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 Anxiety and Panic Attacks 
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Joined: Fri Oct 27, 2006 8:07 pm
Posts: 54
Location: New Hampshire
Post Anxiety and Panic Attacks
Hi Everyone - rought night with Mom. since Saturday she has been having what I can only clal anxiety attacks. She is at point where she knows something is wrong but doesn't understand what. Showing alot of anxiety and then she gets really short of breath and tells me she is "tight" in her head, chest and stomach. Hospice has me give her a small amount of morphine (5 drops) and 0.25 of ativan and it usually works well. Has anyone else had these issues. Its hard because she has pulmonary fibrosis, has had a heart attack in the past (very small one - minimal damage) but with the LBD and her not being able to explain well what she is feeling its making ME crazy.....thanks for listening

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Shelley, Lills daughter, taking care of Mom for 5 years now......


Fri Jan 12, 2007 11:22 am
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Joined: Tue Dec 19, 2006 1:18 am
Posts: 53
Location: Chicago
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Hi! How hard this must be for both your mom and you. My mom has frequent anxiety and panic attacks - had them her whole life, and now with the LBD and Parkinson's. She is not on hospice, so the meds issue is somewhat different - the amounts I can give is limited because she is not yet on hospice. However, it is my role to keep her calm. And for her, the only way is via medication. Logic, soothing talk, aromatherapy, music, etc. do not help her. She is on Seroquel, which does help a lot. I'd prefer her to be alert, not groggy and out of it. But she suffers greatly from the panic and anxiety - is miserable and aware of being miserable. So my choice is to give the meds that relieve her misery. With all the medications available, as the hospice movement reminds us - no one needs to be in any sort of pain, including emotional pain.

You referenced hospice: is your mom in physical pain? Pain, fear of pain, fear of the unknown, etc. can create tremendous anxiety. And the dementia magnifies everything, including the difficulty in making oneself understood. I'm presuming the morphine is for pain. Does the ativan work for the panic and anxiety? I'm asking because my mom had a bad reaction - a paradoxical response - to ativan and all related meds. She became more upset and anxious, not less, with ativan and other d-pam meds, like valium, librium, etc. It would knock her out for a short while, but then she became more panicy and distraught. We could not calm her down. Finally a new MD and athegeriatric pharmacologist where I work told me these meds cause this reaction in some folks with LBD. Thus the Seroquel, which calms her and helps her sleep. She's often out of it the next day, but at least settled and not scared.

I hope you and your mom's clinicians find the mix or dosages of meds that allow your mom calm and peace. You are a wonderful daughter to be so attentive and concerned. I pray for your peace, too, as you make this journey with your mom.

Lin


Fri Jan 12, 2007 11:26 pm
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Joined: Fri Oct 27, 2006 8:07 pm
Posts: 54
Location: New Hampshire
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Thank you Lin:

Yes it is difficult, mom also has bipolar, seems she has been somewhat anxious all my life (I was 15 when she was diagnosed.) She was on lithium for year, but after diagnosis of LBD, we found she could not take it anymore (made symptoms worse), 2 times she was in a coma for 2 weeks because her lithium levels shot through roof. they presently have her on small dose zyprexa and lexapro. I think with all the short circuits in her brain ( I describe it as a light bulb going off and on), it is making the anxiety worse. She is also very afraid, she watched my dad pass away from aspiration pneumonia/alzheimers 3 yrs ago. Very scary for her. I almost can't wait till she gets to the point where she doesnt remember all of that and what she has. Then her emotional pain would go away. Morphine is given in small doses to relieve the tension or tight feeling in her body when she has an attack, ativan to calm down. Meds are given in such a low dose they don't really knock her out. thanks for your support and concern. We are hanging in there. Shelley

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Shelley, Lills daughter, taking care of Mom for 5 years now......


Sat Jan 13, 2007 9:36 am
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Hi Shelly and Lin,
We also went through many a panic attack and they must be so frightning to the person that is having them and it isn't always easy to change their attention to something else, I can't imagine what must be going through their minds with this illness, Ativan was a tough drug for my Husband but I will say the Seroquel worked and did it's job, yes there were times we had to give more because of certain situations and it would knock him out but that was much better than what he was going through at the time, we also used morphine towards the end he had so many problems with swallowing and it did help.
We are all doing the very best we can, don't you think ?


