Doctors Lounge - Psychiatry Answers
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Forum Name: Psychiatric Topics
Question: Could it all be in my head?
|sarta - Sun Dec 24, 2006 11:27 am||
I've been feeling prety sick for about six weeks now. I've seen a doctor who thinks I'm okay, just anxious. I think I am anxious because I am worried that something is wrong with me, and I won't stop being anxious until I know that everything else is okay. But, as I don't have insurance, it's pretty much impossible for me to get a full evaluation by a good doctor.
I am 23, female. I have never really been sick, but I've always had slightly high blood pressure and I get frequent headaches. I have no history of mental illness, including panic attacks or excessive anxiety. I have recenty moved to a new city and started a new job, but I am very happy about the move and my symptoms started after I'd been established here for a while. My mother and sister both have heart murmurs, and there is a family history of hypertension and stroke. I am tall (5' 11") and normal weight (155lbs).
I was feeling slightly ill for about a month. My throat felt tight all the time, I had a hot feeling in my chest sometimes, and I felt anxious. Then about two weeks ago, in the evening, I started to feel like my heart was beating too fast and too hard, and 'fluttering' a lot. I was a really scary feeling. It felt much worse when I lay down flat, and better when I was leaning forward. This went on for five days, occasionally getting better or worse. My chest started to ache finally, so I went to see a doctor. They did an EKG, and the doctor got really worried and told me it was abnormal, and that they had to call me an ambulance and send me to the hospital immediately for further tests . The EMTs came and did another EKG though, and told me it looked fine, and that I didnt need to go to the hospital, but I should follow up soon with a doctor. So I went to see another doctor who I'd seen before, and he said the EKG looked fine too, just fast. He prescribed me inderal, 10mg, three times a day, and referred me to a cardiology clinic, that I am still waiting to hear from. He checked my thyroid, and said it was fine.
That was about 10 days ago. Since I saw that doctor, my stomach has started to hurt. At first it hurt only occasionally underneath my ribs, mainly on the right side. Now it hurts all along the bottom of my ribs, and mainly in the center (the epigastric area). The pain is much worse when I lie on my right side, and better in every other position. I still feel like my heart is racing sometimes, but the inderal is helping with that. I feel totally exhausted, to the point that it's hard to get out of bed, and I am completely winded by walking up a flight of stairs. Since last night I have been very dizzy. I just stood up, walked a few steps, and then fell to the ground, not fainting, but near it. My stomach feels like it's burning, I have a very unpleasant feeling of panic, it's like pangs of fear, in my stomach and my chest. I don't want to see my doctor again because I think he thinks this is all due to anxiety, and I feel like I'm bothering him. I hope it is anxiety, I just want to know for sure, and I need to know if anything is really wrong with me so that I can get it fixed. It is hard for me to see a doctor for financial reasons, but I will if I have to. How extreme can symptoms caused by anxiety be? How does a doctor tell a real illness from psychosomatic symptoms? I really appreciate any advice anyone can give me. Please ask questions if I've been unclear about anything. Thank you.
|Dr. K. Eisele - Mon Dec 25, 2006 2:45 am||
Your symptoms sound serious enough to me to warrant a return visit to your doctor. It is possible for your condition to be the result of cardiovascular problems, especially since there is a family history of cardiac problems.
When you see your doctor, simply tell him that your symptoms have progressed and then relate how you've been feeling lately. Especially tell him about feeling dizzy and feeling winded after climbing a flight of stairs.
Anxiety can produce incredibly intense symptoms that can be easily mistaken for cardiac symptoms. However, it is the standard of care to eliminate all possible medical causes for such symptoms before treating the symptoms as anxiety-related, especially given the potential seriousness.
Please, see your doctor as soon as possible. Ask him for a complete work-up--and make sure he knows that you were diverted from the emergency room by EMTs when he sent you before.
Let us know what happens.
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