Question

Hi, As a bit of a history, i’m a 22 year old female. I’m moderately active as I work 6 days a week and my 2 year old comes to work with me as well on my feet all day. I have smoked cigarettes for 8 years, have not smoked in the last week however due to reoccurring dyspnea. I went for my sob/dyspnea issue a few years back where a doctor quickly diagnosed me with “anxiety,” gave me ativan and basically chased me out the door. Well, I took the medication and it didn’t really seem to help. The dyspnea did dissipate, however years ago this issue was so minor I would only experience the sob for a few hours at a time and it only came on once a month or so. So, I am not convinced it was the ativan that sorted out the problem. Fast forward a few years, I ignored my symptoms for a while as I did’t feel they were very concerning. This month however, it has really begun to bother me. About a week ago, it really kicked in and I haven’t been able to take a relaxing successful breath. I visited the emergency hospital local to me over the weekend due to my symptoms. Upon the nurse triaging me, my heart rate was jumping all over the place. It was anywhere from 60-105bpm, sometimes it seemed to skip a beat. The nurse actually had to take my pulse manually as she did’t think the machine was accurate, but she confirmed that it was in fact abnormal. The strangest thing is although I feel as I am short of oxygen, my o2 stats are in the 95-100 range. As I was in the waiting room, I ended up having what I assume was a complete panic attack due to struggling to breathe. My hands, feet and lips go tingling-numb, heart races, and I feel very faint. By the time they hooked me up to an ecg, I had calmed down a bit, and she said my heart tracing looked completely normal. The doctor on that night completed chest x-rays, b/w, and urine sample—nothing seemed to stand out to her. She, again, said I may have anxiety and asked me to try an ativan. I agreed and took it. An hour later I felt less panicked regarding my breathing, but my breathing was still poor. She then proceeded to get me to try ventolin. I did that and waited another hour. I was feeling a bit better, but I now think it again just dissipated on its own. (when I say dissipate, I don’t mean it goes away completely, it’s just more bearable) I have been trying the ventolin at home now since and it does not help, if anything makes it worse. Yesterday I took a day off work to go in to the doctor to follow up. He seems equally as puzzled, but prescribed me 3 days of prednisone to see if that helps. Today is the first day i’m taking it. All day again, I have had this dyspnea. It is affecting my day-to-day and i’m becoming frustrated as I feel no one is taking me seriously. Everyone keeps pointing to anxiety, but of course i’m anxious as I can’t breathe. My concern is copd as from what I read on it, it presents as sob often accompanied by normal o2 stats, but none of the doctors seem to have pointed to that. Sorry for the overload of information, like I said, I am just desperate.

Mr.Ummang Sharma Bajpai · Accepted Answer

Hi, Your symptoms do seem to correlate with those of anxiety disorders. I would urge you to, however, consult an ent to make sure it isn't copd. If you live in india, or any other polluted country, then copd can't be ruled out without proper investigation. If it is not a physiological issue, I would then suggest using mental health services. If it is anxiety, as the symptoms suggest and as per the earlier diagnoses, then the medication you're getting isn't enough. Lorazepam, diazepam and alprazolam should only be used as first aid. They will stop or ease the symptoms (breathing difficulty in your case) temporarily but will not treat the underlying cause. Anxiety can be managed with proper treatment - both pharmacological (medicines) and psychotherapeutic (therapy by psychologist). Ideally I would suggest a mix of the two. Hope this helps.

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