Please Help - Should I push for another consult

My fear of posting here is that I am automatically lumped into the anxiety bucket.  However, I've had more than a few tests with no answers and my life is really being affected. 33 y/o male. Happily married, good kids.  Had a very tough year last year with several life events.

January - ER with chest pains a few months back.  BP was high, thallium stress test clean. As were ECG, Blood enzymes etc.  Had had arm and jaw pain prior.

Feb - still having some pains, treated with prilosec for several months which led to stomach problems (and testing).  Negative, quit the prilosec in April, stomach got better.

Been on Xanax off and on for anxiety.  .5 mg XR, was on it for 4 months with no real change that I noticed.  Weened off of it.

I've tried zoloft and at 2 weeks when I ramped up the dose my anxiety DID go through the roof.  Quit after 5 days at higher dose, felt better in a few days.  Waited a few months - tried cymbalta 30 - at day 4 I felt like the Zoloft did.  Quit it and felt a bit better (this was last week).

Zoloft and Cymbalta seemed to make things worse.  Xanax didn't do much good or bad.

I'll admit to being very worried about my health through all of this.  But over the last month I started to get extreme tightness in my neck below my jaw, and then along my jaw and up into my face.  To the point that the pain would awaken me.  It's generally a shooting ache/pain, more left than right but bi-lateral.  Can run into my cheeks, tip of my jaw etc.  I get a lot of tingling on the left side of my face.  I also wake up where my whole body feels "seized" up for only a few seconds.  But at that moment, I think I'm going to die.  I wake up more and more lately with both arms numb from the elbows down and tingling. Sleep has been difficult because of this.  

Brain (recent) and c-spine (done in Jan b4 neck and face acted up) - CLEAN

So yeah, a lot of it points to anxiety. HOWEVER, I find it almost impossible to believe that anxiety could cause this crazy jaw pain that moves around, but generally along the jaw bone the most.  On top of that the arms falling asleep, and this body "seize" that happens.  On top of that at times when my entire neck and jaw gets tight for a 10-15 seconds, my upper chest feels "funny"  it's not a crushing pressure, but it feels weird.  More from the clavicle up, but sometimes as low as my nipples.  I am getting a bite guard in case this is all clenching.  I've lost a grandfather in his early 50's to a MI.
  
However my stress test and 64 slice CT of my heart were clean.

Sorry to be crass, but I feel like "****" because of the pain.  I wasn't depressed but I'm working on it since two SSRI's have failed, and this is becoming very hard on my wife.  I HATE how this is affecting me.

1.  Can all of these symptoms REALLY be anxiety, or should I try a different doctor?

2.  Basically, if the physical symptoms would go away I know I'd be fine again.

3. PLEASE any suggestion on tests or drugs?

[Roger Gould, M.D.]

I think you are looking in the wrong place. Whatever you want to call it, anxiety or depression or whatever, you know for sure that your body is expressing your state of internal tension through all these symptoms, many of which are a direct result of muscle tenseness.  Instead of looking for a magical cure with medications, see a therapist and talk these things through until you find the source of your tension with yourself. It's there. Everyone has an interior life.

[Eddie 14]

2 other quick notes.

1.  If I get a ton of sleep, I seem to be a bit better in the morning and it gets worse as the day goes on (which makes me wonder if it really it a nerve problem or muscluar).

2.  However, it does seem to be random.  I might be just sitting around, seemingly relaxed and then WHAM, jaw pain in some spot, neck tight, and then it goes away.  IT happens more often some days than other, and lately more often than not.  I do have some short bouts of "Weakness".  

3.  So far, I have been able to exercise without any real problems other than pain on occasion.

[texassweetie66]

Im sorry your feeling bad.

What meds are you taking now?  Have you tried to go to a chiropractor that might help with the neck pain.  And yes Anxiety can cause those types of pain.  Feeling extreme anxiety can cause you to grind your teeth during the day or at night, causing jaw pain.

Have you tried getting a full body massage that will help.

Let us know.

[rosetoes]

Isn't it amazing how anxiety can cause all the symptoms that you describe.  It is so important to understand anxiety and all the symptoms, so you don't make the medical industry rich.  When I think about the thousands and thousands of dollars I spent on doctors and emergency room care to find out I am as healthy as anyone can be, but I feel like I'm unhealty with heart problems...any I don't have heart problems.

You have to learn how to deal with your anxiety and not let it get the best of you.  There are many self help books that are excellent...my friend currently has mine.

I have xanax that I take only when I have had a stressful day and I need to relax myself.  Even then I try to relax myself without meds.  

Good Luck!

[ScarabRad]

Eddie,

Your post could've been posted by me...34 yo, great marriage and kids, little financial stressors, very bright future, but overwhelmed with certain work and life events.  2 yrs ago, I started a downhill spiral into a life consumed by anxiety and fear of dying/going crazy, out of which I am finally (albeit partially) emerging.  Same symptoms you've posted;  my primary issues now are dysequilibrium/dizziness, neck stiffness, occasional total-body pain, generalized fear that something major is wrong (doesn't help that I am a physician with access to lots of medical equipment).  Often I can sense my pulse beating throughout my entire body (particularly disconcerting).  I am told that my primary diagnosis is "Hyperawareness to normal bodily functions," something many physicians/health care providers experience at some point.

