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Awoke with chest pain a week ago!
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Awoke with chest pain a week ago!

I had taken Effexor for about four years until last August, initially at 33.5mg, to 75mg, to 150mg and then back to 75mg. I quit cold turkey last August with next to no withdrawl (withdrawal) symptoms (lucky I guess). I was continuing to have gastric issues and was tired of experiencing an upset stomach.

About a week ago I awoke at around 11pm with some mild chest pain. Not crushing or tight, more like sharp cramping. I got worried that I was experiencing some symptoms of panic attack so I went to my cabinet and grabbed at 75mg Effexor tablet and took it. Three hours later I awoke with a very rapid heart beat, and intense ringing in my ears. I ignored and continued with a dose the next night. After having had the same symptoms I ceased my dose and went to the hospital. I had an ECG, X-ray and lung function test. All came back negative with the lung function test saying I had some slight asthma. They gave me Ketotifen and Montelukast for this.

Now a week after all this, I still have a strong pounding in my chest (infrequent), elevated heart beat (most of the time between 88-90), blood pressure checked was at 141/90, trouble breathing, very gassy (belching and passing gass), stomach upset and light headedness. I try taking some Ativan that my mom gave me 0.5mg to try and help relax but I'm not sure if it's helping and I don't want to start dosing on something my doctor hasn't approved.

What the hell is wrong with me?
15 Comments Post a Comment
4851940 tn?1385441629
Effexor is an antidepressant.  Do you feel you were experiencing the gastric issues as a side effect from the Effexor?  
Regarding your gastric problem:  Cut out all greasy and fried and fizzy drinks as well as white bread.  

The Ketotifen is an antihistamine and sometimes used to help with asthma and the Montelukast has also been prescribed to you to relieve the asthma.  Take the dosages as recommended.

The elevated heart beat of 88-90 is fine.  The normal range is 70-90 anyway.  My daughter in law who is 29 has a very abnormal and extremely elevanted heart beat when at rest.  Over the last 2 months she has experienced 3 severe bouts of abnormal heart beat rythm.  206 beats per minute.  She has had two injections so far to slow down the heart beat.  She was born with an abnormal hear circuitry that has only recently become a serious problem.  She is 3 months pregnant so the cardiologyst will not give her medication to take when the heart starts to race.  The cure for this is a heart operation, but they will not do this while she is pregnant.  

Your feelings of your strong pounding heart in your chest with the "infrequent heart beat of 88-90)" I feel is due to you feeling anxious.  The breathing problems can be connected to your being anxious but can also be because you are asthmatic.  

With regard to the wind problems, this could simply be due to your diet.  Keep a note of what you eat and drink to find out if there is a culprit food that is causing this.  Too much fibre and eating sprouts and cabbage for example will cause lots of wind.  With the belching, it seems as if you are eating something that your body does not agree with.

Your blood pressure of 141 is only slightly elevated.  Depends on your GP whether he feels this needs treating.

The diastolic of 90 is too high.  Your raised blood pressure can make you feel light headed.  

Did the doctor take your blood pressure reading or did you take it at home?
Some people get elevated blood pressure readings when at a surgery.  This phenomena is called "White Coat Syndrome".  

If you take your reading at home, make sure you are relaxed.  Do not take a reading after you have been rushing and running - it is normal for blood pressure to rise with exercise.  Don't take your blood pressure after you have drunk a hot drink like coffee.  Also do not talk or laugh as this will also give false readings.  You need to stay relaxed.  

You need to be back at the doctors for him to monitor your blood pressure over a period of a few weeks.  If the blood pressure stays constantly at the elevated reading, only then will your doctor decide whether you need to be put on medicaiton to reduce and control your blood pressure.

As a home remedy to lower blood pressure, reduce the amount of salt you consume, eat a healthy diet as well as do gentle exercise.

Ativan was, I presume, prescribed to your mom for a depressive anxiety disorder.  It is not wise to take other people's prescriptions.  Ativan can be addictive and there are side effects.

If you feel that the Effexor was what was causing your digestive  problems, then I suggest you speak with your doctor for a different prescription.

I have used antidepressants on and off throughout my life and I can just stop taking them withought any withdrawal symptoms.  But be warned, that antidepressants take up to 3 months for you to feel any benefit.  So don't allow yourself to get rock bottom into depression before you start taking anyting for the depression.

Home remedy that helps with depression and relaxation:  go for walks in the fresh air, gently exercise and swimming.  Take part in clubs that you have an interest so that you are in contact with other people.  Depression makes you feel that you want to hide from from everyone, but that is the worst thing to do.

