Why do I feel as if I'm suffocating?
July 18, 2010 10:01 PM   Subscribe

Why do I constantly feel as if I'm suffocating, and what can I do to relieve myself of this feeling?

(This is fairly long, and I know you're not my doctor, but I don't have a doctor, so...)

Late Thursday night, I began to have issues breathing; I couldn't take complete breaths (I would just "stop" half-way, I couldn't even yawn completely), and this persisted for several hours. I took Albuterol (a fast-acting inhaler for treating asthma) because I assumed it was related to my asthma, but all Albuterol did was help once I got really short of breath from not being able to breathe-in entirely, it didn't help my inability to breathe in completely. It eventually got to the point where I was considering going to the emergency room, but it subsided. Since then, I've had this constant feeling of suffocation (obviously, I'm not suffocating). I can breathe in completely now, but I constantly have that feeling one gets after holding their breath for a while that compels them to breathe. No matter how many deep breaths I take, I can't get rid of this feeling.

Can anyone provide any insight as to what might be wrong, and perhaps, what I can do, short of seeing a doctor, to relieve me of this problem? I have no health care/insurance, and I'm unemployed, so I absolutely cannot afford to see a doctor.

More details: I'm an asthmatic, and I have been my entire life. I regularly take Albuterol for my asthma, and since Friday, I've been taking Prednisone pills someone gave me (which I'm almost out of, and the Prednisone is taken on the assumption that this is a problem related to asthma) in hopes that it'll help prevent a repeat of Thursday night (so far, it hasn't happened again). I don't know if this is relevant, but I also have mitral valve prolapse, and I have a history of chest pains, but I usually chalked that up to either being really out of shape (I'm not fat or anything, though) or a result of acid reflux, and I didn't have any chest or heart pains Thursday. I don't believe I've ever seen a doctor for my chest pains. It's been about four or five years since I've last been to a doctor.
posted by Dreamcast to Health & Fitness (35 answers total) 5 users marked this as a favorite
Please, please, please, go see a doctor. With a dad who has ended up in the ER way too many times, I've learned that asthma is not something to mess around with.
posted by joyeuxamelie at 10:09 PM on July 18, 2010

I think i've experienced this--even not being able to yawn completely. My doctor told me flatly that it was anxiety. But it took me a long time to learn how to control it. Now, when I start to get the feeling, I've got the discipline to distract myself and it goes away. It seems to get worse if I allow myself to panic and think that I'm not getting enough air. . .Hmm. Don't know if this is your problem. Do you have a history of anxiety?
posted by sunnichka at 10:13 PM on July 18, 2010 [1 favorite]

I understand that you don't have a doctor, health insurance, or money. Are you able to go to a free/low cost clinic? The chest pain and the breathing issues may be related to heart problems. I have severe (i.e. life threatening) asthma and I do not have symptoms like yours. Albuterol is a rescue drug, it does nothing to prevent asthma attacks. Good luck.
posted by fifilaru at 10:30 PM on July 18, 2010

Good Lord... you're self medicating with prednisone? Is it at least a dose pack where you're following the directions, or are you just making it up as you go? Prednisone will almost always make you feel better, but it cures almost nothing.
posted by sbutler at 10:36 PM on July 18, 2010

I realize seeing a GP is not within your means, but I strongly suspect you need to be seen by an expert, even if that means going to your county ER and arranging a payment plan or county assistance to cover the expense.

If nothing else, if you're taking someone else's prednisone without knowing what's actually going on, you could be making things worse. You will need to be tapered off the steroid gradually, too, or you may experience severe side effects-- and this isn't really a thing you can do by yourself without a professional's know-how to get the taper right.
posted by fairytale of los angeles at 10:39 PM on July 18, 2010

I'm kind of freaked out about your description of putting yourself on prednisone "that someone gave you".

My dad, who has bad asthma, used to put himself on and off prednisone to control hid asthma, but that he also was under doctor supervision and the prednisone was prescribed to him. I have always had the impression that it's not something to mess around with.

