Breathing difficulty and apnoea

[Matchew]

Hi, I’m Matt. I didn’t know whether to post this as an introduction or not. Phil gave me a link to this forum to ask about my problems.

I’ve just turned 20, for the past 6-8 years I have been struggling with depression and fatigue. I was on Prozac and later Effexor, both of which only made things much worse. I have been off Effexor for over 3 years now. I don’t have problems with dark thoughts anymore I realise my main problems are fatigue-related.

The most worrying problem I am having at the moment is about my breathing after orgasm. For the past 6 or so months I have had unequal pupils, before that for a few months it was intermittent, usually after orgasm. These symptoms have gradually worsened over the last few months, I don’t get all of them every time…

Immediately after orgasm:

• Pupils become more unequal
• Certain movements, particularly fingers and toes become twitchy
• Slurring of speech, mixing words together
• Facial twitching, particularly eyelids, eyebrows and mouth area

Later:

• Start feeling a sort of “primal fear”: If there is too much talking it can feel overwhelming, if I look into staring eyes I feel a “click” in my brain and I am overcome with fear and have to look away. There isn’t any thought or worry involved, just pure emotion.
• Breathing starts to become difficult, like I can’t get enough air

At night:

• Breathing gradually becomes harder until I feel as though I am having to consciously control my breathing. I sometimes feel myself stopping breathing whilst fully awake.
• As I fall to sleep, I jump back up gasping for air. Initially I thought this was related to the fear feelings, but now I suspect it is an apnoea.

For a week or two afterwards, the fear and non-breathing symptoms subside but I get occasional periods where I struggle to breathe. Sometimes I get muscle twitches around my body.

Luckily I have next to no libido, I am lucky to masturbate twice a month. Though I am trying my hardest to avoid it at the moment because of these symptoms.

I have recent blood tests and a list of symptoms I haven’t forgotten at http://forums.realthyroidhelp.com/viewtopic.php?f=11&t=12824&p=102219#p102219

This is stuff I haven’t mentioned before because it is hugely embarrassing: 😮 While I was depressed and no treatment had worked for me, I was completely hopeless. I would try anything. I found some binaural brainwave audio thing that was supposed to help, I remember listening to it made me feel good, somewhat like an orgasm I guess? I also went through a phase of focusing intensely when I masturbated.

Both these things I suspect could have contributed to my problems, I think one of the first time I felt the fear was after the binaural beats. It was reckless I feel ashamed of it, but I felt I had nothing going for me at that time.

There are a few other things that I’m not sure are related. A couple I can think of right now:

• Sometimes when I masturbate I noticed a tightness in my lower back.
• When I have tried taking vitamin D supplements, as I fall to sleep my body jumps and I felt as though breathing was become difficult again.

Sorry if this message is a bit long. I would really appreciate any input. My doctor has put it down to anxiety and refuses to run any tests.
Cheers
Matt

[JanSz]

Stopping points:

I’ve just turned 20,
◦Serum albumin = 49 g/L (35-50)
Serum testosterone = 11 (10.0 – 28.0)
R SEX HORMONE BINDING GLOB = 33.3 nmol/L (14 – 48)
•TSH = 1.5 (Didn’t get the range)
Thyroid peroxidase antibody level = 6 kiu/L
•Ferritin = Possibly 107 (“)

[Matchew]

Not sure what you mean by stopping points… I retested the TSH again and it came back 1.0 (0.4 – 4.0), though I can ask to see my results again to get the range for it and the ferritin. The antibodies had no range to compare them to. Surprised I hadn’t noticed the albumin before, that seems to relate to calcium breathing issues.

[pmgamer18]

Matchew great you made it here now maybe we can get to the bottom of this problem.
Phil from Yahoo

[DrMariano2]

@Matchew 325 wrote:

The most worrying problem I am having at the moment is about my breathing after orgasm. For the past 6 or so months I have had unequal pupils, before that for a few months it was intermittent, usually after orgasm. These symptoms have gradually worsened over the last few months, I don’t get all of them every time…

Immediately after orgasm:

• Pupils become more unequal
• Certain movements, particularly fingers and toes become twitchy
• Slurring of speech, mixing words together
• Facial twitching, particularly eyelids, eyebrows and mouth area

In neurology, the sudden onset of neurological problems is a stroke unless otherwise ruled out.

Transient ischemic events are also possible (meaning there is temporary loss of blood flow to certain parts of the brain). Such events usually last less than 24-hours. Longer than 24-hours is a stroke.

For example, sometimes when a person has a migraine headache, that person may lose eyesight transiently since there may be spasms of the blood vessels affecting the eye during a migraine. These transient loss of blood flow can be dangerous since the tissues involved could be damaged or killed.

Thus, in cases like this, I would get a consultation from a neurologist for further assessment, testing, etc. Neurologists are great for structural problems like this.

[Matchew]

Thanks for the responses. I will make an appointment again with a different doctor and ask to be referred to a neurologist. Unfortunately they think I am a hypochondriac because I have been down a lot lately. I don’t think they can refuse me if I ask, though.

I guess there isn’t much more to discuss until I can get that appointment, just hope there isn’t any lasting damage. It’s terrifying and much worse when my doctor treats me like I’m making it all up 🙁

[DrMariano2]

@Matchew 493 wrote:

Thanks for the responses. I will make an appointment again with a different doctor and ask to be referred to a neurologist. Unfortunately they think I am a hypochondriac because I have been down a lot lately. I don’t think they can refuse me if I ask, though.

I guess there isn’t much more to discuss until I can get that appointment, just hope there isn’t any lasting damage. It’s terrifying and much worse when my doctor treats me like I’m making it all up 🙁

With many doctors, it is important to remove references to mental health when describing physical health problems.

Unfortunately, mental health issues can cloud medical thinking. For example, when people go to the emergency room complaining about a panic attacks with chest pain, up to 25% are actually having a heart attack. But this can be missed if the doctor overly focuses on anxiety as the cause of chest pain.

One of my patients had a stroke and nearly complete paralysis. However, this was missed by numerous doctors (including multiple primary care doctors, emergency room doctors and even psychiatrists) because they thought her unresponsiveness was an emotional response to her family dying the week before in a car accident – a condition called conversion disorder. I made the diagnosis by realizing the suddenness of her neurologic symptoms was a stroke unless otherwise proven, and realizing she was responsive and awake but she could only move her eyelids. I questioned her through a series of yes and now questions and learned what happened.

Often, as soon as a physician thinks a person has a mental illness, they often blame every physical problem on the mental illness. It is a very human response due to the stigma mental illness has. But it causes physicians to miss actual physical illness. It happens too often, sometimes with dire consequences.

Some of my patients have learned about the prejudice that mental health symptoms have on their primary care doctor. Thus, they avoid talking about it when discussing physical health issues.

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