umm i think you missunderstood me, i wasnt talking about GETTING it at uni, i ment it was my trainning patient at uni. Im a paramedic student so our pracs are either simulated patients or problem based learning .
Nearly passed out today.
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umm i think you missunderstood me, i wasnt talking about GETTING it at uni, i ment it was my trainning patient at uni. Im a paramedic student so our pracs are either simulated patients or problem based learning .
I understood what you said. I was comparing it with own experience with students and anxiety, i.e. most of the time these symptoms are diagnosed as anxiety
oh BTW, alot of cases like this are transitory (and it sounds like yours is too), which makes them very hard to catch (take SVT as an example, i know one women who it took 20 occurances for the ambos to capture the rythum). Going to the doctor is great (especially if its a brain tumor) but calling the ambulance when it happens is MUCH MUCH better. Ambos can do alot of things on site which you just cant get back. Cardiac rythams are notoriously hard to catch. BP, HR, RR arnt possible to get back either
This isnt to say you shouldnt go but rather to say that next time something like this happens call 000 (or whatever it is there). Apart from the loss of clinical indicators alot in that list can be quite serious and need to be treated then and there.
An MI for instance WILL kill if not corrected. Further more anything nerological shouldnt be left either. Basically alot on that list are life threatning conditions
BTW sam, how much med did you do as part of your degree? i dont mean that to be insulting i just want to know how deep an explination to give you (for instance do you want it to the cellular level)
Anyway i found this:
I've stopped training for 5-6 weeks now, was training for over 6 months I think and tbh I didn't experience any problems. Physically I feel as though I am in very good shape. My diet is relatively healthy.
Search & Destroy said:
Nope. Had been walking pretty much since the morning, I didn't feel tired or anything.
Sam said:
I have problems and stuff but I keep it bottled up, I don't get upset or sad, I'm almost always in a good mood. I used to obsessively worry about stuff when I was in my teens but as I reached my early 20s I calmed that down a bit.
I can be very defensive about my problems, I have to care for my brother and this has affected other areas in my life for the past 10 years now, I've had to make sacrifices here and there, I've fallen out with my eldest brother in a very bad way, we live in the same house but we hate each other, haven't spoken to each other in 7 months. I don't get sad or upset, I just get angry and defensive. I don't trust a soul with any of my problems. My friend is always telling me that it will build up and that I will just finally snap, but I don't know if that can even happen.
My mum suffered from depression for a while, but it wasn't anything too serious. Regarding sleep, I do feel sleepy during the day, but that could be because my sleep during the night is often disrupted. Also the brother that I look after is epileptic, my friend did ask if I was going to have a seizure but I didn't know, I know there are various kinds but I wouldn't know how they feel or anything.
I fasted the whole of ramadhan (a month) and was fine, not a single problem. I lost abit of weight (5-7 lbs), and slowly I've been trying to build up my appetite. Yesterday I had breakfast at around 9, some toasted bread + orange juice, I had an energy drink at noon, and then almost passed out around 2 I think. I don't think it was due to a lack of energy or anything. I've felt faint before when I've gone ages without eating in the heat, but what happened yesterday was very sudden, I felt hungry then within a minute or so I was close to passing out, eating didn't really make me feel better either.
Asguard said:
I think my breathing was okay, I can't remember being short of breath.
I have made an appointment with my doctor, will be seeing him on Monday. I don't want to brush it off, I need to know what happened and why.
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Enmos
Valued Senior Member
You're not trying to quit some addiction (like smoking, caffeine, etc) or anything like that?
way to late, to be honest its already to late but the further you go from the event the less infomation that can be gained about it. For instance if its cardiac in origion it has oviously resolved or if its an MI its doing ireprable damage NOW. The same for a nerological event, its either resolved or you would still have the issues (unless its a tumor).
All the other things on the list are the same, about the only things you will be able to tell by monday is your base line obs, wether you have a tumor and possibly wether you are having an MI (possibly because by then if it is you could be dead).
