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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 31. Go back in thread:
Posted by jflange on April 15, 2009, at 1:08:36
In reply to Re: Gym ( fitness) and cardio exercise = Panic att » raisinb, posted by Phillipa on April 14, 2009, at 22:03:11
Dear Vincent,
I always experience an increase in anxiety when I exercise. The more intense the cardio portion of the workout, the worse the anxiety reaction is. And when you are in public like that at the gym, and panic attacks are part of your anxiety spectrum, then I am not surprised that you had a bad reaction. Sorry to hear about it.
I second raisinb above: the trick is to do sustained lower-impact exercise like walking or hiking, giving yourself a day inbetween workouts to recover. Working out everyday for many days in a row makes me feel like I did before my medication: uck. Weights and pilates/yoga are also ok. The key word is moderation. But it's not exactly easy to get in shape fast with this type of exercise. . .
Be well,
jflange
Posted by desolationrower on April 15, 2009, at 2:26:00
In reply to Re: Gym ( fitness) and cardio exercise = Panic att, posted by jflange on April 15, 2009, at 1:08:36
keep in mind that overtraining (not the chronic overtraining syndrome, just doing a few days or week of hard exercise when you're out of shape) is going to be unpleasant and not a good experience. you need to gradually get into it, especially if you've been practicing being out of shape for years. and also pure long-distance aerobic isn't ideal for general health eitehr. some heavy weights, some sprints, some aerobic, not too much of any one, and only once one has a base of fitness. going too hard is pretty common for people starting out. but you can't make big changes all in the first week in the gym.
-d/r
Posted by Vincent_QC on April 15, 2009, at 6:34:24
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks, posted by desolationrower on April 14, 2009, at 11:17:42
> i'm not sure what you mean when you type a blood pressure and heart rate like "#-#-#" maybe saying "Bp:#/#, HR:#" would clarify.
>
>
> I think what you experience physically is normal. Some things like high level of CO2 in body cause panic attacks, but they are normal event during exercise. One of the benefits of exercise on anxiety is that you get used to these physical events, to heart pumping loudly and breathing a lot. but you get to realize its normal so you stop associating it with fear, and just see it as normal and not something to focus on. probably not endorphins though, more adrenaline/noradrenaline, cortisol, etc.
>
> its normal when first starting to exercise, especially if out of shape, smoker, etc. the more you exercise, the more your body will be able to recover quickly from the exertion. its not dangerous, unless you go all out right now when you are out of shape. first few weeks, don't try to do sprints or see how fast you can go, just break a sweat and get your breathing going a bit, i think your coach would have mentioned that. its very unhealthy not to exercise.
>
> keep in mind, people with social anxiety don't actually have greater increase in heart beat or things like that in public, they are just more aware of changes in their body: it is a problem of attention/focus. you are just hyperaware of body reacting in normal ways. like people with anxiety think about what they say and think to themselves "oh that joke wasn't funny, everyone knows i'm boring" when person w/o isn't focused on that, they focus on the conversationa nd other person and don't think about these worries.
>
> so if you are out of shape, your heart can't recover well, and you feel tired and like you are still exercising all day, but after fitness level improves, after 5 mintes of rest from aerobic exercise you feel fine and relaxed because ability to recover is much better.
>
> anyway hope you don't give up, what you experience is normal, and part of why many people get stuck in situation where they don't work out, whereas people who do exercise a lot wonder why other have so much trouble. don't try to become olympian all in one week, but keep at it.
>
> -d/rHi d/r!!!
You're right, as always... adrenaline/noradrenaline, cortisol is probably the problem here. And yes, I have to get used to.That's a new universe for me, a new place to go, tons of people I don't know, I probably just have to take more deep breath, since I tend to just take small breath or forget to breath... and of course, I have a problem of attention/focus and i'm hyperaware of my body reacting in normal ways, I will have to get used to that also.
The proof, I go last night again, even if I don't sleep a lot the night before, even if I had pain in my head, even if I was feeling anxious...and I See the difference, the weird sensation last after only 30 minutes... I think the more often I will go there, and the more faster I will get used of... also, I will have to cool down on the Valium before I go there, that's not helping me, that's probably make me less in shape to do physical exercises...proably a part of the dizness feeling... Anyway, yes today I feel tired, I don't sleep a lot again, probably because I go to late to the gym... get out of there around 9:45PM... This morning i'm ok...more better than yesterday...
IF I was able to go there last night, with the pain, the stress, the no sleep and the headache and do my whole programm (I just cut half of my bike time and try different machines for muscles that are not in my exercises work programm), I will be able certainly to return there and it's a proof that your theory about the ability to recover will be much better with time is true...
For the blood pressure, I mean BP of 140-145/80-90 , double numbers because that's in that range always... The HR is 90-100 at rest....another time, double numbers because it's in that range also...
Anyway, I will ask for some Inderall, since I was on it before (GAD and SAD and panic attack) but at a too low dosage (80mg/day at the time)... It was good to lower my blood pressure and reduce my migraines...but I stop it because of the no effect on the anxiety or the prevention of the panic attacks. Maybe a dose around 120 mg will help me more, since at the time I didn't had high blood pressure, it will be a more good reason to take it again...
Anyway, thanks again d/r...as usual, you find out what was the problem and I feel more well and you help me a lot!
Have a nice day ;-)
Vincent ;-)
Posted by Vincent_QC on April 15, 2009, at 6:38:17
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks, posted by Zana on April 14, 2009, at 11:44:04
> I think you just had a panic attack. Gyms cam be very over stimulating environments- people, music, TVs, the sound of the wieghts. I think you need a med strategy that helps you stay cool because if you can get yourself to the gym- boy that's great. It's just so good for you in so many different ways. Try to find a way to stay with it. It sound like you've made a great start. Work on the panic and stick with the gym if you can.
