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    Suggest treatment for anxiety

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Posted on Fri, 27 May 2016 in General Health
Question: So tell me what I need to know. To understand
In 1999 I had what I would say is my first event of sob. I had been hurrying across campus to get to next class. I had to climb the stairs three levels. This was a different sensation of trying to catch breath

Two years later I had a panic attack that gave sensation of heart attack. This is when panic came on and off till the present every time I climbed long stairwells I would need to catch my breath. From 2002-2006 I had a membership at a gym. I could lift, I could walk but I could only run one lap and I would be shot. In 2004 to 2010 I used the summers to ride my bike 3,days a week then I quit when my granddaughter was born she lived in my home so I would watch her as my daughter attended class.
Occasionally I would do something that would trigger sob In April of 2013 an ice storm came and required quick action to save trees and protect property. Things began fine but shortly in, I ran out of breath like I never have before. My upper chest didn't expand and my stomach expanded but only to a certain point. This is the beginning to today's situation. I take a breath in but after a certain point it stops as if the space is taken up so stop. This is not like I got a full breath but got a percentage of it.

Now you have proven. Dr Cantrall has proven and dr Bhavsar has proven that I have normal lungs. No copd Asthma is up in the air.
So I am getting older, I stand in my office and try to discuss info with my associates and I go sob while speaking. It's not like not taking enough in before starting it's running out as I talk
Or the times I am down the hall and my phone rings. No matter what speed I move be it fast or slow when I grab the handset I am slightly puffing gasping. Just walking along side someone I speak little because I run out of breath.

You have my list of stress events so I will not go into them.

Reading the pft i have normal values on lung FEV and FEV , I have normal DLCO I have slight hypervent or tlc. My mudflows are a bit reduced but come back with albuterol and Bhavsar says stress messes with the inflammatory response and airways I looked back my tlc goes up and down I also read that just as you said that slight increase is nothing to concern with. In fact web md has info on that shows that is seen in asthma patients so it's not a concern. If you look at the lung volume graph you see that my rv is normal so if I have air trapping where is it. In the tlc.

Bhavsar commented the other day that all Drs taking care of me and that I'm fine. So how many events are collectively combining to make my life difficult.
Aging of the respiratory system. Asthma symptoms or anxiety symptoms that mimic asthma. GAD, lack of exercise.

So I've typed enough for now. I'm going to the kitchen to fend for a solo dinner and try to undo the web of anxiety
doctor
Answered by Dr. Alexander H. Sheppe 13 minutes later
Brief Answer:
Private Consultation

Detailed Answer:
Welcome back, and good to hear from you as always.

I feel like I have a good grasp of your anxiety history. It is in fact very typical of the natural history of anxiety/panic. The first events happened in your younger years. This developed over time, particularly with your mother's struggle with and eventual death from COPD. Now anxiety (GAD) has established a large grip on major parts of your life, including frequent worrying about not being able to get a full breath, quickly becoming winded when walking from place to place, and even feeling winded when talking to coworkers at times. This is likely worsened to some degree by deconditioning as you age. But many, many PFTs now have demonstrated essentially normal lungs, except for the questionable possibility of very mild asthma. This is the story of how things have been.

But you're changing that story. You are now able to utilize the rational parts of your mind to say, hey, wait a minute, my lungs are fine. I feel like I'm having trouble breathing, and I worry this could be COPD...perhaps like my mom had...but wait, that can't be, because all my lung function tests say I don't have COPD. So this must be anxiety. And I can work through this -- I can play music, or take a warm shower, or talk to Dr. Sheppe, or try to distract my mind some other way. I can get through this.

You're changing your narrative. And the medication will help, over time. But the positive cognitive aspects are growing. I can see it.

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Alexander H. Sheppe 1 hour later
Well I am glad to see you included "talk to Dr Sheppe" because the irrational and rational mind need someone to ask questions to and of so that the irrational mind can fix itself.

Well some time soon you should write a book, change my name unless you plan to give me a cut of the profits. You should have a good comedic sci fi medical mystery. just need a special cliff hanger
doctor
Answered by Dr. Alexander H. Sheppe 5 hours later
Brief Answer:
Private Followup

Detailed Answer:
I love your sense of humor. It's also psychologically very healthy to have a good sense of humor, it's a helpful way to cope with stress.

Let me ask about something I don't think I have before. Since your separation from your wife, have you started dating? Do you have any romantic interests, or current romantic relationships? I wonder how your anxiety plays into this area of your life.

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Alexander H. Sheppe 5 hours later
Are you asking of my ex wife. I'm still with my current wife but it is a nothing relationship. My ex wants to get back. She has for a few years. She regretted the divorce
doctor
Answered by Dr. Alexander H. Sheppe 9 hours later
Brief Answer:
Private Followup

Detailed Answer:
Oh, maybe I'm picturing the situation wrong. I knew about your ex-wife, but I thought you were also separated from your current wife, and that's why you two aren't living together. But about either or both of them, how do you see your anxiety coming to play in those relationships?

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. Alexander H. Sheppe 1 hour later
Between you and me, my divorce a few years ago was hard on me, I may not have been the ideal husband (who is) but I made a point to always be at home if not at work or with the band. I couldnt understand at first why she divorced me, after some soul searching, i could see what I faulted at. I could not blame her for leaving me, i could only be sad. I come to find out later, she visited with a counselor for a good amount of time and came to realize that she to made mistakes and regretted the divorce.

She and I are still to this day the best of friends, we love to do things together, talk and yet still have room to do our own thing with out disturbing the other.

This is not the case with the current wife. I do not see the divorce being a major war but i do see it to be an anxiety driven event that will cool down once I exit this town.

As per my future and my ex, we will do as we did before i found my current wife and that is celebrate birthdays together, holidays, family events. and if any relationship re ignites, well it will require a big sit down discussion before hand. I do not wish to walk the isle again, we both have our own personal excentricities in material spending. I will keep mine and she can be responsible for hers.

Here is something to comment on about the trust between the two of us.
If I die tomorrow, My house goes to her, My life insurance is in her name, my investments and retirement are in hers and my daughters name.

If she dies tomorrow, I get her life insurance policy. I get her belongings that I am to distribute to our children and grandchildren.

She is co-named as executor of my will.

But I will spend my golden years with her in my life but no to marriage. Just too much to deal with or be expected to take care of.
doctor
Answered by Dr. Alexander H. Sheppe 15 hours later
Brief Answer:
Private Followup

Detailed Answer:
I think your approach to the whole situation is mature and sensible. You seem to have a lot of good will towards these women even though the marriages themselves turned out not to be the best way to move forward. Your calm and sensible approach will certainly keep anxiety levels as low as possible.

You are divorcing your current wife, correct? I just want to make sure I read that right. She lives in SD? Will you be moving back there and both be living in Sioux Falls? Since you see this relationship as being anxiety producing, I think talking about it would be helpful to plan ahead.

Rate and close, and open up a new thread whenever you'd like, and we'll continue.

Dr. Sheppe

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Above answer was peer-reviewed by : Dr. Deepak
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2242 Questions

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