Aa
Need help doctors response and members responses would be appreciated
I just signed up the other day and would really appreciate some help and hopefully a doctors opinion. I am an almost 41 year old male non smoker, 192 pounds 5'11 who has a history of asthma, IBS, anxiety, gerd with a hiatal hernia and a benign fatty liver confirmed by biopsy several years ago when my alt ast and alk phos were constantly elevated and I also have Gout. I also had a colonoscopy about 6 years ago, which was normal I constantly worry about my health and any symptoms I may get. I have had anxiety and depression for over 10 years and I get very anxious easily when I am worried about my health to the point of hypochondria. Overall my life is quite miserable.
The medications I take are Ventolin Flovent Serevent, Allopurinol, Prevacid twice a day, celexa, and ativan as required, which I try to keep to a minimum because of unwanted side effects, because of the elevated anxiety in the past 5 weeks I take 2 to 3 ativan 0.5mg tablets a day.
About a 5 weeks ago I started having more upper stomach issues than usual and I became very worried and ended up in the ER three times over one week. After extensive blood work and an abdominal ct scan with contrast and a Gastrocopy I was told there was nothing wrong other than my existing IBS and my reflux for which I take 2 30mg Prevacid pills per day. For about a week of this I was taking a couple of ativan almost every day.
Once I had the good results and a few days after the aforementioned tests I started getting chest pain in the middle to left side of my breastbone area that is anywhere from sharp to dull and radiates to my back and a bit in the left arm as well. Well this set me off again and I have ended up in the ER 4x in the past three weeks thinking I had either cancer or a heart attack. The doctors did extensive blood work including 4 sets of cardiac blood work over three weeks, a chest x ray followed by a chest ct scan with contrast because I was worried the pain was being caused by my heart or chest/lung cancer . The cardiac blood enzymes chest x ray and chest CT were normal. I also had 4 normal ECG tests. I also just had a stress test yesterday (April 23/09) and I am awaiting the results, although the technician said nothing seemed abnormal and I hit my target of 180 heart beats per minute on Bruce Protocol for 15 minutes. My blood pressure has been slightly elevated during the hospital visits, with the highest being 138/93 but once I calmed down it was around 123/82 and I have been told my blood pressure overall is okay when I am not freaking out.
My question is am I missing anything and could in fact the Ativan be causing my chest pain and feeling breathless at times? I have quit the ativan 3 days (April 20th) after approx 4 weeks on it and have been throwing off possible withdrawl symptoms including more chest pain, breathlesness, dry mouth, Headache crying allot, heightened anxiety & an awful metallic taste in my mouth. I read that some of these symptoms including the crying, heightened, worry and the metallic taste and headache can be ativan withdrawl.
I also gagged badly during the gastrocopy on April 2nd before the sedative kicked in. The Dr yesterday (April 22) said there is obviously no perforation or I would be dead by now but the gagging and coughing could have caused inflammation, thus causing pain in the middle of my chest and the anxiety makes it worse
My family doctor feels given the tests to date and my history of depression and anxiety that the pain is benign given the negative Chest and Abdominal CT with contrast and heart work-ups so far and feels that this is primarily anxiety based and he said in some cased ativan can actually cause chest pain tightness etc whether I am on it or withdrawing from it. There is no heart disease in the family. I am so worried and down. Can someone please help me, am I missing any tests or signs? My doctor feels I do not need a heart ultrasound because of all of the other tests I have had to date including a probable okay stress test.
Thank-you in advance for any responses
The medications I take are Ventolin Flovent Serevent, Allopurinol, Prevacid twice a day, celexa, and ativan as required, which I try to keep to a minimum because of unwanted side effects, because of the elevated anxiety in the past 5 weeks I take 2 to 3 ativan 0.5mg tablets a day.
About a 5 weeks ago I started having more upper stomach issues than usual and I became very worried and ended up in the ER three times over one week. After extensive blood work and an abdominal ct scan with contrast and a Gastrocopy I was told there was nothing wrong other than my existing IBS and my reflux for which I take 2 30mg Prevacid pills per day. For about a week of this I was taking a couple of ativan almost every day.