>
> ZanaThanks Zana ;-)
Yeah, I will stick to the gym... I return last night and it was more easy... I just do less bike, since the panic attack occurs when I do this exercises... Yes, I have pain everywhere and in every muscles...but exercises will help me for tons of things (social exposure, work on my panic and fixation on my heart, things like that).So I don't give up...anyway at 220$ a month, I will go to the gym anytimes I will be able to go!!! ;-)
Have a nice day ;-)
Vincent ;)
Posted by Vincent_QC on April 15, 2009, at 6:48:32
In reply to Re: Gym ( fitness) and cardio exercise = Panic att, posted by desolationrower on April 15, 2009, at 2:26:00
> keep in mind that overtraining (not the chronic overtraining syndrome, just doing a few days or week of hard exercise when you're out of shape) is going to be unpleasant and not a good experience. you need to gradually get into it, especially if you've been practicing being out of shape for years. and also pure long-distance aerobic isn't ideal for general health eitehr. some heavy weights, some sprints, some aerobic, not too much of any one, and only once one has a base of fitness. going too hard is pretty common for people starting out. but you can't make big changes all in the first week in the gym.
>
> -d/rExactly...it's why I will ask to cut down the cardio exercises part and add more musculation exercises, since I find the muscles part of the tranning less hard to do...
I know that too much is like not enought, my programm is adapted for my own need... maybe the coach jusdecide to add too much time spent on the bike in my programm... I will see him again in 1 week and we will talk about it. Maybe cut a 10 minutes of bike and add more muscles exercises...
My goal is not to recover from a bad healt person to a olympic status person... I just want to move more, be more in shape...and have more big muscles in my arms and legs...the gastric by-pass leave me without any muscles...and with no power in my arms and legs...
Posted by desolationrower on April 15, 2009, at 13:25:42
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks » desolationrower, posted by Vincent_QC on April 15, 2009, at 6:34:24
i think it might be worth trying an ace inhibitor or ARB instead of beta-blocker
also have you tried meditation. it probably would help with the breathing and physical sensations
-d/r
Posted by Sweetlilmagnolia on April 16, 2009, at 13:47:50
In reply to Gym ( fitness) and cardio exercise = Panic attacks, posted by Vincent_QC on April 14, 2009, at 7:58:05
Always remember these gym guys are trained in teaching fitness, they are not trained in medical management of their clients. Also know that they are humans, doing a job, day to day and WILL get in a rut, this goes along with MD's, nurses, physical therapists...etc. Im saying this to make a point. There is no cookie cutter program, no one certain magic pill that fits everyone, and while not every one's complaint is the same, you see a non-ending stream of clinets every day, stating the same complaints over and over again. Some times they ramble on and on and on....when professionals try to cut to the core, the clients feel rebuffed, or that no one is listening to them. Then you have those with a little knowledge that like to take the prescribers plan and alter it their way, then return complaining its not working. I say all this to sum up one major point. We ALL must take responsiblity for our own health, our own health history, and learn how to talk to the medical professionals that we are entrusting our health with. #1) Not every med works the same on every one. 2) Give the med time to work, take responsibility in taking the med as prescribed, not as you desire. 3) There are no miracle pills, there is pain, illness, stress & emotions in life, we must learn to deal with life as it is. For those of us that have def. we must take medication and balance the side effects with the outcomes. 4) We HAVE to eat right, rest, exercise & maintain daily hygiene. 5) learn how to talk to our professionals. before any visit, wright down all of your meds, that includes over the counter, herbals, vitamins. The name of the drug, the dose, frequency, how taken, why taken, is it working, side effects. Next, write down your health history, omitting your neighbors, cousins, etc, just your own. Do you have any heart conditions, diabetes, kidney diseases, etc. Are you allergic to any medication. meds that make you feel weird, gives you gas, makes your nauseated or just dont like it doesnt count. A true allergy causes an itchy rash, swelling-especially in the lips, tongue, throat. Any surgery history. That usually means being put to sleep and being cut open. A wart removed, a tooth pulled at the dentist is not. On your list, write your other or previous MD's name and phone#, your pharmacy name and phone number on it.
If this is a new MD or other professional. Stick to the problem you came about. Write this down if you need to. Keep it short and to the point. List your symptoms in one or two words, not paragraphs. The more you run on and talk, the less they listen.
I say this to all for I am a nurse, I take medical historys and listen as MD's try to extract info from pts. Keep your answers simple, factual and to the point. Write a list of short questions you have so you will remember to ask them, keep a pen in hand to write down their directions. Dont be afraid to tell them you dont understand what they just said or what they want you to do.
Lastly, use common sense. If someone tells you to start doing exercises for 30 mins at a time and you have a severe reactions (and I agree it sounds like a body reaction of adrenaline/noradrenaline, cortisol, and you sound very sensitive to these) Then dont do 30 mins. Start very very slow, do just a bit to let your muscles wake up, take your time increasing it as you tolerate it. When I start someone mall walking, we only go around one time for about a week, then we increase it to one and a half rounds, its a few weeks before we kick it up, that way the body gets introduced to the adrenaline release, the muscle stress and reduces the person from giving up too quickly. I also love including Tai Chi, it helps with my anxiety do. Good luck to you
Posted by Vincent_QC on April 16, 2009, at 14:54:01
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks, posted by desolationrower on April 15, 2009, at 13:25:42
> i think it might be worth trying an ace inhibitor or ARB instead of beta-blocker
>
> also have you tried meditation. it probably would help with the breathing and physical sensations
>
> -d/rHi d/r,
Hummm... I prefer to wait to see if the Marplan will be approaved for me, if so, I can't mix an ace inhibitor or an ARB with a MAOI, by ARB you mean meds like Avapro, for people who cant take the ace?Why I should talk to my Family Doctor about the Sabril (Vigabatrin), I see him next monday morning. The Vigabatrin is in the same family of the lyrica or Gabapentin...but have another mechanism of action...it have a strong blocking panic attack effect...yes, that's a anti-seizure medecine, yes it can give weight gain and cause tons of side-effects...but that's seem to work well for blocking the panic attack (work on the NDMA receptors...I don't remember exactly the whole process of this med) but that's seem to be good no?
