Frustrated with chest pressure/heart and GERD symptoms

[anonymous680]

I've posted a lot of this info here before, but I am really having trouble accepting that everything I experience is just caused by anxiety. Anxiety definitely intensifies everything, but I strongly disagree that it is causing all my current problems. I am very frustrated as I feel doctors just don't understand.

Anyway, I am 23 yrs old and I was very sick in the Winter with High Blood Pressure and Tachycardia (constant for a couple months). My blood pressure and heart rate was high all the time, even when I was in deep sleep in the E.R. on a high dose of I.V. Ativan. Nothing would make my heart rate come much below 100 for a few months. I was even told doctors that "some people just have a high resting heart rate, and maybe you have just developed primary hypertension since it runs in your family." None of this was true as the HBP and Tachycardia became episodic, and is now gone. I wasn't suffering from anxiety when this all started but anxiety increased as my health got worse. They never found out what caused all this. Despite the underlying anxiety and some other issues, I think I am better off now.

Now I worry about my health, and I can admit I have developed Panic Disorder. On top of this I had a bad few weeks of gastrointestinal issues. I get clumps of food stuck in my esophagus creating a tremendous amount of pressure. I've had the same types of symptoms during the winter months when I was ill, and thought about seeing a GI doctor, but I was more concerned about the heart symptoms and blood pressure. I still have a lot of trouble exercising as it makes me feel really ill. If I do a few pullups, i get a lot of chest pressure and chest discomfort. The discomfort feels cardiac related, but I am pretty sure it's not since I have had a huge workup throughout the past 6 months or so. Recently, I tried to convince myself that everything was just anxiety, and had a doctor prescribe me Prozac and Klonopin. Prozac made me 10x worse, so I stopped that, but I still take the Klonopin as needed. Klonopin helps with my anxiety and panic, and HELPS with the chest discomfort, but it doesn't make it go completely away. I tried Pepcid AC, Zantac, Rolaids, etc, and nothing was helping much. I thought nothing would help until someone had me try chewable Acidophilus. As long as I take them religiously after I eat anything, it gets rid of my chest discomfort. I went a couple days without any, and as soon as I got my own bottle, I had relief. My resting heart rate is also much lower and recovers much faster when I take the Acidophilus.

I saw a GI doc today that told me if the Acidophilus is working, continue doing what I am doing. He told me the gastro symptoms is not related to my heart, but I say ********! I didn't know my true resting heart rate is close to 60 bpm, and the Acidophilus has everything to do with it.

What's also strange is that I get a very slow heart rate sometimes (bradycardia). I get tachycardia 99% of the time, but I've had a couple nights of bradycardia. One night I had chest discomfort, so I took my pulse and it was in the 40's. This scared the living **** out of me as my pulse has never been close to that, and visited the E.R. with with a panic attack. Of course when I got to the E.R. my pulse and blood pressure were elevated, so no bradycardia has been seen by a doctor. Last night I had chest discomfort and a slow stuck heart rate again that stayed about 60 even after climbing a set of stairs (very abnormal for me). I felt pretty anxious about it last night, and surprisingly, the anxiety didn't have much effect on my heart rate. Normally that type of anxiety would increase my resting pulse to around 100 bpm, but it was like my heart rate was stuck.

After my doctor visit today, I tried to see if my heart issues could possibly be caused by by my GI system. I know self-diagnosing isn't good, but I am frustrated as I don't think anxiety is the heart of my problem (no pun intended). I guess I would fall under the definition of a hypochondriac as I don't think I have been given a correct diagnosis by my doctors, and want a better answer. I am always analyzing what my body is doing, and think about my health constantly. I will go some weeks trying to ignore everything and not pay attention to my body and health, but it's hard to ignore everything when I am in constant physical pain. My body screams "help me". I know the obsessive thinking can make me feel physically worse. I don't obsess about my health at all when I feel good physically.

