Panic attack vs Asthma

[juliesharp]

I went to see my GP today as I have been breathless over the last three days. He explained to me that there is no inflammation in my airways as my FeNO score was only 7 and I have no wheeze so it is a panic attack. I have looked up panic attack on NHS choices website and it says a panic attack lasts between 5 and 20 minutes. Is it possible for panic attacks to last for three solid days of breathlessness. I really know nothing about panic attacks.

To confuse everything GP has given me antibiotics for a clear chest and referring me to an endocrinologist to get me off prednisone as the medication causes panic attacks.

Since when?

Am I missing some new research?

I am already seeing a physiotherapist for hyperventilation where I am being taught to only breathe through my nose with diaphragm muscles only.

I have a hiatus hernia and it is grumpy as physio exercise is moving diaphragm so irritating part of my stomach that is above my diaphragm.

I like my GP but sometimes he can be so confusing.

Like he tried to explain that non inflammed airways can react to exercise, emotion and pollution without gaining any inflammation. I seriously think I am missing some new research into asthma somewhere?! No wheeze now means panic attacks apparently?!

[justTUX]

Its a really tricky one and especially in young people and will often get told its not asthma they are hyperventilating. I have had the same thing happen to me.

I had a long chat with my consultant about it and she was very good and explained it all to me which I shall try and do again here so I hop e it makes sense.

Asthma attacks are scary and no matter what you do when having one you cannot over ride the fight or flight mechanism your brain has. So when under attack in our instance having an asthma attack our brains register the attack and resister that not as much air is getting in and so to counteract this we breathe more or hyperventilate.

It is a really tricky cycle as an asthma attack can make your hyperventilate but as the attack is scary sometimes once the attack has settled we can continue to hyperventilate if it has been particularly scary.

However there are circumstances when we can be told we are hyperventilating and we are sure we are not. This normally occurs in younger people because younger people have a larger oxygen reserve. You could be having a pretty bad asthma attack which in an older person might see oxygen levels drop but in younger people because of this reserve your oxygen levels are maintained and will often drop critically low very quickly once the body is no longer able to compensate. This can be really frustrating because you feel so rubbish but you may get a nurse or Dr telling you your oxygen levels are fine!!! I have had this a number of times and if a Dr does an ABG they will see you are compensating by a higher lactate level due to the extra work the lungs are doing etc!!

I think there is quite a bit of stigma around hyperventilating and asthma. Many think if they hyperventilate then they may not have asthma or that they are just having a panic attack. I used to think this and would often not get help for an asthma attack after having several admissions to hospital and being told Im just panicking.

My consultant sent me to see a psychologist and physio to help with all this and it really has helped. Because we broke down all parts of an asthma attack and where the panic is and that the course of an asthma attack there is naturally a panic attack and hyperventilating too but it is important to learn the signs etc of when the asthma attack may be settling and it is just a panic left. I have had asthma attacks which settle but because it has been so traumatic I end up having a panic attack and hyperventilating which in turn sets off an asthma attack.

Please don't think your Dr is not taking your asthma seriously etc. Drs often don't come across well and can make you feel stupid etc but if you feel you having an asthma attack I am sure you are but there may be some hyperventilation sneaking in there to which is only natural.

I hope this has helped explain it a bit!

Also red can cause havoc with emotions etc and can make us anxious and panicky. It is not a main thing with it but it can have a big impact!

JustTUX

[juliesharp in reply to justTUX]

Young people having a large oxygen reserve is really interesting. That happens with me oxygen ok ok ok ok when after an hour or two of an attack it just drops suddenly very low. I am normally very good at getting myself to hospital to A and E just as it drops.

Yet for years the consultant has always said come to hopsital sooner yet when I do that I get your oxygen is fine why did you come leaving me feeling silly then ending up going back a few hour later as oxygen drops suddenly.

I often think the preventive is very good however doctors only want you once splat happened.

I do think I have a good GP it just gets frustrating when he does not make sense.

Thank you for your long reply it has really helped!

[justTUX in reply to juliesharp]

Glad it helped.

I think your consultant and mine have th same long running battle. Mine always says come in sooner but I find I do that I get left as not that bad then go splat spectacularly and need way more help than I did in the first place.

I now have a care plan saying I never used to come early as always ended up ill anyway but it states in bold that I know the trajectory of my attacks and if I ask for nebs or say my chest is not right its coz I mean it. My consultant put in brackets (she never asks for help so if asking then she's not well!!).

It is an ongoing battle about when the optimum time to go to hospital is and Im not sure anyone knows the answer!

[Katinka46]

Hi Julie. I am not a doctor so take everything I say with a pinch of salt but I think it is unlikely that you could have a panic attack that lasts for three days. You say that you are having physio for hyperventilation. Breathlessness during a panic attack IS hyperventilation. So I am confused. If you are following good breathing techniques then that should prevent you from having panic attacks and help you to relax and manage the breathlessness. Does it feel like panic? Are you anxious? Fearful? Have you had any counselling to cope with any mental health issues that could cause panic attack? Sorry, that's a bit of an interrogation. I think steroids can lead to a slightly jumpy feeling. They make me feel high.

There are other lung conditions that could cause your symptoms. GPs can be too quick to latch onto common causes. Are you seeing a consultant?

I agree it is all very confusing.

And I probably haven't helped!

Push for more clarity.

And let us know how you get on.

K xxx

[juliesharp in reply to Katinka46]

Hi katinka46.

I will try to answer some of your questions and thank you for asking questions it helps me organise my thoughts.

I am not fearful or panicky. I am often too relaxed and calm when I am struggling to breathe because I am focusing so hard on my breathing exercises from the physiotherapist. How can you panick if you are focusing on diaphragm going up and down no more than 10 times in 1 minute only using nose breathing?

Yes I see a consultant who is on annual leave and has left GP in charge this week. I see consultant next week when he returns. Consultant and GP agree it is hyperventilation hence why I am under a physiotherapist but as to why I have suddenly become breathless for three days is a mystery. It has been noted I do breAth holding subconsciously but I focus really hard on my physio and just am unsure where breathlessness has suddenly appeared from?

For example I am sat in my recliner now breathless just typing yet I know if I stop and do physio exercise I will remain breathless even though I am relaxed and calm and getting towards sleepy. I do not feel any panick.

[Katinka46]

Thanks for getting back to me. I do know that doctors, GPs and consultants, can go down the hyperventilation route too readily. But it sounds as if you are aware of that problem yourself.

I think people know what their bodies are doing and should be trusted and listened to.

Take care

K xx