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Remedy to overcome anxiety, stress and nervousness. - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Anxiety and Stress
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
User :   I am having muscular pain in my shoulder and fear that it is spreading down into my legs and arm, I am a computer programmer and spend the majority of the day typing and using the PC. I just need to know if this is normal that i feel these twitches in my legs and etc.
Doctor :   Hi
Doctor :   May I know your age and gender?
User :   22, Male
Doctor :   Since when are you experiencing these symptoms?
User :   For approx 1 year, but it is on and off as far as intensity
User :   for instance, sometimes it will be very bad (i can hear my pecks tearing, like a piece of paper being ripped in half when i stretch it)
Doctor :   Can you describe the nature of the pain that you been having?
User :   not really pain, just muscle twitches throughout the left side of my body
User :   neck, shoulder, arm, back of my leg
Doctor :   Ok
User :   my shoulder is very messed up, it cracks when i spin it in a circle, crack-crack-crack
User :   but it doesn't hurt
Doctor :   For how long are these twitching lasting?
Doctor :   Is it for seconds or for hours?
User :   hmmm, they are constant
User :   very subtle but constant
User :   they happen at intervals, maybe once per couple minutes
Doctor :   Do you feel weakness of the limbs - I mean to say do you feel that you have difficulty in rising your arm or during walking?
User :   no generally my limbs feel the same, maybe a slight loss of mobility compared to the other arm
Doctor :   Ok
User :   maybe also a slight loss of feeling at the top of my left arm, on the top, that is also on/off
User :   it seems that my muscles "act-up" more often when i am drinking alot of coffee (like 3 cups or so)
Doctor :   Do you find any differences in the sensation when compared to the opposite limbs?
User :   only the left arm, and slightly
Doctor :   Ok
User :   only the top of the left arm, i should say
Doctor :   Do you have any medical illness such as diabetes/hypertension?
User :   the twitches by the way are most frequent in my left calf
User :   not that i know of
Doctor :   Do you smoke or consume alcohol?
User :   yes i smoke, approx 1/2 pack per day
User :   i do not drink alchohol
Doctor :   Has any one in your family suffered from strokes or cardiac problems?
User :   not that i know of, my dad has high blood pressure but my mother and father were both adopted
User :   so i don't know my blood heritage far back
Doctor :   Ok
Doctor :   Do you notice any factors that precipitates or aggravates these symptoms?
Doctor :   Symptoms such as stress, anxious state?
User :   drinking excess amounts of caffinated beverages, until i get a feeling of nervousness
User :   the feeling of nervousness is sort of like a panic attack, and afterwards my muscles act up moreso
Doctor :   Ok
Doctor :   Have you seen a doctor in the past for these symptoms?
User :   yeah but unfortunately i couldn't take him seriously
User :   he struck me as more of a "pill doctor" than a real MD
Doctor :   Ok
Doctor :   Let me brief you.
User :   ok
Doctor :   Most often the cause for muscular twitches is not known, in some cases they are due to
Doctor :   neurological problems, electrolytes (salt and water) problems.
Doctor :   The description of your symptoms do not match any neurological disorders and
Doctor :   electrolyte disturbances causing such muscular twitches are often short lived and do not last for more than few days.
Doctor :   Hence based on the description of your symptoms,
Doctor :   I probably feel that your symptoms are somatic in nature.
Doctor :   Meaning that they are due to psychological issues,
Doctor :   issues such as anxiety and stress related factors.
Doctor :   Since your symptoms are not severe enough to disturb your daily activities, a different approach in the form of stress/anxiety relieving would be needed.
User :   i agree with you, about psychological issues, although there definitely is twitching all over in my body and the shoulder pain etc is there
User :   consistent as well, but just coming and going
User :   maybe because when i get nervous my body tenses?
Doctor :   Yes, My opinion is just based on the history that you have provided.
Doctor :   Its probably more related to the anxiety and other stressful factors.
User :   ok, now let me give you some additional information that might be interesting
Doctor :   Yes,
User :   are you familiar with the perscription medication called vyvanse?
Doctor :   Yes,
User :   2 years ago i took too many of them, lost peripheral vision in 1 eye and also feeling in my left arm
User :   i went to the hospital and they also told me i was having an anxiety attack, although i believe it was some sort of small stroke
Doctor :   Ok
User :   do you think the muscles only acting up on the left side of my body could be some sort of after-effect from that?
User :   the right side of my body seems completely fine
User :   since vyvanse is a stimulant, i feel like my body is now super-sensative to stimulants (like coffee) and if i have a little too much my body acts funny now
Doctor :   Vyvanase are know to produce pscyhological effects such as paranoia, depression, and so on.
