[npatterson]

#1070631

I re-posted this from WorriedMum. It was originally about Diazepam (Valium) ~nhp~

Panic attacks are frequently manifested by rapid heart beat, coldness, and hyperventilation–this can cause "tremors" and occasionally "fainting", but the recovery does not take hours.

4 mgs of Diazepam/Valium is not a huge dose, but unless a doctor is physically present and supervising, should not be given more than 4-6 hours apart.

She she having the multiple attacks at home, or in the casualty/emergency room? What you are discribing is altogether different from panic attacks. The slow recovery, dizziness, weakness, headache, sore throuat (?), inability to walk, and going back into the condition are not nornal, and not part of a thyroid condition that I am aware of. She needs to be seen by someone, a specialist if possible. Print out your description and take it with you.

These are not side effects of diazepam.

Please keep us posted.

[npatterson]

#1019296

by WorriedMum on Wed Jun 03, 2009 1:13 pm

Hi,

My daughter has actually been diagnosed as having Hashimoto 3/4 weeks ago but at the moment she is hyperthyroid (I’m not sure if there is a similar foundation for Hashimoto?) She is 13 and is finding the whole experience extremely difficult. She has been taking Tyrodyl for 3 weeks now but most of her symptoms don’t seem to be abating, although I understand that it can take a while for the medication to take effect? Anyway she has hyperventilation/panic attacks, her eyes roll in her head, she feels very cold, she sometimes "fits", she becomes unresponsive, they can last for anything up to an hour and a half. We having been working on breathing techniques and we recognise the signs of an oncoming attack now, I think we are now better at dealing with them (for the first two weeks her teachers at school would call an ambulance each time an attack occurred, I spent more time in casualty than out of it. Now I sit outside school each day and when she has an attack, I can go straight in and sort her out without the need for an ambulance).
This week, her attacks have changed, she was having an attack every other day, more or less. She had an attack last Wednesday and then she was fine until Monday when she had a small attack. Yesterday she had two attacks and today she has had three. We seem to be able to get the hyperventilation under control quicker and there is less kind of fitting. She still loses consciousness and her eyes still roll. But these attacks are different in that we can get her around within 20 minutes but then she is very sleepy and tends to slip back into them again, and then you have to start all over again. After the attacks she is very weak and can’t walk etc. and she has a headache, sore throat etc which you would expect. Her previous attacks were more dramatic but once she was out of it, the attack was definitely over. These attacks are gentler but she slips in and out of them.
When she has an attack we give her 4mgs of diazepam. My question is, could the diazepam be responsible for the change in nature of her attacks? And is this a good thing? She hasn’t been to school this week because of the frequency of her attacks, so to me it seems worse although the attacks are less violent.WorriedMum

[WorriedMum]

#1070632

Thanks for your answer Nancy. We have just spent the last few days in hospital. Emily’s attacks were getting worse and quite worrying, for example she felt dizzy while running down the road, ran into a wall and as she fell down she went into an attack, she had an attack in the bath etc. Finally it was all taken out of our hands when she went to collect something for me in a supermarket and the next thing I knew was the ambulance men running through the door. They were very insistent that she be taken to hospital (although on the previous occasions that Emily has been taken by ambulance to hospital, the only result is that she spends a few hours in a room and is then allowed to go home) However on this occasion she had to stay in hospital as her blood pressure was very low. She had a couple of attacks in hospital and was monitored throughout. The doctors told us that the attacks were partly due to palpitations and she has ben put on Beta Blockers. Since coming out of hospital on Sunday she has had another 4 attacks so the problem doesn’t seem to be abating yet.
We have found that when dealing with her attacks, she comes out of them much quicker if we are really stern with her and almost shout at her. But even after that, once she has come round, she generally feels really tired and then sleeps for an hour or so.
This is a really scarey experience and I’m really hoping that either the Tiradril or the Beta blockers will start working soon.
I have another question, if that’s okay? The doctors have said that once we can get Emily from hyper to hypo thyroid, which she will return to eventually as she has Hashimoto rather than Graves, they want to operate as she has a 4cm nodule. An acquaintance told me that she also has hyperthyroid and was told that she needed an operation, but after seeing a specialist she was told that the fluid could be removed without surgery. I know that you can’t directly compare cases as they are probably different, but should I be asking for fluid to be removed rather than an operation.
Thanks once again,

[npatterson]

#1070633

Are you in the UK? If you are, I will put you in touch with the British Thyroid Foundation. You need some local help and support, as well as what we can give you here.