Once I had the good results and a few days after the aforementioned tests I started getting chest pain in the middle to left side of my breastbone area that is anywhere from sharp to dull and radiates to my back and a bit in the left arm as well. Well this set me off again and I have ended up in the ER 4x in the past three weeks thinking I had either cancer or a heart attack. The doctors did extensive blood work including 4 sets of cardiac blood work over three weeks, a chest x ray followed by a chest ct scan with contrast because I was worried the pain was being caused by my heart or chest/lung cancer . The cardiac blood enzymes chest x ray and chest CT were normal. I also had 4 normal ECG tests. I also just had a stress test yesterday (April 23/09) and I am awaiting the results, although the technician said nothing seemed abnormal and I hit my target of 180 heart beats per minute on Bruce Protocol for 15 minutes. My blood pressure has been slightly elevated during the hospital visits, with the highest being 138/93 but once I calmed down it was around 123/82 and I have been told my blood pressure overall is okay when I am not freaking out.
My question is am I missing anything and could in fact the Ativan be causing my chest pain and feeling breathless at times? I have quit the ativan 3 days (April 20th) after approx 4 weeks on it and have been throwing off possible withdrawl symptoms including more chest pain, breathlesness, dry mouth, Headache crying allot, heightened anxiety & an awful metallic taste in my mouth. I read that some of these symptoms including the crying, heightened, worry and the metallic taste and headache can be ativan withdrawl.
I also gagged badly during the gastrocopy on April 2nd before the sedative kicked in. The Dr yesterday (April 22) said there is obviously no perforation or I would be dead by now but the gagging and coughing could have caused inflammation, thus causing pain in the middle of my chest and the anxiety makes it worse
My family doctor feels given the tests to date and my history of depression and anxiety that the pain is benign given the negative Chest and Abdominal CT with contrast and heart work-ups so far and feels that this is primarily anxiety based and he said in some cased ativan can actually cause chest pain tightness etc whether I am on it or withdrawing from it. There is no heart disease in the family. I am so worried and down. Can someone please help me, am I missing any tests or signs? My doctor feels I do not need a heart ultrasound because of all of the other tests I have had to date including a probable okay stress test.
Thank-you in advance for any responses
I just got my stress test results and they were normal on Bruce protocol 15 min 180 beats per min 180/66 on treadmill at 15 min, so my doctor does not want to do any further heart tests. Unfortunately I have still been having chest and mild back pain and some intermittent tight breathing sensations usually when I feel pain, although they are a bit improved from last week, especially when I lie down with a heating pad and work on breathing through my stomach.
My family doctor feels that the chest pain and mild back pain and breathless sensations are not from a serious cause given the fore-mentioned tests. He strongly feels that my depression, anxiety compounded by Hypochondria, along with acid reflux a rough gastroscope 3 weeks ago when i severely gagged and coughed perhaps caused some inflammation along with possible ouespohegal spasms and the chest muscle tightness from 5 weeks of extreme non stop anxiety and hypochondria are causing my chest/back pain
I started massage therapy today twice a week for a month to try and help with the moderate back pain i have had.
The diagnostic tests I have had to date in the past 5 weeks are:
1) Full Abdominal & Chest CT scan with contrast: unremarkable except for under 3mm benign nodule in right lung (Granuloma)
2) Chest x ray: negative/unremarkable
3) 4 ecg's over 3 weeks when I was having pain with the heart panel blood work were all normal/okay
4) Stress test (Bruce Protocol): Normal
5) Stomach Gastroscope normal except for a small hiatial hernia and the reflux I have had for 8+ years. The Biopsy was negative for Pylori.
6) Abdominal Ultrasound: Unremarkable
7) Numerous blood work including the following normal blood tests... calcium, PTH, glucose 2 hour plasma test (to rule out diabeits) , all Lytes urea creatinine, albumin, lipase, Amylase, magnesium, ferritin, tsh, ck, esr, ld, b12, cholesterol was ok (except for a slightly low HDL) ldl normal.
8) The only abnormal blood results as usual were slightly elevated alt ast and alk phos from a benign fatty liver, which were confirmed by a liver biopsy 5 years ago. Since I have lost weight from 220 to 190 last year those liver markers have actually steadily decreased
I do feel positive about these results, but the chest pain sharp to dull still worries me a bit. I don't think given the detailed tests that I have anymore tests to do and the fact my family doctor says anything serious has been ruled out and he won't order any other tests anyway. He is trying to get me set up in the next month with my old psychiatrist who after a year away is moving back to my area hospital in early June.
