Pots & Panic Attacks - Do I Stress Myself? Or Is It Asthma Symptoms?

[iheartcats]

I had asthma when I was younger, mostly allergy-and-exercise-induced sort. I had a Pulmonary Function Test before my doctor put me on Beta Blockers (all was clear). I take Zyrtec and Flonsae for my allergies.

I know I worry about taking a Beta Blocker with asthma in the past (even though it's not bothered me much in years). Today I encountered both a lot of dust AND a chemical-smell (the smell was not in my house, it was when I was out, so I've no idea what it was). It was just 'too much' and my allergies flared up.

Then I worried I was having an asthma attack, and got short of breath, chest pain, feeling like I was going to pass out, scared, etc. I knew with a Beta Blocker that could be bad. I had to try to 'calm myself' - I had a bunch of the symptoms of a panic attack at that point, including stomach upset. I still have some chest tightness/burning but it feels more like reflux (which I get on occasion), especially after having to 'run to the bathroom' during my panic incident.

I researched online and panic attacks/asthma attacks can be very similar, but asthma often has wheezing (mine didn't) and I could take a deep breath once I calmed down.

So. I've never been one to have panic attacks, but I guess I could be now? I need a BB of some sort for my POTS and if that means switching to a selective one, I think my Dr. will be on board but I don't see her for a month. In the meantime, have any of you had panic attacks before POTS or only got them after POTS? Does this sound like one? I hate the feeling - how do you deal? I now feel really wiped out.

[lieze]

I get the same feeling cat lady that the POTS triggers panic attacks in me.

It seems to start out as POTS symptoms and somewhere along the way trigger a panic attack.

I did not have panic attacks prior to POTS.

Bad anxiety yes my heart would race and I would get very nervous but never went into a true panic attack until after the POTS symptoms started.

[kayjay]

Before I knew I had pots I was diagnosed with asthma. I do have allergies but I have never had wheezing and the meds for asthma did not help much. Now I know that I do not have asthma but my pots really affects my breathing. Shortness of breath has always been one of my worst syptoms. I take nadolol and have much less trouble breathing. I do believe that hyper pots does cause panic attack type symptoms.

Hope you feel better soon.

[iheartcats]

I feel much better today - so I really think it was a panic attack. Well boy is that an annoying POTS symptom! They are terrible!

I figured if it was asthma I would have some type of wheezing (that's so common with asthma), not be able to get a deep breath after calming myself, etc.

Now I'll have to remember to try to 'talk myself out of a panic attack' tips for these situations. They are horrible!

[lieze]

Just had another horrendous one here.

It's taking me forever to come out of it.

My bp was 120/90!

I never see it that high but I was so worked up and it's taking me forever to calm down.

Eating triggered it for me.

[kayjay]

Just had another horrendous one here.

It's taking me forever to come out of it.

My bp was 120/90!

I never see it that high but I was so worked up and it's taking me forever to calm down.

Eating triggered it for me.

Lise, don't worry too much. My BP is 170/120 ( I'm thin and 37). The feeling is worse than anything I think that with lower bp you are in better shape!

[lieze]

Thank you!

Every little bit of reassurance is greatly appreciated.

I am okay but there for a while it felt like every time I got up my vital signs skyrocketed.

I was having various things that were freaking me out.

For one I got a cramp in the back side of my neck-all it was, was a muscle cramp but to feel that happening all at once it was really overwhelming.

I am happy to say I am calmed down now.

I started shivering and I felt like the panic still wasnt out of my system yet so I had to get a blanket and warm up.

I seriously hope this panic lightens up a bit.

I was somewhat out of it for an hour or more.

[Sallysblooms]

Have you had your seratonin level looked at? Good blood testing?

[icesktr189]

PLEASE LISTEN!!!

when i first came down with POTS i had the EXACT symptoms. I could not longer work, drive, or go to school because I felt like i would jump out of my skin at all times. I had about 5 panic attacks a day and horrible anxiety where i no longer felt real. Seriously what cured that was an SSRI. I loved my lexapro! I cant lie the beginning was very hard, but if you have a benzo on hand, you will be fine.

I REALLY urge you to try an SSRI. It changed my life before where i could work, go to movies and not worry about anxiety or anything. Just give it a couple weeks.. ( i had extreme surges when i first started taking them. Give it a chance even if you feel terrible in the beginning) After a month i was a completely new person. After 8 months i got off it and did great until i got pregnant and now everything is down hill again.

