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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6184
Experience:  14 years as clinician in the field of Family Practice
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Hi, I have spoken to you about my issues before. I seem to

Customer Question

Hi, I have spoken to you about my issues before. I seem to be getting worse and worse lately. I've had some shortness of breath and chest tightness ever since cleaning out the litter box the night before last but I am wondering if it could be something more serious. I am also having more fatigue, lightheadedness, and weakness and am wondering if it could all be related to anxiety disorder.
Submitted: 1 year ago.
Category: Health
Expert:  Anthony Bray, MD replied 1 year ago.

Anthony Bray MD : Hello again!!!
Anthony Bray MD : Yes I think that anxiety is definitely an active factor with you! You may have other issues but I really think that you need to have the anxiety addressed. Do you get regular exercise?? Do you have any wheezing?? I believe we need to keep an open mind and reasonable with your symptoms to keep the physical possibilities in mind as well....
Customer:

I don't really get regular exercise. I don't have any wheezing, it's mainly feeling like I can't really breathe deeply and I'm also having chest discomfort. This is usually not an anxiety symptom for me. I tried buspirone for anxiety over the weekend and was feeling great so I thought it helped a lot, I only had 4 pills to try and ran out Sunday, but when I got it refilled Monday it didn't seem to help nearly as much. I am having a lot of physical symptoms now even after 4 doses of buspar over 2 days.

Anthony Bray MD : I do think that you need to have your anxiety addressed as well if not already with a combination of medication and counseling....
Customer:

Do I have anything to worry about with the slight shortness of breath and chest discomfort? I have had some back pains and pains under my arms too

Anthony Bray MD : BTW....Buspar really takes weeks to work properly.....
Anthony Bray MD : there are other options as well that may help you....
Anthony Bray MD : the tightness in the chest and your description of feeling that you can't take a deep enough breath is actually VERY consistent with anxiety as the cause of these symptoms!!
Customer:

Okay, thank you. I have just been worried about it because of breathing in the cat litter. that couldn't cause any lung infections or anything could it?

Anthony Bray MD : it could be an irritant of lungs --- sure -- that would be very possible but would typically be short lived... Also a bit of a cough would be typical from a caterer
Anthony Bray MD : Cat litter irritation ( typo above)
Customer:

Alright. So the back and underarm pain is probably not related? When it happened I felt the symptoms for about three hours, then it got better, then the next day I went to class and had been walking around a little bit and that seemed to re-trigger the chest tightness. Then today I woke up with the symptoms and the back/underarm pain

Anthony Bray MD : I hope this helps . Let me know if you have further questions! Best regards,
Anthony Bray MD : Anthony Bray MD
Customer:

In regard to the other symptoms, I was feeling worse a little over a week ago and went to a walk-in clinic and had blood work done, and everything was perfectly normal. Then this weekend I felt better than I have in a very long time, now I feel worse than ever. Would any illnesses besides anxiety behave this way?

Anthony Bray MD : what makes the back and underarm pain worse?? Any movement ?? This would be helpful clue as to the cause of this symptom...
Customer:

Not really, they are just kind of short waves of pain

Anthony Bray MD : Does it hurt to take a deep breath? How about change in position? Laying on right vs left side??
Customer:

It doesn't usually hurt to take a deep breath but occasionally it does, the pain kind of comes and goes. It doesn't get better/worse with any certain position

Anthony Bray MD : iIt sounds that it is not severe or too frequent so I would advise you to try to minimize your worry about this symptom.... You might try 2 Aleve twice a day and this would help if it were muscoskeletal pain...
Anthony Bray MD : I would think that your anxiety is raising the level of your concern of this pain out of proportion to its real seroiuosness...
Anthony Bray MD : I hope this is helpful for you. Best regards
Customer:

Okay but with the other symptoms, I was feeling worse a little over a week ago and went to a walk-in clinic and had blood work done, and everything was perfectly normal. Then this weekend I felt better than I have in a very long time, now I feel worse than ever. Would any illnesses besides anxiety behave this way?

