# i can't breathe



## Flea (Mar 15, 2018)

I've been having a weird medical problem with shortness of breath, and it's taking a big bite out of my quality of life.

It started a couple of weeks ago, immediately after donating blood. I came home from the blood bank and sorted laundry, and got so winded that I had to stop and gulp air as if I had been sprinting. It happens intermittently, with the only pattern I've noticed being that talking tends to trigger it, as does any kind of physical activity. And standing or sitting upright. The other day it landed me in the ER where I almost blacked out from hyperventilating. A number of blood tests, an EKG, and chest x-rays found absolutely nothing. The doctor tried to pawn it off as a panic attack despite the fact that I was joking around with the nurses in my better moments, so now I'm taking a regular dose of anxiety meds just to formally rule that out.

I have an "echo" test pending (echocardiogram, I think?) My family doctor is taking me seriously and has promised a referral to a specialist based on what that turns up. But in the meantime I'm at a loss. I know all about Systema breathing, but when this kicks in I need so much air that burst breathing isn't enough. I don't panic, but I don't default to Sys breathing as I would in any other situation. It's just feral breathing, open mouth, in/ex, as hard and fast as I can.  The more this happens, the worried I get about what this could mean medically so the fear/anxiety is building. And of course, as I inhale in gulps my lungs are starting to hurt from overuse too. So it's becoming a vicious cycle.

I'm not asking for medical advice here, but I do believe that if I could respond with Systema breathing it would probably help a lot. Is there a technique I'm missing? Or a way to get past the fear factor to get more air effectively when this hits?


----------



## Gerry Seymour (Mar 15, 2018)

Knowing little about what you're experiencing and what medical conditions might cause it, I did immediately spot this: "open mouth, in/ex, as hard and fast as I can". Breathing that fast doesn't help. You probably aren't breathing very deep if you're going as fast as you can. If no underlying medical issue is immediately found, I'd try to focus on the breathing method to see if that helps any. I remember someone teaching me that when I was out of breath (I have a history of mild exercise-induced asthma) to focus on breathing out more fully, and the breathing in would take care of itself. It seems to help me, even if it's just one good emptying of the lungs followed by one deep breath in. It slows my breathing and gets me past the worst of feeling out-of-breath.


----------



## Monkey Turned Wolf (Mar 15, 2018)

Something that may help is along with @gpseymour stated...don't breathe fast, breathe slow. When you notice it happening, force yourself to slow down your breathing. Something that can work is four four and four breathing: inhale for four seconds (through your nose), hold that breath inside you for four seconds, and exhale for four seconds, then repeat. Not sure what the systema burst breathing is, but if it's breathing in 'bursts' don't do that. Keep your breath in and your breath out slow and consistent. Actually counting to four in your head can help.

This isn't medical advice, just a way to help breathing when the fear builds and you are out of breath, so take this advice for what it's worth.


----------



## Flea (Mar 15, 2018)

Thanks everyone. I know about square breathing. In fact, I'm such a big fan that I've taught it to many of my mental health clients over the past several years of my social work career and most of them love it too. 

What I'm surprised and embarrassed to find is that when the suffocation feeling is real and unexpected, all that careful Systema breath training goes straight out the window. It's one thing when everyone's goofing off in the dojo and laughing. But when you're just crossing the street with your friends and suddenly everything goes grey? That's a totally different experience.  I don't think of crossing the street or chatting with my grandmother as "exertion" which has put the whole thing into a completely different cognitive category from Systema. I simply _can't get enough air_, so in this very different context the Systema breathing doesn't occur to me. 

Fortunately I'm off work today so along with picking up the inhaler at the pharmacy, I plan to practice a solid block of meditation as well. Maybe my subconscious has something it's trying to tell me here. I'll practice the square breathing too, to remind myself during a calm moment.


----------



## DanT (Mar 15, 2018)

Flea said:


> I've been having a weird medical problem with shortness of breath, and it's taking a big bite out of my quality of life.
> 
> It started a couple of weeks ago, immediately after donating blood. I came home from the blood bank and sorted laundry, and got so winded that I had to stop and gulp air as if I had been sprinting. It happens intermittently, with the only pattern I've noticed being that talking tends to trigger it, as does any kind of physical activity. And standing or sitting upright. The other day it landed me in the ER where I almost blacked out from hyperventilating. A number of blood tests, an EKG, and chest x-rays found absolutely nothing. The doctor tried to pawn it off as a panic attack despite the fact that I was joking around with the nurses in my better moments, so now I'm taking a regular dose of anxiety meds just to formally rule that out.
> 
> ...