I should take my own advise, but im a stay at home mom, and cant be in bed the first week :/ or else i would have tried this by now

[Lovebug]

I had panic attacks prior to POTS. The first one was after a high carb meal and it ran the gammut...all the way through hyperventilation and tingling extremities (thought I would pass out but never did). Once I knew what it was, I recognized my next one and counteracted it by lying with my feet elevated, my husband fanned me, I took a pinch of Valium, and talked to myself so that I could breathe normally. I didn't use a bag although that would help but I just used pursed lip breathing and slowed it down. The panic attack stopped (I was on my way to my dads funeral so I knew what was going on at the time). Since being diagnosed with Dys, my attacks are completely different. I have IBS-D really bad, get nauseated, sometimes my heart races with increased breathing but sometimes not. And I usually get my other Dys symptoms (dizziness, ringing in the ears, pulsating sound, cold hands/feet, tingling and anxious feeling=fight or flight). I don't even pay them much attention now and they tend to go away quickly and do not escalate. There is power in knowledge and if you know what is going on in your body, it can help you mentally & possibly improve your symptoms. I so hope you get where you can cope with whats going on b/c this stuff is miserable!

[Lovebug]

Hi Dani! I've been on Celexa for almost 2 months now and I don't think I could go without it. It has transformed me from a recluse into a normal functioning/working human being. I didn't want to take it at first (I've been on Lexapro before) but my cardiologist insisted. I was having daily abd pain that made me incapacitated for part of the day. Thank God for my beta blocker, water, & Celexa. Oh yea...and my doctor!

[hilbiligrl]

I am personally so glad to hear that the breathing is not necessarily due to an asthma type situation. I've been told i had seasonal asthma, took combivent for years when needed, but seems it never really did the trick. One of my main complaints is the difficulty breathing. Here lately, it has been horrible, just horrible (then again, i've been in what they call a 'pots hole' for over a year without being able to function for the most part). I was going to post whether or not if this difficulty breathing is actually asthma or if it's a different mechanism causing the difficulty breathing.... i've always said and felt it was not asthmatic. Does anyone know what causes this difficulty breathing????

Also, i've had panic attacks all my life and can't pretty much (most of the time) tell if my 'episodes' are anxiety or if they are the disease. My attacks come out of the blue of course and usually the anxiety is non existent UNTIL my episodes start..... however, after they start massively, all kinds of symptoms pour in, therefore, starting the panic, therefore increasing the severity, therefore causing more panic and so on and so forth in this vicious cycle of feeding into the other. I know that if i don't get a grip, im gonna get dangerously bad really quick. When this happens, i call my hubby (who is towing 24/7) and i usually say 'im scared, you have to calm me down'..... we'll talk a min, i'll lay down and do my ever so best at calming down. So, for me, the anxiety and panic doesnt come until well into an episode.

SSRIs for me, unfortunately don't work. I'm one of those that cannot tolerate an ssri and most meds actually..... my mother can't tolerate an ssri either (she has celiac and chronns, she works great on prozac and so does my son.... but i cant tolerate prozac either). It seems that most these meds would intensify my 'adrenaline surges' and the 'flight or fight' feelings a hundred times more it seemed. I have tried all ssris out there.... all of them, and others..... only lexapro worked initially the first time for about a year, then it just wasn't working anymore (and i loved who i was on lexapro... really really worked for my anxiety, social anxiety, fears, worries, etc...). We attempted trying it again 2 more times in the last 8 years but to no avail. It seems that im so sensitive to these type meds, that everytime i take them, i have the scary, rare side effects of it and lots of them.... they would make me intensely more sick. The only thing that every worked and worked well for me was a benzo, klonopin... highly addictive, but it is a miracle drug for me because i had NO side effects and wow, i was so calm all the time and never had an autonomic episode while on it. I'm hoping the docs will be putting me back on it, since they have found out what's wrong with me. (i also tried buspar and it became apparent that this drug really, really made me very very very sick.... very sick.... i am scared to death of that drug..... so scared that if a doc mentions it, I get openly irate with the doc and tell them where to get off at and i usually am not 'mean' to anyone.... lol.

We are each so very different in our symptoms and with meds too. Even though im highly sensitive to all meds, i still want to try anything that's mentioned on here. I have been jotting down any and all suggestions on this board for quiet a few months now. I'm hoping to try some new meds with my upcoming appts this next week or two.... or until after i have my testing done at vanderbilt in feb.

