My chest pain is freaking me out

September 3, 2014 1:24 PM

I had pneumonia about four years ago in my left lung. Now it's bothering me again in the same spot, but I really don't think it's pneumonia this time. Help me relax until I can get in to see my doctor.

I actually think this chest pain is one of three things: anxiety, GERD, or lung cancer (I take medication that greatly increases my cancer risk). It is located just to the left of where my ribs meet, near my sternum, but is definitely on the left side of my body. But, I have no idea what it is, and I also would like some recommendations about how to talk about the pain with my doctor so that I can receive the best care.

How can I stop thinking about my chest pain and go about my days while I wait? I know that if it is anxiety that thinking about it is not going to help. I am going to ask my doctor about anti-anxiety medications when I see her as well, as I've been trying to get a grip on that for awhile (I had no idea that my life was basically a pit of anxiety until I had a medical procedure where I prescribed some Xanax and it was like... something inside of me just... unlocked, and I felt normal.)

I am under an extreme amount of stress (I'm writing a dissertation) and also struggle with anorexia so food can be an issue. The pain seems worse after I eat or when I drink coffee, but it doesn't always seem related. Are there foods that I should be eating that might help? Breathing exercises I can do? The Anxiety and Phobia workbook is something I've been working through and it's helpful, but it's not making my very real chest pain go away.

Every time I sit down to write I feel a lot of pain. When I am distracted, like when I get into writing or when I am doing something engaging (especially when I'm not wearing a bra, actually, come to think of it) it doesn't bother me as much. This has been an issue for awhile. I went to the emergency room with similar pains last November and they basically told me that there was nothing wrong with me based on the lung x-ray that they did, and that I was probably just stressed out. They did not give me any medication or tips about how to handle it. It went away until about May, and now it is back.

How can I cope with this until I see the doc, and how can I talk about this with my doctor so that I am taken seriously and actually treated instead of just living with pain?

Thanks for your help.

posted by sockermom to Health & Fitness (17 answers total)

I'd go to the ER again. it could be anxiety or something else. :/
posted by heathrowga at 1:25 PM on September 3, 2014

Look at how you sit when you're writing. You could be straining a muscle on that side. Are you using a desktop setup with a mouse?

I went to see my doc when I had a similar pain on the right side of my chest, and she diagnosed a pulled muscle from twisting in my seat on a long flight.
posted by vickyverky at 1:30 PM on September 3, 2014

Response by poster: I don't want to thread-sit, but I'd like to avoid visiting the ER again. It wasn't helpful the last time and I doubt they're going to do anything this time. The pain is dull and annoying but I can still function. If the doctor can't see me for something like another three weeks I'll probably just head in to the ER, but I'd like to wait to see if I can get an appointment scheduled with my primary care doctor at this point.

The emergency room is also incredibly expensive and I am low-income, so I'd like to prevent going into medical debt again. I just got out of that hole three weeks ago (I had a "raging urinary tract infection," doctor's words, in May of this year that cost me over $1,000 out of pocket when it was all said and done).
posted by sockermom at 1:36 PM on September 3, 2014

Does it get worse when you take a deep breath? Like someone's poking you with a pointy stick right at the rib below your left breast? If so, bet you it's precordial catch and will go away in a day or so.
posted by MsMolly at 1:41 PM on September 3, 2014

Is it like costochondritis pain? I have gotten this, off and on,and mine presents on the left side, near my bra strap line. I also tend to hunch a bit when I am sitting. But basically, it's inflammation of the ribs. The stuff between the ribs. And it does hurt like hell.

I also sleep on my left side and have found it helpful to use a mushed up bathrobe, stuffed animal, or extra pillow to keep from scrunching those muscles up.

IANAD but I have had pain like this and also anxiety pain and the two are different. Anxiety chest pain is more like a panic attack where I am also short of breath and dizzy. Haven't had one of those in years, but the costo pain, ugh.

If you think it's GERD, have you tried an OTC med for it?
posted by Marie Mon Dieu at 1:42 PM on September 3, 2014 [2 favorites]

I would follow whatever diet they recommend for people with GERD - it can't hurt. Stop drinking coffee or cut down severely. Stop eating anything spicy or acidic. Try OTC medications (if they're compatible with your current ones). Again, can't hurt.

