What causes swelling in the uvula while suffering from panic attacks?
Patient: I am curious about something that s happened a few times to me now. This is embarrassing, but I really want answers so I m asking here. My uvula will sometimes swell to the point where it can lay down on my tongue. I don t suffer from any anxiety disorders, but each time this has happened, I ve had a panic attack and hyperventilated. In my head, I KNOW I m not suffocating/ choking, but the constant swollen pressure inside my throat makes me agitated, sweaty, and manic. It s like my body is in terror, but my mind is saying There s nothing to worry about. It feels like I can t breathe (which ironically makes me hyperventilate) and it triggers my gag reflex. It s incredibly stressful. I start to shake, hyperventilate, gag, sweat, and experience panic despite the head knowledge that I m really not in danger. It s hard to explain what it feels like to feel your uvula touch multiple sides of your throat. It feels like my throat is clogged (because the contact is the circumference of the uvula) and I unconsciously swallow to clear the obstruction , which only makes it worse. If it matters, the sensation feels like I ve got thick mucous on my uvula, so I feel the need to repeatedly swallow. I suspect the swallowing inflames my uvula which makes it grow WAY bigger. Then it becomes hard to swallow and the sensation of having something stuck in my throat makes me feel like I m choking. In reality, I can still breathe, but it certainly raises all the alarms physiologically that I am choking/suffocating. I m a normal weight (170 lbs, 6 foot tall, 27 year old male). The panic attacks only ever happen AFTER my uvula swells. The uvula swells over the course of hours then stays swollen for hours more. At a certain critical mass, I feel the sensation of having the uvula down my throat which feels like I m choking. Additionally, my saliva glands go into overdrive. Since I can t really swallow, I m left leaning forward over a bowl and spitting to keep my mouth from filling with spit (which only exacerbates the sensation of drowning/ choking/ suffocating). Leaning forward also keeps the uvula from going down my throat though, feeling it lay on my tongue isn t exactly a huge improvement. This only happened 4-5 times in my life and all within the last 3 years. The first three times this happened, I ve gone to an emergency room. Each time, steroids reduced the swelling. I ve been referred to an Otolaryngologist about surgically reducing the size of my uvula. However, when the swelling goes away, my uvula is quite small and it s not medically necessary to do surgery. I ve had blood panels taken before by the ENT to see if I had some rare condition that caused the repeated swelling. Negative. The doctor suspected that I had strep throat, which can uncommonly cause swelling. However, I ve noticed that 4/5 times these swelling episodes happened, I ve had dry mouth due to Vyvanse or Mydayis. When on these medications, I swallow a lot more and my mouth often feels uncomfortable and a little swollen. Right now, as I write this, I am experiencing that same mucous in the back of my throat that makes me want to swallow sensation. If it becomes necessary, I ll see a doctor if it swells more. Are there any medications I can discuss with my doctor that can alleviate this problem? Final stipulation: my family has a history of drug abuse. With the sole exception of Mydayis (previously Vyvanse), I avoid any addictive medications and ask for alternatives that don t come with the risks. I love my life and I ve seen too many loved ones lives ruined by addiction. So if there are non addictive medications I can take to help, I would love to know what they are so I can consult with my doctor about taking them. Additional information: I have tried taking Advil to reduce the swelling. Any reductions in swelling weren t noticable. I ve tried Benadryl in case I m allergic to something (could be anaphylaxis for all I know), still no alleviation of my symptoms. Each time I ve gone to the doctor, it has taken multiple rounds of steroids (shots, don t remember the brand/name) to relieve the swelling. I suspect if I could take medication when I feel the uvula begin to swell, I could altogether avoid these episodes. However, I can t afford to see the doctor each time I SUSPECT it s going to happen. More often than not, the swelling has been minor no worse than a mildly sore throat. But 4-5 times have progressed to the point I described. Doctor: Hi,  Panic attacks come under the anxiety spectrum of disorder and need to be treated fast. Due to anxiety, several neurotransmitters start malfunctioning.  Hope I have answered your query. Let me know if I can assist you further.