Hope I have been able to help you understand about the symptoms you are experiencing and will help you to stop worrying about your heart rythm.
As you have had tests and heart problems have been ruled out and you know that you have asthma, I feel your problem is worrying too much and suffering from anxiety.  But the blood pressure does need to be monitored (by your doctor!)

Take care,
Best wishes.

PS I wrote you a message some hours ago, but pressed something accidentally that deleted my first message.  So I have written this one now.
Avatar m tn
Wow Jemma, thanks for the very lengthy reply.

I have some updates. First some background. I live in China and they don't do GP's here (unless you are elite and wealthy) so everyone relies on hospitals for care. I went to a different hospital as I felt I was receiving inadequate care. The gastroenterologist listend to me describe my symptoms and sent for a stool sample. It came back negative (no blood).

The doctor determined that all this was from a stomach problem, that I didn't need the ketotifen or montelukast but instead has prescribed Nexium for a week and Mosapride. Essentially, they think this is all a stomach acid issue.

This all makes sense when I think back to it; the chest pains, burning, tightness, trouble breathing, stining sensation in the angel of my jaw and in my neck, it all seems to be an acid reflux problem. My anxiety probably caused any other issues i.e. high heart rate, other pains, ringing in my ears and headaches.

Since seeing the doctor yesterday and knowing certainly nothing is wrong, my heart rate has been stable between 70-80bpm.

So I hope this is the end of the problem and we've figured out the issue. With the Nexium and Mosapride we'll see if the acid issues subside.

Thanks again for your kind attention to these problems. If you have anything else, questions or otherwise, feel free.

Thanks so much again.

4851940 tn?1385441629
Hi Expat,

Sorry to hear that you are unable to gain access to a doctor easily.  I am in the UK.  Although we can see our doctors without paying and have access to emergency doctors when our own doctors' surgery is closed,  we get better and faster treatment from private (paying) consultations.  I am not one of the priveleged few, I cannot afford to pay for private treatment.

I have checked the web about Nexium and Mosapride and these are for your acid reflux problem.  I take omeprazole (probably the same thing with a different name).  My husband takes Gaviscon and some other medication which is much better than omeprazone - he has a hiatius hernia (this is a problem with the closing off of his stomach).  I had a barium drink with xray some years ago to find out why I was having a problem and they found that I have a deviated oesophagus, I sometimes get feelings that food is stuck as it travels down when I swallow and I was waking up with lots of horrible bile in my throat  (so if you indulge too much, you suffer).

With regard to your acid reflux (this may be caused because of your anxiety) but you will need to be very careful what you eat and drink.  Nothing fried or strongly flavoured and keep off the fizzy drinks.  To help you be in control, keep a diary of what you eat and drink.  Write down the ingredients of a dish, eg curry, onions and so on.  When you have a bad reaction to something you have eaten, you will know what it is that caused your problem and then avoid it.  Also don't overeat or drink too much alcohol as this will also give you problems.  I have had to modify my cooking techniques because  even though my hubbby takes the medications (and will have to for the rest of his life) he still gets problems with lots of belching, gas and has burning sensations when he has overindulged (eaten too much) and drunk to much alcohol.

In the UK we have Chinese restaraunts and takeaways (we phone up, order what we want and they deliver).  We both love chinese food, but a lot of it is fried.  We both suffer from acid reflux (even with our medication) if we have too much.  We only treat ourselves from time to time.  We both like Yuk Sung, shredded duck with pancakes, crispy king prawn and chicken balls with sweet and sour.  I like to have chicken or king prawn with cashew nuts.  He likes chicken chop suey.

Take care Expat and enjoy your life.  You will be old before you know it.
I will be 61 in April, my brain still feels like I am your age, but my body is dreadful with lots of pain from arthritis, I have just finished an antibiotic for a kidney infection and am waiting for an ultra sound to see what is going on.  I have been getting too many kidney infections over the last few months and may have a kidney stone.  I had to have one surgically removed when I was 39 because it got stuck in the ureter - this is the tube that comes down from the kidney to the bladder.  I was extremely ill for a very long time even after my operation.  It was extremely painful.

Best wishes
Avatar m tn
Thanks Jemma.

It's 1am over here and I've been awoken by my stomach. I've noticed some pain in my left arm and am wondering if anybody else has had arm pain associated with GERD or acid reflux. I know it's not my heart because I had an ECG and x-ray and these both ruled out heart and lung problems. I also did some shoulder and arm lifts the other day which may have tightened up my arm a bit. Let me know if you guys have had any arm pain/tricep pain associated with GERD or acid reflux.


