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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by notfred on December 1, 2006, at 23:56:53
Weds. night I got off work and started the movie "Dogma" about 6:30. I remember the whole movie and the end, which would make it 8:30. At that point things are not clear; very hazy. I got very scared and decided to leave the house and go stay in a hotel; I had some kind of fear about something or someone was going to happen/come to the house and I had to get away.
Leaving town in my car I kept on asking myself, what am I scared/running from ? We had heavy snow here the last few days and I had no business out on the road. I finally got hold of myself and realized there were many hotels in town, much closer. I turned around and finally I decided to return to my house. Slid off the road once.
Once home I was experiencing rapid heart beat (125 bpm) and I was sweaty and flushed (it was 10 degrees outside and 60 inside) and I had significant pain in my chest on the left side, over my heart. I still had no idea why I "ran away", let alone toward to next town, 30 miles away. I took 2 mg ativan. The pain over my heart got worse. I decided I should go the ER & make sure this was not a heart attack; my flatmates had returned and I asked C to take me to the ER. Both my flatmates commented that I was very pale. I am a WASP with a Welsh and Swedish family tree so I am always pale, this was very pronounced.
The ER takes you in quickly if you say heart attack. They hooked up the EKG, blood pressure cuff, pulseox, and O2. I was hypertensive, pulse 125, 97% O2 on room air, and no fever. The doc and nurse both said my presentation was common in heart attack. They drew blood and prepared me for a heparin drip. Gave me a lortab for the chest pain.
Neither the EKG nor bloodwork indicated any heart problems. They decided I was having a muscle spasm in my chest/chest wall on the left side. We discussed panic attack, but it did not seem likely, as the ativan should of stopped that cold. Discharged with a lortab script, told to take 3 mg/day ativan for a while, as it is a muscle relaxer, and ibuprofen. I did not go to work thurs, slept most of the day. Turned out it was a snow day at work so I did not even have to take sick hrs, I get paid for snow days when we cannot get to work.
That all is a reasonable explanation, except:
1) The mental confusion
2) Every muscle in my body hurts, I could not go to work today as my back locked up. Muscles in legs and arms really hurt as does my torso. My jaw muscles hurt. I have a big bruise on my left bicep/tricep, but no where else. Cannot account for it.I first started thinking about heart attack after
I came back to the house and that is when the confusion started to clear up. So I don't think I had a panic attack when I thought I might be having a heart attack. Also I never hyperventilated or had fast breathing.I think maybe I had a tonic-clonic seizure. That would explain the confusion, post seizure, and the muscle pain. I had one decades ago, every muscle in your body hurts after them and there is confusion.
What do y'all think ? I am booking some time with my primary. At least i want an EEG and neuro exam.
I do take Wellbrutrin, but this happened 12 hrs after I took 300 mgs XR & have taken it for ~2 yrs.
Posted by jonathanupr on December 2, 2006, at 0:20:15
In reply to What happened to me ?, posted by notfred on December 1, 2006, at 23:56:53
hmmm....
I do not know a whole of info on seizures so I can't help you out with that theory
though if I were in your shoes I'd look at a few things that could point to what you experienced and why your muscles and body ached the next day: (1) you don't have a cross tolerance developed concomitantly with the Ativan? (such as drinking alcohol on a daily basis, even if only a few drinks....cross tolerances can easily develop with GABA agonists) If so, then the Ativan you took wouldn't have had enough kick to it to spell a panic attack.
(2) Wellbutrin can do interesting things to the body. My mother took it for a couple of months and she began developing muscle aches and then began having severe neurological pain in her neck, followed by headaches. When she kicked the Wellbutrin the issues quit. I took Wellbutrin for well over 2 1/2 years, had night sweats, but nothing major.
(3) the physical aches could also be from your anxiety filled experience. Clinching the body, muscles tighten up and you don't realize it, grinding your teeth and not realizing it, etc.hope ya get feeling better
Posted by notfred on December 2, 2006, at 0:37:11
In reply to Re: What happened to me ?, posted by jonathanupr on December 2, 2006, at 0:20:15
(1) you don't have a cross tolerance developed concomitantly with the Ativan? (such as drinking alcohol on a daily basis, even if only a few drinks....cross tolerances can easily develop with GABA agonists) If so, then the Ativan you took wouldn't have had enough kick to it to spell a panic attack.
Thanks for replying !
Nope, I do not drink and I usually only take 1 mg atavin at a time. 2 mgs would be a big dose & I had not taken any ativan in several days.