Anthony Bray MD : Well I think that the anxiety plays its role.... You have some other reason for the back armpit pain I would say but it does not sound serious in nature.... The anxiety makes many such symptoms worse... Intensifies your perception of pain and worry....
Anthony Bray MD : I'm glad that your blood work was normal....
Customer:

but there is probably still a physical cause for all of these symptoms beyond anxiety?

Anthony Bray MD : Not all--/ the sense of shortness of breath and tightness in the chest is very likely purely anxiety driven...
Anthony Bray MD : Each problem would need to be evaluated within its own reasonable perspective....
Customer:

Well I feel like I've completely stumped doctors. It's so strange to me that one week I'll feel like I'm about to die and then I will feel almost normal the next day, then I will go back to feeling worse again.

Customer:

I am also kind of starting to worry about blood clots from nuvaring because of the chest and back discomfort

Anthony Bray MD : Well I think that the dramatic ups and downs would fit more with anxiety than any chronic lllness....
Customer:

Here is how my symptoms went today. I woke up with the chest tightness and discomfort and felt a bit anxious about it, went back to sleep for a while, woke up feeling extremely weak, lightheaded, and shaky, felt slightly better after eating, but still felt lightheaded throughout the day with the back and underarm pains, then I took my second dose of buspar, took a shower, got out and felt very lightheaded and like I couldn't get deep breaths, now my stomach is starting to hurt and I'm feeling really weak and foggy-headed/sluggish

Anthony Bray MD : Yes--see I think this would be typical of your anxiety problem that you immediately worry about the worst possible scenario... My guess is that your symptoms would not approach the lev of pain, shortness of breath and rapid heart rate that a blood clot to the lung would produce....
Customer:

I also feel like the symptoms as a whole are getting worse. I used to have more days of feeling good but lately it seems I'll only feel good for a couple days at a time, then feel awful, and every time I feel bad it's worse.

Customer:

Are there any specific conditions this could be besides anxiety?

Anthony Bray MD : Hello again,
Anthony Bray MD : i really think that the main initial focus for you should be to concentrate in getting effective treatment of your anxiety. I think that you suffer from somitization symptoms secondary to your anxiety. Control of your anxiety would therefore help with physical symptoms.
Customer:

thank you. so no specific physical disorders come to mind with these symptoms?

Customer:

and is somatization different from health anxiety or hypochondria?

Anthony Bray MD : Hello!
Anthony Bray MD : Yes-- hypochondria is always seeking medical treatment with false belief that you have multiple illnesses--/ you would for example tend to believe you had same illnesses as family members and friends.....
Anthony Bray MD : Somitization disorder has to do with mental stress causing physical symptoms.... You don't specifically seek treatment for specific false believed illness....
Customer:

Okay, thank you. So you don't think there are any specific physical disorders that could be causing my symptoms?

Customer:

it just feels like it has to be something bad since the symptoms are so severe

Customer:

I also tend to feel better really late at night. Would this be consistent with anxiety/somatization instead of a phyiscal cause?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I can't rule out that some of your symptoms may have physical basis. This is an aspect of ongoing care by your doctor! I do think that you have anxiety and somitization disorder that exacerbates some physical symptoms and may actually create others. This is why I think that your effective treatment by a psychiatrist with a combination of medication and therapy is central to your improvement and recovery.

I hope this helps! Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you. But can you think of any specific physical disorders that would cause these symptoms with normal bloodwork?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

I don't have anything particular in mind that would cause the combination of symptoms that you have described. The wide scope of symptoms to me more fits with somitization disorder.

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you. Are there any typical symptoms or can the symptoms be anything?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

The symptoms can be pretty much anything but there are some that are more common. Common symptoms related to somitization disorder would include shortness of breath, tightness of the chest, tingling sensations, dizziness, fatigue , headaches, and stomach aches. These would be some of the more common.