Don't try to force anything, breathe as normally as possible and remind yourself that all your tests came back negative, and that above all, YOU CANNOT, AND WILL NOT DIE FROM A PANIC ATTACK, REGARDLESS OF HOW YOU FEEL. Panic attacks like this come and go, but the most important thing to remember is that a panic attack is simply a dump of adrenaline into your bloodstream. It is meant to keep you alive, not kill you. Imagine 10,000 years ago you're walking in the forest and see a tiger. You'd have the same symptoms but if humans died every time they had a massive adrenaline drop we would have been extinct a long time ago. Panic attacks keep you alive, it's just that yours are happening randomly most likely because of some subconscious (or conscious) stress. Maybe work is getting tough? Maybe kids are being annoying? It's up to you to tell yourself that things will be ok. I had a similar experience at the movies a while back. These things happen to the toughest men I know. Stay strong and remind yourself that this is temporary. Use your meds when you need them. Don't feel embarrassed by them. Like I said, this stuff happens to even the toughest people I know. Follow up with your family doctor and specialists. You'll feel a lot better once everything is ruled out.


----------



## Flea (Mar 15, 2018)

Thanks Dan! You're absolutely right about them not being fatal. But I don't think this is panic, because it usually happens at really prosaic moments - sorting laundry, conversation with friends, or walking half a block down the street. This started very suddenly after donating blood and it's been sustained for about two weeks now.

I worked as a credentialed mental health provider in a number of settings - outpatient clinics, inpatient, and community - so I know it when I see it. And if you read back over my posts from when I was a regular a few years ago, you'll see that I'm no stranger to the other side of the equation either. By which I mean that I'm not stigmatizing mental illness when I say I _*really*_ don't think this is panic in my situation.

My other theory is that this could be a bizarro manifestation of spring allergies. My hometown is known as the "allergy capital of the world." The indigenous americans called it the "valley of death" and refused to come here for more that an annual foraging trip because everybody would get sick. Nowadays, next county over is all agricultural and their #1 crop is grass seed. So it's bad enough that people do get hospitalized with allergies in this city every year. A couple springs ago I had bronchitis for two months and a severe sinus infection for six. Yes it's only March now, but with climate change everything is flowering these days. So who knows? I think that along with the inhaler and meditation I'll add some allergy meds to the mix while I wait for the echocardiogram. I'll try anything at this point.


----------



## Buka (Mar 15, 2018)

You know, Flea, it very well could be the Valley of Death thing. Considering how our immune responses change over the years, that might very well be the path to explore with the most vigor.

Keep us posted, bro.


----------



## Flea (Apr 19, 2018)

You asked for an update, so here it is ...

Since my last post I've noticed that my chest burns with every inhale. After several meetings with my GP and a pulmonologist came up empty, last week the pain got more concentrated in one specific spot prompting a provisional diagnosis of costochondritis. It's swelling and inflammation of the cartilage in the rib cage. I've been taking NSAIDs and using ice packs on my chest. Any results are so subtle that it's honestly hard to tell if I'm improving. Although last night I was able to laugh at my birthday party, so that was encouraging. 

Today my GP offered a referral to physical therapy so I can inhale more comfortably, and another referral to a lung specialist in another city (I'm in a small city, this other guy is in a teaching hospital 2 hours away.) I've been going through this for about six weeks now, so I'll try just about anything at this point. I'm still open to suggestions here if anyone has any ...


----------



## Gerry Seymour (Apr 19, 2018)

I know it’s not much comfort, but connective tissue does usually heal. That’s certainly not the worst diagnosis possible, and you should be able to recover over time. I’m rather a fan of PT after the recoveries they’ve helped me with in the past 2 years. 

Do let us know what the new doc says.


----------



## pdg (Apr 20, 2018)

I think there's still a panic issue at play - but not the conscious "mental health" kind of panic.

If your unconfirmed diagnosis turns out to be correct, it would explain the initial physiological symptoms, and panic takes care of the rest.

You may well not be getting the "I can't breathe, better panic" thoughts, but the signals can still be there, triggered by a firing of pain receptors related to breathing.


----------



## Tez3 (Apr 20, 2018)

I can't help with the breathing thing Flea, I'm so sorry you are having problems but it's lovely to see you back here. Missed you!


----------



## Flea (May 27, 2018)

Tez3 said:


> I can't help with the breathing thing Flea, I'm so sorry you are having problems but it's lovely to see you back here. Missed you!



Thanks Tez! It's great to hear from you too. Other than the occasional cameo appearance I have essentially quit martial arts (it's complicated) which has a lot to do with why I've stayed away from the forum. I always enjoyed the community here, but on some level I feel embarrassed about not training any more so ... yeah. 

