Around Nov, I started amitriptyline. It was great. For the first time in forever, I could sleep without burning legs. About a month in, I started getting the sensation that food was sticking to the back of my throat. Doc thought it was from dry mouth. As per doc's directions, I switched meds to nortriptyline. It was not as effective with pain, but I had incredible energy. Two months in, I had to stop because I was having panic attacks at night and chest pain.

I tried gaba, but it did nothing. So, I decided to try the nortriptyline again because I had a full bottle left. Did not ask my doc about it, just did it. Yesterday was 2 weeks in.

I have been having difficulties swallowing pretty much since Dec. Food will sit in the back of my throat, but not go down. I decided to not call my neuro again because it often feels like I am a hypochondriac.

This past Thursday, I was eating supper. Fortunately, my son was here with me. A piece of chicken got stuck as I was swallowing. I could not get it to go down. It was lodged in such a way that I couldn't breath, but I wasn't choking. My son ran to get his phone to call 911. By the time he got it, I was able to get the food down with lots of water.

Now, the perfect storm. I quit the nortriptyline and haven't taken any since Thursday morning. So, I am having panic attacks that I might have inhaled some of the chicken. Of course I am in pain because I have sfn. My chest is hurting, but it always does. I am exhausted, but I always am. To be on the safe side, I have not ran any since this happened.

The paranoia is real. At night I panic thinking what if I inhaled some of it and I die from pneumonia. I have NO signs of pneumonia. I think I'm going crazy. Plus, I am scared to eat. I put posters up at my job and on my fridge showing how to assist someone who is choking just in case. I also told my co-workers that I am having some issues swallowing food.

On top of this, my body is having all kinds of strange sensations because I quit the nortriptyline. I am so frustrated. Not sure what to do. I hate that it's Saturday. I don't know why I didn't just go by the doc's office yesterday and make sure that my lungs are fine. Someone please tell me to chill.

I wish I was a doctor and could give you some professional advice, but I'm not. I do know, as I'm sure you do, that quitting nortriptyline cold turkey after even just 2 weeks will most likely cause anxiety-like withdrawal symptoms. Throw in lack of sleep and the perfect storm you mentioned has arrived.

Racing thoughts and fear will most likely intensify your symptoms, we all know what effect it has on nerves in sfn. I think you need to try to rationalize your situation from a clinical perspective. (I know, not easy) If you have no symptoms of pneumonia, you most likely did not aspirate any food. Keep in the back of your mind, you can always call your doctor if needed for reassurance, or to ask advice. I'm sure they are reachable on a weekend.

I think the swallowing issue will be hard to ignore going forward since it's such a normal daily occurrence and something we can do involuntarily. Have you been checked by an ENT? In an office visit they can examine your throat for issues and even diagnose GERD which could be a cause. It's not nearly as expensive or time consuming as an upper GI or upper endoscopy.

I know you said the gaba did nothing, but amitriptyline/nortriptylene will definitely cause more dryness than gaba. And the gaba does provide some anxiolytic relief and would probably help at night with sleep. Perhaps you did not have a strong enough dose? It might be worth discussing with your doctor.

I've been in similar situations in which I've experienced strange irregular heartbeats that have caused anxiety, which of course made the situation worse.
Doing things to take your mind off the current situation can be a big help, just reassure yourself if you needed help, it's available.

It's strange that these weird things seem to occur right before, or on a weekend when we feel access to healthcare is not instantly available. Lastly, I don't know how populated your location is, but if you're not happy with your neurologist, or reluctant to call them for fear of being labeled a "hypochondriac", it may serve you well to begin a search for a more sympathetic doctor. The more I read about sfn, the more it appears it's a journey to find the right one.

So please chill. I hope you feel better as the weekend progresses.

P.S. If you're a teacher, you probably knew all this. My daughter's a teacher and she knows everything.

its not good to quit any of these medications cold turkey. titrate down slowly to avoid side effects or other complications . some such as anti seizure medications, ( gabapentin, lyrica) can actually cause seizures if not titrated down.

as far as aspiration pnuemonia is concerned, you will know that you are developing it due to wheezing, coughing, chest pain, rapid breathing etc. unless you develop those symptoms i would try to relax about it as much as possible and move on. if you start to get sick, then you deal with whatever comes up when it comes up.

I plan to call my neuro tomorrow because I am a little nervous about my swallowing problems. I have also been noticing weakness in my hips. When my SFN journey began, I also had high amounts of antibody jo-1 which is associated with polymyositis--a disease that attacks muscles. I am a little fearful that this is related. The weakness in my hips is very similar to what I experienced back when jo-1 was present.

I appreciate the calming words. I kept reminding myself that nortriptyline had the same effect on me last time. I had panic attacks when coming off of it. Last night was much better. Hopefully I didn't take it long enough this time to have long lasting effects.

I hope everyone has a happy Sunday. I plan to actually go out and try to run a little, not far, just enough to get my mind right.

Hi Teachermom,

Just a suggestion that may calm your nerves a bit would be to see an ENT doctor...they can take a close look see with a scope in other to rule out anything else that may be happening. I just had such a procedure a few weeks ago because a recent MRI showed a possible cyst in my throat....I felt better after seeing the ENT doc.

Hope this helps.......

Wishing you a great run,

Cliffman

You might want to post on our Myasthenia Gravis forum here.

Muscle weakness and swallowing problems can be symptoms of this.

The members there are very helpful and can suggest tests you can get.