Breathing, very frightened

[mummyanxious]

For a week or so now I've had issues with my breathing. Some days worse than others. But it has reached a peak now. I am away on holiday and I'm very scared something is going to happen to me.,
I keep getting a feeling when I bend over like the air is being cut off in my chest and I'm badly struggling to breath. Then my tongue will go tingly and I will be gasping. This can also happen when I'm just sat. Like yesterday on a long drive it was happening the whole time. Just writing this now and it's happening. Feels like my whole chest is being compressed and the air is being squeezed out of me and like my tongue then starts going tingly. Yesterday when it happened my chest started to tingle and go warm too. I'm petrified of what this is.
Has anyone ever had anything like this?
I had a spell of it about six months ago. It's proper shortness of breath. Not just oh I feel a bit out of breath. Like the death has completely drained out of me. Don't want to ruin our holiday but I feel I'm not going to make it home.
Is it angina? Oncoming heart attack?

[MyNameIsTerry]

Hi MA,

Do you find this eases if you stand up straight? If so, it could be a postural thing. When we bend or if we don't sit upright, we compress our middle section and this can cause what you are describing. If you compress enough, you may find you need to take a deep breath. This can also make us worry even more that there is a problem with our breathing and anxiety then starts to cause us breathing problems.

The tingling chest and warmth could be a symptom of anxiety alone from the adrenaline if you have started to panic.

When you had it before, why was that? When did it occur? How did it go away?

Is this constant pointing towards a possible breathing issue? If intermittent this seems less likely but thats one for a GP really.

Are you on holiday somewhere hot?

Have you been panicking over going on holiday? Are you panicking because its time to come home?

All these things could add to anxiety.

[mummyanxious]

Thank you for your reply MNIT.
Yes I've been getting worried about coming away. I'm anxious at the moment because this breathing thing started before we got here and I am worried about what it is.
Last time I had it was early in the year when I had some anti depressants. I've been trying to read through my threads but I don't know how it went away.
It is better when I stand up, when it is caused by bending over.
But when I tense my chest even mildly it feels like something is crushing my airways. Even hugging my daughter yesterday I felt like I couldn't breath and had to push her away. It's like they describe an elephant sitting on your chest. Surely this is a heart problem and not just anxiety.
Can't get into the dr till Tuesday at the earliest.
And no I'm nowhere hot.
It happens in waves throughout the day. Felt a bit of relief late evening.

---------- Post added at 07:23 ---------- Previous post was at 07:21 ----------

I'm trying hard not to go into full panic mode but I am struggling to get through another two days. I'm so scared and don't want to draw attention to it as the people I'm with don't know about my anxiety. And the dr just out it down to anxiety before. But surely anxiety doesn't cause full on heart problems and you still be ok.

[MyNameIsTerry]

What you are describing doesn't have to be heart. I have asthma and if I experience issues with my breathing, I can feel like you are describing. I'm not saying that to say you could have a breathing problem either, but to demonstrate that if you restrict your lungs in some way, it has this type of effect. Try sprinting, your chest will be burning afterwards and your lungs will struggle to get enough air in hence the heavy breathing but this is all perfectly normal, we all work like this.

So, I wonder whether in constricting your chest in some way, thus constricting your lungs, you are worrything that something is wrong and then this brings on symptoms of anxiety which cause the same issues as well? Bending causes a similiar scrunching effect on the upper body. Thats why I asked about standing up straight because trust me, if you had breathing issues you would not find that helps it go, it would only ease it on the basis that you made it worse by scrunching your chest before. Does that make sense?

I don't know about the thread you mean but I do recall you had a lot of problems with fatigue and found yourself feeling very unfit, struggling with even more basic stuff. Didn't you do some gardening and were knackered afterwards?

Something I have always found with anxiety is that if you have an issue, you will notice it far more and if something happens, you zoom in on it.

I have asthma and my anxiety has always been an issue with breathing. So, I've often spent a lot of time worrying about whether its my anxiety or my asthma and whether its getting worse due to my anxiety. This stopped me getting exercise as any breathing issues caused would make me zoom in and start thinking about whether something was wrong. I don't have HA, but I'm very symptom focussed and wonder if I'm going to go into a panic attack as opposed to have something more serious. I found that when I started to walk vigorously or have a run, my breathing was worse because I was out of shape and over time this decreases. But my thoughts were very focussed on that breathing issue and then other anxiety symptoms started appearing so over time I started to look for this and try to distract myself.

So, it could just be sensitivity?

I check at the GP's is easy for breathing on a peak flow measure to see if you have any issues.