So I'd be worried that it could be exacerbating whatever it is that's causing the problem.
posted by leahwrenn at 10:41 PM on July 18, 2010

I became randomly short of breath last year. I just could not get quite enough air. Just before it reached its worst point, I had trouble using my inhaler to attempt to treat it because I couldn't breathe in all the way. I thought it was extreme allergies (I have asthma) and blah blah blah. You know what? It turned out to be blood clots in my lungs (pulmonary emboli).

Please find out about low-cost clinics in your area. Don't wait.

If you were a friend, I would tell you to borrow money from a family member or someone if you had to. I would be worried that I was overreacting, but I would urge you to go to make sure.
posted by wintersweet at 10:44 PM on July 18, 2010 [1 favorite]

Dreamcast: "I can breathe in completely now, but I constantly have that feeling one gets after holding their breath for a while that compels them to breathe. No matter how many deep breaths I take, I can't get rid of this feeling. "

To me this sounds like shortness of breath rather than anxiety, and I would certainly make an effort to get to an ER. The ER cannot reject you if you are in a life-threatening situation - they have to stabilize you. You can look at it as my mom always says - an ER bill is cheaper than a funeral. (Well, in most cases anyways.)
posted by IndigoRain at 10:44 PM on July 18, 2010

I should also mention that people with mitral valve prolapse (MVP) tend to also experience more frequent panic attacks. No one knows why, but historically there's been a strong correlation. Chest pain and shortness of breath are classic, plus a sense of impending danger and need to flee.

These things trigger a positive feedback loop... the more you worry about the chest pain, the more paniced you get, the sharper the pain, etc. Same thing with shortness of breath.

But you can't diagnose a panic attack over the internet. You'd have to go to a doctor and let them eliminate other problems.
posted by sbutler at 10:44 PM on July 18, 2010

re: Anxiety - I do have a history of anxiety, but it's largely only in social situations.

re: Prednisone - It is a dose pack with the directions. I wouldn't take something without directions, and I've been taking it sparingly.

There's a 24-hour urgent care in my city, however, it's about $60 (and supposedly, not very good). A family member said I might be able to see their doctor, but it'd cost me somewhere around $80. I can just barely afford either of these options. I'm leaning towards seeing the doctor (which might take a few days to get an appointment), however, if I get any worse, then I'll go to the urgent care.

Is there anything I should avoid doing that could potentially make things worse?
posted by Dreamcast at 11:33 PM on July 18, 2010

I would look into finding charitable clinics in your city. There should be at least one, run by the Red Cross or Red Crescent.

There is one near my apartment complex and they only ask for $10, if you can afford it. You can use their services for free if you can't. They have a doctor and nurse available and different specialists come on different days of the week. They can issue referrals for you too and tell you about any other low-cost options that may be available.
posted by joyeuxamelie at 11:42 PM on July 18, 2010

Sounds like your asthma could be getting worse. Asthma can *kill* you so you really *have* to see a doctor about this.

Perhaps post your location so people can help you find a free or sliding-scale clinic in your area? Better that than ending up in the ER (or dead).
posted by Jacqueline at 11:51 PM on July 18, 2010

OK, a few things for you to consider:

1) It can very much be anxiety. Anxiety can be a delayed thing too - you can be feeling anxious now (and can't breathe) because of something that happened days, weeks, months ago. This is entirely possible. I am currently taking St John's Wort and this has really helped my anxiety. But YMMV.

2) You really do sound like you have reflux. I do, quite severely, and I am currently on Nexium 40mg. By the way, you don't need to be overweight to have reflux.

Both anxiety and reflux cause me to have exactly the same symptoms you've described - breathing in deeply but never feeling like you've got "quite enough air in", and yawning and not being able to breathe in and complete the yawn.

Things have greatly improved for me by taking the above two medicines. But IANAD, so get yourself checked out if you can. Can you hit up a family member for the $80?
posted by humpy at 11:55 PM on July 18, 2010

Maybe you can go to one of the places listed here more inexpensively:
posted by needs more cowbell at 12:23 AM on July 19, 2010

Some patients with MVP experience heart palpitations, atrial fibrillation, or syncope, though the prevalence of these symptoms does not differ significantly from the general population. Between 11 and 15% of patients experience moderate chest pain and shortness of breath.These symptoms are most likely not caused directly by the prolapsing mitral valve, but rather by the mitral regurgitation that often results from prolapse.
Severe MVP associated with arrhythmias and atrial fibrillation that may progress and lead to sudden death can happen at any time.[citation needed] As there is no evidence that a prolapsed valve itself contributes to such arrythmias,[17] these complications are more likely due to mitral regurgitation...[emphasis added]

I think your shortness of breath is probably due to a worsening of your mitral valve prolapse, specifically, an increase in regurgitation.

