Brief Answer:
Panic Disorder

Detailed Answer:
Hello XXXXXXX

I am so sorry for your losses. I lost my father when I was 20, so I have some understanding of what that is like. It sounds, too, like there is a lot of tumult happening in your family's life.

Given all of the cardiac and other medical evaluation you have had, I do not think your symptoms are from a heart attack. And yes, all of the symptoms you described can occur with panic attacks.

Given that your symptoms came on after losing your father and grandfather, I think it is safe to say that they are related to your reaction to that. Have you talked with a grief counselor or a psychologist? Also, have any doctors talked with you about the benefit you might get from medications for panic disorder?

Since your symptoms are ongoing, rather than just being occasional, I'd recommend an antidepressant medication for panic disorder, such as the SSRI medication escitalopram (Lexapro). This medication has an earlier onset of action and fewer side effects compared with some of the other antidepressants. But it may take a few weeks before you really start to see the benefits of taking it. And it can cause some mild nausea in the first couple of weeks but that should go away.

If you decide to take an antidepressant for the panic disorder, hile you are waiting for the antidepressant to kick in, it may be helpful to take an anti anxiety medicine such as lorazepam. This works immediately but has a shorter duration of action, so you have to take doses 2-3 times a day. Or it can be used just at times when panic or symptoms are most severe. The problem with this type of medication is that it can be sedating.

I strongly advise seeing a psychologist or grief counselor to talk about the feelings you have, and your primary doctor or a psychiatrist to talk about medications to help the symptoms.

Please let me know if I can provide further information. And best wishes to you.

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Brief Answer:
You will feel better in time

Detailed Answer:
For people who are sensitive to some mental health medications, it may be best to start with a lower dose, such as taking 5 mg instead. In fact, some people even start with 2.5 mg. It takes longer to get up to a dose that is helpful this way, but it can be worth it going up on the medication gradually helps you to tolerate it.

I can't say that it is impossible that the Lexapro caused the severe panic attack, but initially sometimes symptoms can get worse before the medication starts to help. That's why a low dose of lorazepam might help too.

And are your symptoms forever? The predisposition to having anxiety will be there, yes, but you can heal, and I believe with time and help you will. You have very recently had a big loss in your life, and further upheaval given your mom's trouble too. The meds and cbt can help that too. The loss leaves a bit of a scar, but you'll find that you will be able to gradually feel emotionally better and happy and well again.

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Brief Answer:
I don't think it's a neurological disorder.

Detailed Answer:
I don't think there is a neurological disorder that would give all of the symptoms you are having, and these symptoms can all happen with panic disorder. I know the heart symptoms especially must be scary, but you've had a good cardiac evaluation. Also, it was wise of your doctor to check for diabetes, thyroid disease, and celiac disease.

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Brief Answer:
Treat the anxiety and the chest pain should go away.

Detailed Answer:
Do you have some anti anxiety medication such as lorazepam or Xanax (alprazolam) that you can take? I think this would calm all of your symptoms down. If you have none, can you call the doctor who is on call for your own doctor to get 1 or 2 lorazepam or alprazolam to get you thru the night? If not, is there an urgent care you can go to to get some to get you by?

Your Vit. D level is low, but wouldn't be causing these symptoms.

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Brief Answer:
Nothing life threatening

Detailed Answer:
Given your healthy cardiac test results (and other tests), I do not think you need to worry about a heart attack or anything life threatening.

Anxiety disorder with panic can make a person feel like there is impending doom, but you have evidence that no real physical crisis is impending for you.

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Brief Answer:
Kyphosis

Detailed Answer:
That is a pretty sever kyphosis, but it shouldn't be causing heart pain given that your heart checked out ok.

If you think you might be having "heart burn", you can try Zantac 150 mg and see if that helps you.

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