Doctor :   Its also causes disturbances of vision.
Doctor :   Its difficult to differentiate symptoms of paranoia or a stroke clinically, unless examined by a specialist ( neurologist)
Doctor :   and proved by imaging techniques.
User :   ever since that happened to me i have been paranoid of health related problems, it was extremely traumatizing
User :   another thing to note is ever since that happened light seems to "stick" on my eyes, if you know what i mean
Doctor :   All these symptoms could mean somatic/psychological problems.
User :   now, i did have a brain MRI done that came back negative for any problems, so that is one good thing :) lol
Doctor :   If your symptoms are too many and are disturbing your day to day activities, I suggest you to take the help of a psychologist.
Doctor :   An negative MRI report, especially in the diffusion sequence(one of the MRI sequence) is almost conclusive that you didn't suffer a stroke.
Doctor :   Hence my suggestions are
Doctor :   1. Consult a psychologist for a face to face counselling.
Doctor :   2. Modification of life style such as regular sleep, timely breaks from work,
Doctor :   regular dietary habits,
Doctor :   3. Involving in physical exercises, yoga, meditations and so on.
Doctor :   4. Practising deep breathing exercises/breath counting exercises during the time of anxiety/panic attacts.
User :   understood, i just don't want it to be something cardiac related or like, cancer spreading down my body or anything crazy
User :   cardiac related scares me the most, i feel as though my mental capacity is mostly still good hehe.
Doctor :   5. Quit smoking.
Doctor :   No, your symptoms are definitely not a cardiac related events.
Doctor :   You should be fine, if you modify the life style as mentioned with some help from the psychologist.
Doctor :   Have you followed what I have suggested?
User :   yes i will take what you suggested, smoking being the most challenging
Doctor :   Yes, it will be challenging one, but not definitely impossible.
Doctor :   Your psychologist can also help you with it.
Doctor :   Do you have any other query?
User :   yes, what about the shoulder stuff? the way it sounds like it is tearing a piece of paper when i stretch it
User :   and cracking when i rotate it
User :   the sound is as if someone is squishing a wet wash-cloth or towel
User :   "squishy" sounding
Doctor :   Since you do not have pain, they are probably not related to joint problems,
Doctor :   They could be part of your other symptoms,
Doctor :   However a good physical examination will be needed to differentiate this from the shoulder joint problem.
User :   for instance, maybe i have some muscular problem related to poor posture at the computer and it is feeding into the paranoia/anxiety?
Doctor :   Its difficult to assess that without a clinical examination.
Doctor :   Poor posture and extreme stress on the joints can cause local muscular or joint problems which
Doctor :   can be determined by examination alone.
Doctor :   Have you followed?
User :   yes
User :   another question now, i also have adhd (this is why i was on vyvanse)
Doctor :   Vyvanase is a drug used for ADHD.
Doctor :   How can I help you with this?
User :   do you know of any medication that i could take for it that would be not as intense as vyvanse or adderall, to try to keep it managable without throwing me into a panic attack?
Doctor :   Since these are prescription drugs, its not ethical to suggest these medications on the chat, for the reasons that
Doctor :   they can be prescribed only after a through evaluation of your symptoms and they all have similar side effects.
User :   i understand, so you are saying they all cause the psychosis haha
Doctor :   Hence your treating doctor is a better person who can be able to help you with this.
Doctor :   Yes, almost all of them have similar side effects.
Doctor :   The intensity and the nature of the symptoms that one develops are depending on other factors
User :   then, without suggesting a drug persay, would you say it would be intelligent for me to try something at a low dose and work up from there (i was placed on a very high dose of adderall[30mg XR] and vyvanse as well)
Doctor :   such as the doses, presence of other stress factors and other medical illness.
User :   i feel like the doctor that perscribed me the medications was a "pill doctor" (like i said before) and he was just throwing me on medications, but i have read that adhd medications need to be "ramped up" over time and closely monitored
Doctor :   yes, these medications need a close follow up, prescisely the same reason, why I cannot prescribe you these medication over to you.
User :   and last, you don't think i'm going to do keel over and die from anything crazy soon do you? :)
User :   (sorry about feeding you into my paranoia)
Doctor :   You can try another specialist if you are not happy with your previous doctor.
Doctor :   No, as mentioned with life style modifications and with some help from the psychologist you should be better.
User :   thank you :)
User :   you have been a huge help
User :   i will actually sleep tonight!
Doctor :   Thanks for consulting me.
Doctor :   Bye for now.
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