Good luck with trying to sort this out...... i know that others on here, their episodes seem to be provoked by an anxiety attack, but mine seem the exact opposite order. I also know how confusing and overwhelming this whole mess is.

hilbiligrl

[hilbiligrl]

Also, i've had panic attacks all my life and can't pretty much (most of the time) tell if my 'episodes' are anxiety or if they are the disease.

************ ooops... another reason why i hate this disease is so many typing errors..... what i highlighted in red above... i had meant to say that I CAN tell the difference btwn my episodes and an anxiety attack... although it is confusing, i can tell.

hilbiligrl

[iheartcats]

I see my specialist next month so I will definitely ask about an SSRI. (It has to be a generic - so I will have to look into that - due to insurance).

But...very glad to hear this is likely panic/POTS related and my childhood asthma isn't returning. It felt different than Asthma and I just knew something was off.

Do you take SSRI with other medicines OK? I'm not ready to give up my Beta Blocker and Midodrine yet!

[Lovebug]

To Catlady & Hilbiligirl,

You must check out this website and get a copy of this book if you don't already have it: http://www.mitralvalveprolapse.com/

It explains everything and can help put your mind at ease.

Regarding the SSRIs....have your doctors tried a very, very low dose? My doctor told me I needed neonatal type doses at first and then work myself up if that's even possible. He said I was one of those that are very sensitive to meds. For example, he started me on the lowest dose of Celexa and told me to take half the dose (5mg)...well, I had to get the pharmacy to fill it in liquid form (tastes awful) & I started with 2.5mg. I tried to up my dose one day to 5mg and was a zombie so I went back to a quarter of the dose. Remember, Low & Slow with meds.

Hope everyone gets to feeling better and has a great New Year!

[icesktr189]

Hi!

i agree, it needs to be done very slow. That was the problem for me because they didnt know it was POTS. i started at a normal dose and felt like i was dying. I was also very low on serotonin to start with. Just make sure you have a benzo on hand, and dont give up! The first couple weeks for me were intense, but i promise it was sooooo worth it. I really wish i could go on one right now. I know it would fix me..

I do have paxil sitting in my drawer, just havent taken it yet

[Friedbrain]

What I've been realizing is that the "break-through seizures" that I've had, similar to your panic attacks, are so very much like autonomic activation that maybe my seizures are even *caused* by a dysfunctional autonomic nervous system. My neuro had given me xanax to take at the start of these. It helped for many years (although now I'm scared to take them if I'm by myself because lately, my blood pressure/heartrate has gone very low, and I'm -maybe irrationally?- afraid my heart will simply stop if I take it at night). As for the SSRIs, the cardiologist I saw last month recommended going on one because he said it would reduce the reactivity of my system to upsets-ie stabilize me-so that my body doesn't over-respond and send me off into these spells. I haven't tried it yet, but the logic seems solid.

Fwiw, the last time I was at the ER (for my first-ever workday episode-scared me because it was so unlike usual episodes), the ER doc gave me ativan which made me totally loopy. She sent me home with a prescription for that, to take when I had more episodes. I asked my neuro at my next appt about it, and he said to stick with the xanax; that the ativan was stronger and longer-lasting.

Lovebug, I get heartracing after eating sugar. I can imagine that, if I did that before bed (which is when I am most vulnerable to a runaway autonomic response), I might spike into a full-blown attack. I've been thinking about this a lot lately (because, normally, I'm on a low carb, pseudo-diabetes diet, but had a lot of slip-ups during the holidays). Here's what I noticed: after mild straight-carb load or high sugar content food, my heart races something awful, so maybe that's an adrenaline spike? Not sure why...need to research it. Still, the two times I ended up in the ER with seizures was after eating high sugar (Tgiving and Xmas Eve morning 8 ys ago, pre-medication), so this would fit (if a bit on the extreme side). If I eat a heavy primarily-carb load, I fall asleep. As in my brain shuts off, no matter the time of day. It's an awful feeling; doesn't scare me as much as my heart racing, but I don't have an ounce of energy until I've completely slept it off. (although, over Tgiving, when pie knocked me out, I had heart-racing spells wake me up despite the total exhaustion, so that time, they *were* scary)

[hilbiligrl]

friedbrain ~

What happens with your 'seizure' activity? And, was the docs able to quickly pick up on that your episodes have seizure activity? And, how were they able to identify that there is seizure activity going on? Im curious, as ive had extreme episodes for years and somehow i keep thinking that some seizure type activity may be going on.... i haven't heard anyone on this board yet mention they actually had seizure activity, although i have read it in some doctor reports on the net when referring to autonomic dysfunction..... so your post has caught my curiosity.