Im always irrated by the number of people who think its ok to call an abulance for a sore throat or a cut finger but when there is actually something potentually serious, such as a suden collaps or chest pain or whatever people refuse to use us. THIS is what they (and hopefully me soon) get paid for (herd the same complaint from A&E staff too)
All the other things on the list are the same, about the only things you will be able to tell by monday is your base line obs, wether you have a tumor and possibly wether you are having an MI (possibly because by then if it is you could be dead).
Im always irrated by the number of people who think its ok to call an abulance for a sore throat or a cut finger but when there is actually something potentually serious, such as a suden collaps or chest pain or whatever people refuse to use us. THIS is what they (and hopefully me soon) get paid for (herd the same complaint from A&E staff too)
Nope. I don't smoke, drink or take drugs.
Asguard said:
I feel okay now...
But you're right about the ambulance stuff. At the time it never crossed my mind, I should have gone to a hospital or something just to be safe.
I've a post grad in Clinical Nutrition and Dietetics and another in Advanced Nutritional Sciences - hit me!
Ghost said:
Sounds like a lot of stress. Have you had more than one episode? Anxiety reactions associated with aggression fall into two types: one is the reactive type associated with chronic depression/PTSD and the other is the volatile, explosive type associated with personality disorders. The first type is more common and is usually found in males with high glucocorticoid levels - these men manifest emotions very strongly [the other is what we call sociopathy - the polite young man in American Psycho for instance - and they involve other brain signalling pathways]
From what you tell me, I think you are stressed out, bottling it up only takes it inward and it manifests as psychosomatic problems. You need to work it out - that will suppress your glucocorticoid levels and also increase levels of serotonin and endorphins providing a counter to the adrenaline bursts.
And yeah, do see a doctor and also if possible, a counselor.
Ok so most of the pathways on that list are actually the same, hypoxia
The brain cant store ATP, it has to be made as needed so it needs a constant surply of glucose and O2. Once you cut off the O2 (and its the same for blood sugar) you lose the ability to make ATP, no ATP means no Na+\K+ pump. No pump changes the electrical conductivity of the cells, which means you get an irritable focus firing off when its not surposed to (this works for the heart to BTW except for the next bit). This causes 2 things, odema and siezures (errent firing), if the siezure is doesnt spread you dont get the full tonic clonic and the other general siezures but rather you get more focalised effects. Now if this is in the optic center of the brain you get vision problems, wierd lights, blindness and other effects, if its in the taste center you get wierd tastes, if its in the motor control centers you lose mussle tone and can start shaking. If its in the frontal lobe the only signs may well be personality changes such as agression.
Now i use the word "sizure" generally because its an irritable focus firing off but its the EXACT same pathway for everything, if its caused by low sugar we refer to it as a symptom of hypoglucimia, if its hypoxia we refer to it as hypoxic brain injury and so on but in reality it all boils down to exactly the same thing, a change in the electrical conductivity of the nerons leading to cells deplorizing when they arnt surposed to and on a physical level the potentual for the injury to spread as the cells swell and cause further injury to naboring cells and the problem gets worse, intra cranial pressure goes up, BP tries to compensate if it can but it can only do that for so long and then hypoxia gets even worse.
Its a very vicious cycle which can rapidly lead to death if it starts to feed back on itself.
The brain cant store ATP, it has to be made as needed so it needs a constant surply of glucose and O2. Once you cut off the O2 (and its the same for blood sugar) you lose the ability to make ATP, no ATP means no Na+\K+ pump. No pump changes the electrical conductivity of the cells, which means you get an irritable focus firing off when its not surposed to (this works for the heart to BTW except for the next bit). This causes 2 things, odema and siezures (errent firing), if the siezure is doesnt spread you dont get the full tonic clonic and the other general siezures but rather you get more focalised effects. Now if this is in the optic center of the brain you get vision problems, wierd lights, blindness and other effects, if its in the taste center you get wierd tastes, if its in the motor control centers you lose mussle tone and can start shaking. If its in the frontal lobe the only signs may well be personality changes such as agression.