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

I went to a walk-in doctor today and he definitely thought it was an underlying stress issue causing my physical symptoms. He prescribed zoloft but I am afraid to take it because of the side effects and withdrawal symptoms if it's discontinued.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Well I think you have been struggling with these issues for over a year now --- isn't that right??? I think it is time to try such a treatment as Zoloft as the chances of it helping you to feel BETTER are greater than it making you feel worse. Most people can discontinue such MEDS as Zoloft without problem if they need to. There are other MEDS that may help to treat your condition but Zoloft us quite reasonable to treat this condition. If you take the medication and have a problem with it --- it is not written in stone and you may discontinue it! This stopping of an anti- depressant is generally very straight forward for most people in this situation.

I hope this information helps! Best Regards!

Anthony Bray MD
Customer: replied 1 year ago.

Thank you! Yes it has been a year. After I got back from the doc I was feeling slightly better but then I got a little stressed about something and started feeling much worse again, and now I am once again worried about the physical symptoms. When I breathe in my back kind of hurts, my legs are weak, I feel lightheaded, etc. I have also been feeling extremely weak and nauseous when waking up and it's really hard for me to get out of bed because of this. Can anxiety cause this? I'm usually a lot less anxious right before I go to bed so that's why I find it odd that I always wake up feeling so bad.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Yes I think that your symptoms are stress related. Some of your physical symptoms are more typical and some are less typical but the broad range and quick variations of symptoms would be very consistent with stress related symptoms. The early morning situation may be that you quickly begin to worry about the plans for the day and this may lead into physical symptoms. Early morning symptoms are actually a common pattern -- one common example is the child starting a new school that begins to have stomach aches in the morning.

I hope this helps. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you. When the issues first started a year ago I was actually throwing up most mornings, but some days it didn't happen and I had days where I felt almost normal. I thought I was really sick then but that was probably stress related too?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello!!

Yes I think that it seems most likely that this start of your illness with the morning nausea was very likely due to stress as well. I think this would fit with how things have developed.

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you! Would these symptoms be expected to get progressively worse or would they get better for a while and then worse? Mine were bad in late spring/early summer, started to get better in late summer/early fall, were a lot better in late fall and early winter, and I've been getting worse lately. Plus I've had new symptoms recently that I didn't have before and I think that's why I am worried.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again ,

Your symptoms would be expected to vary but would do so proportional to YOUR particular stress. So it would seem likely that the times that you felt better physically probably corresponded with less psychological stress. This could be anxiety , depression, or stressful events in your life. There would not be any preset predictable pattern. Each individual with this would tend to have their own pattern. I think that aspects if your wide variety of symptoms may suggest a high degree of HEALTH WORRY( one of your major stress factors would probably be fear of illness itself) Other emotional stress factors would interact with that underlying fear.

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you. The thing most alarming to me now is the shortness of breath since this is usually not anxiety symptom for me at all. It seems to get worse when I eat. Is this consistent with anxiety symptoms?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Shortness of breath is EXTREMELY COMMON as an anxiety symptom!! It is not typically associated with eating per se however.

Best regards XXXXX XXXXX to leave positive feedback if my answers are helpful and to your satisfaction.

Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6184
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 4 other Health Specialists are ready to help you
Customer: replied 1 year ago.

Thank you. Would it be constant or more when I feel anxious? It's been pretty constant for me for about three days. Are there any signs to look for if it's something serious?

Customer: replied 1 year ago.

I was feeling a little better tonight and I just tried to eat something and it felt like it was irritating my throat and making the shortness of breath worse and I was also getting lightheaded/dizzy while eating. Is this the anxiety?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!

Yes I would think that this is most likely somatic symptoms. I would advise you to develop a sense of being skeptical of your own symptoms and try to reassure yourself---- I think that working to control your fear and anxiety will over time help you to reduce the somatic symptoms.