[mummyanxious]

I had a peak flow test earlier in the year and was deemed fine.
What you're saying make perfect sense if course. What is happening is the middle part of my chest is tensing up BUT the crushing and complete lack of air can happen within a split second. If I try and relax it will ease, though not go completely?

[MyNameIsTerry]

Obviously, its only for a qualified medical professional to say when it comes to something like this but in my personal opinion I don't think it would ease if you tried to relax if you had something more serious. I don't know on that in terms of whether with a heart issue, relaxing when it flares up would ease it or that it is too late to prevent it getting to that level and needs intervention. What I can say from the point of view of an asthma sufferer, that wouldn't help you at all and people might say "breath slowly & regularly" but thats like saying "stop moving" to someone on fire!!!

What you say in regards to it easing when you relax more does however fit perfectly with anxiety & panic. It may not go completely because you have put yourself under some sort or pressure and the body needs some time to resolve that or move its focus elsewhere. Think of exercise and how a muscle becomes sore. The body has to make some minor repair work (all perfectly natural) but you may linger on the sensations.

One thing to remember about adrenaline as well is that whilst you have the initial rush, it takes a while for your body to either pee it out or metabolize it. This is why we feel anxious for hours after a panic attack. Adrenaline has quite an impact on our internal organs as well so I wonder if this is why you are feeling that it lingers?

I wonder if you could try breathing exercises such as Calming Technique which is good for panic and uses a deep breathing method. I think its also referred to as 7/11 breathing?

http://www.cci.health.wa.gov.au/docs/ACF3C65.pdf

[mummyanxious]

I don't know on that in terms of whether with a heart issue, relaxing when it flares up would ease it or that it is too late to prevent it getting to that level and needs intervention.

I don't get what you mean here? You think this could be a problem that has developed with my heart?

This morning it's not been quite a severe. I've only had a couple of minor episodes. I do feel anxious when it happens. But I'm worried its a blockage or construction in the coronary artery or something and its cutting off the blood to my heart.

What's frustrating is last time this happened earlier in the year they just said, just sounds like anxiety. Don't think they fully understood what I meant. And my ECG a few days later was clear other than left axis deviation. Which they said I didn't have. But if it was something that was happening intermittently like angina or something then it may not show up?

It's awful as I can't wait for tomorrow to come so I can go home as I feel like hiding away and don't want to move.

---------- Post added at 09:39 ---------- Previous post was at 09:37 ----------

The thing I'm trying to tell myself though is that this has relatively gone away for a period of perhaps six months so that wouldn't have happened if this was a progressive thing? I don't know, I'm just very frightened and feel isolated at the moment.

[mummyanxious]

So not had too bad a day, but now I'm lying in bed its come back :(

[MyNameIsTerry]

I don't get what you mean here? You think this could be a problem that has developed with my heart?



What I meant was that I'm personally not sure whether you can prevent an attack of something coming on such as angina by relaxing. I just don't know much about heart issues. maybe someone with more experience can help on this?

I don't mean to imply that its a heart problem of any kind, I worded it badly, sorry.

I know what you mean, GP's can be dismissive when they know you have anxiety but if they are sending you for the tests the determine if there is an issue, all you can do is question them as to whether those tests would show what you are concerned about and if they say they would, you need to trust them and look at whether this is more anxiety.

I'm not sure on the gaps either. I just don't know much about anything heart related so could never offer much of an opinion but I can say that what you are describing does also fit into anxiety, so if your GP rules everything out, try to work on this and see if it works.

[mummyanxious]

Ah ok I get what you mean now, sorry for sounding dumb!
I'm back at the dr Thursday so I will chat about it then.
It was a bit better today but came on again this evening as I was driving. It seems to be whenever I tense my chest.

[MyNameIsTerry]

Well that could be part of it MA because I suffer a lot of breathing symptoms and I am tensing a lot but its more my diaphragm. Tensing will bring on shortness of breath and the horrible thing about it with anxiety, the more you focus on it, the more it will happen.

Are you doing a lot of manual breathing? If so, this is not going to help with this and you need to use breathing techniques to learn how to let this go as well as techniques that prevent you from focussing on symptoms as much, which for me is a Mindfulness thing. This isn't easy though, it will take time.

[mummyanxious]

Manual breathing?
This morning when I stretched out in bed under my ribs, so where my diaphragm is, was very very sore and that then lead to feeling short of breath too.
So there seem to be two patterns with it. One where I feel short of breath from under my ribs and one where it comes from my chest.
I tried that headspace app which was quite good but for some reason it doesn't work on my phone anymore.