Not much to report with the costochondritis. After a month of NSAIDS and ice, I'm on an absurdly slow recovery curve with lots of plateaus and relapses. I've noticed that those relapses seem to coincide closely with stressful moments, so I'm reducing my exposure to the news and cutting back my work schedule temporarily. My family doc offered to give me a cortisone shot in my sternum, and after some deliberation I turned him down because reasons. The appointment at the teaching hospital isn't until the end of July, so now it's just a waiting game.

Thanks again everyone for the kind thoughts.


----------



## Monkey Turned Wolf (May 27, 2018)

Flea said:


> Thanks Tez! It's great to hear from you too. Other than the occasional cameo appearance I have essentially quit martial arts (it's complicated) which has a lot to do with why I've stayed away from the forum. I always enjoyed the community here, but on some level I feel embarrassed about not training any more so ... yeah.



I'm not sure if you mean that you've permanently quit martial arts, or just for the moment, but had to comment when I read this. I've had times when, do to medical, financial or scheduling reasons I wasn't really able to practice, and took a break from martial arts. Those are the times I end up on here more...I don't think of it as something to be embarrassed about, but instead that I look at this forum during those times as a way to stay connected to the thing that I love, even when I can't physically practice it.


----------



## Gerry Seymour (May 28, 2018)

Flea said:


> Thanks Tez! It's great to hear from you too. Other than the occasional cameo appearance I have essentially quit martial arts (it's complicated) which has a lot to do with why I've stayed away from the forum. I always enjoyed the community here, but on some level I feel embarrassed about not training any more so ... yeah.
> 
> Not much to report with the costochondritis. After a month of NSAIDS and ice, I'm on an absurdly slow recovery curve with lots of plateaus and relapses. I've noticed that those relapses seem to coincide closely with stressful moments, so I'm reducing my exposure to the news and cutting back my work schedule temporarily. My family doc offered to give me a cortisone shot in my sternum, and after some deliberation I turned him down because reasons. The appointment at the teaching hospital isn't until the end of July, so now it's just a waiting game.
> 
> Thanks again everyone for the kind thoughts.


Even when you're not training, you still have plenty to contribute - if only making fun of those of us who whine about our training. There will be those who will say, "Yeah, but you don't train, so...." But don't let them spoil it for the rest of us.


----------



## Flea (Oct 17, 2019)

After roughly a year and a half of chasing my tail and getting dismissed as a Hysterical Female,* I finally have a diagnosis! Apparently it's "vocal cord dysfunction." In short, my larynx and trachea are constricted such that from an anatomical standpoint I'm breathing through a cocktail straw. No wonder I constantly feel smothered.

In short, my family doctor got so tired of me being persistent that he referred me to pulmonology at  a teaching hospital a couple hours away. The pulmonologist was fantastic, never once harping at me about "anxiety" but running every appropriate test several times. At first we thought it was adult-onset asthma, but I didn't respond to any of the treatments for asthma. So as a last-ditch effort I got a laryngoscopy with an ENT. Bingo!

Apparently VCD is rare enough that there isn't much research and no medication (just my luck!) They gave me to a speech pathologist who specializes in this, but there's no one in my own city so I make this commute at least once a month. So I do breathing and speech exercises designed to relax my throat. I've made a remarkable recovery so far, but it's a squiggly process with lots of plateaus, setbacks, and power surges. Still, I'm a whole new person from where I stood a year and a half ago.

_*Yes, I ordered all my medical notes from everyone. The last straw with my family doctor was the note where he wrote "clearly psychogenic. I do not recommend any unnecessary scans or tests."_


----------



## Monkey Turned Wolf (Oct 17, 2019)

Flea said:


> After roughly a year and a half of chasing my tail and getting dismissed as a Hysterical Female,* I finally have a diagnosis! Apparently it's "vocal cord dysfunction." In short, my larynx and trachea are constricted such that from an anatomical standpoint I'm breathing through a cocktail straw. No wonder I constantly feel smothered.
> 
> In short, my family doctor got so tired of me being persistent that he referred me to pulmonology at  a teaching hospital a couple hours away. The pulmonologist was fantastic, never once harping at me about "anxiety" but running every appropriate test several times. At first we thought it was adult-onset asthma, but I didn't respond to any of the treatments for asthma. So as a last-ditch effort I got a laryngoscopy with an ENT. Bingo!
> 
> ...