Now i use the word "sizure" generally because its an irritable focus firing off but its the EXACT same pathway for everything, if its caused by low sugar we refer to it as a symptom of hypoglucimia, if its hypoxia we refer to it as hypoxic brain injury and so on but in reality it all boils down to exactly the same thing, a change in the electrical conductivity of the nerons leading to cells deplorizing when they arnt surposed to and on a physical level the potentual for the injury to spread as the cells swell and cause further injury to naboring cells and the problem gets worse, intra cranial pressure goes up, BP tries to compensate if it can but it can only do that for so long and then hypoxia gets even worse.
Its a very vicious cycle which can rapidly lead to death if it starts to feed back on itself.
Is that right? I thought hypoxia acted through the HIF-1 receptor [Hypoxia Inducible Factor], hypoglycemia through the glucose receptor in the pituitary [or some part of the HPA], and anxiety through the dopamine receptor. But its ages since I poured over neurotransmitters, so I'll need to dig out my faithful Lehninger
I didnt mean anxiaty acted the same way, yes that works on nerotransmitters and whatnot.
As for the rest, your talking about the bodies coaping mechnisiums, im talking about once these are exusted (decompensated shock). Sure a cell can cope for a while being hypoxic but firstly it cant get the same amount of ATP out of each glucose molicule (from memory and this was a while ago its 16 from arobic and 4? 2? from anerobic respiration). In the case of glucose i dont think there IS a back up system at all (ie if there isnt enough glucose its game over, which is why they go unconcious, they fit and then they die), and as for the rest, once you start playing with BP your not actually getting ANYTHING to the cells.
As i said its the same process in every cell but nero cells and cardiac cells have the shortest time from start of hypoxia to necrosis
Feel free to double check because its good revision for me. Sure this will all be on my exam this semester. But i am right about the conditions which cause it.
Can you expand on 'bottling up' in psychological and chemical terms more? I assume you believe that bottling up is more stressful than releasing. Is that correct? It's confusing for me. Hold on let me paint a picture...
So imagine you are living with a roommate that plays loud music. Every day you hear it and get angrier and angrier but are too 'polite' to say anything, until one day you burst. This is a classic example of bottling right?
I'm having a hard time understanding why anyone would act this way. I guess I'm not a bottler. Any information would be helpful.
Usually the body is at a steady state [or should be under a non-stressful condition]. When a person is faced with a stressful situation, example, suppose you step off the curb [or kerb] absent mindedly and suddenly hear a honk which means that you are stepping into the path of a car/bus/truck. This is a stress situation. Your body reacts immediately and goes into fight or flight mode [basic survival mode where car/bus/truck is predator] by initiating these physiological responses
First, your hypothalamus activates two systems: the sympathetic nervous system (SNS) and the adrenocortico system (ACS).
The SNS acts through the nervous system.
- it sends impulses to the muscles and glands to prep them for action
- it sends impulses to the adrenal medulla [near the kidney] to secrete epinephrine [adrenaline] and norepinephrine [noradrenaline]. Both these hormones are released into the blood
The ACS acts through the blood stream - it produces the corticotropin-releasing factor [CRF] which activates the adrenal cortex via the pituitary hormone ACTH [adrenocorticotropic hormone] resulting in the release of a mix of corticol hormones
Adrenaline constricts blood vessels, dilates respiratory vessels and increases heart rate - basically it makes the blood go fast where its needed and ensures its fully oxygenated
Noradrenaline releases glucose from stores, increases the rate of contractions of the heart and increases blood supply to muscles.
The cortical hormones or corticosteroids as they are called are a mix of hormones that have a variety of functions relating to the availability of nutrients, water, electrolytes, releasing fat stores by lipolysis so glucose can be spared for brain and muscle, numbing feelings of pain etc etc - you can look up mineralocorticoids, glucocorticoids, androgens [testosterone, DHEA, DHT]
And you step back from the curb [or kerb] in that split second that all of the above happens. At that point, you can feel the changes: the rapid heartbeat, the heating of the muscles, the sweating, the preparedness of your body, the rise and fall of your breath. All systems are go!