Lastly my family Dr.mentioned that overall, other than being a male 40 and the stress anxiety depression issues, which I have, that my overall risk for heart disease is relatively low given the tests to date and no family member has heart disease and I don't smoke or drink, no diabetis, good weight, relatively low carb diet, cholesterol ok (except hdl slightly low) and exercise when I resume it will help increase the hdl etc..
Until the chest pain goes away though I am kind of scared to continually exercise?
If any member or doctor has any further suggestions I would be happy to hear from you and thanks so much for the responses on my other post, much appreciated.
My family doctor feels that the chest pain and mild back pain and breathless sensations are not from a serious cause given the fore-mentioned tests. He strongly feels that my depression, anxiety compounded by Hypochondria, along with acid reflux a rough gastroscope 3 weeks ago when i severely gagged and coughed perhaps caused some inflammation along with possible ouespohegal spasms and the chest muscle tightness from 5 weeks of extreme non stop anxiety and hypochondria are causing my chest/back pain
I started massage therapy today twice a week for a month to try and help with the moderate back pain i have had.
The diagnostic tests I have had to date in the past 5 weeks are:
1) Full Abdominal & Chest CT scan with contrast: unremarkable except for under 3mm benign nodule in right lung (Granuloma)
2) Chest x ray: negative/unremarkable
3) 4 ecg's over 3 weeks when I was having pain with the heart panel blood work were all normal/okay
4) Stress test (Bruce Protocol): Normal
5) Stomach Gastroscope normal except for a small hiatial hernia and the reflux I have had for 8+ years. The Biopsy was negative for Pylori.
6) Abdominal Ultrasound: Unremarkable
7) Numerous blood work including the following normal blood tests... calcium, PTH, glucose 2 hour plasma test (to rule out diabeits) , all Lytes urea creatinine, albumin, lipase, Amylase, magnesium, ferritin, tsh, ck, esr, ld, b12, cholesterol was ok (except for a slightly low HDL) ldl normal.
8) The only abnormal blood results as usual were slightly elevated alt ast and alk phos from a benign fatty liver, which were confirmed by a liver biopsy 5 years ago. Since I have lost weight from 220 to 190 last year those liver markers have actually steadily decreased
I do feel positive about these results, but the chest pain sharp to dull still worries me a bit. I don't think given the detailed tests that I have anymore tests to do and the fact my family doctor says anything serious has been ruled out and he won't order any other tests anyway. He is trying to get me set up in the next month with my old psychiatrist who after a year away is moving back to my area hospital in early June.
Lastly my family Dr.mentioned that overall, other than being a male 40 and the stress anxiety depression issues, which I have, that my overall risk for heart disease is relatively low given the tests to date and no family member has heart disease and I don't smoke or drink, no diabetis, good weight, relatively low carb diet, cholesterol ok (except hdl slightly low) and exercise when I resume it will help increase the hdl etc..
Until the chest pain goes away though I am kind of scared to continually exercise?
If any member or doctor has any further suggestions I would be happy to hear from you and thanks so much for the responses on my other post, much appreciated.
Go to the mental health forum -- that's where the doctor answers questions. He's pretty mainstream, though, and will probably just tell you to go see a doctor.
Thank you for the responses, very much appreciated. I don't know how to get a doctors response on this board though?
I am still waiting for the stress test results (next week), although my doctor pointed out that my stress test completed under two years ago was fine and the technician did not stop this test and I hit the target on bruce protocol 15 minutes 180 heart beat per minute 180/66 BP on treadmill, so there is likely nothing wrong with my heart. All of the 4 ecg's over a few weekswith the pain symptoms I was having and heart blood panels and chest and abdominal ct with contrast scans were fine and my gastroscope was ok except for reflux and small hiatial hernia.