4851940 tn?1385441629
It seems as you have overdone the exercises.  
If you don't use muscles and don't do warm ups before exercise and then start to lift and exercise,  then you will experience painful and sore muscles. Start exercises gently and build up gradually, always do stretches to warm up the muscles before any form of exercise (I never to and then suffer!)  At the gym, they always tell you to warm up before exercise routines.

I suffer from arthritis and do get pains that come and go a lot in the different joints.  I have not experineced arm pains due to acid reflux.

If you worry too much, that will cause anxiety and stress - that is no good for acid reflux problems.  You need to learn to relax.  Good form of exerise is swimming and walking.

All the best.

Avatar m tn
Thanks Jemma

YEs, this is what I`ve been told as well, to relax. It`s very difficult when I cannot sleep and fear a repeat of sleepless nights. Its a rather vicious cycle I`m afraid.
4851940 tn?1385441629
I have problems getting to sleep at night too.  I agree it is a vicious circle.
Try not to sleep in the day and do not have any caffeine drinks like tea, coffe, cola.  Go out for walks in the fresh air.  Exercise and walking and swimming or whatever your preference is also good to help deal with depression.  Find a hobby that would interest you to take your mind off yourself, singing in a choir for example.

I'm one to talk it is nearly midnight and I am about to have a cup of cofee. LOL

Avatar m tn
I try dirnking Red Tea to soothe my throat. The odd thing is that I don't actually FEEL like I'm in that much pain. Sure, I feel little shootings every now and then, and I get some dull cramping in my jaw, neck, back, epigatrium, and my throat, but the pain is actually relatively mild. I've been on Nexium now since Saturday afternoon (it's Monday afternoon over here in China) and I'm not sure if I'm noticing any results.

I'm keeping the diet really simple. Oatmeal in the morning, some broccoli, carrots and fruit at lunch (raw veggies) and then a salad for supper with a boiled egg. I don't know yet if any of these is causing problems with my stomach though.

I have some gravol and tylenol with me so I took some tylenol then waited a few hours, then took some gravol to help me get to sleep. I was finally able to get a good five hours, which is good for the last week or so.
4851940 tn?1385441629
I don't know much about Red Tea, but if anything like normal tea, it will contain caffeine and this won't help you fall asleep. I think Green Tea would be better.

I presume the throat and other pains are due to the acid reflux.  

The Nexium you are taking is for the acid reflux problem you have.
I know that you obviosly took the tylenon to help you sleep, but it is not a good idea to take tylenon when you already have acid reflux problems.  The side effects of tylenon (I have copied and pasted the some of the side effects from

Treatment with Tylenol PM may cause oral or nasal dryness in certain people, reports. These side effects may lead to dry mouth, a sore throat, increased thirst, nasal irritation or sneezing.

Stomach Upset
After taking a dose of Tylenol PM, certain people may develop stomach upset side effects due to the presence of diphenhydramine in this medication. Nausea or vomiting can occur, which may lead to a temporary decrease in appetite. Certain people may also experience constipation, or difficult bowel movements, in conjunction with nausea or vomiting, MedlinePlus reports.

Read more:

Gravol is for nausea and dizzy spells and motion sickness.  This medication also has side effects and may not be compatible when you taking the Nexium.  

If the doctor has prescribed you with these medicins that would be fine because the doctor would know which medications are fine with each other.  

I would keep off the broccoli because that can cause you a lot of wind.  Done't eat any citrus fruits.  Keep off the onions too.  Nothing fried.  Have you tried boiled mashed potato and plain rice, even rice pudding?  Keep to a light bland diet until your stomach settles and then gradually introduce other foods into your diet.  Anyting you feel starts to upset it, then don't eat or drink it.

Light porridge is good.

You cannot take some medicines together.  When you buy over the counter medicines, tell the pharmacist what you are already taking and he would be able to tell you if it is OK or not.

Avatar m tn
Fortunatly my mom is a medical office receptionist and said taking Tylenol with gravol wont interact with the Nexium or Mosapride. I took the Tylenol and Gravol lastnight and had the best sleep I've had in weeks. I think they were able to settle my nerves and reduce the pain enought to help me sleep.

I've gont off the broccoli completely as I think it was causing problems. For eating I usually have some porrige with honey and that settles nicely. I've reduced my veggies to carrots now. Needs to get some color foods in my diet (unless you advise against that for now).

I never thought of potatoes. I had assumed they would be too heavy. I did find some whole wheat breasd (heard to find where I am in China) so I've eaten a little bit of that and it seemed to not cause any problems. I've read that whole wheat rice is better then white rice for acid problems. Your thoughts?

Thanks for keeping up to date with me. I really appreciate it.
4851940 tn?1385441629
Glad to hear there is improvement for you.