The benzo option for me is no no for now... Valium30mg...when things will be more stable in my life I will withdrawh it slowly...
I go slow on the cardio...I try to explain how I was feeling to the trainer last night again, he say to stick to the 30 minutes of bike cause the muscles exercises are also a lot hard for the cardio and I need to do both.
I return for the third evening last night and at the end I was exhausted, but it take less time to recover after, I feeled lighthead and dizness less time after...1 hour... my ears become all reds and I sweat a lot from my "hands"...strange...anyway...out of breath also but probably related to cigarettes...
I try to do 3 sets of 7 minutes, separeted with muscles exercises period, instead of 10 minutes divided in 3 sets... that's more good than nothing at all.
I also figure out that the trainer never explain to me what kind of stretch exercises I have to do before...and also don't show me how and when to breath, especially for the muscles exercises...(breathing and inspire).
I also know now that if I chew a gum, my pain in the head is worst while I exercise and after. Probably a nervous tic that I have...I Tend to do strange mouvements with my jaw... I especially do this when i'm nervous so with a gum that's worst...
I also need to calm down, even if the trainer want me to do more... I just begin... I cannot became mister muscles and be in good health in 1 week...It will be a long process so I do what I can do, if I want to take 10 minutes of break because I feel weak and lightheat I will take it... that's my body... I still believe that's better than stay inside my house and doing nothing... I go there, I pratice my social exposure in a situation that I don't like (tons of cute guys, i'm gay remember...lol), music, TV's, noise, birght light, everything so make this place a nightmare for someone with social phobia and panic attack with agoraphobia...I have no place there to calm me down, it's full of people, even in the lockerroom...
I have also to learn to be less shy in the lockerroom...that's a lot for me... Avoiding the lockerroom and the shower will just worse my problem, just like avoiding the bike, I just need to learn to cope with the adrenaline effect...
For the muscles, I recover more faster also...had terrible pain lasting for 2 - 3 hours after and when I go to the bed and wake up in the morning that's number one...some pain in the left legs and arms...probably more weak then the right ones... but that's ok...
Anyway, I have the proof now that I will not die of an heart attack, that's purely a panic trouble related to social environement and the heart.
Tonight I return...I meet the nutritionist girl...we will work the part of the "eat well"...trying to avoid the "spring boulimia symptoms I live each year by doing strict proteine diet...I need to try to eat healthy, I will loose more slowly the pounds but will not gain it after like I do each fall and winter... and since i'm returning into the AD world that's worst because all the meds tend to make me eat more...or just tend to make me fat without eating more... that's a tons of bad habits that I have to break... I also have an appointment with the trainer after from 7:30 to 8:30...
Physical exercise will not be a funny part of my recover, but i'm sure it will help, since my problem is not a depression to start it but a social phobia and a panic attack with agoraphobia problem, it tend to make the whole process of finding a good med and having a good lifestyle more hard...
Well enought for today... I'm sure you understand me....
You are so nice for your help, I appreciate it and I hope you believe me when I write this ;-)
Take care of you d/r ;-)
Bye!
Vincent ;-)
PS: Relaxation techniques...I had some courses of that in one of my group therapy... I was unable to do mental imagery or relaxation at the time, maybe I should try it a second time... I just remember the technique of how to breath (deep breathing and count 1,2,3,4,5 and after inspire for 5 seconds...do this 5 times...that's help me a little bit sometimes, especially after a panic attack of before a stressfull event like social exposure...
This message also apply to the person who answer after... I 100% agree with you...we are all different... no med fit to everyone...health is something very important...and I know I neglect mine for a long time... but I can't also stop all the bad habits I have at the same time, I stop the coffee...I just begin the gym, next step will be trying to eat more healthy food...and after stop smooking...why the cigarrettes at the end? Well, because smooking is a kind of AD drug...stop smooking now will just make me more depress and jump into the bad food or worse... I tend to wanting to change everything at the same time and I always give up everything...this time I will do it step by step, anyway I already lost 2 years of my life, so add another year to recover or more time will not be worse, I have to cope with everything I live and accept the fact that I will not be at 100% top shape in 1 month...
For now, I try to learn the whole process of "psyshological resilence , I have a good wenlink about this...
http://en.wikipedia.org/wiki/Psychological_resilience
One of my PDoc talk to me about this...I have to find a book about it...
Posted by Phillipa on April 16, 2009, at 20:00:26
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks » desolationrower, posted by Vincent_QC on April 16, 2009, at 14:54:01
Vincent also the muscles build up lactic acid which can cause soreness stretch well afterwards and give your body time to recover with a day off inbetween. On the other days is ther something else you can do. Yoga could be good as a lot of stretching. Rome wasn't build in a day. Love Phillipa
Posted by Vincent-QC on April 17, 2009, at 7:44:49
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks » Vincent_QC, posted by Phillipa on April 16, 2009, at 20:00:26
> Vincent also the muscles build up lactic acid which can cause soreness stretch well afterwards and give your body time to recover with a day off inbetween. On the other days is ther something else you can do. Yoga could be good as a lot of stretching. Rome wasn't build in a day. Love Phillipa
I agree at 100% Jan!!! ;-)
I didn't know the english people used that expression...we have the same in french... " Rome ne s'est pas construit en une journée"... lol
You see, my muscles now recover more fast, at the begining of the week I had pain for 3 days...now it's ok...I go to the gym, do my muscles exercises, have pain for 1-2 hours after and in the morning I recover at 100%... all the machines are set very low , i'm a beginner...but I can increase them of 10-20 pounds each weeks if I feel that i'm able to... the more exercises I Will do, and the more good my muscles will be able to absorb the oxygen ... I tend to not breath and exhale often while I exercises, so its why I tend to have dizness... The trainer last night help me on that point... I tend to don't breath deeply... I try to take deep breath but that's not easy...
The trainer told me she was very proud of me last night, she was so nice...she said that just the fact that I go to the gym, that I see a lot of peoples that I don't know, that I do my exercises in front of them, is a BIG step in the good direction, for someone with social phobia...