Do you still have Xanax? Are you taking it? Can you call up that doctor and ask him/her to prescribe more? They might do this over the phone depending on their relationship with you.
posted by desjardins at 1:45 PM on September 3, 2014 [1 favorite]

Best answer: and also struggle with anorexia

This may not be your problem, but during a period when I was purging regularly I injured something that felt similarly to the pain you describe. It eventually healed. Even if you don't purge, it might be helpful to disclose your ED symptoms when you have this checked out to rule out associated health issues.

how can I talk about this with my doctor so that I am taken seriously and actually treated

Clarify that you are in pain and that it is affecting your daily life. Be firm and assertive about your pain and don't downplay your discomfort in any way. Write down your symptoms, just like you did for us, and bring an outline on paper with you to the appointment. You can use that piece of paper for your own reference like notecards, or you can give it to the doctor. If you feel that you are being talked down to, repeat yourself firmly, and emphasize again that you have a problem that affects you.

And even if it is anxiety, anxiety is also serious, so don't let that make you think that you don't have a legitimate right to healthcare for this issue.
posted by epanalepsis at 1:48 PM on September 3, 2014 [1 favorite]

Dude, I've had something like that for two weeks now. So far, it has been diagnosed as a sinus infection, a cartilage infection in my chest, bronchitis, and possible pneumonia. Antibiotics didn't work, so now I'm on steroids. If this thing is going around, it may well be what you have, and sounds like similar symptoms. Can you get to an urgent care?
posted by roomthreeseventeen at 1:53 PM on September 3, 2014

Response by poster: I do not purge and my anorexia is mostly in my brain at this point in time. I think I'm fat and obsess about it but I eat very healthily and normally and make sure I get protein, fat, and carbs in good proportions. It's a daily struggle, a constant struggle, but I am in a good maintenance mode right now and am a very healthy weight.

I have been diagnosed with precordial catch in the past and this is a different pain. It does hurt more when I breathe in or when I move but it's not as sharp, if that makes sense. It's dull.

Suggestions about how to relax and not get balled up in the knot that is anxiety would be super helpful. Suggestions about how to talk to the doctor are also helpful.

I really, really appreciate the ideas about what it might be, but I think that looking at more stuff about what could be causing this pain is probably only going to enhance my anxiety (even if it's benign like PCC) so I'm not really interested in that right now. Thanks, though. I really appreciate the reassurance.

Also, the doctor that gave me Xanax was a different doctor and it was for a scary medical procedure, and I have none left (they gave me one pill! that's it!) I felt so, so normal after taking it, but discussions with doctors since have left me with the understanding that these drugs aren't good long-term and that I should work on my anxiety using other, non-drug-related, methods at this point. Which I'm trying to do, but damn, it's hard.
posted by sockermom at 2:05 PM on September 3, 2014

Best answer: I have found that doing guided meditation really helps me get out of my own negative thoughts feedback loop. I really like the Simply Being and the Relax and Rest iPhone apps because you can set the background sounds to continue playing after the meditation ends. Good luck.
posted by PorcineWithMe at 2:13 PM on September 3, 2014

Best answer: I have been in this position with my health anxiety and understand the very real knots you describe. Talking about relaxing is so much easier than doing so for you and me, I think. I had chest / throat issues (pains, often severe, aches and a "lump" feeling) around two years ago that effectively precipitated a mental breakdown caused by anxiety but which actually turned out to be a hiatus hernia. By the time it was identified I had also had an endoscopy that showed some stomach inflammation caused by excess acid - so a combination of relatively benign physical health issues combined to create a perfect storm of anxiety fodder.

To overcome this took time, antidepressants (citalopram) and me constantly trying to reassure myself that if it were serious, it wouldn't come and go, it would be getting worse, there would be other symptoms, and that my GP is amazing and reassuring and has not been wrong yet. Getting sleep helped, as did mundane activity such as gardening. Going to work was hard when things were at their worst but the routine helped.
Talking to people was also an effective way of self-soothing - they could help me get things in perspective sometimes.

I really hope you find some peace of mind soon - I've been where you are and it is draining.
posted by Martha My Dear Prudence at 2:47 PM on September 3, 2014

If the doctor can't see me for something like another three weeks I'll probably just head in to the ER, but I'd like to wait to see if I can get an appointment scheduled with my primary care doctor at this point.

Apologies if this is something you have on your calendar for sometime in the next 24 hours anyway, but: CALL YOUR DOCTOR and make the appointment so you can move forward and stop what-iffing a bit.

Sometimes medical anxiety requires pragmatic triage; if this isn't how your medical anxiety works, apologies.
posted by deludingmyself at 2:50 PM on September 3, 2014 [2 favorites]

Now it's bothering me again in the same spot

It is possible that you have scar tissue that is bothering you while you are under stress, in much the same way that an old break in a long-healed bone can hurt during cold weather.