I hope this helps. Let me know if you have further questions ! Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thanks. I woke up very sick to my stomach today and was also very nauseous right before I went to bed. I also feel extremely weak and shaky. It's so hard for me to believe this is anxiety when I feel like this as soon as I wake up.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

You may be right. I have believed from your past history that you suffered from gastritis and this may be the reason for your nausea . I have supported your treatment along these lines. I can' t truly test you or examine and therefore can't diagnose you ---- I can Hope to provide you with useful information and speculate as to your diagnosis. I suspect that you probably have an underlying physical GI problem with somatic symptom exacerbation of the physical symptoms.

I hope that this information is helpful to the process of helping you to arrive at the correct diagnoses and best treatment!!

Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you. Is it common at all for someone with anxiety/somatization disorder to feel very weak and shaky upon waking up?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!No--- I would say that your feeling weak and shaky are atypical symptoms. I do think that your variation in these symptoms to me seems more consistent with a somitization symptom as opposed to a neurological symptom... We have discussed this in the past too... I really do not think that these symptoms are reflective of neurological disease...I hope this helps! Let me know if you have further questions. Best regards!!Anthony Bray MD
Customer: replied 1 year ago.

Thank you. It's more of a weak, shaky feeling that feels like low blood sugar more than a neurological type thing. I think the low blood sugar feelings (when my blood sugar is normal) are part of the anxiety and maybe when I wake up I feel weak since I haven't eaten for a while. I usually feel better once I can get myself to eat.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Yes it may be a trait that is just somewhat unique to you and not really anything that we can or should attach any illness label to.....maybe you just feel "crappy" in the morning and feel better after you eat. I would bet that many people may experience a similar transition in the morning after waking up !!

I hope that this helps. Let me know if you have further questions. Best regards,

Anthony Bray MD

Customer: replied 1 year ago.

Thanks. It's usually only bad when the other symptoms are worse. I've been feeling weak and lightheaded most of today because I've had a lot of trouble eating. Eating makes me kind of dizzy/lightheaded too. Could a food intolerance cause these symptoms or is it probably just from the stress?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!!

I think that the light headed and weak feelings are probably stress related. To the best of my recollection you have said at times that eating HELPS these symptoms but at other times / now you state that eating makes these symptoms WORSE. There seems to be much variation to your perception of feeling weak and light headed. This makes me think that these symptoms are more likely somatic stress related in nature. The normal testing would also seem to support this.

I hope this helps. Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thanks. Yes, it seems that I get really lightheaded before eating, then I'll eat and feel lightheaded in a different way. Today is the worst I have felt in a long time... woke up sick to my stomach and weak and I have had a very hard time eating. And I've been very dizzy. But with normal blood work anxiety is really the only thing that could cause this range of symptoms isn't it? I have been worried about viral illnesses and infections but I had similar symptoms (not as bad) last week and blood work was all normal, and I haven't had a fever.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!!

I think that stress is the main factor that is causing your distress. It is possible that some illness such as gastritis MIGHT be a cause of your nausea for example. This would not be disproved by your normal blood tests. I do not think that you have a viral I fraction or other infection. An infection would be expected to cause some abnormalities of blood work. Your CBC would be expected to show a shift in the subtypes of white cells if you had any infection. Also the inflammatory markers especially C-reactive protein would be elevated in either infection, auto-immune or inflammatory disease. Even a cancer would typically make the C-reactive protein abnormally high.

I hope this helps. Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you. A SED rate also checks for inflammation right? Mine was 11 when I last had blood work, I didn't get CRP checked.


Can anxiety cause a sore throat at all? I don't usually get respiratory anxiety symptoms so this is very new to me, but my throat feels tight and sore and I'm getting a slight pain in my chest when I breathe in.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Well recently developed sore throat would be very likely to be an acute( recent and short term) infection. Keep in mind that such infections are not usually serious and usually run their course in about a week. A sore throat would not typically be a stress type somatic symptom. Now on the other hand the description "tightness in the throat " would more fit potentially with a somatic stress related symptom. Similarly the symptom of shortness of breath is VERY OFTEN an anxiety related symptom. The description of " feeling as though you can't take a deep enough breath " would be pretty classic as an anxiety type description in my experience.