I was proud if myself... Sorry if I look a lot turning into MYSELF ...but I can say that from monday to friday, my feeling about the gym change around 100%... Monday I was exhausted and I wanted a refund from the gym...now I just want to go the more often I can... YES, I have a lot of dizness on the cardio machine, I tend to feel lighthead and I focus on my heart...but each time I go there, the fear decrease and I feel more comfortable... I"m also not shy anymore in the lockerroom, even if I have to be naked in front of 10 guys...who cares... that's a lot of SMALL victory for me...each time I go there I feel stronger...stronger in my minds and my muscles also... it will do a good job for me, maybe more than every pills I try in the past...
Posted by Sweetlilmagnolia on April 17, 2009, at 16:01:42
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks » Phillipa, posted by Vincent-QC on April 17, 2009, at 7:44:49
I am very impressed with your determination, and your strength inside yourself for making yourself continue to go. The dizzyness may also come from hyperventalating during your work out from the physical exerction as well as your heightened fear, try different music in your ipod, either something to soothe you or something to distract you. When I havent exercised in awhile, I start easing into it by taking the stairs down a flight or two, and returning via elevator. I wouldnt be able to breath if I tried to go up the stairs, even one flight, and with my palpatations, it would trigger a panic attack as well. I also add brisk walks before my shift and afterwards. A couple of physical therapist friends taught me some stretching techniques to warm up my muscles and it really helped. I hope to hear you post soon that you are sleeping better and have more good energy. Good luck, think Ill go for a walk in the rain! You just inspired me to kick my physical activity up a notch!.
Posted by desolationrower on April 17, 2009, at 23:24:20
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks » desolationrower, posted by Vincent_QC on April 16, 2009, at 14:54:01
well, to warm up, just do maybe 5 minutes on a bike, and then i do 1-2 sets each of pulldowns, bench press, and squat, with about half of the weight i would use for a real set. then i do a few stretches in between sets while i'm catching my breath. stretching itself isn't the same as warming up. warming up is to prevent injuries, and stretching is what you do if your range of motion isn't sufficient.
for breathing, main thing is don't hold your breath (this can slightly increase amount you can lift, but also give you an aneurism...), breath in or in and out both on the part of the lift where the weight is going down (eccentric, or where muscle is lengthening), then when pushing breath out through the movement.
also, i think using nicotine patch/lozenge would be good, even if you don't do anything to try to quit. it would probably make it easier to reduce how many smokes you take each day, without doing anything to cause withdrawal.
also i don't think theres any reason that MAOIs and arbs/ACEi are not to be taken together. yes avapro is one. beta-blocker can cause soem people to be depressed. also probably cause more orthostatic hypotension problems.
yeah i think meditation work could help a lot with the kind of anxiety you notice. i don't really have any good links handy, i read a few books, which doesn't really help on the internet....
with the nutritionist, tell her you do well on protein diet, but try to figure out a version that is more sustainable. probably some lean meats/fish and nuts would be important, and some vegetables of course. probably with the surgery, getting grains or beans and fibre isn't really the best idea. and working out some meals so theres variety and something you can stick to easier, when you hit times like autumn .
you're a very affable guy
-d/r
Posted by Vincent_QC on April 18, 2009, at 6:53:51
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks, posted by Sweetlilmagnolia on April 17, 2009, at 16:01:42
> I am very impressed with your determination, and your strength inside yourself for making yourself continue to go. The dizzyness may also come from hyperventalating during your work out from the physical exerction as well as your heightened fear, try different music in your ipod, either something to soothe you or something to distract you. When I havent exercised in awhile, I start easing into it by taking the stairs down a flight or two, and returning via elevator. I wouldnt be able to breath if I tried to go up the stairs, even one flight, and with my palpatations, it would trigger a panic attack as well. I also add brisk walks before my shift and afterwards. A couple of physical therapist friends taught me some stretching techniques to warm up my muscles and it really helped. I hope to hear you post soon that you are sleeping better and have more good energy. Good luck, think Ill go for a walk in the rain! You just inspired me to kick my physical activity up a notch!.
Haaa thanks...you also inspired me a lot with the good words you write that's so nice...
Before going to the gym, I try to park the car as far as possible from the gym, so I work 20 minutes before...and after. You're right about the breathing, I tend to not breath often...or hyperventalating, I need to pratice this as well as doing some stretching exercises on the floor, before I begin the cardio exercises.
I think the main problem with the gym is the fact that is a "distracting and embarrassing" environnement, I mean that it's full of people who just look at themself and try to be THE greatest muscle guy of the world... This people look at you when you do your muscles exercises and i'm shy because I see the weight I put on a machine is very low...
I still try to stick to the 30 minutes of bike, separated in 3 sets of 10 minutes...at level 5 with a 75 mph speed but that's not easy.
For now, I do panic attack of feel weird almost every night I go there. I try the music, it make me worst. I try to watch the TV, I tend to stop thinking breathing and start feeling a lot of dizness...
I really need to find something to blook the panic attack. 1mg of Rivotril, even if it does nothing for social phobia, is good to block the panic attack...but I fear to fall again in the addiction circle...it's why I will ask for the Vigabatrin (Sabril)...For now, 1 h before the gym, I take 20mg of Valium...but that seem to not help me a lot. I found out last week that Clonazepam was more good to prevent panic attack cause my sister use it and I go to her house and pick up some pills in the "pot pills"... I take 1 mg of Clonazepam and I was ok, less dizness than on the Valium overall... So that's my two options for now, even if I know the Family Doc will say no for the Clonazepam (addiction in the past)... for the Sabril, I don't know if he is award of his blocking effect on panic attack...
I also notice that I have BIG pain in the jaw during and after the exercises...worst after and last 2-3 hours after...and my ears are very RED... that's really strange...my blood pressure stay always the same...is it purely a panic effect? Anyway, I feel uptight all the time I stay at the gym, making the 2 hours very hard for my body (psychologicaly and physicaly also)...