As you can see from the quoted passage, this can progress to sudden death at any time.

I think you are in the midst of a true medical crisis and should spare no effort to be seen by a specialist in mitral valve prolapse as soon as possible.
posted by jamjam at 12:36 AM on July 19, 2010 [1 favorite]

I can't speak to your heart issues nor your asthma, but I can tell you that your description sounds exactly what the beginning of a panic or anxiety attack feel like for me.

See a doctor. Please. Go to the emergency room if you have to. Get the other issues ruled out. If it's not a physical issue, it's anxiety or panic - a stupid condition to live with, yes, but ultimately harmless and ultimately temporary.

Also - and I say please again - stop self-medicating. Okay? It's stupid. Just because something is easy to get does not mean that it's harmless.

If you should find yourself in need of support for panic or anxiety, my favorite place to go is panicsurvivor.com.
posted by goblinbox at 2:14 AM on July 19, 2010 [1 favorite]

Certain breathing exercises can help with the symptom of shortness of breath. I've had shortness of breath off and on my whole life, and belly-breathing combined with pursed-lip breathing is the best way to get relief that I know of. These exercises would best be used for symptom management after you've seen a doctor and determined that there is nothing serious going on.

Here is a link with a good description of the exercises. You don't have to do them like an "exercise program" that you have to perform daily in order for them to work. Once you have the technique down you can just do it when you feel short of breath to get relief.
posted by Serene Empress Dork at 2:59 AM on July 19, 2010

Nthing go to a doctor already. While I am fortunate to be reasonably well-insured now, I have no trouble remembering what it's like to be poor and uninsured and to need help that costs more than you've got in your bank account. It sucks. Financial anxiety can skew your thinking to the point that you almost value your tiny checking account balance above your life. It sounds to me as if you've crossed that line.

With heart and/or lung issues, you could find yourself suddenly unable to think clearly, drive or otherwise navigate to a hospital. This is really dangerous, especially if you live alone. Please don't mess around.
posted by jon1270 at 4:06 AM on July 19, 2010 [1 favorite]

Dreamcast I don't want to insult you but you are really being a bit er.... silly about this. Breathing is kind of important to staying alive, and given your symptoms and medical history I have no idea what you are thinking in not going to an ER or seeing a specialist immediately. From your description it sounds like you have grade 4 dyspnoea. Look it up on wikipedia.

I strongly second jamjam's suggestions.

I strongly disagree with needs more cowbell's suggestion of St John's Wort. It interacts dangerously with many, many other medications and you will not want to be on it if you require emergency medical care.

And why would you take prednisone without the supervision of a professional??? It's a powerful medication with many possible complex and serious side effects.

I don't care if you're unemployed and don't have access to healthcare. You need to somehow see a professional in the next few hours or your problems may be a lot worse than being a bit short on cash.
posted by ruperto at 4:11 AM on July 19, 2010

Once you get checked out, if they don't find anything else, you might want to check out info on costochondritis. But rule out the immediate life-threatening issues first.
posted by galadriel at 5:35 AM on July 19, 2010

Go to the emergency room. Just go. It's not unduly alarmist to say that the worst case scenario in this situation is you die. That supersedes any other considerations.

I'm not a doctor, although I work in emergency medicine. You're not my patient, because you haven't called 911 and I haven't shown up in your living room carrying a big defibrillator. But if I encountered someone complaining of a constant sense of suffocation since Thursday night, I'd be on my knees in your living room practically begging you to allow me to take you to the hospital.
posted by itstheclamsname at 6:25 AM on July 19, 2010 [3 favorites]

IANYD, but I wish I was, so I could help you.

