those are like, yet...). Thank you for the GREAT link on CBCs!!!

2) If it were Legionnaire's disease--wouldn't there be exacerbations after going to work? It could be an unusual presentation, but it doesn't sound like a typical Legionnaire's presentation to me.

Tracy:

CBCs are done routinely on people who appear to have an infection, and to just get a general idea of what's happening in the body. It is probably the most commonly ordered lab test, because it can be so helpful. You can tell a lot: you can tell whether something is affecting the red blood cells, which will affect oxygenation to your tissues--which, if inadequate, can cause any number of problems in the body. The second thing CBCs are used for is to see whether your body seems to be fighting an infection, by elevated WBC counts. Differentials (which are a count of the different kinds of WBCs) can tell about a number of problems, such as with eosinophilia, which is either caused by allergic rxn or parasitic infection.) I took a whole class on hematology many years ago as a Microbiology major--fascinating subject.

By the way, it's great to see that your husband is so pro-active with his health! It's great that he's been able to manage his UC without drugs! Steroids (prednisone) are nasty drugs, but can be very effective. Since he has allergies and UC, might want to explore whether it might be due to another autoimmune disorder.

Good luck,

NurseFirst

[UM Review RN, ASN, RN]

When I blew into one of those tubes the other day, my doc called it a peak flow meter. And he has referred me for pulmonary function tests (so, I don't know what those are like, yet...).

Glad you liked the link on the CBC, NurseFirst. Here's another, this time on lung function tests, because there are a few:

http://wegert.net/trish/peak_flow.htm

It appears the peak flow meter is used more for asthmatics at home.

The full PFT--the easy explanation--has the patient blowing into a tube, several different times and via several techniques, and the tube is hooked up to a computer. Results are generated that look like line graphs, and several different values of lung capacity are measured. The entire test takes about half an hour.

http://wegert.net/trish/peak_flow.htm

[hospitalstaph]

L&D,

I was rereading this thread at something just hit me, you know one of those duh moments. In one of your posts you mentioned what he does for work- heating and cooling. If thats correct one more test they might want to add is for Legionella. It is the cause of Legionnares Pneumonia. This bug likes to live in poorly kept ie poorly drained AC systems. He may have come in contact with it there. Have seen it present a couple times in the ER, symptoms run from vauge to pneumonia's on xray. There is a urine antigen test for it, tx is with antibiotics.

Rj

Have you seen or heard of Legionnares Pnemonia without the flu-like symptoms? He has no coughing or fever. I am beginning to learn quickly that nothing is "by the textbook". I mentioned Rhematic Fever to the NP yesterday and she laughed and said that she seriously doubted it since he was not having any of the other symptoms. However, when she was ordering tests for him, she ordered them to look for RF (which I believe is actually a strep test). I guess you just never know huh?

Tracy

[hospitalstaph]

First, a couple of comments:

1) Angie O'Plasty--When I blew into one of those tubes the other day, my doc called it a peak flow meter. And he has referred me for pulmonary function tests (so, I don't know what those are like, yet...). Thank you for the GREAT link on CBCs!!!

2) If it were Legionnaire's disease--wouldn't there be exacerbations after going to work? It could be an unusual presentation, but it doesn't sound like a typical Legionnaire's presentation to me.

Tracy:

CBCs are done routinely on people who appear to have an infection, and to just get a general idea of what's happening in the body. It is probably the most commonly ordered lab test, because it can be so helpful. You can tell a lot: you can tell whether something is affecting the red blood cells, which will affect oxygenation to your tissues--which, if inadequate, can cause any number of problems in the body. The second thing CBCs are used for is to see whether your body seems to be fighting an infection, by elevated WBC counts. Differentials (which are a count of the different kinds of WBCs) can tell about a number of problems, such as with eosinophilia, which is either caused by allergic rxn or parasitic infection.) I took a whole class on hematology many years ago as a Microbiology major--fascinating subject.

By the way, it's great to see that your husband is so pro-active with his health! It's great that he's been able to manage his UC without drugs! Steroids (prednisone) are nasty drugs, but can be very effective. Since he has allergies and UC, might want to explore whether it might be due to another autoimmune disorder.

Good luck,

NurseFirst

Thanks so much for all of the great info! Yes I am really happy that my hubby is on the ball about his healthcare. He was interested in going off of the Predisone because I kept getting yeast infections! Yep you read that right I was getting them! His doctor said that there was no possible connection but after having 12 yeast infections in 11 months we were not buying that. He went off the Prednisone and on acidopholis and I have not had a single one since.

Tracy