I am not familiar with Triadril. It does not seem that the reason for her "attacks" has been identified. Has she had an EEG?

So far as a nodule is concerned, you certainly need to have her seen by a specialist. "Nodule" is not a definitive term–sort of like a "bump". They can be hot, cold, and there are many types in between.

[WorriedMum]

#1070634

Thanks Nancy. No we live in Spain. Fortunately, since Emily has been taking the beta blockers, her attacks have decreased , in fact we haven’t had an attack for 12 days now. Her nodule has been tested and it is not cancerous. So it seems that now we have to wait and allow the tirodril to do its work and when the over activity has decreased they would like to either operate or use radio-iodine, which I have to say, doesn’t make any sense to me. If she has Hashimoto and her thyroid has therefore already been damaged and is likely to return to under-production, why would you want to reduce its productivity further just becasue she has just been through a temporary period of over-production. Still I’m sure things will become clearer in the fullness of time?

[Ski]

#1070635

That’s because it’s very hard on the body to go back and forth from hyper to hypo ~ by definition, when a patient has both Hashimoto’s and Graves’, there’s no telling which antibodies will be "dominant" at any particular time, so it’s constantly chasing "normal" that can be so debilitating. Everything takes so long in the interim, testing, figuring out levels, and then BAM something changes and off you go again. The body never has a chance to rest and heal, if the levels don’t arrive at normal and then stay there. With these two opposite sets of antibodies in the bloodstream, you have little hope of a long period of stability without taking the thyroid itself out of the equation.

[WorriedMum]

#1070636

That’s what we’ve just been told by a friend of a friend who happens to be an ear, nose and throat specialist. We have to remove the thyroid and nodule completely and thus get rid of both diseases. The doctors at the hospital seem reluctant as say it is dangerous to operate when the thyroid is hyper? The friend disagrees? He says that growths on thyroids have a high tendency to cancer and should be removed asap?

Our worry right now is that she had been having hyperventilation attacks. These stopped after 4 weeks of taking beta blockers. 6 weeks ago, the doctor told me to stop giving her the beta blockers after a month. A month later, 2 weeks ago, I reduced her dose to 2 tablets a day instead of 3 and now she is having attacks again. I don’t think it is good for her to be on beta blockers but the attacks are not good either so this is a quandry. The friend says that he thinks that the hyperventilation attacks may be linked to something as yet undiagnosed, and not linked to the thyroid condition? are hyperventilation attacks generally associated with thyroid conditions?

Thanks.

[mamabear]

#1070637

Hello and welcome. Prayers for your little girl, I am sorry you and she have to go through this.

I would check with dr., but could the hyperventilation attacks be due to her racing heart beat? Since the body is pumping faster and she feels it, we tend to "feel it in our head so to speak" as well and therefore we get upset and therefore hyperventilate. Like seeing a needle when your a kid and you hate needles and your given a bag to breathe into because you can’t calm down because you are so upset about the needle.

Well maybe since she was doing ok on the beta blockers the hyperventilation stopped because her heart rate was normalizing. Since you changed the dose the heart rate might have gone up again and therefore is putting her (or her mind) into a panic and causing the hyperventilation.

I only say this because that is how I was when my heart rate was high when I was hyperthyroid.

[Bobbi]

#1070638

Hi, Worried Mum:

Hyperventiliation could be associated with excessive levels of thyroid, but it would not be wise to assume that is the cause. Your daughter needs some really good medical evaluation.

As to undergoing surgical procedures while hyperthyroid, it is usually not advised unless the risks of waiting for medication to bring thyroid levels down are worse than the estimated risks of the surgery.

This whole series of events must be wearing on you and your daughter. I hope she gets relief soon.

[WorriedMum]

#1070639

Thanks for your comments, it is pretty scary stuff. We had to go and pick her up off the street today when she took the dog for a walk and only the dog came back. We found her with a crowd of people all insisting that we call an ambulance. She’d felt dizzy, fallen down and hit her head and gone into hyperventilation. She slept all afternoon and feels much better now. We have an appointment at the hospital on Thursday, so we can talk about our concerns about the continued use of beta blockers and what else we can do about the hyperventilation attacks. I wonder if there are any tests you can do to find out what the hyperventilation attacks are related to and whether they are just her brain objecting to what is happening in her body?