The hypervigileance make me a lot tired after...but strangely, my sleep time and quality diminish since I start the gym. The fight or flight reaction in my head is totally out of control...I try to apply the "change my minds or mental discourt", that's not working, I try to forget the people around me but that's make me more overstress and anxious... I just feel watched there and I don't like that feeling at all... The fear of having fear is something that I can't control by myself, even after years of therapy and tons of books reading about that subject...
BUT I will not give up and continu to go there...after a while I will be able to control a little bit more myself I hope...
The strange pain I feel in my head is linked to the JAW pain...It's like the muscles of my mouth is a lot painfull after...all the jaw muscles to the temples... I can't chew a gum when I exercises because it's worse the pain and make me feel a lot anxious about this strange pain... I just feel like I take "speed" drug or an "exctasy"...crisp all over my body, I can't just relaxe...
Anyway..thanks for your support and i'm glad I inspire you ;-)
Have a nice weekend ;-)
Vincent ;-)
Posted by Vincent_QC on April 18, 2009, at 7:54:54
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks, posted by desolationrower on April 17, 2009, at 23:24:20
> well, to warm up, just do maybe 5 minutes on a bike, and then i do 1-2 sets each of pulldowns, bench press, and squat, with about half of the weight i would use for a real set. then i do a few stretches in between sets while i'm catching my breath. stretching itself isn't the same as warming up. warming up is to prevent injuries, and stretching is what you do if your range of motion isn't sufficient.
>
> for breathing, main thing is don't hold your breath (this can slightly increase amount you can lift, but also give you an aneurism...), breath in or in and out both on the part of the lift where the weight is going down (eccentric, or where muscle is lengthening), then when pushing breath out through the movement.
>
> also, i think using nicotine patch/lozenge would be good, even if you don't do anything to try to quit. it would probably make it easier to reduce how many smokes you take each day, without doing anything to cause withdrawal.
>
> also i don't think theres any reason that MAOIs and arbs/ACEi are not to be taken together. yes avapro is one. beta-blocker can cause soem people to be depressed. also probably cause more orthostatic hypotension problems.
>
> yeah i think meditation work could help a lot with the kind of anxiety you notice. i don't really have any good links handy, i read a few books, which doesn't really help on the internet....
>
> with the nutritionist, tell her you do well on protein diet, but try to figure out a version that is more sustainable. probably some lean meats/fish and nuts would be important, and some vegetables of course. probably with the surgery, getting grains or beans and fibre isn't really the best idea. and working out some meals so theres variety and something you can stick to easier, when you hit times like autumn .
>
> you're a very affable guy
>
> -d/rHi d/r ;-)
Thanks for your help, I really appreciate it !!!
Well, I do exactly what you told to do... I start very low on the bike, just to prepare my muscles for the work... I do some muscles exercises but at a low weight also... I just lack the part of stretching muscles for now, I don't know what to do to stretch my muscles...normally you do this before starting the gym...on the carpet on the floor...
I also learn last night how to breath... I try to don't hold my breath but that's not easy, i'm a lot hypervigileant with the environement and people around me so I tend to forget to breath... I try to breath in where the weight is going down and breath out when I lift the weight... but I always forget to breath at some point...so I begin to feel a lot of dizness...
Ok...if I ask for avapro, or the one with the hydrochlorothiazide inside, Avalide, since I do a lot of water retention, it will be good for me? My dad was switch to 150mg of Avalide, same as Avapro but with a diuretic inside... Is it dangerous to take a pill of 150mg of Avalide (Dangerous for low blood pression)if my normal blood pressure is in the range off BP:130-150/80-90 with a Pulse rate of 90??? I don't want to fall into hypotension...since that's not more good than hypertension...
And for the Beta-blockant...I know it's linked to depression... but it will not help me? since the heart increasing pulse rate make me panic most of the time and overfocused on it? beta blocker are good for situation anxiety or situation performance no? It will maybe help me to stop focusing on the heart beat?
For the interraction with the MAOI, it's write everywhere...never mix a beta blocker or an ace inhibitor with them...the MAOI will make the beta or the ace more powerfull...causing more orthostatic hypotension... I'm a lot sensible to the hypotension effect also...On the Parnate, I had severals hypotension episodes, to the point that I had photophobia and I was unable to walk or open a light...I had a nightmare night where I had to cry to my mom to help me and bring me the box of salt with water to help my blood pressure to be a little bit more normal... I Was unable to get up of my bed...I was so weak... I totally freak that time... I Think I stop the Parnate the day after...It was so scary...anyway...
For the nicotine patch? It's also dangerous to smooke when you use them no? I smooke around 25-30 cigarettes day... I swear the god I try to stop...I try 2 times last year...I try the new med to stop call "Champix" in the Canada...not working... I try the patch...I try without anything... I think that's too much for me... Maybe the patch without quit smooking will help to reduce the amount of cigarettes I smooke each day...if you think it's safe to smooke and having a patch, maybe it's worth the try?... Also, the patch, while i'm at the gym, I have to remove it no? The sweating will make the nicotine to be release in the body too much no?
Last question here... Do you know the med call "SABRIL" (Vigabatrin)? I don't think they have it in the USA...Some studies conclude it's a good anti panic agent (vigabatrin reduced cholecystokinin tetrapeptide-induced symptoms of panic disorder, in addition to elevated cortisol and ACTH levels, in healthy volunteers)... It's an irreversible suicide inhibitor of gamma-aminobutyric acid transaminase (GABA-T), the enzyme responsible for the catabolism of GABA, which increases the level of GABA in the synapses. Do you think it's more good than the Lyrica or the Gabapentin?
I will have to find a solution cause for 240 $ each month, I cant afford going to the gym and ending to not going because I cant augment my cardio exercises time and because I will not be able to stop having panic attacks... I prefer to cancel the membership and buy a bike and doing this oustide alone or whit a friend...it will be less expensive like this!!! I do a lot of bike at summer time before, back in 2002 until 2005... I stop because the bike broke and I Didn't had money to buy a new one at the time...but well...that's a big decision... The gym will help me not only for the cardio but for the muscles also...with the weight I loose, it was so fast that I lost almost all the muscles in my arms...the bottom part of my body is ok...my muscles stay in good shape...but the upper body was completly destroy...Since riding the bycicle outside will not help my upper body muscles...what I do???