What you're doing is playing with fire. Do you know how many times I've seen people roll in with asthma on death's doorstep, because they tried to avoid coming to the doctor until it was nearly too late?

The last one I saw was a few months back. He was about 30 years old. He came in blue, all over. He had gone into cardiac arrest. We couldn't get him back. I still get the chills thinking about it. 30 years old, healthy aside from asthma, and he died.

Do not pay any attention to people who are saying things about anxiety or costochondritis (galadriel, costochondritis does not cause shortness of breath). Anxiety is a diagnosis of exclusion - it should never be assumed that shortness of breath in an asthmatic is anxiety!

Also, using Prednisone 'sparingly', to treat an asthma attack you're not sure that you're having, is not a good idea. Prednisone for an asthma attack should be given in a burst course, large doses for about 5 days, taken every day. But you don't even know that's what you've got.

What if you've got a blood clot in your lung (pulmonary embolism)? Prednisone's not going to help you. I'm not saying that's definitely what you have, but you haven't said anything that rules that out as a possibility.

Don't go to the urgent care. Go to the ER. They will not make you pay on the spot, so forget about whether you have the money to pay - the drunks and the homeless certainly don't think about that!! You can put the payments on a payment plan or negotiate them down, once you know that you are going to live. You need more than an urgent care can offer. At an urgent care you may not even see a real doctor, and you need to go to a hospital, because you might need to be admitted to it! Get there and get there now.
posted by treehorn+bunny at 6:34 AM on July 19, 2010 [7 favorites]

My MRI for a paralyzed arm got knocked down to $500, on a payment plan of $50 a month, and I was employed at the time. Get to the ER; the urgent care visit cost $65 for them to say that to me, so you're already getting a discount.
posted by SMPA at 6:51 AM on July 19, 2010

Borrow the money and go to the doctor. A friend had this symptom (among others) and it turned out to be stage IV cancer which had metastasized to the lungs and filled them with fluid.

If I sound like a jerk for bringing up the (remote) possibility of the c-word to an anxious person, well, whatever it takes to get you out the door. FYI, my friend had symptoms for months and didn't go to the doctor until, well, Stage IV. Which meant everything cost much more than it would have if it had been caught early.
posted by availablelight at 7:00 AM on July 19, 2010

1) When you feel you can't draw a full breath, focus on emptying your lungs. Purse your lips as if to whistle and gently, over as long a period of time as possible, empty your lungs. They will then fill naturally. The energy should go into emptying your lungs, not filling them.

2)links to the #1 respiratory hospital in the U.S., a goldmine of information

3) For the love of heaven, do not self-medicate with prednisone--you are playing with fire. What happens when you run out? Bad, bad things. I live in Canada, but others, above, have directed you to low-cost medical options. Or give up something you need less than your health. Please, don't end up in ER involuntarily.
posted by uans at 8:34 AM on July 19, 2010

Please also look into Chronic Hyperventilation Syndrome (CHS). It sounds like a ridiculous thing, I know, but I have it and it feels similar to what you've described. When I'm having problems with it I feel as though I cannot take a deep breath and I feel like I *always* need to take a deep breath. I yawn and sigh frequently and it really does feel at times like 'suffocating'.

You should probably go to the doctor either way, but do a little research about CHS. Maybe that will help. I spent a lot of time and money and underwent a bunch of procedures trying to find out why I could never get a good breath. The good news is that CHS is relatively harmless and can be easily controlled. Also knowing you're not dying when you're having an 'attack' helps to relieve the anxiety and get it under control more quickly. For the record, I also have asthma and this CHS is unrelated. Good luck. I hope you feel better soon.
posted by Katine at 8:45 AM on July 19, 2010

N'thing "doctor". If you are a woman in your 30s, a possibility (if unlikely) is LAM.
posted by kestrel251 at 9:46 AM on July 19, 2010

Could be anemia (easily treatable).

Although it's pretty unlikely, it could possibly be a collapsed lung. I knew someone whose lung collapsed and the nice people at the hospital simply re-inflated it. It took a few days though.

If you've been having a spell of warm steamy weather, that could be the cause of this exacerbation of your asthma, anemia, anxiety or whatever else may be the matter.

