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Medical Forum / Diseases and Disorders / Asthma / July 2005I don't get that at all. If you fear for your life that is a panic at
I don't get that at all. If you fear for your life that is a panic attack, and panic attacks always end, so if you do nothing you will be just fine. If you feel afraid of some thing, it never ends so fear of using some technical thing can paralyze you with fear and that fear will never end, even if there is no harm in the thing. If I am afraid when I put on a tiny radio it will destroy all of the electricity in the house, I can be reassured that this will not happen, but I will still be afraid to use the radio. Every time I think to use the radio I will see in my mind the house not having electricity for lights and AC and I am afraid to turn it on. Exposure may not cure it. I may turn it on and off and see the same horrific events in my mind the next time. This is simply an example. But if I feel I will die I can just ignore it, for by the time I get to a doctor I well feel better? That makes the lesser fear more of a crippler than the greater fear? Assuming of course that the physical feeling and the radio feeling are realistically groundless! ??????? > I don't get that at all. If you fear for your life that is a panic > attack, and panic attacks always end, so if you do nothing you will > be > just fine. An intense feeling of fear is a clue that there may be more going on than just asthma but I would not go quite as far as you do. It is scary to not be able to breath and knowing that the attack you are having could end up in hospitalization or death can logically lead to some feeling of fear. Rapidity of onset and offset and lack of physical findings often do indicate panic. BTW - rapid onset and offset with wheezing can mean vocal cord paralysis. Response to meds can also be a clue. Of course, there is no reason why a person can't have both with the asthma attack triggering the panic attack or vice versa.  Signature00doc doc, I'm not sure which thread this post relates to but I am interested in knowing what you meant by "Response to meds can also be a clue" I would appreciate if you would elaborate on that - as in my recent experience the response to medications was very slow. My husband was told it would take hours and it ended up taking days (4 days on positive pressure ventilation). I was on salbutamol drip and prednilosone drip as well as inhaled relievers through the mask. The specialist has since told me we will probably never know what triggered that attack - but we better make sure that's the only one I ever have like that. We also have a history of anaphylaxis in our family (my brother to fish, my sister to insect bites) - I wondered if that could have played a part -- although I did have a cold at the time and had been wheezing the day before the attack. Thank you, franki. > > I don't get that at all. If you fear for your life that is a panic > > attack, and panic attacks always end, so if you do nothing you will [quoted text clipped - 12 lines] > there is no reason why a person can't have both with the asthma attack > triggering the panic attack or vice versa. > doc, > > I'm not sure which thread this post relates to Neither am I. > but I am interested in > knowing what you meant by "Response to meds can also be a clue" > I would appreciate if you would elaborate on that - as in my recent > experience the response to medications was very slow. In asthma the onset is usually gradual (but there are exceptions) and the response to meds is over the course of minutes to days dpeendin on severity - the more severe usually the slower the response. In vocal cord spasm the onset is rapid, there is wheezing heard in addition to the feelings of chest tighness and shortness of breath (but a sharp clinician may realize it is comming from the glottis and not the chest*), there is no response to meds, and then it suddenly reverses. Usually the voice is severely altered or tjhe person cannot talk at all (which the less astute clinician may confuse with indicating a severe asthma attack). The good news is that vocal cord spasms is never fatal and usually lasts minutes to hours but usually not days. In panic the onset is sudden with a felling of shortness of breath, chest tightness, and often a lump or obstruction of the throat. The meds either have no effect or make it worse. The resolution is usually over the course of minutes or an hour or two and usually not immediate (over seconds like vocal cord spasm) and not over days (like a severe asthma exacerbation). In panic attack there should be no wheezing unless, of course, the the panic and asthma are triggering each other. > My husband was > told it would take hours and it ended up taking days (4 days on > positive pressure ventilation). I was on salbutamol drip and > prednilosone drip as well as inhaled relievers through the mask. The endotracheal tube goes through the vocal cords and is inserted after the administraction of large doses of sedatives and paralytic agents. This virtually eliminates vocal cord spams and panic as possible causes of your symptoms. > The specialist has since told me we will probably never know what > triggered that attack - but we better make sure that's the only one [quoted text clipped - 4 lines] > the > time and had been wheezing the day before the attack. Thank you, That makes it all the more likely that you have some kind of allergy associated asthma. I hope they have prescribed an Epipen and given serious consideration to letting you have some prednisone to take at home. Signature00doc * This is one place where pediatricians are probably more tuned in than Internists or Pulmonologists. Peds deal with croup and upper airway issues more frequently and are more likely to listen to the throat as well as the chest to try to figure out where all the noise is comming from. doc, They have given me prednisone to take at home when I need it and I have undergone skin tests for allergy - showing allergies to dust mite, housedust, mould and cat and a rast test - no results as yet. I don't have an epipen - there has been no mention of that (my sister does carry one as she's had to have adrenalin given by paramedic before). The type of ventilation wasn't via a tube (sorry if I gave wrong impression) but by something they call a cpap machine. Well it sounded something like that I'm not sure but it is a mask sealed to the face ( I was not intubated) - my husband called it the darth vader mask. My O2 stayed pretty good ; CO2 built up to high levels. I guess the specialist is right and we'll never really know the cause. I did wonder if it might be something besides the athsma because the athsma meds didn't seem to work for a long time - but I now see that doesn't mean it wasn't athsma. I have read some of the other threads and always have found your posts to be clear and concise and obviously coming from a knowledge base. Thank you for your reply. franki. > > doc, > > [quoted text clipped - 52 lines] > serious consideration to letting you have some prednisone to take at > home. |
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