thanks for any info

hilbiligrl

[Friedbrain]

So sorry to hear that hilbiligrl, because my guess is that it would be really, really hard to diagnose! Here's my long story, and hopefully you will understand what I mean: 8 ys ago, during the night, I started seizing. It was status epilepticus, a long series of seizures where I was unconscious for a long period of time. My dh woke up and called an ambulance; I was still seizing when I reached the ER, so LOTS of people witnessed the seizures. They never figured out a cause, but I was put on AED (anti-epilepsy drugs). That helped. I later had a two-day in-hospital VEEG (video EEG) and they didn't observe any instability. I then had a sleep-deprived EEG-again, no instability. From reading on an epilepsy board, it's not uncommon for people with seizures to have negative results. If I hadn't had that ER trip, I think my episodes nowadays would not so easy to diagnose.

For the first four months (8ys ago), I had unconscious seizures (grand mal) once a month, about 30 days apart, in the middle of the night. It became clear that they were related to my menstrual cycle, such that I was having them before my period ("catamenial"). So there was a VERY clear pattern to them. After switching to a different AED, I only had periodic "break-through" seizures (what I called them)-same timing but different *expression*. My brain was always very active towards the end of the month, like a pinball zinging around in my head while trying to fall asleep. Sometimes, near the end of the month (particularly when under stress), I would wake up suddenly in the middle of the night, heart beating, nauseous, heat flash, buildup of pressure in my head, then all over body shaking. Again, I just assumed they were break-thru seizures because the timing was SO predictable, and no neuro ever contradicted that. At one point, an extra AED (making a "cocktail") was added because of the "breakthroughs".

The only daytime near-seizure I had in 7 years was when we had gone skiing. It was around dinnertime and I took both my AEDs AND a xanax to hold it off. It was only because of a trip up Pike's Peak this summer when I got really sick (just driving up, I became dizzy and seizurish) that I later thought about that skiing episode again in the context of dysautonomia.

Anyway, at one point, it occurred to me through research that maybe these seizures were at least in part autonomic in nature because of the symptom match, but I still assumed they were seizures because the timing was exactly like my grand mal seizures. It wasn't until this past Fall, when autonomic problems became exacerbated and I started doing more research that I learned about dysautonomia and saw such a great match with many of my problems. I now wonder if docs have had my problems *reversed* this whole time! That I actually have a primary problem of dysautonomia and that maybe uncontrolled autonomic activation (during a time of month when my brain is more vulnerable: in catamenial epilepsy, the hypothesis is that estrogen is still high at the end of the month when progesterone is dropping, so the brain is more excitable) was actually *causing* the seizures.

However, since it's easiest to diagnose the "obvious", nobody's really said that the episodes WEREN'T seizures. Does that make sense? I may very well have exactly the same episodes as others here, but mine are labeled seizures. In fact, in October, I had my second daytime "episode", probably due to stress (like I said, my problems have been worse lately). I went to the ER because I was shaking, my fingers were tingly, and the timing was so unusual that I got scared. The ER doc said it was a seizure (I had given them my history) and loaded me up with ativan. I can kinda understand it's not her job to figure out what was really going on, but it was disappointing anyway.

So.....that's the long way of explaining why I'm not sure how it would be diagnosed. My seizures are both related to the timing of the month (and scheduling a VEEG in the hospital is dependent upon availability; not like I can call up and ask to come in for monitoring because my brain is acting up) AND environmental conditions (ie level of stress, probably diet, mostly at night, etc). So it would be SO hard to catch an episode. Which was why I was so upset with the cardiologist's office: I accidentally induced a seizure so that an episode could be caught on the heart monitor; then the nurse told me that I should feel glad that there was no evidence of irregularity.....I about blew. I told her I understood that, from her point of view, it was good news (because she was trying to be comforting), but for ME, something was still seriously wrong, even if it wasn't primarily heart-related. And I was upset because clearly the heart monitor was NOT going to help diagnose those episodes (tho it picked up tachycardia).

Sorry so long. Did that make any sense/answer your question?

[Lovebug]

I can relate to your reaction to your nurse b/c I can't tell you how many times I went to the doctor hoping to find something wrong and an abnormal test. My husband would say to me..."it's like you want something to be wrong" and I'd simply tell him: "YES, I DO!!! I want something discovered so that I can be treated and keep living my life & ultimately feel much better". But when I finally did get a diagnosis, it wasn't so good since this is a very poorly understood disease.