Dr Hive - what does this sound like?

[AngieW in Texas]

My 15yo has panic attacks and anxiety attacks. She knows when one is happening and what it feels like.

 

She also has something else that happens that we haven't been able to figure out and are thinking is maybe allergy-related.

 

Sometimes when she is eating, it will suddenly feel like her throat is closing up. This happens only when she is eating something with wheat or noncooked dairy, but it happens only about 5-10% of the time when she is eating something with wheat or noncooked dairy. If it happened every time, we would know what the problem was, but it doesn't.

 

She also sometimes has a throat-closing sensation occur with traffic fumes. It happened today when we left the book festival to go to the parking garage. She was just fine one second and then she could barely breathe the next because it felt like her throat was closing off and she almost passed out. It lasted for a few minutes and then went away.

 

Doctors have dismissed it entirely as being related to anxiety, but she says it feels completely different from an anxiety attack or panic attack. She has had plenty of those, so she is quite familiar with what an anxiety attack or panic attack feels like for her.

 

Any ideas? I want to do some allergy testing. I would also love to get her on anti-anxiety meds. They really helped her sister a lot. My 15yo doesn't want any part of anti-anxiety meds at this time though. Just thinking about taking meds can throw her into another anxiety attack. I do think it is quite likely that it is actually anxiety even though she doesn't think it is. But there are lots of allergies in the family, so it could very well be allergies.

[ElaineJ]

I have no medical expertise, but if it were my daughter I think I would try to get the allergy testing. If it were anxiety related, you would think that the reaction would occur at unpredictable times rather than only when eating dairy or wheat. At least the testing would give you some more objective information that would help you decide what to do next. Hope you get some answers!

Elaine

[Tammi K]

Vocal chord dysfunction? It can happen to anyone but, according to my allergist, it is more prevalent in young females women. There are simple exercises you can do to relax it and help the spasm pass.

 

It happens to me most often on bad seasonal allergy days. It feels a bit  like what I imagine asthma would feel like. Airborne irritants can set it off. So can stress.

 

Does that sound like a possibility?

[Pawz4me]

Laryngospasm?

 

And here.

 

I have them occasionally.  Mine are most likely related to acid reflux.  They're very frightening, especially the first few times or if it's a really bad one.

[Jennifer in MI]

My daughter gets this!  I've been shrugging it off - blaming it on anxiety.  But, after reading that, it really sounds like it's the laryngospasm.  My dd always has to have water with her - and to read that that helps, makes me feel so guilty for ignoring it.  

 

And, I realize I get it too!  I just assumed I had eaten too fast or inhaled spit or something, but it really is something different.  Huh.

[Cinder]

We discovered the extent of ds's allergies because he'd started having trouble breathing a couple times when we'd gone out for ice cream. He mentioned feeling like his throat was closing and was very distressed. We thought it was related to milk since that was what he was eating when it happened--both times. We decided we needed allergy testing. And it turned out he's not allergic to milk (or nuts or any foods) at all but very allergic to just about every tree, weed and grass that grows around here. The pollen was particularly bad that year and both times we'd gone we sat outside to eat. We never even considered environmental allergies at the time so testing really helped.

 

I know allergy testing is expensive but it might be worth it to try to figure out your dd's problem. :grouphug:

[Tammi K]

Vocal chord dysfunction? It can happen to anyone but, according to my allergist, it is more prevalent in young females women. There are simple exercises you can do to relax it and help the spasm pass.

 

It happens to me most often on bad seasonal allergy days. It feels a bit  like what I imagine asthma would feel like. Airborne irritants can set it off. So can stress.

 

Does that sound like a possibility?

 

 

Laryngospasm?

 

And here.

 

I have them occasionally.  Mine are most likely related to acid reflux.  They're very frightening, especially the first few times or if it's a really bad one.

 

Just wanted to clarify, laryngospasms are one type of vocal chord dysfunction. It seems like several of us had the same idea. Check with an allergist. There are simple things that can be done to help, depending on the cause of the problem.

[Staceyshoe]

Allergy testing is so non-invasive that it would be a good idea to rule out.  Eosinophilic esophagitis is another possibility but would require an endoscopy to diagnose it (and is frequently diagnosed as GERD).  Difficulty swallowing and/or food impactions would be a stronger indication of EoE, though many people with EoE won't experience them.  But if your daughter has ever experienced them during these episodes, it's one clue that it could be EoE rather than GERD.

[Mommyof4ks]

I would go ahead with the allergy testing. When I eat soy my throat closes up so that I cannot swallow. I will not stop breathing or anything, but it is scary.