[MyNameIsTerry]

I think its a free one for 10 days and then you have to pay a subscription. Not sure how much it is though.

You could always try the free downloads on Professor Mark Williams Frantic World MBCT programme website.

I get that issue with my ribs, sometimes round the back as well and its virtually always on the right side.

Manual breathing is where you keep concentrating on your breathing to the extent that you believe you need to control it or you won't do it properly. This causes a load of tension in those areas, muscle acheing, etc so it would add to this issue, hence asking as thats something many on here have experienced and it is completely anxiety related so there are ways to tackle it.

[mummyanxious]

Thank you so much I will look into this.

One thing that happens is that when I go upstairs and get to the top I suddenly feel like I can't breath. I'm fine going up the stairs but its when I get to the top.

And I also get with the ribs. Mine is left side rather than right. Sometimes it feels like someone is pressing on my sides of my chest. It's really frightening and then I feel like I'm suffocating.

[Cags48]

Peak flow isn't a proper test for asthma you need to ask for a spirometry test if you think it could be asthma

[mummyanxious]

Why would my dr not know this? She got me to take peek flow readings and said based on findings I didn't have it. I had asthma as a child but never had a test like you're saying.

[Fishmanpa]

Your doctor knows more than anyone on this forum. Learn to trust what she says. I know your symptoms have been attributed to anxiety. Learn to trust that too and seek help.

Positive thoughts

[MyNameIsTerry]

Peak flow isn't a proper test for asthma you need to ask for a spirometry test if you think it could be asthma

Spirometry testing isn't available at all GP's as far as I now, so I guess it would require a referral to a hospital. The thing is though, my GP surgery is also an asthma clinic and they use the peak flow as do the GP's. I'm not sure whether a they would use the spirometry after using the peak flow though and since I am already diagnosed, the peak flow is all they ever do. Mine was diagnosed over 20 years ago with peak flow and older methods such as exercise inducement which they no longer use.

Should they use the spirometry for monitoring of diagnosed asthma?

---------- Post added at 02:47 ---------- Previous post was at 02:43 ----------


Your doctor knows more than anyone on this forum. Learn to trust what she says. I know your symptoms have been attributed to anxiety. Learn to trust that too and seek help.

Positive thoughts

Yes, I agree in terms of physical conditions, in terms of anxiety GP's are woefully educated in comparison.

GP's often misdiagnose between mental health conditions and are well known to attribute symptoms to anxiety if you have been diagnosed with an anxiety disorder as I've found on several occasions. I think if GP's are ruling physical conditions out though, anxiety is the very likely cause.

Isn't this the problem with the HA issue though? If you had GAD, it wouldn't be the same as your anxiety wouldn't be leading you into the obsession over illness trap. It must be hard to separate the 2 issues with HA.

[Fishmanpa]

Yes, I agree in terms of physical conditions, in terms of anxiety GP's are woefully educated in comparison.

GP's often misdiagnose between mental health conditions and are well known to attribute symptoms to anxiety if you have been diagnosed with an anxiety disorder as I've found on several occasions. I think if GP's are ruling physical conditions out though, anxiety is the very likely cause.

Isn't this the problem with the HA issue though? If you had GAD, it wouldn't be the same as your anxiety wouldn't be leading you into the obsession over illness trap. It must be hard to separate the 2 issues with HA.

Honestly, there are times when I get a pang or ache in my chest or have an unusually bad day (like yesterday) in terms of pain and side effects from my treatment that the thought doesn't cross my mind but I've actually had serious health issues. However, I KNOW my heart is Ok as I was just checked and the "new normal" pertaining to my cancer recovery is no different. I see doctors on a regular basis for all my health related issues. Thing is, I recognize when it's my mind vs. physical. For example: I have an appointment in less than three weeks with my cancer team for my "scope, poke and prod". I'm feeling edgy, irritable and find I have little patience as well as getting some tension headaches. That's GAD. Take the "chill pill" and the edge comes off.

I do agree that some GPs, based on your history, especially if you have a rather intense case of HA, may mentally fob you off ("ohhh, here she is again" type of thing), but they do check you nonetheless. They do look at your history, test results and past diagnosis's in order to determine if something is wrong. They have to! In today's sue happy world, if they were to neglect their duty as a physician, they could be sued. So if you're complaining about breathing issues and they listen to your chest and tell you nothing is wrong, then it's not a physical issue. And you're right. While a GP has knowledge of mental disorders, that's not typically their area of expertise. One should go to a health professional that treats the part of the body that needs treatment.... in this case a mental health professional. I've done it and it helped me tremendously.

