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Suggest Treatment For Symptoms Of Psychogenic Breathlessness
Question: Hi, my name is XXXX ( YYYY@YYYY )
Issue: Airways blocked and couldn't breathe.
I have now had 2 instances of my airway being blocked and unable to breathe.
Nov 2013. It was morning, having just finished scrambled eggs with a fair bit of freshly ground pepper and ham. Having just finished breakfast, was plugging in the kettle for another cup of tea and all of a sudden I could not breathe in or out…my airway just seemed to be totally blocked. My friend used the Heimlich on me, and although I don’t think I was choking on anything, the maneuver seemed force air out of my lungs and thereby opening up the airway. Having gone to the doctor and specialist, we went down the path of perhaps of an allergy of some sort, and got myself an epipen, however after going to specialist and allergy testing, this does not seem to the case, however a cause or diagnosis was never determined.
Aug 2015. It was 2:00 am in the morning, sound asleep and all of a sudden exactly the same thing happened. I sat up out of bed with a start, couldn’t breathe at all, got my partners attention, and again he performed the Heimlich. It worked at first and I coughed a bit, drank some water, and then the airway closed again. Did the Heimlich again which opened the airway, I coughed drank water and then I was fine. A very scary experience, in both cases.
Following the first episode, the doctors were saying that if it was an allergic reaction, that if I was by myself and I used the epipen, I might pass out, but that the epipen would relax my muscles and open up the airway and I would be fine. On this understanding I mentally dealt with it this way. The reality is that I live by myself and my partner just happened to be there in both instances.
However, based on the recent episode, where I really don’t think it was an allergic reaction, since I ate the same food I often eat for dinner and I was sound asleep, I am now extremely nervous about being by myself and what would happen if this happened again since it would be difficult for me to give myself a Heimlich! If it is not an allergic reaction, perhaps the airways won’t open, especially if no one is around to do the Heimlich.
It almost feels like there is a flap or something covering the airway and that it just closes totally by accident, but I can’t get it open to breathe. I do have the feeling there is some phlegm in the middle of my throat….could this be it? But I do not suffer from indigestion or reflux, at least not such that is obvious to me.
I am 53 years old, generally very fit (I bike, hike, spin, do weights), eat extremely well and I am not overweight and do not have any other health issues. I do not take any medication whatsoever and never have (other than previously birth control).
I did however have a reaction to sulpha which was in an antibiotic that I took for strep throat, probably 15-18 years ago, and following the initial reaction of hallucinations and full body muscle spasms, to the point that I couldn’t walk for week, I ended up with a terrible cough which lasted forever. I still have remnants of the cough today, however, it lessened gradually every year such that it is not really an issue today. However in the early couple of years I could have 8-10 coughing fits a day, which would have me hyperventilating and exhausting me.
I am very nervous about being by myself and looking for some answers. What could this be? Could the airway just not open if I can’t get the Heimlich and that is the end? What is my best precautionary measure. How should I go about getting this properly diagnosed? Looking for any assistance or guidance.
Issue: Airways blocked and couldn't breathe.
I have now had 2 instances of my airway being blocked and unable to breathe.
Nov 2013. It was morning, having just finished scrambled eggs with a fair bit of freshly ground pepper and ham. Having just finished breakfast, was plugging in the kettle for another cup of tea and all of a sudden I could not breathe in or out…my airway just seemed to be totally blocked. My friend used the Heimlich on me, and although I don’t think I was choking on anything, the maneuver seemed force air out of my lungs and thereby opening up the airway. Having gone to the doctor and specialist, we went down the path of perhaps of an allergy of some sort, and got myself an epipen, however after going to specialist and allergy testing, this does not seem to the case, however a cause or diagnosis was never determined.
Aug 2015. It was 2:00 am in the morning, sound asleep and all of a sudden exactly the same thing happened. I sat up out of bed with a start, couldn’t breathe at all, got my partners attention, and again he performed the Heimlich. It worked at first and I coughed a bit, drank some water, and then the airway closed again. Did the Heimlich again which opened the airway, I coughed drank water and then I was fine. A very scary experience, in both cases.
Following the first episode, the doctors were saying that if it was an allergic reaction, that if I was by myself and I used the epipen, I might pass out, but that the epipen would relax my muscles and open up the airway and I would be fine. On this understanding I mentally dealt with it this way. The reality is that I live by myself and my partner just happened to be there in both instances.
However, based on the recent episode, where I really don’t think it was an allergic reaction, since I ate the same food I often eat for dinner and I was sound asleep, I am now extremely nervous about being by myself and what would happen if this happened again since it would be difficult for me to give myself a Heimlich! If it is not an allergic reaction, perhaps the airways won’t open, especially if no one is around to do the Heimlich.
It almost feels like there is a flap or something covering the airway and that it just closes totally by accident, but I can’t get it open to breathe. I do have the feeling there is some phlegm in the middle of my throat….could this be it? But I do not suffer from indigestion or reflux, at least not such that is obvious to me.
I am 53 years old, generally very fit (I bike, hike, spin, do weights), eat extremely well and I am not overweight and do not have any other health issues. I do not take any medication whatsoever and never have (other than previously birth control).