I used to have fairly bad scar tissue in my left lung from prior infection. It sometimes really hurt like a bitch and was the first thing to get symptomatic if I had a minor cold or something. It is better than it used to be but, when under stress, if my lungs are going to bother me, they tend to do so in the places that used to be seriously problematic.
posted by Michele in California at 2:52 PM on September 3, 2014 [1 favorite]

Best answer: Thanks for the clarification. Things that have helped me:

- Massage. If you don't have someone to do it for you, a few minutes of self massage, especially the fleshy part above your chest/breasts and below your collarbone.

- Crunching something (like crushed ice) or chewing gum. Fresh veggies or wasabi peas also work.

- Essential oils, like lavender. You can even get lavender based lotions and powders at the Dollar Tree (since I assume you might be on a budget, being a student). Pick a scent that you like and use it (I even got on a Suave coconut shampoo kick for a while).

- Doing one yoga pose for a few minutes, like the Child Pose. Or pick one that feels good to you. The thought of taking up a daily yoga practice can be intimidating, but picking one pose and mastering it can be relaxing.

- Standing up and walking in place, or talking a walk around the block.

- A shower or bath.

- A fan blowing almost in my face. Sometimes two fans, one on either side. I just like fans, and they relax me.

- Getting outside and looking at plants, even if it's potted herbs on the deck.

- Walking in nature.

- Any sort of outing that does not involve mundane things like work or school or grocery shopping (drive in the country, taking photos, picking Fall leaves, local park, art museum, etc.).

- Exercise, biking or walking, swimming, dancing. 15-20 minutes a day.

- Also, look at your posture. I have horrible desk posture, lean against the arm of my chair, and constantly reminding myself to sit up straight or get up and walk around for a few minutes. This contributes to my left side pain.

Things you can ask the doctor about are things like checking your vitamin levels (as sometimes low D can cause aches and pains), how to assess your pain on a scale of 1 to 10, when to go to the ER, and when to wait for an appointment. Ask if there is something you can try that is not a benzo, like a beta blocker or hydroxyzine. Or if it could be GERD, how to treat it and when to know if that isn't working (some meds take several days to work). How soon to follow up if something isn't working.

I have had a heart work up, including 2 stress tests, EKG's, and an ultrasound. I go to my doctor on a regular basis (every 6 months, or whenever she tells me to, unless I am sick, then I go earlier). When you call to make your appointment, ask them about your pain. You can also call a nurse hotline and speak to them. I think, however, that it's important that you do something, because worrying isn't going to get you anywhere.
posted by Marie Mon Dieu at 2:56 PM on September 3, 2014 [2 favorites]

Maybe a bit of a digression, but you have REALLY got to sign up for the affordable care act! That shit saved my life when I was diagnosed with cancer this year. In 2014 there is no reason you should be avoiding the ER because you can't afford it.

And I'd say you need to see a doctor sooner rather than later. That's not to say this is definitely something serious... but if you walk into any ER in the US and say you have chest pain, they will drop everything and see you immediately. Chest pain is scary stuff.
posted by Ursula Hitler at 5:41 PM on September 3, 2014 [2 favorites]

Best answer: In addition to the other great suggestions so far, you might try progressive muscle relaxation. If you do a google search, you can find lots of guides for how to do it if you've never tried it before.
posted by litera scripta manet at 8:22 PM on September 3, 2014

Response by poster: This thread was really helpful. The doctor is pretty confident that this is an ulcer and I am inclined to agree. We will do an endoscopy if the preventive measures and medication she's having me take now don't work just to make sure.

I was pretty confident that it was not cardiac based on the pulmonary and cardiac workup I had last November when I went to the ER with the same pain. The ER basically told me to chill out and sent me home, so I've been living with the pain off and on for about a year. My doctor was also confident that it was not a heart issue, lung issue, or a clotting issue based on some tests I had in May of this year when I was in the hospital for something unrelated.

Anyhow, I wanted to thank y'all for the advice. I talked to my doctor first about the chest pains and after she diagnosed me with a probable ulcer I talked to her about my anxiety. We worked out a plan for that, too, which I am a little anxious to try (hah!) but I'd like to live without anxiety so I will probably give it a go in a few weeks after I get the chest pain to calm down a bit.

Thanks for all of the advice here. It was very helpful.
posted by sockermom at 8:48 AM on September 5, 2014