Positive thoughts

[mummyanxious]

Thank you all for your musings. I have one go who always listens to my chest just to make sure. Though I don't really know how much this can tell him, he does it anyway.
The other gp I like doesn't ever check, she just listens to what ok saying and says no it's just anxiety. Even when I've gone in gasping for breath and palpating all over the place.
The other GPS at the surgery who don't know me do just read on their screens and say I see you're being treated for anxiety. And because the symptoms are identical it gets put down to anxiety without any examination.
I'm going today for my stomach issues but I will mention all my concerns as although it has gotten slightly better, I'm still horrendously out of breath all the time.
I've noticed now, it comes from under my ribs.

[MyNameIsTerry]

Thats sounds like the diaphram then. It could be a tension thing because you said you can calm it down by relaxing but I'm less sure of the issue with the stairs. I do remember your thread ages ago where exercise was causing these types of problems so is it the same thing? Like a general fitness thing for instance?

Sadly, your post highlights the issue of GP's that I have found. Mine has told me its anxiety for me to ask a pharmacist to be told its not anxiety but a side effect of medication hence I'm less accepting of the standard of service of our GP's. Not having HA does help me more with that though. From what FMP says, perhaps the standard is different between the US & UK?

[mummyanxious]

It's certainly worse in certain positions, especially if I slump to one side or sit crunched up. I suppose you tense tour diaphragm when you go up the stairs?
I don't know, I'm just fed up with them saying its nothing, because it is SOMETHING. Fair enough it may not be serious (or it may) but its SOMETHING I'm not imagining.

[Fishmanpa]

It's certainly worse in certain positions, especially if I slump to one side or sit crunched up. I suppose you tense tour diaphragm when you go up the stairs?
I don't know, I'm just fed up with them saying its nothing, because it is SOMETHING. Fair enough it may not be serious (or it may) but its SOMETHING I'm not imagining.

With all due respect MummyA... this thread has been going 4 days. You're still here right? And of course you would have more difficulty getting a breath when you crunch yourself up in odd positions. That's just common sense right? You're hyper focused on this (ya think?) and yes it IS something... anxiety disorder would be my guess. When will you get fed up with that and do something about it?

Positive thoughts

[mummyanxious]

With all due respect FMP I am in cbt at the moment so I am taking my anxiety seriously.
But there will be times when one has to distinguish between anxiety and real problems.

[cpe1978]

Completely agree with you MA there is a need to distinguish between the physical and the mental. Unfortunate for those of is who suffer from HA, in my experience at least it is extremely challenging to do. The only option we have as I see it, is to find a doctor that we trust and accept their view on things and that in all likelihood they are right.

Isn't this the worry you had a few months ago? Sounds to me like anxiety is a likely culprit. My body ached all over for nearly nine months. Even months after I didn't think I was anxious any more. Eventually it went - I am pretty certain that it was anxiety causing me to focus on things.

What outcome are you looking for? A doctor to take you seriously? Seems to me that at least one of them is. Your best bet fwiw from my perspective is to give accepting that it might just be anxiety causing your symptoms. What do you have to lose?

[Fishmanpa]

With all due respect FMP I am in cbt at the moment so I am taking my anxiety seriously.
But there will be times when one has to distinguish between anxiety and real problems.

Good to hear... good luck and keep working hard!

Positive thoughts

[mummyanxious]

Thanks for your responses.
Well I've been. Listened to my chest and got me to do deep breaths and said he couldn't hear anything wrong. Probably just from the diaphragm being tight.
Yes I had this a few months ago. I don't know how it lessened or whether it went away completely. He said nothing was being cut off in my chest anyway. Lol it sounds stupid when you say it doesn't it. My cholesterol (4.4) etc are all great as I had bloods done recently. So I should be reassured. But as we know there'll be a little gremlin tapping away...

[mummyanxious]

Oh and incidentally I forgot to mention, my pulse was 101 in the gp surgery. And my SARS were 98%
I said, funny that because when I'm at home my pulse is only 60. Wasn't interested.

[MyNameIsTerry]

Tension and posture all cause issues like this MA. If you tense your core a lot, you are restricting your diaphram and this will cause breathing issues and muscle stiffness. This is something a GP should easily spot from the description and upon ruling out any issues, should be explaining how this works in our bodies with anxiety and what you can do about it. Thats what I would expect but sadly GP's tend to gloss over a lot of this as mine always has. So, I would suggest discussing this element with your CBT therapist who will look at ways in which you can a) change how you think about it b) conduct any experiments to prove its anxiety by bringing it on and taking it away and c) practical physical techniques to help such as relaxation e.g. Progressive Muscle Relaxation (PMR).