I'm torn between cancel the gym and doing bike outside...it will help me to cope with the heart effect in a less "social" environement...and maybe in the fall I will be able to return to the gym and I will be more well prepare to face the gym environement???
What do you think about that idea???
Posted by Phillipa on April 18, 2009, at 21:22:33
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks » desolationrower, posted by Vincent_QC on April 18, 2009, at 7:54:54
Vincent I say ride the bike outdoors and also benefit from the sun the vitamin D. Then buy some weights of your own and do your routine. Free weights great for upper body. And then some Yoga stretching after walking a bit. Love Phillipa ps didn't hear from you today?
Posted by garnet71 on April 19, 2009, at 0:15:45
In reply to Gym ( fitness) and cardio exercise = Panic attacks, posted by Vincent_QC on April 14, 2009, at 7:58:05
Hey Vincent!
Not that this would help your anxiety issue - I think the supplement D-Ribose would be very helpful to getting back in shape.
http://www.anti-aging-guide.org/d-ribose.html
I have severe anxiety, and it did not affect those issues. When I was having energy problems, this supplement helped. It might give you an extra 'kick'....
Yeah, I understand the gym culture and all. I frequented hard-core military gyms, but I prefered the all women gym I used to go to when I could afford to pay a membership. The thing about gyms though, when you're there, its easier to be motivated to complete a workout. If you depend on biking and free weights at home, you may not get the same benefit (though I think you should do biking and gym). You really need the strength training that a gym provides, imo. I'd keep up with the gym for now; who cares about all the muscle heads, huh?
They are likely to be more focused on their grunting noises rather than what you are doing anyway. lol
Hey, you deserve a commendation here for perserverence. Like I mentioned before, you are a breath of fresh air on this forum :-)
Keep it up and best of luck to you!
Posted by garnet71 on April 19, 2009, at 21:03:18
In reply to Gym ( fitness) and cardio exercise = Panic attacks, posted by Vincent_QC on April 14, 2009, at 7:58:05
Vincent, I think you fit in with our island community...please read post above....we need more men there...join us! :-)
Posted by Vincent_QC on April 20, 2009, at 10:22:59
In reply to Re: Vincent - come to our island » Vincent_QC, posted by garnet71 on April 19, 2009, at 21:03:18
> Vincent, I think you fit in with our island community...please read post above....we need more men there...join us! :-)
Lol ;-) Well, I read the post but didn't had the time to answer... I promise I will do it before tomorrow.
I have some problems to solve taht take huge energy and times since saturday... A lot of stuff in my minds (thanks for the GAD), I can't shut off my brain to off, so I do a lot of panic attacks and I have repetitive thoughts in my minds that's before thwy will be resolve, will take all my times and energy...I hate being like that but I have to learn to deal with that problem, since i'm like that...
I'm going to my Family Doctor appointment in 10 minutes... I have 3 things to talk with him...heart issue (high blood pressure), anti panic agent to find with him ( 2 problems in one, probably CLONIDINE, since I read it's better than a beta-blocker to help to cope with panic attacks and prevent them by diminish the noradrenaline amount into the synapse...), I will talk to him about the Vigabatrin also...maybe a mix of this two agents together will help more and the last thing will be to change my last RX of Bromazepam to Rivotril 3 or 4 mg/day...since no benzo seem to work on me anymore for social phobia, and that's the Rivotril is still the only one who is able to help me to cope with general anxiety and help a little bit to prevent panic attack... without the SEDATION of the Valium, the valium who is totally not efficient for anxiety on my , I just get more depress and more sedated... 30mg or 40mg now....I was around 20mg before... that's a nightmare... I hate it, even more than the Rivotril or Xanax...but well I have no choice...
So I go for the Cloridine + Rivotril + maybe Vigabatrin...
The jaw mouvements I do constantly is now confirm by myself to be the strange sensation I feel inside my head... I just realise it last week... The more i'm anxious and the more pain I feel inside my head but the pain is also linked to the Jaw...I didn't notice that before... So the problem is that if I chew gums when I do the cardio exercises at the gym, after I have pains in head and jaw that's is not tolerable at all... the jonction of the jaw and the templs region in the head is a realistic assuming... It remember me the time I was on hard drug like cocaine... so that's not comming from the benzos drugs like I was thinking before and not linked to the fact I will do a seizure...
I will keep you inform of everything as soon as I can !!!
Thanks ;-)
Vincent ;-)
Posted by Phillipa on April 20, 2009, at 20:04:34
In reply to Re: Vincent - come to our island » garnet71, posted by Vincent_QC on April 20, 2009, at 10:22:59
Vincent well what's going on you haven't written? Phillipa
Posted by Vincent_QC on April 21, 2009, at 7:08:48
In reply to Re: Vincent - come to our island » Vincent_QC, posted by Phillipa on April 20, 2009, at 20:04:34
> Vincent well what's going on you haven't written? Phillipa
Well, I see the Doctor... Clonidine low dose 0.2mg/day...wil be good for the blood pressure and the panic attack....alpha 2 antagonist are more safer for me to use...he didn't wanted to RX to me something like "Avapro"... because he is not sure if my blood pressure will stay elevated for a long time or not...
Seem that I had a bad reaction on the Parnate, probably an increase NE level and that my brain never recover from this...so it's why I do more panic attack and i'm more anxious now...
Clonidine is safer than an ace inhibitor...the worst I can get is hypotension...but I take the 0.1 mg x 2 yesterday and feel nothing, no reduction of the blood pressure... just a weakness in the muscles...but it's related to the gym i'm sure...
For the gym, I continu to go there... The Doctor say that my muscles produce an acid...I forget the name...but in some person like me, more sensible to anxiety and stress and NE effect in the brain, that acid can provoke panic attack when the level get too high...