Yes sed rate is also a marker of inflammation and 11 is normal. So a normal CBC and sed rate is a very good screen to rule out many types of disease processes. Not everything of course but it is an excellent screen for physical disease.

I hope this helps. Best regards ,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you. The sore throat is kind of off and on and I don't have a fever so I don't think it's a viral infection but I am still having some underarm pain so I am concerned about swollen glands. I've also had no appetite today which is difficult because I have to eat so frequently.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Well it does not sound to me that any of these last mentioned symptoms are severe --- underarm discomfort, sore throat, lack of appetite --- so with regard to these I would advise to TRY not to WORRY and give it time and respond only to symptoms which seem more clearly defined and perhaps of a progressive nature. I think to control the anxiety and fear at this point would be the most to your benefit.

I hope this helps! Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thanks. Is it common to have bad side effects to Zoloft at first? It seems like when I take it, about an hour later I get bad nausea that lasts all night and into the next day. Last night I could barely sleep and kept waking up feeling sick and confused because I was having weird symptoms. I finally had to get up because I was getting really bad hunger pains even though I have no appetite and feel nauseous.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Se nausea is a side effect that sometimes occurs as you START on an SSRI antidepressant. This tends to dissipate as a side effect within the first few days of taking it... It is the CHANGE on levels of serotonin that may cause nausea....once you are taking the med regularly the levels stabilize again and the nausea typically disappears. You are probably MORE sensitive to this side effect because a you have had problems with nausea all along and the Zoloft may make this worse. Try to hang in there as your somitization disorder and fear are likely to be a MAJOR contributor to your perceived side effects. Some people may report feeling " weird" as well as other symptoms but the majority usually do fine on the medication. It may help to try 1/2 tablet a day for first week to lessen potential side effects.

I hope that this helps. Best Regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you. The nausea is pretty intense, is there anything I can do to help it? I think part of the reason I am feeling so sick in general is because I haven't been able to eat enough.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

Yes over the counter medications that mat help with nausea include Dramamine, Benedryl( many people are not aware of its benefits outside allergy relief but it helps with nausea too) and Emetrol.

Your doctor might prescribe Zofran or Phenergan to help.

I hope this helps you! Best Regards!

Anthony Bray MD
Customer: replied 1 year ago.

Thanks. I was having some heartburn earlier and it seemed to make my throat sore and eating was difficult. I took a nap and when I woke up my throat was very very tight. Can this be caused by acid reflux? It's not extremely sore, mainly just tight and has a dull ache.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again.

Yes it sounds that you have reflux--- this often will cause or aggravate a sore throat. This may benefit fro reflux precautions ----this would include waiting 1.5 hours after you eat before you lie down --- elevate the head of bed by 4 to 6 inches---avoid acidic or spicy foods, alcohol, coffee, anti-inflammatory MEDS ( Tylenol would be OK) avoid citrus fruits( short term ) as well as tomatoes, onions, peppers...

You would have continued benefit also fro Prilosec or solar acid reducing medication.

I hope this helps. Best regards, XXXXX
Customer: replied 1 year ago.

Thanks. Even the roof of my mouth is sore in the back, can this be reflux too? I will start taking the Prilosec again. I didn't feel like I was having acid issues for a while until I started taking the Zoloft, then it got really bad.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I don't think the Zoloft would CAUSE reflux but rather you stopping the Prilosec makes more sense to me as an aggravating factor. I think the discomfort of the roof of the mouth could also potentially be related to this. I think restarting the Prilosec would be helpful plus adhering to reflux precautions.

I hope this helps ---let me know if I may be of further assistance! Best Regards!!

Anthony Bray MD
Customer: replied 1 year ago.

Thanks. My throat actually feels swollen, and even my tongue and the roof of my mouth feel swollen. It's really hard to swallow food. So this is probably acid reflux and not a virus or infection?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!!

It could be either of these as a cause of the soreness of your throat and roof of mouth. If it worsens over a couple of days then I would recommend that you have your doctor check this out. In the meantime take the treatment and precautions for reflux---these may likely help some of your symptoms!!

