Trying to stay away from Dr. Google... lots of information/questions.

[turtleonaleash]

Hi All,

In November 2009 I had H1N1. This was before anxiety took over my life. I was sick and I stayed home for eight weeks. I wasn't deathly ill, it was just like an annoying flu. I felt better after the eight weeks but I had a persistent cough for weeks and months following. My lungs have always been a weak point for me because I was born very premature and my lungs were not fully developed when I was born.

I had a panic attack just before Christmas and I became agoraphobic. I was convinced I had pneumonia and my Dr. listened to my chest and told me my lungs sounded fine, he sent me for a chest x-ray and it came back fine. He told me I would be prone to picking up infections for a few months and my body would not begin making anti-bodies against H1N1 for 6 months - 12 months. So I could pick up H1N1 again.

When my chest x-ray came back fine I recovered quickly, my cough and symptoms went away rapidly but my anxiety remained. My dr. upped my dosage of mirtazapine and I began therapy. I am still having a terrible time with my anxiety and I am starting to over come my agoraphobia (very slowly.)

Fast forward to now. Sunday I accidently left my window open and a small bird flew in my car. It crapped all over and made quite a mess. I was terrified to clean up the feces. I was convinced I would get avian flu or some other kind of disease from the bird droppings. I washed the droppings off using a towel and soap and Lysol. I then drove the car to the store and I purchased Clorox wipes and Lysol spray. I wiped all of the surfaces with Clorox and I sprayed the entire car with Lysol spray.

Monday night I went out with my boyfriend. It was a very challenging evening. I was very anxious all evening.

Tuesday I had to go to the dentist which caused me to feel very anxious.

Wednesday I drove myself to the therapist. Driving by myself I feel very anxious.

Thursday I went out early with a friend. Again, I drove by myself.

Friday (today) I woke up feeling terrible. My chest was so sore and tight. I started coughing (only in the morning.) It hurt to take a breath. I became very anxious. I began really focusing on my breathing, I was afraid I would forget how to breathe. I had a dentist appointment and I really did not want to go but I had already canceled many times. I pushed myself to go out. I went to the dentist and everything was fine, I then went to the store and on my way home my chest was so sore... I had terrible stabbing pains.... I drove home as fast as I could and I got into bed. I then had a bath and I had absolutely NO chest pain in the bath.
I still feel off. I feel warm to the touch, my head is sore, I am very red in the face and my chest is achy.

My question. Could I have picked up avian flu or some other disease from the bird droppings? Or is my chest just sore from being so tense from having a very anxious week? It seems like a muscle thing since the hot bath made it feel better... but I just don't know. It's the weekend and I have no way to reach my doctor.

[Vanilla Sky]

You've hit the nail right on the head, quote, it seems like a muscle thing since the hot bath made it feel better.
When we are anxious as you know we are very tense, the most common areas are shoulders, neck and chest. I learned this a long time ago and i try to have a professional massage monthly it really helps release the tension, in fact when i'm going into the room i start to unwind with the smell of the oils and relaxing music. The stabbing chest pains you describe sound like mine , like i get the pain and then it stops, then a while later it starts up again , usually when i move awkwardly or sometimes when i just move lol . If it was heart or lung related it would be there all the time even in a hot bath.
You were tense all week hun and it took untill friday to show its self in the form of tight chest ( tense muscles ) and so it escalates from there.
Try to relax over the weekend hun ,
Paige :)

[RLR]

Okay, let's bring some clarity to several issues. Firstly, your lungs are just fine and there is no such condition at adulthood which relates to being born premature wherein the lungs have not yet fully developed. The lungs continue to develop following birth and there are no consequences which would make your lungs more susceptible to inadequate performance, weakness or increased exposure to pathogens.

Any increased suseceptibility to pathogens which result in upper respiratory conditions is strictly due to genetic variation involving the general immune system. Structural abnormalities are very specific and would not be the consequence of simply being bore premature. While there is theoretical speculation about such a connection, it is absent any factual supporting data. Increased susceptibility to infections or other difficulty is strictly during the period of infancy while the lungs are under development, not a consequence that persists into adulthood.

Secondly, you will not develop avian bird flu by means of the episode described.

The problem which has developed is an irrational fear based upon your own interpretations rather than explicit medical facts. This occurs for many persons with health anxiety and can sometimes produce drastic measures taken by such persons to prevent exposure to pathogens. The general nature of health anxiety produces diminished self-confidence and the sensation of danger when feeling insecure causes the brain to respond in a very specific manner that is innate in all humans. The resulting physiological changes are universally misinterpreted as symptoms of disease or an impending event construed as threatening to their well-being, sometimes even producing a panic threshold.

The sharp stabbing pains in your chest are the result of a phenomenon known as DaCosta's Syndrome and is the direct consequence of intense somatoform anxiety. It is not in any way associated with your heart or lungs. Submerging into a hot bath reduces the anxiety and muscle tension which underlies the onset of the syndrome, thereby producing an absence of the symptoms.

The vigilence to respiration produces the characteristic result described because it causes brief voluntary imposition over an autonomic process, the result of which is erratic respiration and the sudden sensation that automaticity of lung function will cease if continual effort is not maintained. This can never actually be the case, however, and sufficient distraction by means of a physical task is typically sufficient to break the vigilence and sensation.

It's important for you to realize that pathogens are a natural occurence in and around all humans on a daily basis. The human body is specifically designed to protect and defend from such invasions. Taking the appropriate precautions actually has to do with simply practicing good health so that your body's immune system and general abilities remains sufficient. Trying to block exposure to pathogens can ultimately lead you down a very complicated path because in the absence of being able to detect that which cannot be seen, sometimes drastic measures become daily ritual in order to feel safe. It's also critical to realize that such efforts are entirely in vain because they are being instrumented based upon your misinterpretations regarding the nature of pathogens and their vectors and not the actual circumstances at any given time.

My suggestion here is that you take a breath and relax. Your body is not nearly as fragile as you've interpreted and you'll actually remain extremely healthy in the absence of trying to instrument methods to avoid exposure. You must come to trust in your body's ability to fend off invasion rather than feel you must exercise all due diligence in manually performing this function. While it's prudent not to stove up in cramped quarters among persons with a cold, it's also just as unwise to try and create artificial precautions to avoid the over-stated fear of infection because in some instances, it removes the natural environmental circumstances under which the body performs best in preventing disease. If you alter this natural context, you may well be laying groundwork to invite what you are alternatively working so hard to prevent. Do you see what I mean here?

The human body is designed to work best in a context it recognizes as natural within its environment. Taking extreme measures can expose the body to circumstances that would otherwise have not taken place, in other words creating exposure to hazard by one means in the attempt to avoid it in another form.

Best regards,

Rutheford Rane, MD (ret.)

[turtleonaleash]

I have been visiting Dr. Google again. Can you tell me Dr. Rane, would Postural Orthostatic Tachycardia Syndrome be anything I should consider after having H1N1.
Lately in the morning I feel awful. Headache, chest tightness, racing heart beat, dizziness. I know these are all anxiety symptoms but they seem to be POTS symptoms as well? They say a viral infection can cause POTS. I am 21 years old. I have always been anxious but never like this. I experienced globus hysterics after recovering from H1N1. The racing heart beat comes and goes. Sometimes I will have a heart beat of 80-90bpm for weeks at a time, other times I do not notice my heart beat at all. I was monitoring my blood pressure for a while and it was in the normal/low range, but my heart rate was still high.