He was pround of me because im going to the gym and approve my choice... I do social exposure and I get used of the effect of the exercises on my body... He say it will be less hard with time...that's possible I will continu to experience dizness sensation and sometimes panic attack but that's totally normal and not dangerous, even if my blood pressure is high...
Valium is now substitute with Rivotril 4mg/day, a low dose for me... not effective for social phobia but more good as an anti panic agent... The Valium did nothing on me at the end...just add more depressive and lack of motivation... Since I Was on a more high dose of Rivotril in the past, and I was 100% functional (I was full time student,had a crazy night life style, going out 4 nights week... had the time to study and do big works, traveling from the city where I Was a student to my parents house some weekends...) I was more active on the Rivotril than on the Valium...and strangely, I became depressive a couple of weeks after I begin the Valium... is it linked or not to the Valium? I think it is... the Valium was the option to stop the benzo drugs...I never stop cause I never get stable on a good AD...
I can say for now that I will not be free of benzo drugs before a long time...I have to accept this reallity... if I need them all my life what I Can do??? ... Anyway, Rivotril never affect my cognitives abilities... others benzos like Xanax was the worst in that domain...
So that's the new... 0.2mg of Clonidine and 4mg of Rivotril... I see the PDoc next week, will see if the Marplan is approved...if not, don't know what will be my next move... probably pristiq...or luvox...or the cymbalta...3 meds that I never try...luvox is worse for the weight gain...so in order...Pristiq (less NE increase), Cymbalta (more NE, so more blood pressure) and luvox (weight gain and sedation)...
I write more later...for now I have to go !
Thanks everyone...
vincent ;-)
Posted by Phillipa on April 21, 2009, at 20:00:38
In reply to Re: Vincent - come to our island » Phillipa, posted by Vincent_QC on April 21, 2009, at 7:08:48
Vincent I never gained weight on luvox and at one time was on 250mg of it. My anxiety is so bad whole family need both benzos and luvox. Just now how to get them???? Love Phillipa
Posted by desolationrower on April 24, 2009, at 17:52:21
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks » desolationrower, posted by Vincent_QC on April 18, 2009, at 7:54:54
> I also learn last night how to breath... I try to don't hold my breath but that's not easy, i'm a lot hypervigileant with the environement and people around me so I tend to forget to breath... I try to breath in where the weight is going down and breath out when I lift the weight... but I always forget to breath at some point...so I begin to feel a lot of dizness...
yeah, the first month or two at the gym, getting breathing, technique, stuff like that down is whats important, to prevent injuries.
> Ok...if I ask for avapro, or the one with the hydrochlorothiazide inside, Avalide, since I do a lot of water retention, it will be good for me? My dad was switch to 150mg of Avalide, same as Avapro but with a diuretic inside... Is it dangerous to take a pill of 150mg of Avalide (Dangerous for low blood pression)if my normal blood pressure is in the range off BP:130-150/80-90 with a Pulse rate of 90??? I don't want to fall into hypotension...since that's not more good than hypertension...
well, i didn't find anything in the cardiologist books i look at, but my guess is that since the main orth. hypo. problem w/ maoi is related to lack of sympathetic activation to counteract physical changes, the NA affecting antihypertensives will have a worse effect on Ortho. for the a given amount of resting BP reduction. but i can see not wanting to start 'avapro' if you might not have hypertension in near future.
i thought you had tried a B-blocker before and it didn't help anxiety for you?
remember, it tends to go away if you stay on the MAOI for a while
> For the nicotine patch? It's also dangerous to smooke when you use them no?
i had never heard that. you could get too much nicotine, which could make you nauseated, but before that point i'd think you'd feel like you had enough nicotine (like when you smoked sort of recnetly, and don't feel the need for another smoke yet.)
I smooke around 25-30 cigarettes day... I swear the god I try to stop...I try 2 times last year...I try the new med to stop call "Champix" in the Canada...not working... I try the patch...I try without anything... I think that's too much for me... Maybe the patch without quit smooking will help to reduce the amount of cigarettes I smooke each day...if you think it's safe to smooke and having a patch, maybe it's worth the try?... Also, the patch, while i'm at the gym, I have to remove it no? The sweating will make the nicotine to be release in the body too much no?
i don't know how sweat affects it, i say just go by feel, if you feel like you have too much nicotine, take it off next time. i've not ever been a smoker, but its quite addictive, and you have other things to worry about, trying to quit is very hard...
> Last question here... Do you know the med call "SABRIL" (Vigabatrin)? I don't think they have it in the USA...Some studies conclude it's a good anti panic agent (vigabatrin reduced cholecystokinin tetrapeptide-induced symptoms of panic disorder, in addition to elevated cortisol and ACTH levels, in healthy volunteers)... It's an irreversible suicide inhibitor of gamma-aminobutyric acid transaminase (GABA-T), the enzyme responsible for the catabolism of GABA, which increases the level of GABA in the synapses. Do you think it's more good than the Lyrica or the Gabapentin?i think its somewhat like valproate. not sure how effective it is. i think there are some bad side effects at low probability, like eye problme or something.
> I will have to find a solution cause for 240 $ each month, I cant afford going to the gym and ending to not going because I cant augment my cardio exercises time and because I will not be able to stop having panic attacks... I prefer to cancel the membership and buy a bike and doing this oustide alone or whit a friend...it will be less expensive like this!!! I do a lot of bike at summer time before, back in 2002 until 2005... I stop because the bike broke and I Didn't had money to buy a new one at the time...but well...that's a big decision... The gym will help me not only for the cardio but for the muscles also...with the weight I loose, it was so fast that I lost almost all the muscles in my arms...the bottom part of my body is ok...my muscles stay in good shape...but the upper body was completly destroy...Since riding the bycicle outside will not help my upper body muscles...what I do???
>
> I'm torn between cancel the gym and doing bike outside...it will help me to cope with the heart effect in a less "social" environement...and maybe in the fall I will be able to return to the gym and I will be more well prepare to face the gym environement???
>
> What do you think about that idea???well i'm not you but i'd think getting in a routine of gong to the gym would be a good thing to accomplish.
