Hey steemians, hope our day has been good. I want to share an experience i had today with you.

As you may know, if you follow my blog or previous posts, i'm a medical practioner and i enjoy what i do, at least sine i left medical school. I never had a phobia for blood, i was already killing and disecting lizards and insects at age five, i enjoyed my Anatomy dissection sessions where we worked on one cadaver as a group it was all skeleton left, i have done and assisted several surgical operations and i'm studying to become an Anaesthesiology specialist (i.e. doctores in charge of putting a patient to sleep and ensure they don't feel pain during surgeries).
I was called today to assist in an operation, i have not been involved in one in about 3 months but i was not perturbed till it happen again.

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So What happened?

you may ask, i also am asking myself the same question since i was trained to make 70% of my diagnosis without laboratory investigations but i cant seem to place a finger on it though i have several possible answers (differentials as we call it).

History

1st episode

As a 4th year medical student i was very excited to observe my first surgical procedure, once again it was no big deal as I had worked with cadavers as i earlier mentioned, I got into the theatre and was observing the surgical procedure before i noticed i was becoming light headed, dizzy and feeling faint, i could feel my heart beat faster and had a sudden urge go visit the toilet. I ran out of the theatre, eased myself and got a bottle of coke to calm my nerves.

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I had all the symptoms in the picture above except choking and a sense of dread. All inclusive qualifies for a panic attack but I thought to myself it was because i didn't eat earlier in the day and maybe i couldn't stand the smell that emanated as the diathermy machine was used to cut the skin. That was the only episode that year as i stopped spending so long in the theatre at a time and always made sure i ate and had an extra drink.

2nd episode

This was in 5th year in my first autopsy session. It was a requirement for all medical students to attend several and give reports on the possible cause if death if the patient. Once again i was confident, i had dissected cadavers myself and i had attended several surgeries. This time though was different as the autopsy is done in the morgue. The feeling of being amongst the dead was overwhelming. The subject was a police officer, who died less than 24 hours on admission, as such a coroners autopsy must be performed. He was HIV positive and was dead less than 24 hours. The autopsy began and there was fresh blood coming out, all the internal organs had been destroyed by the illnesses that come with AIDS. Then it got to the point of sawing open the skull to study the brain, thats when it happened again. I just couldn't stand it, the sweating, fast heart rate and feeling faint came hard on me with a very urgent need to ease myself. I ran out, eased myself, got a drink and calmed myself down. I didn't bother going back to sign my attendance or get the report. Well it was part of my requirements, so i had to attend the subsequent three sessions to get my reports done. I did all that without any subsequent issue.

Today

During my internship program, i had occasional dizziness in before and after surgeries but nothing significant happened, i did and assisted a whole lot till four months ago and i felt i had out grown it all until today. So the patient had been prepared for surgery with all the necessary pre-medications given by me. I was to assist the operating surgeon and we had another doctor on standby. Then i felt it, dizziness, weakness, sweating and feeling faint but thank goodness there was no urge to use the toilet. I simply explained to my colleagues, removed my sterile gloves and sent for a bottle of Coke. I went into an office, calmed myself down and walked back into the theatre before the Coke arrived. I must say it wasn't that bad and i feel i was just being extra careful.
Like i said earlier, i'm giving this history cos i want to make a diagnosis. A panic attack comes to mind but there is more against it than for it from my history.

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Panic attack is defined as a period of intense fear in which 4 of 13 defined symptoms develop suddenly and rapidly peak within 10 minutes from onset. These symptoms are

1. chills or hot flashes
2. fear of dying
3. chest pain or discomfort
4. nausea or abdominal distress
5. feeling dizzy, unsteady, lightheaded or faint
6. fear of loosing control or going crazy
7. numbness or tingling sensation
8. sweating
9. palpitations, pounding heart,or accelerated heart rate
10. sense of shortness of breath
11. decentralization (i.e. feeling detached from oneself)
12. trembling or shaking
13. feeling of choking

The other possible causes which to me are more scary include

1. Asthma
2. Acute coronary
3. Acute pericarditis
4. Pulmonary embolism
5. Myocardial infarction
6. Heart failure
7. Acute respiratory distress syndrome

The list goes on and like i said i'm in a diagnostic dilemma. I leave the power in your hands, do i see these episodes as nothing, a panic attack or one of these scary differentials?

I'll welcome your comments.
Cheers