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Dr. Andrew Rynne

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Suggest treatment for nausea, breathlessness and hyperhidrosis

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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Posted on Fri, 23 Oct 2015 in General Health
Question: Hi,
I am 31 Year old. I am in IT professional and goes to office everyday. But after some time, I start feeling suffocated and my feet gives me the feeling that they are boiling and because of this, I keep on removing & wearing the shoes whole day. Situation gets worsen after lunch and it keeps on increasing as day passes. Often I do vomit due this suffocation. Below are few situations when I feel it the most.
1. While riding or walking in XXXXXXX weather,
2. My sweat has bad order and if my shirt becomes wet from underarms, then I wont be comfortable even in a/c.
3. Stinking Area or restroom
4. After a long day, if I have dinner outside (without changing the dress). I will have tough time to reach back home.

As soon as I reach home, with half breath, I remove all the cloths and I can feel the heat coming out of my body. My heart beats will be all time high and ready to vomit and I am supposed to lay down immediately. I drink 5-6 liter of water every day and eat normal home made food. My BP is normal and I regularly donate blood. I do feel that psychology also plays some part here. Intensity of suffocation increases as I approach towards my house. Once I feel uncomfortable, there is no way to become normal until I reaches home and change my dress. If I use one shirt even for 1hr, I can't wear it again even though if it is absolutely fine.
doctor
Answered by Dr. Chintan Solanki 8 hours later
Brief Answer:
thyroid and B12 level should be checked, need further evaluation

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us. Your problem is somewhat unusual and I read it twice to understand your concern.

Feeling of suffocation and boiling in feet are mostly anxiety features the way you described. Still we need to rule out any physical problem first. Serum Vitamin B12 and thyroid hormone testing should be done first.
Often vomiting after suffocation needs to be checked with chest x -ray and ecg.

Your problem is more when there is bad smell or sunlight. It happens in migraine.

I would like to know more from you.

- Since when are you feeling such problems?

- What is situation on Holiday? If you are at home problem remains the same or not.

- You mentioned, ''If I use one shirt even for 1hr, I can't wear it again even though if it is absolutely fine.'' Does it mean you wear new shirt everyday?

- Is your suffocation noticed by others at work place or home?

- Do you have any complain of headache with such symptoms?

- Are these symptoms continuous during a day or occurring in episodes?

- During suffocation do you feel like you are dying?

- Are you married? Let me know some family background.

- Is there any stress (social, occupational, emotional, economical etc.) in your life?

Revert back to me with answers as well as reports I mentioned (if you have done already).

I will be happy to help further.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Chintan Solanki 2 hours later
Hello Dr.

Thanks for your response.

I kept on thinking last night, that how better I can jot down my problem.

I have this problem since 10-11 months but it was not that prominent. I used to get this feeling rarely but then it used to continue for atleast couple of days. I used to have long office hours that time. Recently I switched my job and now most of the time, I work from home(means sitting relaxed wearing shorts and no shirt and shoes). This might be the reason that every time I get dressed and go out, I start feeling uncomfortable in no time.

Take bath, get dressed and go out on bike and after sometime my feet start becoming hot. I realized that I feel more uncomfortable once underarms make shirt wet. After that, I just wait to reach back home and I will not be comfortable all this while. As I approaches home, I start feeling suffocated and remove the helmet as soon as possible. Enter inside the house, throw the shoes and remove the dress including watch in 4-5 sec and just lay down on bed with fan ON. 5-10 min, I will be normal. So I mentioned, I feel its psychological as well.

Other reason I noticed that while I have gastritis. I can feel that my stomach is hot. I tried having raw milk on empty stomach everyday for 2 weeks and that time I got some relieve. One more thing, I felt that frequency of this problem increases when I feel that my weight got increased or stomach is bulging out (due to excessive/outside food or gastritis).

Answer to your questions are below:

- Since when are you feeling such problems? : 10 - 11 months and now days it is regular.

- What is situation on Holiday? If you are at home problem remains the same or not. : Usually I don't wear shirt at home and remains fine. But yes, say I came back from outside and body odor and sweat stickiness will keep me uncomfortable

- You mentioned, ''If I use one shirt even for 1hr, I can't wear it again even though if it is absolutely fine.'' Does it mean you wear new shirt everyday? - Shirt has be washed and after every use, it goes for washing again.

- Is your suffocation noticed by others at work place or home? : I try my best to hide it from others. I will not talk much and use restroom. Say friends are at home and I am feeling uncomfortable, I will be keep on trying to be normal and as soon as they leave, same 5 sec process I repeat.

- Do you have any complain of headache with such symptoms? : I do get headache but not necessarily during these times. Had complete checkup 3 years back including MRI scan and nothing was diagnosed. That time, I used to have frequent headache.

- Are these symptoms continuous during a day or occurring in episodes? : If I feel it once, it will be there till I reach home and change dress.

- During suffocation do you feel like you are dying?: No. I just feel puckish and yes, it does little help when I am outside and can't remove the shoes/shirt.

- Are you married? Let me know some family background. : I am single, stays alone. My mom has depression, anxiety and thyroid problems. Dad and younger brother are fine.

- Is there any stress (social, occupational, emotional, economical etc.) in your life? : I wont say it as stress but yes mind will always be busy thinking sometime, be it financial or mom's health or anything.

I am going for a complete checkup next week sometime and as you suggested, i will get those things also checked.

Regards,
xxxx.
doctor
Answered by Dr. Chintan Solanki 3 hours later
Brief Answer:
Behavior therapy is needed, very rare possibility of agoraphobia

Detailed Answer:
Hi XXXXXXX

Thanks for answers and detail history.

Your problem is more likely psychological we can say. But still I prefer to go for basic required investigations as I mentioned.

You have got adapted to relax situation and in clothes as well as when you are out of home you feel uncomfortable. This is anxiety. At present I cannot say that it is a typical anxiety disorder but we need to rule out rare possibility of Agoraphobia.

From history it seems that behavioral modification with cognitive behavior therapy will help a lot. If needed you can be given low dose anti anxiety medicines.

With check up I suggest to meet psychiatrist personally also.

Hope this answer will help. Feel free to discuss further.


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Chintan Solanki 2 hours later
Thanks Dr. XXXXXXX

I will surely consult it asap but I do not feel if it is Agoraphobia.

Would be great if you can suggest any medicine or some natural way to reduce this problem.
doctor
Answered by Dr. Chintan Solanki 28 minutes later
Brief Answer:
anti anxiety medicine can help

Detailed Answer:
Hi,

Thanks for follow up.

Yes agoraphobia is not likely there if you are confident.For a while I can usgest only anti anxiety medicine.

Clonazepam or etizolam in daytime to reduce suffocation and burning sensation is helpful. These are prescription medicines and you need to consult doctor for the same. With this medicine you must actively try to remain in clothes for long and remove your discomfort without reaching home.And even after reaching home first you need to be relax and then only change the clothes like everyone does (not for alleviating suffocation).

Apart from medicines you need to maintain healthy lifestyle. This includes regular daily exercise (walking or running), hygienic food habits ( no junk food, no fatty food, preferably only home-made food with law salt and fat with more fruits and vegetables) and timely scheduled sleep. Yoga- meditation can also help.This may help or even can stop your problem after continuous efforts.

All the best and take care.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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