-d/r
Posted by Vincent_QC on April 25, 2009, at 5:46:08
In reply to Re: Gym ( fitness) and cardio exercise = Panic attacks, posted by desolationrower on April 24, 2009, at 17:52:21
> yeah, the first month or two at the gym, getting breathing, technique, stuff like that down is whats important, to prevent injuries.
>
> well, i didn't find anything in the cardiologist books i look at, but my guess is that since the main orth. hypo. problem w/ maoi is related to lack of sympathetic activation to counteract physical changes, the NA affecting antihypertensives will have a worse effect on Ortho. for the a given amount of resting BP reduction. but i can see not wanting to start 'avapro' if you might not have hypertension in near future.
>
> i thought you had tried a B-blocker before and it didn't help anxiety for you?
>
> remember, it tends to go away if you stay on the MAOI for a while
>
> i had never heard that. you could get too much nicotine, which could make you nauseated, but before that point i'd think you'd feel like you had enough nicotine (like when you smoked sort of recnetly, and don't feel the need for another smoke yet.)
>
> i don't know how sweat affects it, i say just go by feel, if you feel like you have too much nicotine, take it off next time. i've not ever been a smoker, but its quite addictive, and you have other things to worry about, trying to quit is very hard...
>
> i think its somewhat like valproate. not sure how effective it is. i think there are some bad side effects at low probability, like eye problme or something.
>
> well i'm not you but i'd think getting in a routine of gong to the gym would be a good thing to accomplish.
>
> -d/rHi d/r,
Thanks for you another very complete answer ;-)That's true, quit smooking is hard, that's maybe not the good moment for now... One thing at the time...
Updates... I See the Family Doc, I talk to him about ace inhibitor, as well as others meds like Avapro, Avalid...and Clonidine (who act differently by decreasing the NE amount)... We choose the Clonidine because it have some advantages over the ace of the Avapro kind of med. Some studies show that it can be helpfull as a anti panic agent and as an anti anxiety. Look a lot like a beta-blocker...
Anyway, I'm on a small dose of 0.2mg/day... and it help... my blood pressure dont get lower, but I can manage more well the "Adrenaline" increase in my body and have less panic attack symptoms also. That's not doing "miracle"...the dosage seem to be too low also, will need an increase, probably to 0.4mg/day... He start it at a low dose to prevent hypotension... since I monitor closely my BP, I don't see a change for now... always in the same range... I just see that at the gym, my pulse rate is lower while I exercises and it help also for the "after" effects of exercises, like lighthead feeling, dizness or red ears...
For now, no side-effect except of a small drop of my energy level after the first dose in the morning... not related to the BP cause I monitor it... Same effect than a regular Beta blocker...
So that's my new. Since my PDoc cancel my next appointment again who was next week, I was suppose to have the Marplan answer, approved or not by Health Canada... the appointment was delayed until the middle of may... I don't recieve any reason from the PDoc and don't know what happen... I think he do this at every scheduled appointment, they are always delayed... I hate that... The Marplan "plan" dont look like it will approved for now...
If it's not approved, i'm going to try the Pristiq, probably, not fix yet, and encounter the NE effect or possible increase of BP with the Clonidine...
For the gym I continue to go... but less often, 5 days a week was too much...this week I go 3 times... I Can now do 30 minutes of bike without stopping and I don't do panic attack, I still have some dizness here and there. I also try different machines who are more hard for the cardio system... that's something I will have to get used to...
I continu to do my muscles exercises and I increase the weight on the machines as well...
Did I feel more well mentally since I start the gym? No... did I have more energy at daytime and sleep more well at night time? No... Did I feel more well physically... a little bit... I gain some strenght in my arms and legs...but they hurts at night time...
So what do you think about the Clonidine? 0.1mg x 2 times day, that's a low dosage no? 0.4 make more sense no? I just want to have your opinion on that ;-)
Thanks again ;-)
Vincent :-)
Posted by desolationrower on April 26, 2009, at 23:16:41
In reply to Re: Gym ( fitness) 'Updates' for d/r » desolationrower, posted by Vincent_QC on April 25, 2009, at 5:46:08
hey, sounds good. hope the marplan comes in. i think the clonidine could be good, can have some of the focus effects like nri drugs, but reducing overall sympathetic activation. i took .7mg once and fell assleep right away. if you aren't getting fatigue thats probably a good sign it could work for you. it can help adhd hyperactivity symptoms. do need to be carful to take a few times a day or could get rebound hypertension.
-d/r
Posted by Vincent_QC on April 27, 2009, at 6:39:45
In reply to Re: Gym ( fitness) 'Updates' for d/r, posted by desolationrower on April 26, 2009, at 23:16:41
> hey, sounds good. hope the marplan comes in. i think the clonidine could be good, can have some of the focus effects like nri drugs, but reducing overall sympathetic activation. i took .7mg once and fell assleep right away. if you aren't getting fatigue thats probably a good sign it could work for you. it can help adhd hyperactivity symptoms. do need to be carful to take a few times a day or could get rebound hypertension.
>
> -d/rWell d/r... I experience now intense fatigue and muscles pains...who tend to make me feel impatient and aggressive.... the clonidine remember me a lot the Inderall med (beta blocker)...
And yes, only 0,1 mg dose make me wanted to jump in my bed right now! lol I take 0.1mg in the morning and 0.1mg around 5PM... that's not a lot...
I plan to stop it already, since I found it leave me more weak than usual... I think the starting idea of lowering my NE level was good...but the Clonidine make my BP unstable...one day it lower my BP too much, the day after the Clonidine do nothing for the BP... in the same time, I can told you that I Really feel the muscles pain when I Take it...
So I stop it for now, will continue to monitor my BP 3 times day...and return to see the Doc and maybe ask for something more stable and new like Avapro or Avalid...
Well, I loose hope on the Marplan... PDoc call and delayed the next appointment... without any reason... Surprise!!! Not really... so maybe my next option will trying the Pristiq...
Thanks for your support mister ;-)
Vincent ;-)
This is the end of the thread.
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