[AMJ]

The throat-closing sensation you describe sounds like anaphylactic shock, which can quickly become life-threatening. Get you child tested by a good allergist ASAP. Anaphylaxis can start out less severe, but can grow (quite suddenly) to a deadly level that can kill in less than a minute. Don't wait another day -- you need to find out what to do when this occurs.

 

If your child starts feeling this way again take her to the emergency room with a complete sample of everything she was eating, and/or a full description of the air and surroundings. Once at the emergency room get her inside and start yelling (if you have too) that your child can't breathe. Don't wait in line -- seconds count.

[Mergath]

It could be a combination of anxiety and GERD.  For me, when one is acting up, it makes the other worse.  Why?  I couldn't tell you.  But if you google, a lot of people seem to have issues with both, and it can definitely make you feel like your throat is swelling shut, or like there's a huge lump in it.  I've actually called dh home from work because I swore I was having an allergic reaction and my throat was closing and I was definitely going to die.  What a coincidence that the seeming throat swelling went away as soon as the Ativan began to take effect. :P

 

If there's a chance it could be allergies, I'd do the testing to rule it out.  But from what you've described, it sounds more like anxiety to me.

 

 

[Mergath]

The throat-closing sensation you describe sounds like anaphylactic shock, which can quickly become life-threatening. Get you child tested by a good allergist ASAP. Anaphylaxis can start out less severe, but can grow (quite suddenly) to a deadly level that can kill in less than a minute. Don't wait another day -- you need to find out what to do when this occurs.

 

If your child starts feeling this way again take her to the emergency room with a complete sample of everything she was eating, and/or a full description of the air and surroundings. Once at the emergency room get her inside and start yelling (if you have too) that your child can't breathe. Don't wait in line -- seconds count.

 

Anaphylaxis by definition affects multiple body systems.  If what happens only affects the throat, it's not anaphylaxis.  That doesn't mean it's not an allergic reaction, but it's not anaphylactic shock.

[Melissa in Australia]

could she have Multiple Chemical Sensitivities?

[AngieW in Texas]

When she was going through her 2 years of no sleep and having multiple panic attacks every day, we went through all sorts of doctors and had tons of testing done. She did have airborne allergy testing (trees, grasses, weeds, ...), but not food testing. The airborne allergy testing didn't find any allergies at all, but I think her problem is with car fumes and that wasn't tested for. I also do think that she has some kind of issue with some foods and I want to have that tested too.

 

I really think the biggest issue is anxiety. We stopped the anxiety and panic attacks before by getting her on sleep medication which she is still taking. She went 1.5 years without any anxiety attacks or panic attacks, although it did become pretty obvious that she has OCD, fortunately less severe than her sister's though. This year she has begun having more problems with anxiety again. She doesn't want to go on medication for it, but I would really like for her to. I think it would improve her life and ours.

 

I am trying to get her into allergy testing just to make sure there isn't some sort of trigger going on with that and I will ask about laryngospasm as well. She has had issues with acid reflux before and my dh has issues with that as well, so that is also a possible factor.

[MariannNOVA]

could she have Multiple Chemical Sensitivities?

This was my thought as well.

[AngieW in Texas]

We did the allergy testing today. She had a very mild reaction to cinnamon and that was it. They tested 90 foods.

 

The doctor thought that eosinophilic esophagitis was a possibility that we ought to consider. She has had GERD before. When she was about 8yo, the doctor put her on prilosec for one month and after that she didn't have any problems on a regular basis.  Since then, she has had reflux happen maybe 4-6x/year.

 

Because dairy seems to be a clear trigger for it, he said we should try lactaid (or generic) just to see if lactose intolerance is an issue, because he doesn't test for that.

 

He recommended keeping a food diary and seeing a gastroenterologist to see about an esophageal endoscopy and biopsy to check for the presence of eosinophils. We aren't going to see the GE at this time. From what I have read, EE that is caused by food triggers is pretty much treated by avoiding those foods, so we're going to work on it from the food end for now.

[J-rap]

I don't think this is it, but I'll throw it out there anyway.  My daughter used to complain about her throat feeling really strange (off and on), for a few years!  It wasn't a sore throat, it wasn't reflux.  It never seemed bad enough to see a doctor about it, but it did puzzle me.  When she reached puberty she started getting migraines, and suddenly it all came together for her.  When she had a migraine, she'd get that funny feeling in her throat at the same time.  I don't know why -- migraines can have lots of bizarre symptoms.  I think she was experiencing migraines without the headache for several years, and then eventually got the headache part too.

[Tammi K]

The one thing I didn't see here that you may want to investigate is vasovagal syndrome. It can have several different 'appearances' and can tag along with panic/anxiety symptoms at times.

Sorry your allergy results weren't more conclusive. Good luck sorting out your daughter's issues. It can take a lot of detective work.