Also gargle with salt water or Listerine and this would help if you are coming down with an infection.

I hope this helps! Take Care!

Anthony Bray MD
Customer: replied 1 year ago.

Thank you. Right now it's mainly the roof of my mouth and tongue that are sore. I can barely swallow, it's so painful. It's worrying me because I can't eat.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello!

It is sounding more like you are coming down with a throat infection .... Try the salt water gargles( or Listerine) plus an anti-inflammatory such as Aleve or Tylenol. Get some chloroseptic or similar throat spray to help the soreness. If it gets worse then you might benefit from an antibiotic but the majority of these cases are viral and just run their course.

I hope this helps! Take care!

Anthony Bray MD
Customer: replied 1 year ago.

Thanks. It seems like every day when I wake up I feel weaker. Could this just be because I haven't been eating as much this week? Today before I got out of bed I almost felt too weak to breathe and my arms and legs felt very weak.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello!!

I think that your sense of extreme weakness in the morning is probably part of the somitization disorder. I suggest that you try to push through these symptoms. Working to deal with underlying stress issues and health fear issues with the help of therapy would probably pay dividends for you.

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thanks. It usually gets better when I eat, though. My throat/mouth don't feel anymore sore today but it's still really hard to swallow food so I'm having a hard time eating enough to curb the weak feelings.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again ,

I see--- hopefully your sore throat will settle down soon. Continue the gargles, anti- inflammatory and a throat spray for pain relief. If symptoms are progressing over next few days then consult your doctor!

I hope this helps!

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thanks. I kept waking up feeling short of breath, went back to sleep and woke up sweating, and I have chest discomfort when I take deep breaths. My nose is slightly stuffy and my mouth is still sore but I'm not coughing or anything.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Your discomfort with taking a deep breath may be due to some pleuritis. This is inflammation between the lungs and chest wall that will often occur with a respiratory infection. With your recent sore throat this would make sense. You may benefit to take Aleve 1 to 2 tablets twice aday with food to calm down the inflammation.

I would watch for development of cough or fever as signs that you may need to follow up with your doctor .

I hope this helps! Let me know if you have further questions.

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thanks. Does waking up covered in sweat mean a fever? And could the throat and roof of mouth/tongue soreness just mean a cold?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Yes waking up in a sweat can be due to fever . I would advise that you check on your temp with thermometer. Normal is a RANGE. 98.6 plus or minus up to 1.3 degrees.

And yes the soreness of the mouth may be due to a cold...
Customer: replied 1 year ago.

Thank you. I have been worried because I breathed in that cat litter last weekend but it is probably just a coincidence. I have never had a cold start out with a sore throat and chest pain but that is probably what it is since I get colds a lot.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Yes this would be the probable scenario here ....

Best regards. Please remember to accept with positive feedback periodically.. This would be very much appreciated! Thank you and best regards ,

Anthony Bray MD
Anthony Bray, MD, Doctor
Category: Health
Satisfied Customers: 6184
Experience: 14 years as clinician in the field of Family Practice
Anthony Bray, MD and 4 other Health Specialists are ready to help you
Customer: replied 1 year ago.

Thanks. The nasal stuffiness is going away but I'm trying to eat and swallowing is making my chest hurt and throat feel tight. I've never had anything like this before so I'm kind of concerned.

Customer: replied 1 year ago.

I also felt like I was going to throw up while eating and now everything feels swollen and tight. Is there anything I can do about this?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello !

I would try something for the nausea ( Dramamine , Benedryl , Pepto Bismol , or Emetrol)

I would recommend taking some Tylenol and this may bring you some relief.

I hope this helps. Lets know if you have further questions!

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you. Is is possible this could be an allergic reaction to Zoloft or something else? I have never felt like this before and I'm worried I won't be able to breathe.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again ,

It would be possible to have shortness of breath due to an allergic reaction but I do not think that this is your cause . Things to watch for for allergy related shortness of breath would include wheezing coughing sneezing likely as well. Itching and rash would also be allergy type symptoms. I don't think that this represents any reaction to Zoloft though so try to relax regarding this!

