Anxiety attack or not??

Nurses General Nursing

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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

What pinged me on your initial post is the he is not under any unusual stress? Hmmmm. I am thinking, with you in nursing school and having young children, he may be under some major stressors that the two of you are not aware of. It's not easy when one of the breadwinners in a family goes to school (although the pay-off in the long run is totally worth it).

My best advice...follow through w/ your regular doctor to rule out any other potential causes. If it turns out that he is having panic attacks, there are ways that he/you can cope. Anxiolytics are the way to go I think. Might also just be a matter of recognizing how much things have changed since you started in school and addressing those issues head on. I know that men don't like to admit any weakness, especially to family members. However, to keep your family in a healthy state (physically and emotionally) these issues must be addressed. The kids are of concern here also. They may be reacting to everything going on also. They may be worried that daddy is "going to die" as kids sometimes take things to the extreme. Regardless of what is going on w/ your hubby.....maybe a mini family vacation would be in order. Take the weekend off. Go somewhere fun for everyone or even have a "vacation at home" for a weekend. Take the some time and "see the sights" in your home town. :)

Good luck to you and your family. I hope all goes well.

Specializes in ER.
Anxiety=hyperventilation=hypocapnia=tingling in toes and fingers

Well now come on, give me some credit:) I understand that hyperventilation will cause his symtoms but for 4 days? If you were to hyperventilate that long wouldn't you pass out?

Tracy

Specializes in ER.
Still, is it possible for an anxiety attack to last for days??? Why didn't the Xanax help?

Does your husband smoke? Does he drink caffeinated beverages?

No he does not smoke, he stopped 11 years ago. He does drink caffeinated beverages but not in excess.

Tracy

Specializes in ER.
What pinged me on your initial post is the he is not under any unusual stress? Hmmmm. I am thinking, with you in nursing school and having young children, he may be under some major stressors that the two of you are not aware of. It's not easy when one of the breadwinners in a family goes to school (although the pay-off in the long run is totally worth it).

My best advice...follow through w/ your regular doctor to rule out any other potential causes. If it turns out that he is having panic attacks, there are ways that he/you can cope. Anxiolytics are the way to go I think. Might also just be a matter of recognizing how much things have changed since you started in school and addressing those issues head on. I know that men don't like to admit any weakness, especially to family members. However, to keep your family in a healthy state (physically and emotionally) these issues must be addressed. The kids are of concern here also. They may be reacting to everything going on also. They may be worried that daddy is "going to die" as kids sometimes take things to the extreme. Regardless of what is going on w/ your hubby.....maybe a mini family vacation would be in order. Take the weekend off. Go somewhere fun for everyone or even have a "vacation at home" for a weekend. Take the some time and "see the sights" in your home town. :)

Good luck to you and your family. I hope all goes well.

Yes I would say that in some ways our family is more stressed but also in many ways less so. I am only in class on Monday and Wednesday morning, so that does not affect his schedule. I did not leave a job to return to school and my family is almost completely footing the bill for my education. I have asked him repeatedly if he is feeling stressed and he says that the only thing stressing him out is me asking that over and over again:)

The kids are not aware that he is ill. They do know that he has a NP appointment tommorow but they don't seem concerned at all. (They are actually excited because they get to stay with grandma for a few hours)

I must admit I am stumped:)

Tracy

Specializes in ER.

I just thought of something! He had strep throat at the beginning of January. Does this give anyone any ideas?

Tracy

Hi,

Yes he is currently on xanex and is getting no relief. This is now day three of this so called panic attack. He does regularly work out and his trouble breathing does not get worse. He does work in the heating and cooling field, so I am wondering if he may have been exposed to some strange mold. He is seeing a NP on Friday.

Thanks so much:)

Tracy

I just re-read this. Isn't HVAC a tough occupation for someone with allergies?

NurseFirst

Specializes in ER.
I just re-read this. Isn't HVAC a tough occupation for someone with allergies?

NurseFirst

Yes, but his allergies are very mild in nature. For example, our cat only bothers him if he touches his eyes after petting her. Other than that no allergies (that we are aware of).