Don't keep trying to take deep breaths if you already are, cause that's hyperventilation. Quit trying, and the desire to do so should quickly pass.

Wear loose clothing, of course.

Chances are the emergency room trip won't be all that expensive. After diagnosis, you can always postpone treatment until a later date if your situation turns out not to be that urgent. (As long as it's not going to get any worse in the meantime!!)

When I went to the emergency room on no insurance, when their collection agency contacted me and I told them I had no insurance, they cut my bill in half. (and set up a reasonable payment plan).
posted by serena15221 at 12:14 PM on July 19, 2010

Can anyone provide any insight as to what might be wrong, and perhaps, what I can do, short of seeing a doctor, to relieve me of this problem?

The road to hell is paved with good intentions.

Anyone here offering up diagnostic impressions is doing you a disservice. I wouldn't dream of it, and I'm a pulmonologist. Listen to t+b. You are short of breath, and prednisone doesn't appear to have fixed the problem. There is only one piece of advice that is of any use to you:

Stop fucking around, and go to the EMERGENCY ROOM.
posted by drpynchon at 10:44 PM on July 19, 2010

I went to the emergency room, and they couldn't find anything wrong with me.
posted by Dreamcast at 3:34 AM on July 20, 2010

I'm glad you went: now you know that you're okay. Did they offer any advice for you?
posted by sunnichka at 11:49 AM on July 20, 2010

When I had a similar feeling, the only thing that worked was to stop taking the deep breaths. They made it worse.
posted by sunnichka at 11:51 AM on July 20, 2010

The emergency room didn't have any advice, other than to come back if I had a repeat of what happened Thursday. The papers the emergency room gave me afterward stated that they thought it was probably anxiety because none of the tests they took showed anything. They took my vital signs, blood, a chest x-ray, and then monitored my heart rate and blood oxygen, all of which, they said, were fine. I had also gone to another doctor earlier on in the day, and she listened to my breathing and took my blood pressure, and said she didn't notice anything wrong with me, but that I should go to the emergency room, anyway, because she couldn't test anything else.

Despite experiencing the symptoms before leaving to go to both the walk-in clinic and the emergency room, they were diluted considerably on the way to both locations, as well as while I was there. I took 40mg of dimenhydrinate (Dramamine) before I went to the walk-in clinic, and then another 40mg about eight hours later when I went to the emergency room (because I get incredibly motion sick in automobiles). If this is anxiety, then perhaps the pills had some kind of effect on the anxiety. I read somewhere, perhaps it was here on Metafilter, that some people take Dramamine to help them with stage fright, but I didn't recall that until after leaving the emergency room.
posted by Dreamcast at 1:03 PM on July 20, 2010

I'm glad you've experienced some relief. Being told that you're experiencing anxiety doesn't automatically make the feeling go away, that's for sure. It took me months to learn to control that suffocating feeling. Uans and Katine have advice that I would have appreciated back in the day.
Good luck! Let us know!
posted by sunnichka at 3:10 PM on July 20, 2010

I hope you're feeling better. I stumbled across a description of "hyperventilation syndrome" on wikipedia today.

I didn't realize that too-deep breaths were a form of hyperventilation. I also didn't realize there was such a succinct explanation for why you feel starved for oxygen when you take too-large breaths (hyperventilate): you are causing your CO2 levels to fall below necessary levels, which acidifies your blood, which makes you feel like you aren't getting enough air, which makes you want to breathe faster and deeper, which causes your CO2 levels to fall further . . . all of which is very harmful to your body.

Before, I was just giving you advice based on my own anecdotal evidence. Now it makes more sense. If doctors can't find anything else wrong with you, then you're probably hyperventilating, and the only thing you can do to break the cycle is to force yourself to stop taking those deep breaths.

I hope you're feeling better--and that you've found a way to make reasonable payments on that ER bill. There's usually a 'Go to the ER! Now!!' pile-on in these threads, and sometimes it's more necessary than other times. But over the internet, we didn't have any way to know if you were okay until you'd made that emergency visit.

Do let us know how you are.
posted by sunnichka at 5:57 PM on October 11, 2010

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