Good luck!

[mummyanxious]

You've been so helpful MNIT thank you.
Just noticed when I stretched out in bed again, same thing happened. Pain all over my chest and back and restricted breathing.
Not helping that yesterday afternoon I spent most of it sneezing and coughing so now I have a cold to contend with too :(
But what you say makes sense and I will speak to the cbt lady about it. Last session we spoke briefly about my fears I had angina and how I need to increase my exposure to the things that bring these symptoms in as experimenters. Such as climbing the stairs etc. take note of how I feel but not dwell on it.
Last night was a bad night. I had a small glass of wine in the evening and spent most of the night tossing and turning and woke up at one point with my heart thumping like the clappers and sweating. Not good. I know alcohol increases anxiety so I usually don't drink much at all so didn't think one small glad would hurt :/

[mummyanxious]

Well here we go again. Wide awake in the middle of the night with chest pains.
Dr listened to my chest Thursday, was confident we'd treated the root of the pain as being a hernia with omoprazole. And late yesterday the pain comes back again and now I've got cramping pains in the top of my chest on the sides again. I seriously don't know what to think I'm going out of my mind. I'm so fed up.
Just when I thought I was coping quite well with having a cold as well.
Surely if you're on acid tablets you wouldn't get indigestion/gas pains right?

---------- Post added at 03:50 ---------- Previous post was at 03:30 ----------

Uh this is awful. The only benign reason I can think of is trapped wind or something. But I can't see how that'd be so high up. It's like a twisting knifelike pain under my ribs all the way across and up. Just when you think it's easing off it comes back.

[MyNameIsTerry]

No worries MA, I think its veyr important to understand what some of these normal bodily sensations are as it can be hard to differentiate between normal physical responses and adnormal ones with any anxiety disorder, let alone HA!

Its good that your CBT therapist is helping you with this already. I have been through something similiar and mine was keen to try experiments to bring on the symptom whilst challenging your thoughts. You end up getting the habituation effect of exposure therapies.

It may take some time and effort though. Sometimes its about bringing yourself up level by level like in an exposure hierarchy. I found that sometimes you have to go up a few levels above your fear before you habituate, its not always about going one step up.

Do you use Thought Records? These can help document these things and they have sections on the end for challenging them. For the expsoure exercises though I would expect your CBT therapist to have provided you with the format they prefer to use such as the experiment docs they have.

Stretching causes things like this as well, it can feel similiar to tensing. So, performing exercise, yoga, etc can all be a form of exposure with these types of symptoms. Its worth doing them though because they make you mroe resilient even if you still feel the symptoms.

Another thing to try is bodyscanning. Your therapist would be able to advise if this is useful to you.

I don't know about the indigestion issue, I'm still looking into my own issues on that front so you will know far more than me. Just a thought though, if you have been doing a lot of coughing it could also be a pulled muscle from that or a chest infection maybe? If the latter, you would know from the greenish/yellowish colour of anything you have coughed up but its nothing to worry about, just a short course of anitbiotics and you would be fine.

[mummyanxious]

Thank you MNIT. Have you considered becoming a therapist yourself? I think you'd be fab.
I must say though while I am doing this cbt it isn't what I expected it to be. I thought it would be more intense but she seeks pretty laid back about it all and just listens to me talk so far and chimes in a couple of times with thinking patterns etc.

The indigestion thing is getting me down. Dr thinks it is a hernia but based on my age and lack of risk factors won't send me for an endoscopy to diagnose for certain what's going on. I get all the stuff about unnecessary testing but I don't want to be treated for something it might not be if that makes sense. Especially as I keep having flair ups of something. I can't recall anything I've eaten that might be particularly aggravating. The pain is still here this morning. It's tucked up under my ribs and into my sides and slightly into my back. It may well be trapped gas. It's very uncomfy and intense at times. Someone pointed me once to splenic flexure. The trouble is with this pain is that it reinforces my checking. Like I will get the pain and if my BP and pulse are ok then I will think it can't be my heart? Tightly or wrongly of course as I don't know if that's correct. But my mind assumes that if it were my heart my BP would be very high or very low.

I don't think it's anything to do with my cold as I've not had it long and he did check my lungs the other day. I've had pleurisy in the past so I'm pretty ofay with the world of chest infections sadly.