My family Dr. said if there is an issue with the stress test then definitely more heart tests will be done but he doubts there will be a problem. Overall, my risk factors for heart disease other than being a male 40 and suffering from stress and anxiety are low because I don't smoke or drink, maintain a good weight of 188 5'11, no cholesterol problems other than the hdl being a little bit low, no diabetis and no family members with early heart disease etc. I also eat healthy when I am not worried.
My chest pain has been improving the past 24 hours and the Ativan with-drawl symptoms are finally subsiding (thank god). Ativan is very addictive and it doesn't take long to be on it to get really bad side effects if you quit, especially cold turkey. The withdrawl made my anxiety go way up and I just couldnt stop crying and the metallic taste in my mouth which is also fading was awful and I had a really bad headache. I have read articles comparing ativan withdrawl to that of cocaine and heroin, so Ativan it is a powerful drug
Personally, I will not take Ativan or any benzo medication ever again. I think from reading vasrious posts they work for some people, but they are not for me, especially after the withdrawl issues and the fact that you constantly have to up the dosages to maintain the desired effect. Hopefully in the next week the symptoms I have been having (especially chest pain will be gone, as I am starting to believe my doctors that all of the tests are fine, so cancer and heart disease are not causing my pain.
My psychiatrist who helped me up until June of last year left the area because of a dispute with the hospital and my family doctor said he is coming back to my area in June and he will speak with him to get me back seeing him once a week. He really helped me for a couple of years and I have gone downhill since he left, so it elevated my mood yesterday knowing he will be back soon :) My family doctor has also been reassuring because he says all the detailed tests have been unremarkable to date and I need to accept that reflux/hiatial hernia, tremendous stress & anxiety and something called globus hystericus are causing my chest pain and the fact when I lie or sit down with a heating pad and relax my breathing tends to reduce the chest pain is also reassuring. My doctor also said I could have some oeusphegal spasms and the nerves and muscles in the chest are tight from the constant stress. a rough gastroscope three weeks ago didn't help where I severely gagged and coughed before they increased the sedative medication
Thanks again and any other suggestions/comments are welcome :)
I am still waiting for the stress test results (next week), although my doctor pointed out that my stress test completed under two years ago was fine and the technician did not stop this test and I hit the target on bruce protocol 15 minutes 180 heart beat per minute 180/66 BP on treadmill, so there is likely nothing wrong with my heart. All of the 4 ecg's over a few weekswith the pain symptoms I was having and heart blood panels and chest and abdominal ct with contrast scans were fine and my gastroscope was ok except for reflux and small hiatial hernia.
My family Dr. said if there is an issue with the stress test then definitely more heart tests will be done but he doubts there will be a problem. Overall, my risk factors for heart disease other than being a male 40 and suffering from stress and anxiety are low because I don't smoke or drink, maintain a good weight of 188 5'11, no cholesterol problems other than the hdl being a little bit low, no diabetis and no family members with early heart disease etc. I also eat healthy when I am not worried.
My chest pain has been improving the past 24 hours and the Ativan with-drawl symptoms are finally subsiding (thank god). Ativan is very addictive and it doesn't take long to be on it to get really bad side effects if you quit, especially cold turkey. The withdrawl made my anxiety go way up and I just couldnt stop crying and the metallic taste in my mouth which is also fading was awful and I had a really bad headache. I have read articles comparing ativan withdrawl to that of cocaine and heroin, so Ativan it is a powerful drug
Personally, I will not take Ativan or any benzo medication ever again. I think from reading vasrious posts they work for some people, but they are not for me, especially after the withdrawl issues and the fact that you constantly have to up the dosages to maintain the desired effect. Hopefully in the next week the symptoms I have been having (especially chest pain will be gone, as I am starting to believe my doctors that all of the tests are fine, so cancer and heart disease are not causing my pain.