So what happens when you have the same reactions in response to a stress situation where you don't react or you don't respond i.e. you bottle it up. You have all this soup of hormones, glucose, lipids, minerals, oxygen, all ready to fight or flight and you suppress it. This stage is called resistance or coping. You try to deal with this soup of responses by taking some form of action. But if you don't take action, that's also a form of stress. So now you are stressed about stress, adding to the soup. Stress becomes your status quo and you are using up energy stores, taxing your muscles and nerves, pumping hormones into your bloodstream and ... doing nothing about it. This leads to the final stage --->exhaustion.
Depending on the soup, exhaustion can be a breakdown, an outburst, a reactive violent act. Its basically any outlet for that soup.
Hope that was clear.
Great explanation - very clear and easy to conceptualize. Thanks. Shukriya. I was missing the link between stress and fight-or-flight and adrenaline. It makes a lot of sense now.
My mate has recommended I see a counsellor too.
The thing is I don't feel stressed, though there are alot of stressful things in my life, maybe I am just blanking them out in some way, but I do carry alot of emotional baggage. I'd say I'm a nice person (I've never fallen out with a friend), quiet in nature but sociable, friendly etc. but I do have phases were I get agitated and I feel like hurting someone. I can get agitated if someone looks at me in a way I don't like or if he is just standing in a certain way, for no reason whatsoever basically, my face feels flushed, hands start trembling etc. that does happen. I can get into a rage for no reason whatsoever, but at the same time I feel I can control it. I'll just sit down, leave wherever I am etc.
It sounds like multiple independent issues occurring at the same time. The one that stands out as really being bad for you is the mania (the feelings of aggression). You might be Bi-Polar, but rather than having episodes of depression, you may be having episodes of mania.
I've seen a real life decompensation reaction. Its pretty scary :bugeye:
Okay I see what you are talking about now.
Is that right? Cellular apoptosis induced by hypoxia and nutrient deprivation?
bipolar disorders manifest as cycles of depression and expansiveness. The cycles can last for days, months. They interfere with the ability to function normally - I have never heard of a bipolar presentation where the subject has short episodes of aggression and long periods of normal functioning.
Ghost said:
You said you don't feel stressed. How does stress feel, in your opinion? We all function at some level of stress in modern life and we all have to suppress our natural responses or sublimate them. And usually if we cannot direct our anger or energy at the person or incident concerned, it just transfers itself to someone or something else. Even ourselves. So headaches, sleeping too much or too little, eating disorders, irritability, muscle stiffness, cramps any of these can be signs of stress. I bet when you were working out you didn't have as many episodes of aggression, because the physical exercise would serve as an outlet for all the frustration.
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I think that Bi-Polar II may correspond to what you stated via hypomania.
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Sam your working at a level below my knowlage level but i dont think so, your talking about programed cell death. What im talking about is cell necrosis
perhaps this will help you (i honestly dont know i cant understand it at a quick glance)
http://www.pnas.org/content/100/5/2825.full.pdf
As i said what we are expected to know is
no glucose\O2 leads to low (and then no) ATP
No ATP = no Na+\K+ pump
No Na+\K+ pump means higher resting potentual
more positive resting potentual means that the Cells deplorise with alot less stimulas leading to sizures, altered concious state, personality changes and all sorts of other simptoms
Further more it leads to changes in the osmotic pressure gradient leading to water rushing into the cells following the flow of ions
This leads to odema (increased cranial pressure) and further hypoxic injury for other cells
the swelling cell membranes reach there max threshold and burst
perhaps this will help you (i honestly dont know i cant understand it at a quick glance)
http://www.pnas.org/content/100/5/2825.full.pdf
As i said what we are expected to know is
no glucose\O2 leads to low (and then no) ATP
No ATP = no Na+\K+ pump
No Na+\K+ pump means higher resting potentual
more positive resting potentual means that the Cells deplorise with alot less stimulas leading to sizures, altered concious state, personality changes and all sorts of other simptoms
Further more it leads to changes in the osmotic pressure gradient leading to water rushing into the cells following the flow of ions
This leads to odema (increased cranial pressure) and further hypoxic injury for other cells
the swelling cell membranes reach there max threshold and burst