It Happened Again... Panic Attack?

in #steemithealth7 years ago

Hey steemians, hope our day has been good. I want to share an experience i had today with you.

As you may know, if you follow my blog or previous posts, i'm a medical practioner and i enjoy what i do, at least sine i left medical school. I never had a phobia for blood, i was already killing and disecting lizards and insects at age five, i enjoyed my Anatomy dissection sessions where we worked on one cadaver as a group it was all skeleton left, i have done and assisted several surgical operations and i'm studying to become an Anaesthesiology specialist (i.e. doctores in charge of putting a patient to sleep and ensure they don't feel pain during surgeries).
I was called today to assist in an operation, i have not been involved in one in about 3 months but i was not perturbed till it happen again.
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So What happened?

you may ask, i also am asking myself the same question since i was trained to make 70% of my diagnosis without laboratory investigations but i cant seem to place a finger on it though i have several possible answers (differentials as we call it).

History

1st episode

As a 4th year medical student i was very excited to observe my first surgical procedure, once again it was no big deal as I had worked with cadavers as i earlier mentioned, I got into the theatre and was observing the surgical procedure before i noticed i was becoming light headed, dizzy and feeling faint, i could feel my heart beat faster and had a sudden urge go visit the toilet. I ran out of the theatre, eased myself and got a bottle of coke to calm my nerves.

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I had all the symptoms in the picture above except choking and a sense of dread. All inclusive qualifies for a panic attack but I thought to myself it was because i didn't eat earlier in the day and maybe i couldn't stand the smell that emanated as the diathermy machine was used to cut the skin. That was the only episode that year as i stopped spending so long in the theatre at a time and always made sure i ate and had an extra drink.

2nd episode

This was in 5th year in my first autopsy session. It was a requirement for all medical students to attend several and give reports on the possible cause if death if the patient. Once again i was confident, i had dissected cadavers myself and i had attended several surgeries. This time though was different as the autopsy is done in the morgue. The feeling of being amongst the dead was overwhelming. The subject was a police officer, who died less than 24 hours on admission, as such a coroners autopsy must be performed. He was HIV positive and was dead less than 24 hours. The autopsy began and there was fresh blood coming out, all the internal organs had been destroyed by the illnesses that come with AIDS. Then it got to the point of sawing open the skull to study the brain, thats when it happened again. I just couldn't stand it, the sweating, fast heart rate and feeling faint came hard on me with a very urgent need to ease myself. I ran out, eased myself, got a drink and calmed myself down. I didn't bother going back to sign my attendance or get the report. Well it was part of my requirements, so i had to attend the subsequent three sessions to get my reports done. I did all that without any subsequent issue.

Today

During my internship program, i had occasional dizziness in before and after surgeries but nothing significant happened, i did and assisted a whole lot till four months ago and i felt i had out grown it all until today. So the patient had been prepared for surgery with all the necessary pre-medications given by me. I was to assist the operating surgeon and we had another doctor on standby. Then i felt it, dizziness, weakness, sweating and feeling faint but thank goodness there was no urge to use the toilet. I simply explained to my colleagues, removed my sterile gloves and sent for a bottle of Coke. I went into an office, calmed myself down and walked back into the theatre before the Coke arrived. I must say it wasn't that bad and i feel i was just being extra careful.
Like i said earlier, i'm giving this history cos i want to make a diagnosis. A panic attack comes to mind but there is more against it than for it from my history.

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Panic attack is defined as a period of intense fear in which 4 of 13 defined symptoms develop suddenly and rapidly peak within 10 minutes from onset. These symptoms are

  1. chills or hot flashes
  2. fear of dying
  3. chest pain or discomfort
  4. nausea or abdominal distress
  5. feeling dizzy, unsteady, lightheaded or faint
  6. fear of loosing control or going crazy
  7. numbness or tingling sensation
  8. sweating
  9. palpitations, pounding heart,or accelerated heart rate
  10. sense of shortness of breath
  11. decentralization (i.e. feeling detached from oneself)
  12. trembling or shaking
  13. feeling of choking

The other possible causes which to me are more scary include

  1. Asthma
  2. Acute coronary
  3. Acute pericarditis
  4. Pulmonary embolism
  5. Myocardial infarction
  6. Heart failure
  7. Acute respiratory distress syndrome

The list goes on and like i said i'm in a diagnostic dilemma. I leave the power in your hands, do i see these episodes as nothing, a panic attack or one of these scary differentials?