My psychiatrist who helped me up until June of last year left the area because of a dispute with the hospital and my family doctor said he is coming back to my area in June and he will speak with him to get me back seeing him once a week. He really helped me for a couple of years and I have gone downhill since he left, so it elevated my mood yesterday knowing he will be back soon :) My family doctor has also been reassuring because he says all the detailed tests have been unremarkable to date and I need to accept that reflux/hiatial hernia, tremendous stress & anxiety and something called globus hystericus are causing my chest pain and the fact when I lie or sit down with a heating pad and relax my breathing tends to reduce the chest pain is also reassuring. My doctor also said I could have some oeusphegal spasms and the nerves and muscles in the chest are tight from the constant stress. a rough gastroscope three weeks ago didn't help where I severely gagged and coughed before they increased the sedative medication
Thanks again and any other suggestions/comments are welcome :)
The upper chest is exactly where you feel gerd. On the other hand, prevacid won't get rid of gerd, it will guarantee you need to keep taking prevacid. Anything that permanently interferes with the body's production of acid will cause it to produce more, since the stomach requires an acidic balance when digesting protein. I recommend seeing a naturopath or holistic nutritionist. There are things like aloe juice, dgl, peppermint oil caps, just a whole lot of things that can help with these problems that don't keep you in this endless cycle.
But the above post is correct, anxiety is causing a lot of this. Your diet is probably bad for you, you probably don't chew your food enough because you're nervous, etc. These conditions don't come from nowhere. I had this problem and a bleeding ulcer when I was 24, and a doctor recommended TM, a form of meditation. End of migraines and acid problems! Now, I'm still plagued by anxiety, but there are things you can do to help your body stay strong.
But the above post is correct, anxiety is causing a lot of this. Your diet is probably bad for you, you probably don't chew your food enough because you're nervous, etc. These conditions don't come from nowhere. I had this problem and a bleeding ulcer when I was 24, and a doctor recommended TM, a form of meditation. End of migraines and acid problems! Now, I'm still plagued by anxiety, but there are things you can do to help your body stay strong.
Yes, you have serious health anxiety and hypochondria......NO medication will truly help your symptoms because most of your problems (IBS, anxiety, GERD, and the chest pain probably) is being caused by your DEPRESSION AND ANXIETY.
Get to a psychiatrist and explain your health history and your irrational concerns...therapy and possible medication for your depression wil help relieve many of your symptoms...If you follow your Psychiatrists orders and work on your thought process and take your meds, guarrantee within 6 months you will be coming off of the previcid, celexa and maybe even lightening up on the ativan and your asthma medications...
NO ONE CAN BELIEVE THE EFFECT ANXIETY HAS UNTIL THEY HAVE BEEN THROUGH IT!!! AND I AM A PERSON WHO HAS BEEN THROUGH IT!
Best to you!!!!!!
Get to a psychiatrist and explain your health history and your irrational concerns...therapy and possible medication for your depression wil help relieve many of your symptoms...If you follow your Psychiatrists orders and work on your thought process and take your meds, guarrantee within 6 months you will be coming off of the previcid, celexa and maybe even lightening up on the ativan and your asthma medications...
NO ONE CAN BELIEVE THE EFFECT ANXIETY HAS UNTIL THEY HAVE BEEN THROUGH IT!!! AND I AM A PERSON WHO HAS BEEN THROUGH IT!
Best to you!!!!!!
Having health anxiety can be REALLY difficult cycle to get out of. I am sorry that you are having to deal with this right now. I know it is difficult, but you did the right thing by going to get checked out...now you have to believe the results and your doctors.
When I initially went through this three years ago, I got stuck in that 'what if?' thinking. I knew they must be missing something. Until I accepted the anxiety, I would and could not make any progress in dealing with it. Once I accepted it and confronted it, I was able to thrive with it and be a better person for it.
Throughout all of this have you sought the help/advice of a therapist? (counselor, psychiatrist, psychologist, etc?). I think that your family doctor is spot on...you have had the tests and you can be thankful that you are okay....that is a good thing:). I know that this is a difficult process to say the least, but you WILL get through it...and please keep on using this forum and feel free to ask as many questions as you like!
When I initially went through this three years ago, I got stuck in that 'what if?' thinking. I knew they must be missing something. Until I accepted the anxiety, I would and could not make any progress in dealing with it. Once I accepted it and confronted it, I was able to thrive with it and be a better person for it.
Throughout all of this have you sought the help/advice of a therapist? (counselor, psychiatrist, psychologist, etc?). I think that your family doctor is spot on...you have had the tests and you can be thankful that you are okay....that is a good thing:). I know that this is a difficult process to say the least, but you WILL get through it...and please keep on using this forum and feel free to ask as many questions as you like!
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