[carla]

#1070640

Hi worried mum,
I to am the mother of a 13 year old daughter who was diagnosed with Graves disease on 3 June this year. My daughter to was having panic attacks, palpitations, rapid heart beat of up to 160 beats and around 130 when asleep. Along with all the thyroid medication, she to was put on a beta blocker which she is still on 2 months later. She was taking 10 mg twice a day, but as of 3 days ago is taking half a tablet twice a day and so far so good. We did try to take her off the betablockers a few weeks ago, but she became very anxious and emotional and descibed it as a feeling of being outside of her body. Isn’t it amazing that our poor daughters have to go through this at such a young age, it is so unfair, I wish it were me and not her, but we are getting there, 3 months in to it now. Keep in contact and let us know how you go. Carla and Val Best

[WorriedMum]

#1070641

Hi Carla and Val

That’s very interesting about the heart beat monitoring, Emily was monitored once in hospital when she was kept in over night. She was monitored over night but we were only told that her heart beat was too high, not what the measurements were. Do you have a machine at home?

We have put her back on to 3 tablets of Beta Blockers again until we can get to see the doctors at hospital. We tried to discuss our worries about continued use of beta blockers with the doctors last thursday but they explained that they were the theatre team and therefore could only tell us about operation procedures not other treatment. Apparently, we have to get the local pediatrician (in Spain, children see a children’s doctor rather than the family doctor) to order another appointment at hospital with the pedtrician or ear/nose/throat team as her next appontment with them isn’t until October. The local pediatrician is on holiday until September but we have an apponitment on 3rd.

The theatre team told us that Emily will have to have her thyroid removed and the sooner the better, but they have to wait for a directive from the pediatrician team. Apparently this will happen when the pediatrician team realise that they can’t control Emily’s condition with medication. The theatre team think that this will happen sooner or later, since the anti-bodies will continue to attack the thyroid until there is no longer a thyroid present.

It’s really interesting to hear that your daughter has experienced the panic attacks/ palpitations as well, perhaps young people find it harder to cope with the condition?

Please do keep in touch, and my very best wishes for your daughter.

[carla]

#1070642

Hi Worried mum,
my daughter sees a paediactric ophthalmologist once a week, a paediatrician once a week and a paediatric endocrinologist once a month. She has been having all this care since her diagnosis on 2 June 2009. This for us is a huge performance as we don’t even live in the same town as these doctors, but after 2 months, the journey is getting better. She misses every Friday of school now for her Intravenous medication (500 mg Methylprednisolone soon to be 250 mg for the next 6 weeks) and occasional other days when she needs to. Lucky for us, I work at the same school (I teach secondary school maths and science), so I am always there for her, otherwise she would have missed a lot more. What betablocker is your daughter on? My daughter is now on 5 mg propanolol in the morning and 5 mg in the evening, but that is a trial since last week and with todays panic attack during a maths test, I think we will go back to at least the 10 mg in the morning to get her through the day.

[Andros]

#1070643

Well, I do believe more is going on than meets the eye here. If your daughter truly has Hashimoto’s (only fine needle aspiration is definitive based on the presence of "certain" Hurthle cells), your daughter may have Hashimoto’s Encephalitis which would cause seizure-like activity.

I would post a link for I am not sure of the forum rules regarding that. I am new here and trying to sort my way through things.

The above is a possibility but so are other things like Myoclonic seizures due to hyper state.

Lu Anne

[WorriedMum]

#1070644

Thanks for your replies, I have to say Val, that I still can’t get over the level of care that you are receiving, I was impressed with the amount of testing etc that emily had received but weekly visits, whilst inconvenient, is very reassuring.

I’m not sure what fine needle aspiration is Lu Anne, but one of the tests that Em has had involved a very long, thin needle being jabbed rather firmly into her throat, maybe this is it? I wouldn’t really describe Em’s attacks as seizures, they are more often characterised by hyperventilation and a lack of consciousness rather than the fitting that you would generally associate with epilepsy etc. Having heard from Val, whose daughter also experiences panic attacks/ palpitations, it seems reasonable to assume that perhaps young people do experience these types of symptoms when they are hyperthyroid?

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