I did however have a reaction to sulpha which was in an antibiotic that I took for strep throat, probably 15-18 years ago, and following the initial reaction of hallucinations and full body muscle spasms, to the point that I couldn’t walk for week, I ended up with a terrible cough which lasted forever. I still have remnants of the cough today, however, it lessened gradually every year such that it is not really an issue today. However in the early couple of years I could have 8-10 coughing fits a day, which would have me hyperventilating and exhausting me.
I am very nervous about being by myself and looking for some answers. What could this be? Could the airway just not open if I can’t get the Heimlich and that is the end? What is my best precautionary measure. How should I go about getting this properly diagnosed? Looking for any assistance or guidance.
Brief Answer:
Possible Psychogenic breathlessness .
Detailed Answer:
Hi Mam,
I understand your concern.
This is not a major issue to worry about.
You possibly seem to have Psychogenic breathlessness sometimes referred to as Hyperventilation syndrome.
This can result from metabolic changes in blood lactate ,oxygen and carbon.
dioxide along with variations in Respiratory/breathing mechanics.
Such individuals tend to breathe by using the upper thorax rather than the diaphragm, and this results in chronic overinflation of the lungs. When stress induces a need to take a deep breath, the deep breathing is perceived as dyspnea. The sensation of dyspnea creates anxiety, which encourages more deep breathing, and a vicious circle is created.
But you seem to have extremely milder form of such dysfunction.
Heimlich can be advised in any case of sudden mechanical blockade.
Generally women who panic are more likely to be affected with such kinds of episodes.
Complete Cardiovascular check up consisting of ECG,2D ECHO,CXR has to be done to rule out heart diseases or other life threatening diseases.
Arterial blood gas analysis will help to support psychogenic causes.
Breathing techniques and stress management will help to prevent .
Stress reduction therapy, administration of drugs like Clonazepam or beta blockers, and breathing retraining have all proved effective in reducing the intensity and the frequency of episodes of hyperventilation.
Consultation with Chest physiotherapist will help.
Post your further queries if any.
Thank you.
,
Possible Psychogenic breathlessness .
Detailed Answer:
Hi Mam,
I understand your concern.
This is not a major issue to worry about.
You possibly seem to have Psychogenic breathlessness sometimes referred to as Hyperventilation syndrome.
This can result from metabolic changes in blood lactate ,oxygen and carbon.
dioxide along with variations in Respiratory/breathing mechanics.
Such individuals tend to breathe by using the upper thorax rather than the diaphragm, and this results in chronic overinflation of the lungs. When stress induces a need to take a deep breath, the deep breathing is perceived as dyspnea. The sensation of dyspnea creates anxiety, which encourages more deep breathing, and a vicious circle is created.
But you seem to have extremely milder form of such dysfunction.
Heimlich can be advised in any case of sudden mechanical blockade.
Generally women who panic are more likely to be affected with such kinds of episodes.
Complete Cardiovascular check up consisting of ECG,2D ECHO,CXR has to be done to rule out heart diseases or other life threatening diseases.
Arterial blood gas analysis will help to support psychogenic causes.
Breathing techniques and stress management will help to prevent .
Stress reduction therapy, administration of drugs like Clonazepam or beta blockers, and breathing retraining have all proved effective in reducing the intensity and the frequency of episodes of hyperventilation.
Consultation with Chest physiotherapist will help.
Post your further queries if any.
Thank you.
,
Above answer was peer-reviewed by :
Dr. Raju A.T
I have never had a panic attack or anything similar to that. How is that this "mechanical blockage" happens in my sleep. This was not breathlessness, but rather a complete inability to breathe. In the situation of another "mechanical blockage" or inability to breathe, if no one is around to do the Heimlich, what would happen?
Brief Answer:
Require HRCT chest and Polysomnography.
Detailed Answer:
Hello Mam,
I understand your concern.
If your consideration is a mechanical blockade,then its highly important to get a HRCT scan of the chest.Only this can diagnose the presence of any mechanical obstruction of the airways leading to sudden respiratory arrest.
Heimlich maneuver is very successful in those with upper respiratory tract obstruction.
So Going by these lines I advise you to have CT scan of the chest and Polysomnography(This can detect any sudden upper airway collapse).
Patulous airways can get collapsed during sleep--Sometimes referred to as Sleep Apnea Syndrome.This needs to evaluated further.
Your symptom approach has to go on lines of exclusion.
Straightforward diagnosis cannot be made in your case.
Hence it is very important that you get these tests.
Further management is based on the test results.
Thank you.
Require HRCT chest and Polysomnography.
Detailed Answer:
Hello Mam,
I understand your concern.
If your consideration is a mechanical blockade,then its highly important to get a HRCT scan of the chest.Only this can diagnose the presence of any mechanical obstruction of the airways leading to sudden respiratory arrest.
Heimlich maneuver is very successful in those with upper respiratory tract obstruction.
So Going by these lines I advise you to have CT scan of the chest and Polysomnography(This can detect any sudden upper airway collapse).
Patulous airways can get collapsed during sleep--Sometimes referred to as Sleep Apnea Syndrome.This needs to evaluated further.
Your symptom approach has to go on lines of exclusion.
Straightforward diagnosis cannot be made in your case.
Hence it is very important that you get these tests.
Further management is based on the test results.
Thank you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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