Re: Accepting Panic/Anxiety diagnosis: at what point?

Discussion in 'Health and medical' started by Jessica Vincent, Jun 25, 2003.

  1. "Oklahoma" <[email protected]> wrote in message
    news:[email protected]
    > Preface: I am a 24 year old male, nonsmoker, non-drug-abuser, in
    > generally good health.
    > Once or twice a month, usually after I have just gone to bed, I will
    > awaken with a queer feeling, and I will succumb to what could be
    > described as a "panic attack":
    > My heart rate accelerates quickly from around 65 to around 195+, and I
    > begin to feel "tingles" in my extremities. My mind begins to race at a
    > fever pitch, seeming to scream out vividly "I am going to die now,"
    > and I begin dashing around the house--checking my pulse with the
    > kitchen clock, clutching at the nearest telephone as I fight back the
    > urge to call 911 (I've made this call several times, and they tell me
    > I am fine; very embarrassing). Finally, I often begin dumping cold
    > water on my head, frantically trying to stop my heart from its
    > terrifying, jackhammering gallop.
    > This can go on for half an hour or more: my heart, pounding away, at
    > or near 200 BPM, as "wave" after "wave" of what I suppose is
    > adrenaline surges through my body, driving my heart to beat faster and
    > faster, harder and harder.
    > Eventually, these episodes do seem to run their course. My heart rate
    > comes down, and my arms and legs--which moments before had been
    > violently trembling--calm down and feel, suddenly, leaden. My
    > mind/body in general feels like a blown fuse.
    > I am terrified I am going to have a heart attack during one of these
    > "episodes." I do not think it can be healthy for someone's heart rate
    > to essentially triple within 60 seconds, and then stay at the 190-200
    > BPM level for half an hour.
    > Which brings me to the point of this longwinded (sorry) post: Should I
    > be concerned about these episodes?
    > I have consulted the family doctor, and he has felt all along that I
    > am having a clear cut case of panic disorder. This is supported by the
    > fact that I have been having these "episodes," in varying degrees,
    > since I was 15. (my first panic attack was drug related, and was a
    > "classic" case).
    > Nevertheless, I have "badgered" him into giving me several tests,
    > which are as follows:
    > EKG -- Multiple times in Dr.'s office. Multiple times by EMT's who I
    > have summoned to my house. Multiple times at Emergency Room, when I
    > have driven myself during a particularly "bad" spell.
    > ECG--One Echo test. It turned up very mild MVP with no leaks and no
    > regurgitation. Otherwise, my heart is "sound" according to the
    > cardiologist who read the ECG for my family doctor.
    > 24-hour Holter Monitor--One time. This test turned up nothing, save
    > for the fact that my pulse routinely dips into the low 50's and upper
    > 40's at night.
    > Blood Tests--Various, all normal.
    > 24 Hour Urine Collection--This test is designed to check for tumors on
    > adrenal glands. It came back normal.
    > Chest X-ray--Normal.
    > My Dr. insists that my heart is fine, and as such he never refers me
    > to a cardiologist. I asked him about a "stress test," to which he says
    > in essence, that my panic attacks themselves are functioning as stress
    > tests--which I routinely pass.
    > He prescribed me Paxil, and a small dose of Xanax for emergencies.
    > At what point does one accept a diagnosis of panic disorder?
    > Should I have more tests?
    > If so, what tests do I need to have done so that I can have peace of
    > mind about the health of my heart?
    > Is it safe for my heart to beat as fast as it does during these
    > episodes?
    > One other factor is this: I appear to have dysautonomia (sometimes
    > referred to as Barlowe's syndrome, MVP Syndrome et cetera). In fact, I
    > am pretty well convinced of this. I have been taking 50 mg of Atenolol
    > since I was 18 because my pulse was so sensitive to "adrenaline," (at
    > the time, if I walked up a flight of stairs, my heart would be
    > pounding out of my chest). This drug has been a miracle, but my
    > "attacks" have not been affected by it.
    > Please help.
    > Thank you.
    > Steven

    Hi Steven,

    Do you trust your doctor? If not maybe it would ease your mind to get a
    second opinion, or possibly seeing a psychiatrist would be helpful. Given
    all the tests that you have had and the results of each, it does indeed
    sound like a classic case of panic disorder.

    Paxil & xanax are effective medications for treating PD.

    When I was first diagosed with panic disorder at 23 it was a huge relief to
    me to finally know what it was that was wrong so that it could be treated, I
    had a list a mile long of things that weren't wrong...after 7 years of
    actively trying to get a diagnosis. I make sure I get annual check ups to
    be sure nothing has changed and my psych insists that thyroid levels are
    checked annually to be sure that isn't contributing.

    Take care,