---------- Post added at 07:34 ---------- Previous post was at 07:09 ----------

Oh and btw I have a great body scanning relaxation on my iPod. I must get that charged up and have a listen. Usually knocks me out to sleep though ;)

[MyNameIsTerry]

Thanks MA, thats a very nice thing for you to say. I'm just happy if I ever help anyone. I've been asked if I wanted to be a coordinator at a local mental health charity running sessions, but I have a rule about leading by example so until I get myself out of the other end of my anxiety disorders, I don't feel I should.

That sounds like a good thing to try then. I was always skeptical about body scanning as I was already constantly thinking about how I was feeling but its focus and realising that things are happening either because they have always happened like that or that there is a symptom there that is a result of anxiety and that we need to accept it for what it is. It can take some practice though.

I'm a big endorser of Mindfulness and this also includes body scanning exercises where it teaches you how to understand what is happening in your body.

My CBT started like that, the therapist was taking more time to understand what I was going through. As things progressed she would take the lead more. Are you finding it is helping you? Are you continuing to use what you learn when you leave the sessions?

There are a couple of types of hernias that impact on the diaphragm. Has your GP ruled out whether the hernia is impacting this? Was this why he/she checked for a blockage? Why is your GP saying he/she won't perform an endoscopy to diagnose it when they use an ultrasound to determine a hernia? Hernia's such as Hiatus can cause heartburn, is that what you take the other medication for? You mentioned you were concerned whether that medication was working, so making there is a link here?

I know it is not good to start down the "What if" route with any anxiety disorder and adding the context of symptoms makes it worse for HA sufferers but your GP thinks you have a hernia, something is actually wrong there in some way. So, perhaps this will explain some of the things you are experiencing if your GP sees them all?

I don't know about hernia's impacting the diaphragm but given hernia's can be left without treatment, unless they are proving to impact on quallity of life, I'm sure your GP (and the NHS) would always remove any that would impact on internal organs, in this case the lungs. So, it doesn't sound like there is any impact there, its just that its causing some other symptoms. It is interesting that with Hiatus, they don't really know why is occurs but they believe it could be age related due to pressure on the abdomen causing the diaphram to become weak.

Perhaps make a note of things like this and when you are due to see your GP or need to go back, take them with you and see what he/she says. It might help him/her confirm their diagnosis.

[mummyanxious]

Yeah I completely get what you mean there. When I've had really good patches in my life I can be so rational and sound like a counsellor to other people but I have always relapsed so don't think I'm qualified to preach if that makes sense.

I will ask my therapist about mindfulness as I'm pretty sure they do a course on it, but I think you have to go through the cbt first. But I will ask.

Yes he thinks its a hiatus hernia and that's why I'm on the acid tablets as apparently that's how they treat them. But I don't want to be on tablets forever as I know they impact on your absorption of vitamins etc.
He won't do an endoscopy as they're invasive and unpleasant so given my age he doesn't think in his opinion it's anything worse than a hernia. My ulcer blood tears came back normal. All my routine blood resets came back normal.
I just don't get what all these chest pains are. A lot of the time I can get on with my day and ignore them but when I'm sat alone quiet or in the middle of the night the what ifs creap in. Especially as they are so high in my chest. But it's always in a band under my ribs and up the sides. If I feel it nice around that sort of reassures me a bit that surely a cardiac issue wouldn't move about. But I don't know, I'm not a gp or a specialist.
I think I read once though that coughing can aggrevate hiatus hernias. Maybe the pains are my diaphragm going into spasms. Who knows. All I know is I'm fed up of being in pain.

[MyNameIsTerry]

If they have a course on Mindfulness MA, sign up, it can only help you. It has no connection to any form of therapy unless tailored as seen in the blended versions such as MBSR & MBCT as well as some of the practice specific ones that have been created by such as Breathworks.

Can't he do an ultrasound which is the standard check for hernias?

Hiatus can be linked to a weakened diaphragm due to age so perhaps there are ways to strengthen the diaphragm again or learn different breathing techniques to help with this? I think you would need GP advice on this though and maybe a physiotherapist could advise on any strengthening.

You may even find stretching exercises help with that so could look at yoga or pilates but given you have a pre existing medical condition, its going to need their advice. If you can use exercise to help with this, and it really is an if because I don't know anything about hernias, GP's can refer you to a local gym for a course of free exercise treatment which personal trainers have been doing for years. These personal trainers are trained to deal with medical conditions in rehabilitation.

[mummyanxious]

I think what they say is that they want you to work on techniques and then go on it so you not doing two things simultaneously. I don't know really but will ask.