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you! I decided to go to a walk in clinic and they said it could be the beginning of strep or a sinus infection. They said my nasal passages looked swollen but my throat looked okay which was odd because I'm not having nasal congestion but my throat definitely feels tight! Maybe I am just having to breathe harder through my nose and getting the chest discomfort?

Expert:  Anthony Bray, MD replied 1 year ago.
Hi again,

OK--- I see! I hope that you feel better soon !!

Best regards ,

Anthony Bray MD
Customer: replied 1 year ago.

Thank you very much. Out of curiosity, how common is it for people with anxiety/somatization disorder to report feelings of low blood sugar when blood sugar isn't actually low? That seems to be my most persistent symptom and on the days I don't have an appetite I feel so much worse because I can't eat very much, and it's really disabling.

Expert:  Anthony Bray, MD replied 1 year ago.

Hello again,

 

This specific complaint would be quite unique to you!! The problem of somitization disorder may be often DIFFICULT to correctly diagnose> depending on the patient's complaints and general pattern over time.... This diagnosis often does take time and as in your case careful history, physical exam and tests to rule out physical problems for the given set of complaints... Sometimes there can be clues to the diagnosis with a careful history of the patient from a psychological and family history and evaluation of possible precipitating factors>> An example would be a person with abdominal pain that was reacting to the stress of their mother being diagnosed previously with pancreatic cancer... this may lead to the recurrent worry and stress to cause the abdominal pain along with the health fear of the cancer...

 

 

So each case such as yours is unique really and carries its own particular story....

 

I hope this helps!! Let me know if you have further questions!!

 

Best Regards!

 

Anthony Bray MD

Customer: replied 1 year ago.

Thank you. I have talked to some other people with anxiety who have the low blood sugar symptoms but not as bad as I have. I have been wondering, are there any autoimmune diseases I could have? I did have a negative ANA test but I know that doesn't rule out everything.

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again,

Well I think the set of negative tests that you have had provide good evidence AGAINST any active auto-immune disease process. You have had the normal CBC, inflammatory marker( sed rate) ANA among other tests. So on the absence of further POSITIVE evidence, my advice would be to try and RELAX!! Try to curb the stress that is added from your health anxiety!!!

As you recent illness points out -- you may still have physical illness as well as somitization symptoms. The physical illness was confirmed by the objective evidence of the physical exam. So I am not saying for you to ignore all symptoms by any means!! As your stress level is decreased your somitization symptoms should graphically recede. The knowledge that it exists should itself be somewhat therapeutic to you. This process of having these symptoms would be expected to be helped along by good therapy to help understand the whole process and then improve from these symptoms.

I hope that this helps!! Best regards!

Let me know if you have further questions!

Anthony Bray MD
Customer: replied 1 year ago.

Thank you, that definitely helps! Are there any other tests I need to rule out physical causes for the long-term symptoms?

Expert:  Anthony Bray, MD replied 1 year ago.
Hello again!!

No I don't think so at this time. I think that you will be better off to avoid OVER-TESTING!! If you have a new different pattern such as your recent sore throat/ upper respiratory infection then see your doctor about any such new concerning symptoms. The strategy is to differentiate as best possible between the somitization symptoms vs new physical symptoms. The key to the somitization part of your symptoms is to learn to recognize ( as best possible) these and if possible to identify and intervene with the underlying causative stress factors.

I hope this helps! Let me know if you have further questions !

Best regards,

Anthony Bray MD
Customer: replied 1 year ago.

Okay that makes sense, thank you!


I hadn't had the chest pain/shortness of breath for a day or two but today I walked outside to check the mail and my chest started hurting when I breathed in. It was a lot warmer outside than it has been. Can chest pain be caused by allergies?

Expert:  Anthony Bray, MD replied 1 year ago.

Hello!