I also really felt the 2 mgs ativan hit me. Very relaxed. I also have over 20 yrs experience with anxiety and I have never flipped like this. My stress level is pretty low this week.Still I will take anxiety over a seizure any day.
Posted by SLS on December 2, 2006, at 5:36:04
In reply to What happened to me ?, posted by notfred on December 1, 2006, at 23:56:53
Hi NotFred.
I don't have enough knowledge in the area of seizure disorders to be able to comment on your experience.
I'm just glad your ok.
- Scott
Posted by madeline on December 2, 2006, at 6:34:18
In reply to What happened to me ?, posted by notfred on December 1, 2006, at 23:56:53
If you had a tonic clonic seizure, then you very very likely would have lost consciousness.
However, the symptoms you describe may have been a partial seizure.
A neurological work up may be in order.
Additionally, I would have a complete cardiac work up. So many anxiety symptoms actually have their organic origin in the heart and not the brain - mitral valve prolapse, irregular heart rhythm all can cause anxiety and so often go undiagnosed.
I'm sorry you had to endure this, but thank goodness that the ER staff was responsive to you.
Maddie
Posted by notfred on December 2, 2006, at 14:38:08
In reply to Re: What happened to me ? » notfred, posted by madeline on December 2, 2006, at 6:34:18
Posted by Phillipa on December 2, 2006, at 17:49:09
In reply to Re: What happened to me ? » notfred, posted by madeline on December 2, 2006, at 6:34:18
Madeline if it was a seizure wouldn't bladder control be lost? And a prolapsed mitral valve could be the cause of the anxiety as my sister has one. And it's classic to have anxiety. Love Phillipa
Posted by madeline on December 2, 2006, at 18:24:11
In reply to Re: What happened to me ? » madeline, posted by Phillipa on December 2, 2006, at 17:49:09
Not necessarily. Partial seizures can manifest in a variety of ways and evidentally are quite common in children.
They may or may not be associated with incontinence in fact, they usually aren't.
Posted by Jost on December 2, 2006, at 19:28:38
In reply to Re: What happened to me ? » Phillipa, posted by madeline on December 2, 2006, at 18:24:11
I also don't know about seizures.
I guess if you had one in the past, it's important to have it checked out. Some people have a lowered seizure threshold-- which might possibly-- and I mean possibly, as in I'd wonder-- be an issue with wellbutrin, even at a low dose.
I want to stress, that I'm purely saying it's a question I would ask, if I were in your position-- not by any means a theory I have about it. Just a question.
Maybe the bruise on your arm was related to taking blood, or the heparin drip? depending on where it was?
I'm mostly just glad you're okay, too.
Jost
Posted by notfred on December 2, 2006, at 20:40:22
In reply to Re: What happened to me ?, posted by Jost on December 2, 2006, at 19:28:38
>
> Maybe the bruise on your arm was related to taking blood, or the heparin drip? depending on where it was?
>
Thanks, I appreciate you answering my post and in general am glad you are on this site. The bruise is on my right arm, I only let them do IV stuff on my left arm. It is hard to hit a vein on the right side, easy on the left. They did start a line for
heparin but never gave me any as blood and EKG tests indicated my heart was fine & I take asprin
every day. heparin & asprin combo can be tricky.
They are both anticoagulants.There is no evidence in my room that I was thrashing about but I was sitting at my computer desk in a chair on rollers so I could of either slumped forward, hitting my chest and arm on the hard edge of the desk (explaining my chest pain and arm bruise) or the chair would have rolled back and I could of slid to the ground from the chair. In any case there is lots of room to have a seziure without disturbing anything.
My first memory was me on my feet, I cannot remember if I was seated, on the floor, etc., prior to this. I do remember using the bathroom sometime during the movie so the fact i was not incontinent is not useful. While I did have some signs of anxiety(heart rate, sweating) my hands and body were not shakey. Both are very common when I have anxiety.
Though better today all my muscles still hurt a lot. I would of seen my primary yesterday but I could not get out of bed; my back locked up.
Hopefully I can see him Monday.nf
Posted by Phillipa on December 2, 2006, at 21:25:28
In reply to Re: What happened to me ?, posted by notfred on December 2, 2006, at 20:40:22
notfred my thoughts are with you and if anything like this happens again call the hospital. Please. Love Phillipa
Posted by notfred on December 2, 2006, at 21:46:49
In reply to Re: What happened to me ? » notfred, posted by Phillipa on December 2, 2006, at 21:25:28
> notfred my thoughts are with you and if anything like this happens again call the hospital. Please. Love Phillipa
Please note i did go to the hospital when this happened. I will return again if I have more trouble.