Anyway, after my appointment today, I googled something along the lines of "bradycardia and tachycardia with GERD". I don't recall the exact search phrase I used, but I ended up finding something very interesting called "Roemheld syndrome" on Wikipedia. The syndrome is not very well known in the U.S., but basically gastric pressure stimulates the vagus nerve causing either bradycardia or tachycardia. Now of course I can't self diagnose myself, but I do fit the description of that syndrome pretty well. Sigh.

http://en.wikipedia.org/wiki/Roemheld_Syndrome

[anonymous680]

Not doing as well today as other days. Feel a bit ill today. Didn't take any Klonopin last night and wonder if that has to do with it. Continued weening this morning and feeling a bit better now.

It's just so weird that anxiety effects me physically, but I usually feel fine mentally. Is it common to experience anxiety without the psychological issues? I never break down, I am mentally and emotionally stable, I am not depressed, but the anxious feeling just makes me so physically ill. I do get severe panic attacks though out of nowhere that can send my heart to 200 bpm+. Not lately though. Most people with anxiety post that they feel like they are going crazy; I don't have this feeling at all. If anything, i feel that my body is going crazy, not me. Honestly, everything I experience feels 95% physical. I don't get it.

Anyway, I am still doing ok, and I don't have too much to complain about. Just not feeling as good as the last couple days. That's all.

[anonymous680]

Day 3 of weening off of Klonopin. I continue to feel even better. I took Valerian, Scullcap, and Hops, and I haven't needed to touch the kava. I don't feel any obvious psychotrophic effects when taking these supplements (maybe slightly sedated?), but I don't feel any anxiety. Nothing is bothering me physically. I've had pretty constant chest discomfort for a long while, but strangely, I don't feel it today. I'm still avoiding moderate to strenuous exercise, so no severe palpitations. My heart rate is actually a little high at 96 bpm, but I don't feel any pressure or tightness, so nothing to worry about. My heart rate always gets stuck between 110-130 for several days or weeks after exercise, so that's why I avoid moderate to strenuous exercise. My heart rate getting stuck after exercise unfortunately does not correlate with my anxiety level. I wish it did. I know everyone here likes to attribute every problem to anxiety, and I realize I will probably get a response telling me I need to "accept that it's anxiety". Unfortunately, exercise induced tachycardia runs in our family.

[anonymous680]

I haven't tried the roots. I just meant to say my health food store also sells those. I've been taking it in tea and liquid extract form. I did a little more research on Valerian, and while kava isn't recommended to take when weening off of benzos, Valerian is supposed to be a good transition medication when stopping benzodiazepines. I picked up some Valerian, Scullcap, and Hops today. I can't really tell you if they helped me (the effects aren't obvious or maybe it hasn't taken effect yet), but what I can say is that today I feel even better than yesterday, and yesterday was my best day in several weeks. Even though I got good sleep, I had the case of the yawns all day today. I feel very relaxed though.

While it isn't recommended to take kava when coming off of benzos, I have continued to do it without any adverse effects. If anything, the combination is what gives me the yawns and the tired feeling. Not a big deal. I've only had 75 mg of kavelectones today though as I feel any more would make me want to sleep all day. I took .25 mg of Klonopin today, and depending on how I feel, I may or may not take another .25 tonight. I'm thinking it might be best to just take another .25 mg so I don't wake up feeling sick tomorrow.

I'll try to go with just the Valerian, Scullcap, and Hops tomorrow, but if I don't feel good, I'll add a little kava to the mix. I'm also looking forward to my appointment on Monday with an ND. The guy at the health food store says she measures neurotransmitter levels to help determine what I need. The word on the street is that the ND I am seeing is awesome at what she does. A lot of people around here see NDs, but this will be my first visit to an ND.

Paxiled: I appreciate your knowledge and insight, and I don't doubt that you know your stuff. Thanks for the info.