It is a very long times since I had to be on a bland diet.  Just came to my mind as I was writing, you could eat boiled none fatty fish.  

With gastric problems is keep off the strong foods (like onions especially fried), sprouts, cabbage and broc (anything that can give you a lot of wind).  Avoid all fizzy and cola and caffinated drinks (coffee, tea) Green tea is OK.

The brown rice should be fine as with any rice as long as you do not have it fried and no fried egg - in fact nothing fried.  Keep to boiled or steamed fish, chicken (without skin).  Natural yogurt should be OK too.

Whatever you try, right it down and then if it causes a problem, you know to avoid it.

Once your disgestive tract starts to settle (could be many months), then gradually add other foods.  

Glad at least you are having some improvement.  Keep it up.  
Best wishes.
Avatar m tn
Does GERD/Acid Reflux cause weight loss? I've noticed that in the last week I've lost about 10 pounds. I have drastically changed my diet and was already a little overweight at 220lbs at 6'4". Now I'm 210 after a week of suffering with these issues.

I don't want to go right to the worst, stomach cancer, but I can't help thinking that this weight loss is a sign something major is wrong.
4851940 tn?1385441629
Because you are now eating a healthy diet and minimum fat, you can expect to lose weight.  Your body will have got rid of fluid retention too.  It should settle down.  

The weight loss would be of conern had you not changed your diet.  

Continue to eat healthily.  I also found that to help my acid reflux is to eat small meals (little and often) rather than overloading on the eating and drinking.  

I wish I could lose weight.  I weigh a lot more than you and I am 5'2".   I am up and down and swell up with fluid retention.  My doctor told me to stop taking Ibuprofen as this can cause oedema.  As well as to stop taking bendrofumethiazide (one of my high blood pressure medications) as this can cause problems with fluid retention. I have had a number of urinary tract infectins with a lot of sediment recently so may have had or still have a kidney stone.  I am waiting for blood tests to check on kidney and liver function and the doctor is also arranging for an appointment for me for ultra sound on my kidneys.  

I have badosteoarthritis in most of my joings, eczema, asthma, high blood pressure.  Over Xmas I got cellulitis and phlebitis.  At the moment I have a sinus infection and am drinking Lemsip.

Keep up with the diet you are doing which is helping with the acid reflux.  Losing weight if you overweight will make you feel better.  You are too young to be worrying to much. You are a 6'4" tall young man - most girls dreams.  My husband is 6'2".

Best wishes.
Avatar m tn
HI Jemma

Yes, I am worrying a lot. I'm in a foreign country where the healthcare system is questionable at best. I haven't lost such weight before and doing so now was very questionable to me. Intellectually I know it's because of the diet change and stress I'm putting myself under, but emotionally I can't stop myself from thiking the worst (lastnight I had convinced myself that I had stomach cancer). I have entirely too much time on my hands I think.

4851940 tn?1385441629
I thought it was unusual for a Chinese person to be 6'5" LOL

Sounds like you do have too much time to worry and worry.  This is no good.  You are a tall young man.  Get out there and enjoy your life while you can.  You will be old before you know it.  

Don't become a hyperchondriac.

Worrying a lot and stressing yourself out is not good.  This is turn will get your gastric juices going causing the acid reflux.  I had a really bad chest pain two nights ago (acid reflux), but it did make me wonder if it was a heart attack.

Stick to the no fried and no strong spices and fiz, take your meds and relax.  Give it time to settle.  If after all you do, does not settle down your symptoms, then seek further medical advice.  There are different gastric medications out there and you need to find the one that suits you.  Gaviscon is pretty good, Losec, Omeprazole and probably others too.
If it doesn't settle after a couple of weeks, you may need to have a barrium meal xray or a camera put down to see if you have a problem there.  I have a deviation in my osophagus, but my husband has a hiatus hernia.

Cramping can be from muscle spasms.  I get them from time to time and it does make you worry when you can't move.

I feel that a lot of your gastric problems are stress and anxiety related.  But, again, if it does not settle after all that you are doing, get back to the doc for the other tests I mentioned above.  You could end up with a gastric ulcer.  I hope that doesn't stress you out me saying that.  

The invesigation with a camera put down your throat will not only investigate what is going on, but a sample taken for analysis to rule out halibacte pilori.  That bug can cause gastric problems and ulcers.

Keep CALM.  Do NOT stress.  If you do not see an improvement after all that you are doing, then go back to the doc and ask for further invesigation.  Worrying will get you nowhere, but will make you feel worse.
My geography is useless!  Where is Vernon BC?

Take care.

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