 

I think your recent diagnosis with upper respiratory infection (sinus infection plus sore throat) would be more likely to be associated with this than allergies. It sounds to me that you may have a degree of pleuritis (inflammation between the lung and chest wall) This frequently occurs with respiratory infections (not often a symptom with allergies though...) Costochondritis would be another possible cause if you have tenderness of the front of the chest (beside the breast bone (=sternum)) This latter is inflammation of the cartilage segments (one or more of these) between the sternum and the ribs. Either of these conditions would typically benefit with using an anti-inflammatory med such as Aleve 1 to 2 tablets twice a day with food..

 

I hope that this helps. Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.

Thank you! The reason I'm not really sure if it's associated with the possible respiratory infection is because it's been on and off all week. Last night I did housework and did not get the chest pain but today I did just from walking outside.

Expert:  Anthony Bray, MD replied 1 year ago.

Hi again!

 

I see >> yes I suspect that it is just some secondary inflammation associated with your upper respiratory infection. Especially of and on signals to me that you probably have a mild case and it should settle down within a couple of weeks..

 

Let me know if you have further concerns..

 

Best Regards,

 

Anthony Bray MD

Customer: replied 1 year ago.

Thanks! For the past few days I have had on and off weak and crampy feelings in my arms and legs, especially when waking up. I'm getting concerned about neurological disorders but since it is off and on is this probably just an anxiety symptom?

Expert:  Anthony Bray, MD replied 1 year ago.

Hello,

 

I agree the off and on nature of this sounds like it is a stress related symptom.

 

I hope this helps!

 

Best Regards,

 

Anthony Bray MD

Customer: replied 10 months ago.

Hello again. As you know from my history I have suffered physical symptoms of anxiety and depression for over a year, but for roughly two months I was doing MUCH better after starting on Zoloft. I almost felt "normal" most of the time, except some acid reflux which seemed to be a side effect of the Zoloft, but I was managing it with Prilosec. I started working again and was getting back to my normal life, but this week I have not been doing very well. Several days ago I started having some stomach cramps, mostly in my lower abdomen, sort of felt like menstrual cramps but also intestinal cramps. It was uncomfortable but bearable and I didn't have any other symptoms. Then it started getting worse, one day I woke up with very bad abdominal cramps and used the bathroom several times (no diarrhea, just normal) which relieved it temporarily but I was extremely nauseous and could not eat so I called off work. The next day was about the same except for not as many bowel movements, just one and a small amount. The cramps lasted that whole day as well as the bad nausea, and the last few days have been the same.


I saw doctors and they said it was most likely IBS, but in the last 2 days I have developed a feeling of malaise and fatigue and my temperature has been higher than normal (99.2 when it was checked at the doctor, it's usually around 98.0). I slept for a very long time last night (about 11 hours) and woke up very nauseous and eating brought the cramps on again.


Do you think this is IBS or something more serious?

Expert:  Anthony Bray, MD replied 10 months ago.

Hello again,

 

Some of your symptoms do sound possibly consistent with IBS.. the intestinal spasms especially.. IBS would fit with you having anxiety too.. IBS usually is more prevalent in those with anxiety. You might benefit from anti-spasm medicine such as Levbid or Librax if the symptoms are that bad....

 

The nausea could be due to irritation of the stomach lining >> gastritis or ulcer as possible causes here... Nausea may be a symptom with IBD too but this is not typically that predominant of a symptom with IBS >> if an ongoing problem then you may wish to discuss this further with your doctor... testing for H. Pylori may be considered (bacteria that is common cause of ulcers) If H.Pylori were present then it would need two weeks of double antibiotic treatment. I would for now advise that you avoid foods and other items that tend to irritate the stomach >> avoid acidic foods and hot spicy foods>> tomatoes, onions, peppers, coffee, alcoholic drinks, citrus fruits and anti-inflammatory medicines (Tylenol is OK though)

 

The temperature is still within normal range so i would not attach much significance to that at this point (Normal = 98.6 plus or minus 1.3 degrees)

 

I hope this helps! let me know if you have further questions! Take Care ,

 

Anthony Bray MD

 

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