What's helped:  very supportive and understanding wife and even kids (5 & 8 years old...they know when dad needs a hug or needs them to chill), bike riding (haven't been great about exercise and lately, have put on some weight [10 lbs over ideal]), repeatedly reminding myself that the recurrent bothersome symptoms I may be experiencing for the moment (sometimes these persist for hours) will have been experienced time and time again before, will dissipate and can be controlled if needed with Klonopine, and yes, infrequent use of Klonopine (Vitamin K, as I like to refer to it).  I use 0.25 mg prn (on average 1-2 x per week).  I do live with a lot of anxiety/fear, particularly centered on my symptomatology and the possibility that I have a severe underlying illness (to this day, after much blood work, MR C-spine, Brain, abdominal/carotid ultrasound, high level visits with Immunologist, 2 neurologists and every-other week visits with my psychiatrist, I still ruminate over the possibility of a severe underlying disease).  I never, ever, ever was like this prior to initial onset of anxiety attacks 2 years ago (just a happy, go-lucky guy who went with the flow and was unscathed by life's stressors).  Then, BAM!!!  The rest is history.

You're absolutely right about the sleep pattern.  When I get a good night's sleep, I feel great in the morning but start to relapse later in the day.  Oddly enough, when I get poor/little sleep, I do pretty well.  Not sure why.

I could go on and on, but will leave it at this.  As a scientist and physician, I must say I am fascinated about what my body is doing and have tried to rationalize certain symptoms on the basis of underlying physiology.  This is often more frustrating than helpful and for the most part, I cannot explain many triggers and what exacerbates/improves my symptoms.

Just hang in there and remember, you are not going crazy, you likely will not die (my father had a massive heart attack but survived in his early 40's, something I keep in the back of my mind...I understand your concern with your family history), and that there are probably millions out there who are in the same boat as we are but without a strong support system.  And try to learn to ignore the most bothersome symptoms...something I am slowly trying to accomplish.  Anxiety creates vigilence which begets more anxiety.  Learning to ignore the symptoms and fears may be the best (and cheapset) form of medicine.

SR

[Eddie 14]

SR,

GREAT to read your post.

Yup, we could be twins.

I'm not a physician, but I am in the medical field and have extensive training on the heart from both an electrical and plumbing standpoint.  I can read ECG's and have access to a machine as needed.  I understand drugs and have had stress tests, 64 slice on the heart, Brain MRI, stomach CT, and an upper GI scope.

Tried a couple SSRI's and they made things worse.  Xanax does help at times, as did finally breaking down and taking ambien for a few nights to finally get some sleep.

It's hard when I still have jaw pain, arm pain, neck pain etc.  However, this week I made a concentrated effort to listen to my shrink, not work as much, take a xanax when I was really ramped up, and exercise.  It all seemed to help. Also went to the Chriopractor a couple times and a massage to loosen my back up.  Doc thinks a lot of my pain comes from my back and neck completely tightening up with my jaw and causing the cascade.

Good to hear in some ways that you have the same symptoms and such a similar background. I'll keep working at it.  Sucks in that for 32 years I never went to the doctor, felt great and had no problems handing anything.  Argh.

[anya77]

Hi Eddie,

i'm very sorry to hear what are you going through.

I had panic attack disorer myself, and had the bouquet of associated symptoms, including chronic tension headaches, which were also produced by anxiety. As soon as i got my enxiety under control, the headaches stopped automatically, in fact i didn't took any of the pills prescribed by the doctor for the headaches, when i realized what was the real underlying reason.

For treating anxiety, i completely agree with ScarabRad:

"...try to learn to ignore the most bothersome symptoms...something I am slowly trying to accomplish. Anxiety creates vigilence which begets more anxiety. Learning to ignore the symptoms and fears may be the best (and cheapset) form of medicine".

Learning how to do it, will remove the anxiety at the root.

Try this simple mental trick, it helped me a lot when for the first time i stopped my panic attack myself, without taking a lorazepam (tranquillizer). After that i never had to take lorazepam! For a year now.

When my panic attack started, with all the sensations of having a heart attack right then at that moment, i made myself to stop thinking that way. Instead, i started thinking of my body as my child, or a loved person. Imagine someone you care about is very sick and feels owful starts complaining to you, that he may be having a heart attack. What will be your responce? Will you say - oh yeah, probably you are going to die. No. You will try to calm him down and comfort him as much as you can. Now, imagine that your thoughts is the way you are communicating with you body (which is proven to be the fact; the thoughts directly change the chemistry in the body). Why are you scaring your body when it already feels like a ****? So, that day, when i started having a panic attack, instead of panicing in responce, i started to hug myself instead (however ridiculous it sounds) and i started saying to myself "don't worry, everything is fine, you are a beautiful and nice and such a comfortable body, i like you and want to stay with you" heh-heh. It was difficult to keep my fear even deeper than my thoughts, but it helped as a miracle!

Please try it and let me know if it works for you!

Yoga, meditation, relaxation also help with learning to accept your body and set your mind in a more peaseful state. My tension headackes were gone after i seriousely started practising yoga. Stretching of the spine and neck muscles provides a natural massage and removes the associated pains. It is really worth trying! Always stretch before and  especially after your more active exercises. If you do not stretch, the muscles will stay tight, and you may get even worse pains and crumps.

Good luck!