Posted by LlurpsieBlossom on December 2, 2006, at 22:58:17
In reply to Re: What happened to me ?, posted by notfred on December 2, 2006, at 21:46:49
Notfred,
sounds like a very traumatic evening. I'm glad you're okay. You sound very clear as you write these posts, so I imagine that the confusion and so on must have been very uncharacteristic of you.I've got a couple of theories. They may be totally off the wall. Maybe I watch too much TV.
1) dissociative fugue state. something in the movie triggered you, and you literally took off. you didn't know who you were, or why you were headed to the next town. When you got there, you gradually started coming to your senses. By this time, though, you were probably starting to experience increasing panic. By the time you got home, full-fledged panic attack. I wonder whether you would have responded to a beta-blocker? Perhaps the chest-wall muscle spasm and your muscle aches and tension the day after were due to anxiety. Also, I find bruises all the time that I don't remember. Maybe the arm got banged up because you were shovelling snow or slipped on the ice at some point? or maybe one of the hospital folk had to handle you or pick you up and bruised you by accident? If you take aspirin, perhaps you may bruise more easily. Have you been getting enough vitamin C?
2. Mini-stroke. a little bloodclot or minor brain bleed might cause confusion. Who knows how your brain (which is already predisposed to get anxious) might respond to such an event. Did you have any headaches or anything like that? I think that this kind of thing is fairly common.
The most important thing is that you are safe and sound. You did the right thing, and I hope it never happens again and turns out to be a benign phenomenon. I'm glad you're getting yourself checked out. Make sure that you get a good work-up from a neurologist who actually takes the time to listen to the story, rather than just reading your chart and ordering an MRI.
best to you,
-ll
Posted by Phillipa on December 3, 2006, at 18:27:55
In reply to Re: What happened to me ? » notfred, posted by LlurpsieBlossom on December 2, 2006, at 22:58:17
Well if it were a TIA mini stroke the MRI would show that. But definitely a neurology consult. Love Phillipa
Posted by notfred on December 4, 2006, at 17:34:26
In reply to What happened to me ?, posted by notfred on December 1, 2006, at 23:56:53
Back from the doc, he has me on a 30 day heart monitor. A workup for epilepsy is not worth it
unless right after a seziure. I wish I would of thought of that at the ER. If I have another "event" like this that cannot be explained in a cardiac context I could be looking at a Dx of epilepsy. This has we very scared as my drivers liscence would be taken away and no more Wellbrutrin.I am finding this place very negative, esp. posts like Vale's so I am going to stop coming here.
Posted by LlurpsieBlossom on December 4, 2006, at 19:32:19
In reply to Re: What happened to me ?, posted by notfred on December 4, 2006, at 17:34:26
(((((notfred))))))
I hope you get things sorted out with your health. Feel better soon, and I hope you have something nice to distract you in the meanwhile.
We all need a break from time to time. I hope yours is peaceful.
-ll
Posted by Honore on December 4, 2006, at 19:44:40
In reply to Re: What happened to me ?, posted by notfred on December 4, 2006, at 17:34:26
Notfred,
I'm sorry the medical evaluation was inconclusive.
Wearing a heart monitor for a month must be very difficult, and I can understand why you might want to stay away for a while. If you're not getting support here for making it through the next few weeks-- you're right to be careful.
I wish there were some way of answering the questions more or less right away and, of course, in a good way.
I wondered if you could find old medical records of your other episode, or could contact the doctors who treated you. Even if it doesn't give you answers about what happened this time-- specifically why, and whether it might happen again-- and what to do to prevent it-- it might at least provide more information or something more to go on.
Also, if you have the time to make an inventory of medications, herbs or supplements (even OTC medications, just in case)-- it might reveal some cause that you aren't aware of. Even OTCs, presented as harmless,do occasionally cause strange side-effects.
Do you have a therapist or other person to talk to? Having to be aware of this unresolved issue, particularly with the heart monitor, strikes me as a strain.
Also, as a aside, you'll probably agree with me that Vale's analysis is flawed. While s/he is definitely entitled to her/his opinion, that particular opinion isn't well founded, IMHO. Most evolutionary arguments are somewhat conclusory (ie it happened so it's an advantage, or the "way it has to be")--also IMO.
There is help, and there are worthwhile medications, and there will be more.
Hope to be seeing you around, and hearing that you're doing well.
Honore
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