Well here's how awful the mind can be. Spring awake at 5am with tummy cramps just where your ribs part. Feeling really sick and bubbling. And then my mind goes 'what if its your liver or pancreas?' And then my mind starts ticking. Terminal c spread to liver....and bang goes sleep.....

No one ever suggested an ultrasound for a hernia. Thing is I has a chest X-ray about a year ago for a chest infection. I would have thought it would have shown up on there?

One bit of good news is my cold doesn't seem so bad after a coupe of hours sleep. Every cloud eh.

[MyNameIsTerry]

Yeah, every cloud MA!

Thats the classic HA thoughts then. You know there is a possibility that your GP is working with you on otherwise its just anxiety and you can work with your therapist on it. Don't give into the anxiety.

My therapist introduced me to it within the sessions but it was a matter of using CD's rather than a course. It makes sense how your therapist is doing it because if you are new to CBT, they will want understand you and get you moving forward first but nnot with too much otherwise it can be overwhelming which is a classic issue in anxiety disorders. Its all micro goals but the more you move on, the bigger those goals can get.

An xray can show them up I believe but the NHS advise having an ultrasound. An xray or endoscopy can be used to determine which of the 2 types of hiatus hernia it is. NHS Choices recommend an ultrasound on their main hernia's page but then make no mention of it when discussing purely a hiatus hernia! They seem to recommend a barium meal for it, so not sure whether that could be a factor?

Are you taking the other medication for GORD? GORD can result in chest pain, heartburn, problems swallowing and an unpleasant sour taste in the mouth. If so, have you been given advice on types of foods to avoid, lying down within 3 hours of eating, etc?

[mummyanxious]

No I'm not taking anything else for it. This is supposed to cure it. Surely omoprazole should do the trick without you needing anything wise? That's why I get in a flap because I'm on a 40mg dose split in two so if I'm still getting pains every now and again my mind thinks there's more to it.
Yesterday I did have that awful sour taste after a burp though. Maybe it's just a temporary increase in acid I don't know. Maybe there are hormonal links to increase in acid.
The dr said he didn't want to see me again. He said to carry on taking the medication at that dose for another month then experiment with dropping down to one a day and then tailing off.

The thing about the cbt is I think it's only a limited amount of sessions. I've airway had four and we've not really done much work. So I am worried its going nowhere and I'm going to end up still as bad at the end.

[MyNameIsTerry]

Its worth raising that concern with your therapist. Mine felt like that at times and the way she adjusted it was to lengthen the gaps between the sessions but this was once I had had enough not to need them so often due to making improvements. I had about 12-15 sessions (can't remember now, I think closer to 12) with 2 follow up reviews (these were at 3 month intervals). My CBT lasted over 6 months due to the longer gaps we took between sessions.

If you have GORD due to the hernia then its recommended that diet is assessed because what you are eating will be creating more stomach acid which then means the medication has to reduce it. However, if diet is adding to this problem, that could still be a problem when you come off them. My dad is on them for a different problem with stomach acid and his GP has just left him on them permantely and not even discussed changing diet. My GF is on them for GERD and she has dropped them off to find the same problem is still there which is because she needs to change her diet. So, GP's may be a bit variable with how they tackle this. I guess yours is determining if it will be encouraged to go away but if not, a longer term solution is likely needed such as change in diet. I don't know about the hernia side so I don't know whether people have flare ups so take the medication for a month and then are fine again until another flare up.

Maybe cutting out certain types of foods would help alongside the medication?

[mummyanxious]

Thing is I don't really notice a pattern with it, say I eat an egg and it will affect me one day but not the next that kind of thing. I don't eat particularly bad things either. I have cut out tea as I had an attack after a cup. Don't know whether it was related or not but I'm not that fussy for tea anyway so happy to give it the elbow.
I will monitor it for a couple of weeks but think I will pencil in another appointment just in case. At least I can cancel it if things are ok. You wait four weeks for an app with a good dr here which is rubbish.
I don't know whether I do have a hernia. It's like I said, he's guessing based on symptoms. My chiropractor didn't think I had one. And when the dr examined my stomach said he couldn't feel anything when he diagnosed. I'm not overweight so would be easy to feel bits and pieces on exam.
The only link I do find to flare ups is hormones as I stated before. I don't like googling though so I'm not sure whether this is a trigger. And my gp generally poo poos anything hormone related.
Got another cbt session next week so will see what comes out of that.

---------- Post added at 10:44 ---------- Previous post was at 10:40 ----------

I think the thing is while I don't want to go for unnecessary tests, I don't want to be being treated for something I might not have if that makes sense.