Sat Jan 13, 2007 8:02 pm

Joined: Sat Aug 19, 2006 5:01 pm
Posts: 79
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Hi all,
I posted on another thread, but wanted to add to this one. I wonder if anxiety is a very common symptom of this disease. My Mom has been doing very poorly recently. I have been able to handle almost all aspects of what this damn disease is doing to her. But the worst started recently. She is not able to carry on a conversation, gropes for words then gives up and is silent for hours. BUT at the end of the day she wants to go home (we are in her home). She insists on going, she begs to go, she cries and then she tells me she's scared. She is unable to talk back and forth, but when it comes to her "going home", she has no problem speaking. It almost kills me. It makes me cry. It's the worst because there is nothing I can say or do that makes her feel better. Hugs, reassurance, reminding her where she is just doesn't work. She doesn't remember I'm her daughter, so I don't feel like I am much comfort to her. This is the sort of issue that drove me to Xanax (for her, not me....though not a bad idea!) I give it to her at a low dose when she is anxious and she calms down. Not saying this is a med you should use. Just saying don't give up on finding something to make her feel better.
Thanks everyone,
Sallyann


Sun Jan 14, 2007 2:44 am
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Joined: Fri Oct 27, 2006 8:07 pm
Posts: 54
Location: New Hampshire
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Hi Everyone - Sallyanne, I too use xanax, have for the last year, I only take it during bedtime to help me fall asleep and relax, when mom's aide comes at 7pm, hard to shut off caregiver mode for the night. Regarding anxiety, it is awful for mom, she gets so scared and edgy, she actually shows physical symptoms, face gets flushed. My problem is she has pulmonary fibrosis too, so is she getting anxious from LBD, or anxious because she is short of breath from pulm.oh boy sometimes I feel like I'm saying eenie meenie minie mo, which one is it. Thank goodness ativan and morphine work for both Amen. Hate giving the hospice drugs because its like which is causing this but like I said its good for both. Had to give Mom a little ativan last night and it helped her immensely which in turn helped me feel like I accomplished something. Dreadful disease. When your mom says she wants to go home try telling her we will go in a few minutes and then try redirecting her, I had to do this with my Dad who had alzh. most of the time it worked. Sometimes agreeing with them and saying I will take you home in awhile makes them feel better. Good luck. Thanks for the advice once again Irene. I am a little anxious myself this morning, ice storm coming for New England, anniversary of Dads death tomorrow (3 yrs), and mom is sneezing, not a good sign, hopefully just oxygen making her nose dry, says she doesn't feel like she is getting a cold but who knows, plus my daughter Tracey is due for her 4th baby (3 girls and finally her boy is coming), in a few weeks. Feel like everything is going to happen at once. Well gonna go clean and get rid of this antsy feeling. Thanks again, Shelley

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Shelley, Lills daughter, taking care of Mom for 5 years now......


Sun Jan 14, 2007 11:06 am
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Shelly,
I am happy for your daughter , finally the boy is coming , how nice!
Little story, I also had 3 daughters and ................... after 16 yrs had the son and he is such a blessing to me, of course my girls are too but he is still home with me and we are very close we went through the whole ordeal with Jim together and I think it just made us closer where the girls are all married with their own families!
I wisxh your daughter well and I hope your Mom isn't coming down with a cold and your idea of redirecting is great I always did it and it would defuse the issue at hand even if was only briefly! :)


Sun Jan 14, 2007 12:46 pm

Joined: Tue Dec 19, 2006 1:18 am
Posts: 53
Location: Chicago
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Dear Friends - It is a horrid disease, period! Mom very anxious and panicy today, too. Often very hard to tell what prompts the behavior - sometimes there's an actual reason (UTI, needs to have a BM, orthostatic hypotension and she gets out of breath, etc.). Sometimes just the disease itself.

I am glad your LOs can handle the ativan and Xanax, and that they seem to help. As I said, my mom can't, and once I read the restricted meds list recommended for PD and LBD, I just tweaked her Seroquel up some.

My mom also wants to go home. In fact, she is away from her home by over a hundred miles. Sometimes she actually just talks about taking a drive there - the sensible times. Often, though, she cries inconsolably and becomes very agitated. Wants to pack her bags. Says if I won't take her she will walk, etc. Yes, this is heartbreaking. Conversation doesn't help, and usually diversion by someone other than me is all we can do. She becomes very angry with me because I won't help her.

About people wanting to go home: this occurs for people in hospital, hospice, folks anxious prior to surgery, and of course those with dementia. There's some literature that indicates the "going home" may not be their adult home but an earlier home when they were children. This helped me some years ago when mom was in her married-life home and still wanted "home."

Of course, our LOs have dementia - we cannot reason with them about this sort of thing. They have their feelings, their needs and it is all as real to them as our reality is to us.

Do your LOs remember their anxious, scared, crying moments? They pass and my mom seems to have no recall, for which I am very grateful.

A quiet night of rest and a peaceful tomorrow for us all is my prayer.

Lin


Mon Jan 15, 2007 2:24 am
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