It's good you finally figured out what it is, and even got someone who can (hopefully) help. Obviously, we're only getting a limited story as a result of the medium, so I don't know if the doctor has been better in the past, but I personally would try finding a new primary care, especially after finding out that it was in fact not psychogenic.


----------



## JowGaWolf (Oct 17, 2019)

gpseymour said:


> Breathing that fast doesn't help. You probably aren't breathing very deep if you're going as fast as you can


  Totally agree.  If it's like what I used to have then the problem is that the lungs aren't taking in oxygen correctly so breathing fast would just make stuff worst for me.  I would breath slowly but at a pace where I could feel the symptoms ease.  Breathing too slow was just as bad as breathing too fast.  For me I learned to focus on breathing relaxed where I'm so focused all of the fear and panic goes away.   But I also had an inhaler for emergencies for when the breathing techniques weren't enough.

In my case the Environment that I lived in caused my breathing problems.  I don't know what triggers it, but the Air in DC and Maryland is no good for me.  I moved to Georgia and all of that went away..  I like Maryland but I can't live their without an inhaler and I rather live without an inhaler so I won't be moving back there.

If anything I would pay close attention to when and where the breathing issues occur.  It may or may not be triggered by allergies.  Pollen, mold, mildew can trigger breathing difficulties.  Pollution can do it also.  The doctors weren't able to solve my problem because I didn't think that stuff was relevant until I took a trip to Australia where I had no problems breathing there.  I came back to Maryland and the breathing issues started again.


----------



## Flea (Oct 17, 2019)

Thanks. Yes, I went to an allergist. It's not allergies. There are a number of potential causes for VCD, including environmental irritants, stress, acid reflux, and too much exercise (I wish!) I had acid reflux since 1995 but wasn't diagnosed with it until I mentioned it to my pulmonologist a few months ago. I've never been a smoker so that's out. And since I've had so many providers write me off as psychogenic I have a tendency to bite people's heads off when they suggest that it might be stress. It's probably a combination of several factors.

And yes, I have not only a new family doctor but a new clinic entirely. I made a formal grievance against my last family doctor that went nowhere. Who listens to a Hysterical Female? The speech pathologost told me that I have a particularly bad case of VCD, probably because it took me so long to get the right diagnosis. Most people can shake it in a month or two, but she said it's going to take me much longer as a result of the delay. I've been toying with the idea of a malpractice suit. I must be Hysterical after all!


----------



## JowGaWolf (Oct 18, 2019)

Flea said:


> Thanks. Yes, I went to an allergist. It's not allergies. There are a number of potential causes for VCD, including environmental irritants, stress, acid reflux, and too much exercise (I wish!) I had acid reflux since 1995 but wasn't diagnosed with it until I mentioned it to my pulmonologist a few months ago. I've never been a smoker so that's out. And since I've had so many providers write me off as psychogenic I have a tendency to bite people's heads off when they suggest that it might be stress. It's probably a combination of several factors.
> 
> And yes, I have not only a new family doctor but a new clinic entirely. I made a formal grievance against my last family doctor that went nowhere. Who listens to a Hysterical Female? The speech pathologost told me that I have a particularly bad case of VCD, probably because it took me so long to get the right diagnosis. Most people can shake it in a month or two, but she said it's going to take me much longer as a result of the delay. I've been toying with the idea of a malpractice suit. I must be Hysterical after all!


I'm glad someone out there was able to figure out what was going on and not just throw stuff at it.  I know I wasn't happy when one doctor told me I had COPD (which I don't). She was willing to start me on treatments for COPD, so I went somewhere else.  Sometimes I wonder if these doctors aren't communicating with each other like they should.  Like when techs have a problem they ask other techs if they experienced the same thing.

Don't these guys have a "doctors forum" or something where they can reach out to other doctors.  Have a good recovery.on this.


----------



## Gerry Seymour (Oct 18, 2019)

Flea said:


> After roughly a year and a half of chasing my tail and getting dismissed as a Hysterical Female,* I finally have a diagnosis! Apparently it's "vocal cord dysfunction." In short, my larynx and trachea are constricted such that from an anatomical standpoint I'm breathing through a cocktail straw. No wonder I constantly feel smothered.
> 
> In short, my family doctor got so tired of me being persistent that he referred me to pulmonology at  a teaching hospital a couple hours away. The pulmonologist was fantastic, never once harping at me about "anxiety" but running every appropriate test several times. At first we thought it was adult-onset asthma, but I didn't respond to any of the treatments for asthma. So as a last-ditch effort I got a laryngoscopy with an ENT. Bingo!
> 
> ...


Hey, good to see you here again, and glad you finally found some answers!


----------