I'll welcome your comments.
Cheers

Sort:  

You sound a lot more like me around blood rather than having a panic attack. I just simply cannot endure the sight of blood. It has nothing to do with panic. The first time it happened, I nearly fainted (in a hospital, ha!).

I had to go to the lab to get my blood drawn for employment. I thought the whole thing was rather fascinating. From the lab atmosphere to the draw, I watched the whole thing. Asked questions. Felt fine. Walked out into the hall, got on the elevator, and the edges of my vision started to fade to black with little sparkly stars. Fortunately the elevator was stuffed with nurses and doctors.

It doesn't happen every single time I see a drop of blood. It does tend to happen if I watch blood drawn (which I would watch still to this day if I wasn't so opposed to fainting).

Also, if there's an adrenaline demand with the event (like in an accident), I'm fine until the adrenaline realizes it's not needed. Then I start to feel a little weak and ill. Usually, I just remove myself from the situation and I'm fine. From what I understand, though, those are the same symptoms of an "adrenaline dump."

Have you considered blood sugar levels (high and or low) as they can also cause issues during stress?

And no , I'm not in anyway involved in the medical field (except to try to avoid it ;)

Hope you figure it all out. Including the solution!

Oh geez
Tanx a lot for sharing your experience.
I had adrenaline somewhere at the back of my mind but couldn't connect it.
I'll check out the 'adrenaline dump' theory.
I really appreciate your concern.

You're welcome :)

Don't forget the wacky blood sugars reacting to adrenaline theory.

But neither explains the ... but I wasn't stressed at all ... incidents .

Best of luck. Leave me a comment somewhere when you figure it out :)

I will and I'll sure get back to you

I think I can also relate with this
Like I commented I'm one of ur old posts. I get some of this 1st symptoms u mentioned earlier although at a minimal degree but the increased heartbeat rest usually scares me. But it only happens when I sprint really hard during sporting activities

That's the adrenaline rush boss.
That's how the body compensates for the increased amount of energy spent.
Tnx 4 stopping by

Uwc boss

Hmm same as me, I have a phobia for dissection I can't watch people or animal being dismembered even when I tried to for instance, but I can watch gory gruesome movie without keeling over I guess because my mind tells me it's fake. Maybe it's the combination of the knife and scissors put in the body and the sight of blood filling those little vials that does it. But as a doc I always believe you guys must have seen it all so it's easy for you to do anything with no adverse reaction, BTW what is it with you and coke lol .

Lol @dreamchasser
I've no issue with dissections started my own personal 'autopsies' on lizards as a kid but I've come to dislike horror movies, they all started irritating me after I watched 'Drag me to Hell'.
Glad u mentioned come, dats my best drink ever.

This happen to so many people including me. Many do not know what it is. However, I studied it through online materials. And with knowledge I got I have beginning to take it easy, knowing that it is not death after all. Mine is caused by untreated GAD, general anxiety disorder. I live and manage it. Today, I stand in a large congregation and preach God's word, something I don't do before due to fear of crowd. So many things I could do today because I realised what was happening to me.

Anxiety disorder is a possible cause and not difficult to manage, a lesser evil than a panic Attack. Knowledge is power, ...the truth you know sets you free. Ride on boss

Amazing, to tell you the truth, i do not envy you. I dont know how you guys have a heart to watch cutting or you cutting a hunam. Well you doing it to save lives. I really admire you med doctors, but i dont wanna be like you. I cant even stand seeing blood.
Very educative post. So all this while in my life, i have had panic attack serveral times....lol. Now i know i need a doctor when i am having those symptoms. Thanks @drepo.

Yea @ceepee lol.
It's an experience indeed.
Don't let this knowledge scare you, it's easily managed at the level of your psychology. There are relaxation techniques taught by psychologists that also help. Simple conscious slow and steady breathing helps a lot.

So, I finally get to read this post. Interesting. Mine is sweating and a kind of dizzines from the inside. I just try and bring myself back to conciousness as there is nothing to be anxious about.

Tnx for reading @dorth. There is indeed nothing to be anxious about. We Nigerians just have some innate immunity to most of these stuff. Nothing psychological really brings us down.

Happens to me sometimes. Palpitation, sweating, numbness, dizziness.... at times without any identifiable cause. At such moments I'm often forced to stop whatever i was doing n just find a quiet place to sit. Dunno if it's panic attack or anxiety disorder u just mentioned to someone. I think it would be more helpful if u draw a clearer line between both. Plus the best means to deal with it. Sure a bottle of coke won't fix it for everyone.