---------- Post added at 11:01 ---------- Previous post was at 10:44 ----------

And here we go again. About an hour after I've had my breakfast (porridge) and the pain has started up under my left breast. I'm almost certain it's my stomach but its so frightening. I've had a clear hpylori test so no ulcer. It's just no way to be living this isn't. It makes me irritable and sad.

[MyNameIsTerry]

Yeah, its sadly a problem with the NHS. I wait for about 3 weeks to see any GP at my practice but they at least run an open surgury in the morning so if you get there quick enough, you can see whoever is covering. My GF has to wait 4 weeks for anything for hers so she tries not to go. He treating her for GERD at the moment, followed the withdrawal he advised and she still has the same issues and now can't get back in to see him due to his 4 week wait.

The thing about the hernia is, it should be possibly to feel it to diagnose it, if not they can use the other methods. I've always found GP's are always sending people for xrays & blood tests for things so I don't understand why he couldn't do that. Given his attitude to 'hormones', he sounds a bit old fashioned. Your GP shouldn't be guessing at his diagnosis, the fact he can't feel a hernia suggests he can't determine that diagnosis to me.

[mummyanxious]

Well I've managed to find a cancellation for two weeks time for the other dr I see. She was going to send me for tests. But they seem to cancel each other out.
Anyway I've just had my dinner and been hot by tummy pain again so something's not right.
Maybe now the problem is not having any acid? Surely it can't be god to not have any stomach acid.
I'm just really worried about it because its so painful I keep getting fleeting thoughts that it is probably something serious.

[MyNameIsTerry]

Or it could be that the medication your GP has given you is not doing enough? Maybe they need to adjust it or switch to something else?

In a few posts now you have commented on it after eating, so there is some pattern there. I suggest writing down any patterns & symptoms so your GP can work through them. Stomach acid is going to increase when you eat, moreso with higher volumes of foods and (I think, but I'm less sure) with certain types of foods hence how people get things like GERD which can be managed through diet as wel as medication.

So, perhaps your medication needs addressing or perhaps it needs some dietary changes to go with it to stop this. Your GP should be able to help you with this but it seems you have 2 different GP's, one that doesn't want to test and one that does. The one that doesn't can't find a problem in examination so is going off the symptoms you have described but the other GP doesn't seem to agree. The obvious thing to do is a test, perhaps the easier xray route.

Like you said, you don't want to be treated for the wrong thing and one of the 2 GP's hasn't been very efficient in manking the diagnosis. It reminds me of a situation I had with a GP who was quite old, yet senior at the practice, who would not prescribe steroid treatment for my chest infection for asthma. This is often done because if several courses of antibiotics don't work, they aren't going to as something stronger is required. I spent weeks getting worse until my mum made a complaint and demanded a different GP, one who understands asthma. So, we waited, went in to see a young GP who looked at the situation, had a listen and...dished out the steroids! A week later I was fine. The root cause was an old GP who wasn't current so debunked modern methods and when I saw what yours said about 'hormones' and the poor diagnosis, I made me think of this situation. I was a child though...I can fight my own battles thesedays! So, seeing this other GP sounds like a result as they seem more competent.

I should say, there are many excellent GP's, I just don't agree with them blindly because they have been trained and have experience. Sometimes you have to keep pushing and if this was any forum but the HA one, people would be saying the same...its just a lot harder for HA people and also hard for us non HA people to understand where the line is drawn.

[mummyanxious]

I think the pattern seems to be that when I wake up in the morning this pain will be there. It's deep in my chest where my ribs part and is quite specific. Like it's not a spreading pain, it's pinpointed. A bit like a poker. It may be relieved when I've had something to eat/eating, but about an hour after I've eaten it'll be back for about an hour and then will go away.
I do some huge burps at times. In fact a man would be proud of them ;)
But having said this its only the past couple of days it's come back badly. I'd been, bar a day here and there, mainly pain free for about a month.
When it initially flared up I was in agony. Even walking was hurting. Deep breathing. Which lead him to make his diagnosis because obviously the diaphragm would be moving and pulling it up and down.
I rennet the other dr I'm going to see remarking a few months back when I asked if I could have a hernia 'well the treatment would still be the same, it'd be acid tablets' and sort of giving it no importance.
I'm just so frightened its something sinister. I'm frightened its more Lilly my liver or pancreas :/
I have a lot of tension under my ribs again at the moment though so that won't be helping.

---------- Post added at 06:46 ---------- Previous post was at 06:45 ----------

But that's like a vicious circle isn't it because if you're in pain you tense up.