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    Suggest treatment for tightness in chest while having anxiety

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Posted on Wed, 1 Jun 2016 in General Health
Question: Well we will pick up from the last thread to clear up spouses
Presently I am married to a woman who is from and lives in Nebraska. I will be divorcing her and moving back to SD.

My previous wife lives in SD and I have a wonderful relationship with her. Strangely enough after she divorced me she is eagerly awaiting my return. She sent me a message with my granddaughter telling me that they BOTH were making cookies with lots of love for papa.

Well I had a bit of a panic yesterday. I also sent the full pft to DR Bhavsar so he could fully analyze it for any questions that I might ask He got back to me with a comment on the normal pft but the radiologists report concerned him. First it turns out that he was at the end of a long day and did not see what was exactly written. He saw Mild pulmonary HYPERTENSION and was suggesting I best get an ekg and a few other tests to verify. I texted him back and he apologized for his error. I never told him my anxiety jumped till I figured out his misread

In a conversation with him we talked of tightness in chest and asthma and he said asthma would not be just keeping upper chest from inflammation but whole lung. So he asked a couple questions regarding coughing, chest pain or mucus. Well it's no to all but chest tightness but no pain. He concluded that said no copd or asthma but more than likely anxiety symptoms so if I breath but my chest does not expand and fill as it once did and my belly breathes would you agree.
If I am exerting and my chest try's to expand but stops is that anxiety factors.
When my chest doesn't expand fully the belly takes over but can only go out so far. And feels pushed on I had an upper gi done a few years back and all was fine except they said there was some gerd. So is my stomach or something keeping the diaphragm from moving down when inhaling. I am not obese, far from it but since stress has many changes to the body would the slowing of my digestion causing a fullness to push on diaphragm.

Rational mind is trying to uncover possibilities leaving copd lung damage asthma out.

Oh. What hormones does the body release in a panic and anxiety attack and if it's rare attack it would take how long to leave body
If it's prolonged as in my case would take how much longer. Considering it gets in control.

One of you Drs responded to my question regarding allowing stress to go so long that the results not only gave sensation to and tightened the chest but also the anxiety levels were so high that when talking in conversations you could become sob.

So this is a thread in itself. My main concern in here is to understand what is actual chest tightness when exerting self. And why when I belly breathe the expansion is so much then feels as if diaphragm is pressed against.

doctor
Answered by Dr. Alexander H. Sheppe 4 hours later
Brief Answer:
Private Consultation

Detailed Answer:
I think I understand the spouse situation now. Thanks for clarifying.

You're asking some questions about your abdomen being involved in breathing. You ask:

"I breathe but my chest does not expand and fill as it once did and my belly breathes, would you agree?"

I'm going to point out that this is really just another form of the question "Why can't I get a full breath?" You're asking if your lungs are somehow constricted and if your belly is somehow making up for it. The answer to both these questions is that your lungs are fine, your belly is fine, and this is all anxiety.

The abdomen does not play any role in breathing. Breathing works this way: the diaphragm, which is in the lower chest and cannot be felt/sensed, tightens and causes the chest cavity to expand. This expansion pushes down lightly on the abdominal contents, which can be seen on the outside of the body as the "belly expanding," but the belly is not expanding, the diaphragm is simply expanding the chest. Digestion has no effect on the diaphragm, or breathing. Your PFTs tell the entire story: you have no significant problems with your lungs.

The hormones released in an acute panic attack are epinephrine and norepinephrine. They typically act on for a number of minutes, and increase the heart rate and respiratory rate. Their effect is brief, but the mental effect of anxiety is not controlled by hormones (we don't know how consciousness works), and can last several hours, days, or years. It is the mental effects we are trying to fight, which requires therapy.

Dr. Sheppe


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Alexander H. Sheppe 46 hours later
I have to work harder on you to realize my sarcasm a bit better. Other than my expensive specialty breed dog who can actually smile when she does something wrong and when stressed will pee uncontrollably most animals don't have stress they just have fight or flight. Humans have developed stress to a fine art. That's what we get for getting advanced thinking.

Let's try one more. Back in the 70-80's there was a commercial for preparation h. The actor stood on screen and had his arms pointed up , open palms facing each other and were at least two feet apart. And he would bring them together without actuall meeting all the while saying " helps shrink the swelling of hemoroids Well if you think about it. Anyone with roids that size cannot be helped with that medicine. You need plastic surgery.

What are "downs little pills".

Why do we show feminine hygiene freshness commercials during the hours that dinners are being served. Why do I want to know about smelling like a floral shop or a trash can ? I'm eating.

Now to business at hand. We have chatted in upcoming move, of need for job, new basses, PFTs new and old asthma anxiety flying into power lines. Now I am certain it would be foolish to try a program of better health with exercise diet mental healing etc. the best is to start slow so not to trigger any sensation that will set me back. Time to heal is relative to the patient what are some reasonable times that small changes can happen and what might you think for normal levels. I am also believing that I will need maintenance therapy for rest of life but that I'm sure will be much different than CBT today. You once said that fitness nuts can lose training in just 6 months of inactivity well I have a few years to make up for. Along with stress, aging, possible asthma and CBT to recognize the issues that frighten me. I will start with one ore two stairs. Up and down. Slowly. Then add to it. Must find mental distraction to avoid getting panic. Change diet. Cut 80 %!of my caffeine out. Lose 28 lbs my lands I've got a big program ahead of me. I hope your in it for the long haul.

Why am I only limited to make or female at gender. I want to answer yes but it's not there. What about XXXXXXX Jenner there is no Selection for half and half
doctor
Answered by Dr. Alexander H. Sheppe 3 hours later
Brief Answer:
Private Followup

Detailed Answer:
I always appreciate your sarcasm and humor, it makes me laugh and keeps things light! I'll make sure to send a sternly-worded letter to the site to have a XXXXXXX Jenner option for the gender column :)

I totally agree with your starting an exercise program. I also totally agree with starting slow. I would actually suggest starting with walking rather than jumping straight to stairs. Go out and walk 30 minutes a day. Believe it or not, just walking for 30 minutes a day has enormous positive benefits for your health. And I think it will slowly reintroduce you to how normal it is to run out of breath while exercising. Try to keep your mind focused on the task of exercise rather than worrying about what your SOB means -- and remember, you have a lot of evidence now that your rational mind can use to tell you nothing is wrong. And of course keep me updated on how this progresses.

We will eventually transition from CBT to more long-term dynamic psychotherapy when your anxiety is better controlled. But I think for now we should stick with what appears to be working, slowly but surely.

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Alexander H. Sheppe 12 hours later
Well I agree with walking but i am at such a point that i will walk a 10 block walk that will give about 15 minutes to start and then build.

Not even two steps, up with right, then with left, down with right, down with left. Awww your no fun.

Is it safe to restart watching all 62 episodes of Breaking Bad just so I can get ready for the upcoming remake or continuation of it. Its so intense. Heck then I can go watch Better Call XXXXXXX If not then I better go watch all episodes of Scrubs and House.
doctor
Answered by Dr. Alexander H. Sheppe 4 hours later
Brief Answer:
Private Followup

Detailed Answer:
Walking even a little bit and working your way up is good! And sure, a little bit of stepping won't hurt :)

Breaking Bad and Better Call XXXXXXX are both amazing. Nice try to get away from the exercise.

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

Psychiatrist

Practicing since :2014

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