[Paxiled]

How can you know you're taking 300mg of kava if you're buying the root?  The traditional drink tastes awful, and there's not way to know how much you're taking.  Not that I care; it it helps you, I'm happy, I'm just curious since you mentioned kavalectones -- the only way to know the amount of kavalectones is to test the herb, so you have to make an extract.  And while I did say it was milder than benzos, which it is, that doesn't mean it won't work as well, it means it doesn't have as many possible side effects.  It just isn't as strong as an isolated pharmaceutical product.  And those studies didn't study very many people, weren't that rigorous, and didn't study any seriously anxious people, but I don't personally care about that, either.  I only want people on here to understand the upsides and downsides.  I'm a veteran manager of health food stores, so if I were starting today I would have tried to do it naturally; unfortunately, I was already on the medication carousel when I learned enough about natural remedies to know what to use and how to use them, and when I went off Paxil to try them, the withdrawal just never ended and I had paradoxical reactions from most of them.  Maybe someday . . .

As for 5htp, it doesn't work the same way as ssris.  Ssris, the meds you've tried, prevent the breakdown of serotonin, allowing the neurons to bathe in it longer than they would normally.  Whereas 5htp is a metabolite of tryptophan, the amino acid that manufactures serotonin in the body.  It's the difference between making more, or making it more efficiently, in the first place versus using it in a way that is different than the normal mechanism the body would normally do it.  So it won't be at all like taking an ssri.

Good luck with the naturopath.

[anonymous680]

To my understanding, taking 300 mg a day of kava (100 mg 3x a day) is as effective as benzodiazepines in studies I have read. I wouldn't call the effects mild as the effects are obvious and I feel them as quickly or quicker than something like Ativan. I don't know how effective kava would be for treating a panic attack though. I am hoping that I won't ever have one again anyway (wishful thinking?). I haven't had a "high" experience on kava, but that's not really what I'm looking for. It's just very calming. Kava isn't supposed to make you tired, but it makes me very sleepy for a while and I get a case of the yawns. I've only took .25 mg of Klonopin yesterday, and roughly 225 mg of Kava (~75mg 3x a day), and I physically felt the best I have in a while. I know I said that I wasn't going to take Kava with Klonopin, but I only took .25 mg the whole day, and it was easy! The people at the health food store sell the roots (from Vanuatu I think), and they say preparing it the traditional way gives the best effects. Everyone that works there are hippies, so I assume they know what they are talking about.

I currently take Natural Calm magnesium supplement. The majority of people are magnesium deficient (61% according to the USDA), and it really does help me. I've looked into the Valerian and hops combination, but I heard the Valerian loses its kick quickly. I guess it couldn't hurt to give a try though to see for myself. Melatonin works very well for me for sleep, but I don't currently take it. I've read about 5-HTP, and the people at my health food store highly recommended it, but I didn't get it because it was expensive, and I haven't had good luck with any drugs that target serotonin (SSRI's). The drugs either didn't do anything at all, gave me weird side effects, or increase my anxiety ten-fold. I know serotonin targeting drugs and supplements can help with anxiety, but in my experience they don't. I just wonder if it is worth giving 5-HTP a try.

I'll definitely check that book out. My sis is attending Naturopathic med school in Oregon next quarter, and I think she may have that book. Thanks for all your info and input too.

Anyway, before I get too carried away on trying to be my own doctor, I am going to see an ND next week. :)

[Paxiled]

The kava liver toxicity all involved people taking standardized kava except one -- there were actually only five people involved.  So to avoid liver toxicity, you can take it in its traditional form.  Eclectic Institute makes a capsule of kava in juice form, the way it was traditionally used.  When you speak of kavalectones, that's standardized kava.  I'm personally not afraid of it, but if you have any history of liver problems, just avoid the standardized version.  However, kava alone may not be as strong as you expect, and herbs are best taken two to three times per day, not just once.  They are food and have to be digested.  They are also best taken in combination.  For example, an anti-anxiety protocol might go something like this:  kava or valerian or passionflower or hops or a combination, magnesium citrate, 5htp, taurine (the amino acid that makes serotonin in the body), some adaptogens, and perhaps some homeopathic remedies.  If you see  a naturopath, that's the kind of program he or she would devise, and then experiment with trial and error.  They would also counsel therapy, meditation, exercise, and such.  It's much more complicated than a magic pill.  Try a book by Hyla Cass called Natural Highs; she's a psychiatrist at UCLA who uses natural remedies in her practice and discusses a good part of the universe of natural remedies for mental disorders.  It's a good place to start so you have a better chance of success.