Does Rheumatic Fever with the absence of joint pain sound possible? He did have strep a month ago.

Tracy

Yes, but his allergies are very mild in nature. For example, our cat only bothers him if he touches his eyes after petting her. Other than that no allergies (that we are aware of).

Does Rheumatic Fever with the absence of joint pain sound possible? He did have strep a month ago.

Tracy

Did he have strep a month ago as you state here, or in January, as you stated in a prior post?

I would think if he'd had problems with RF (i.e., valve problems) there would have been some irregularities that the physician should have heard on auscultation. I don't know about RF without joint pt--but I do know we were taught that RF isn't seen very often in the U.S. any more--do to a variety of reasons.

NurseFirst

Insist on a full cardiac AND pulmonary workup complete with bloodwork. Also think about an upper GI workup as well. Hope you find the help you need.

Does his problem get any worse after he eats? I thought I was having a panic attack that just kept getting worse, went to the ER and got a full cardiac work up (I'm only 24). Everything was fine then the doc pushed on my gallbladder and I screamed so loud I'm sure I woke up everyone in the hospital. I had some nasty stones and had to have my gallbladder removed. Do a little science experiement, have him eat some ice cream and see what happens. Gallbladder pain gives you the same heart attack and panic attack symptoms. It even radiates to your back and causes some serious shortness of breath. I was hyperventilating and I think the the pain from the gallbladder attack triggered a panic attack......but all in all it wasn't fun. Just a thought to throw out there for the ole hubby.

So they assume anxiety b/c of the bilateral numness/tingling? Just wondering, since it's what I learned in school. Also, does he overdo the caffiene, or does he take "health supplements" with ephedra as an ingredient???

I just reread your post. You said he has ulcerative colitis:

CDDW: Study Suggests Link Between Anxiety and Ulcerative Colitis Flares

By Louise Gagnon

Special to DG News

MONTREAL, QC -- February 4, 2002 -- A study has identified a link between autonomic nervous system abnormalities and anxiety in patients with ulcerative colitis.

Investigators speaking here during Canadian Digestive Diseases Week, the annual meeting of the Canadian Association of Gastroenterology, say their results showed sympathetic activation was linked to colitis symptom severity.

"Animal studies have shown that changes in the autonomic nervous system are correlated with changes in the severity of colitis amongst animals," explained Dr. Subhas Ganguli, principal researcher and clinical scholar at McMaster University Medical Centre, in Hamilton, Ontario, Canada. "Human studies have shown that a subset of patients with inflammatory bowel disease have either abnormalities of the vagal or the sympathetic nervous system."

The researchers hypothesised that patients with ulcerative colitis would have increased activity of their sympathetic nervous system while Crohn's patients would have increased activity of the parasympathetic nervous system, and that increased sympathetic activity would be associated with increased measures of anxiety, Dr. Ganguli explained.

They enrolled 12 patients with Crohn's disease and 12 with ulcerative colitis and matched them against healthy, historical controls. Participants underwent heart variability testing to determine heart rate and low frequency, referring to activity of the sympathetic nervous system, or high frequency, associated with activity of the parasympathetic nervous system. They also completed questionnaires on quality of life and anxiety or depression.

Results showed statistically significant differences on low frequency and high frequency testing between patients with ulcerative colitis and controls. Crohn's patients were not different from controls on any measurements of heart rate variability.

"The changes in anxiety come before flares of disease and do not merely reflect acute symptoms," Dr. Ganguli said. "This implies an association between anxiety and flares of disease. It emphasizes that when patients say flares of their disease could be related to stress, one should not discount that fact."

An intervention study aimed at minimizing stress and preventing disease would be worthwhile conducting, he added.

Dr. Ganguli's study was entitled "Patients with Ulcerative Colitis Demonstrate Abnormalities of Autonomic Function which are Correlated with Measures of Anxiety".

from: http://www.docguide.com/news/content.nsf/news/8525697700573E1885256B56006F68B1

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