Usually when I have some sort of physical pain, feeling, etc., that alone will send me into panic attack mode immediately. The "not part of reality" thing, I also deal with often when I'm having my anxiety issues. You may need to adjust/change the medications.
Hope this helps.
I would bring these concerns to yourmprescribingphysician - perhaps these are side effects of your med. If these are side effects he/she should be able to make some suggestions about how to ease or prevent the symptoms.
And remember to keep tracking your symptoms - the very act of doing that can help you feel empowered. Taking a few moments to do some deep breathing can also help as it can help prevent you from getting too tense and physically rigid, which can addmtomthe physical discomfort.
Also, and this may sound silly, but I have found it helpful,to remember to "talk to your symptoms" "ok, anxiety is,here again " ....when you remember to call your symptoms by their name, it takes away some of the stress,by de-mystifying them a bit.
Hope this helps!