lightheadedness, fatigue, shortness of breath

For the past 8 weeks or so I've been experiencing some relatively bizarre and (so far) unexplained symptoms:

I went to visit my family in Dallas for Thanksgiving. The day after Thanksgiving, I was riding with a friend to meet up with my brother and cousin at a local bar to watch a hockey game. On the way there, though, I started experiencing some inexplicable lightheadedness, fatigue and (most notably) shortness of breath. I tried to play it off, but the feeling(s) started to increase rapidly -- ultimately, to the point where I seriously felt like I was going to die. So, as a result, I convinced my friend to take me to the ER.

By this point I'm admittedly panicking. To expand a little more on the symptoms:

* The most disruptive one is difficulty breathing. I feel a definite tightness in my throat, but it's kind of coupled with a tightness in my chest. That's accompanied by an ache that feels kind of fluish. Like, when you go for a jog when it's cold outside and you breathe in cold air too deeply for too long...that kind of ache.

* The fatigue can get to the point where I almost feel like I'm about to lose consciousness. However, it kind of doesn't bother me all that much because, to be honest with you, sometimes when this is going on, I wish that I would lose consciousness so I wouldn't have to deal with not being able to breathe. I know it sounds morbid, but it is what it is.

* The lightheadedness is almost always accompanied with my hands and feet becoming uncomfortably and noticeably cold. When this is happening, I'll usually have momentary bouts of confusion. — Weird, right?

Long story short: every nurse and doctor in the house decided to weigh in on my issue. By the time I left, the possibility of hypoglycemia had been introduced to me, as well as asthma, an acute allergic reaction and, of course, the blanket answer; panic attack. So, they basically pump me up with Valium, write me a 10 dose prescription for Xanax and send me on my way. By this time, I'd pretty much accepted the fact that I'd had a panic attack. The Valium seemed to help in that, my symptoms were still there, but I wasn't flipping out about them anymore. I went to sleep that night assured that everything would be back to normal when I woke up.

Well, it wasn't. In fact, I've had the same symptoms pretty much 24/7 since that evening, even after returning to Phoenix. Of course, the degree(s) vary and not all of the symptoms are constant (except for the difficulty breathing -- no matter what. The fatigue and lightheadedness only come in what I'd refer to as "attacks" which can last anywhere from 15 minutes to 2 hours and happen anywhere from 1-3 times a day (mostly at night, for some reason).

Since then, I've had two extensive physicals from two different GP's. Blood work, x-rays, EKG's, breathing tests...you name it, I've done it...twice. And, surprise-surprise, I've got no answers. -- It should be noted that the first Dr did make it a point to A) not listen to anything I said and B) treat me like I was completely out of my mind. After two visits with her, she had written me prescriptions for Xanax, Celexa (sp?) and some sort of bizarre "blue starter kit" for bi-polar disorder (after I had a really intense adverse reaction to the Celexa).

Dr #2 has come up with zilch, also after two visits. But, on the bright side, they're actually trying to treat my symptoms. On the first visit, I was prescribed an Albuterol inhaler and Bioxcin for acute bronchitis. This surprisingly seemed to help a lot for the week I was on it. The constant pressure and ache in my chest and throat was still there, but I felt a definite change for the better after Day #2. However, that was about a 5-6 weeks ago and the symptoms were back in full swing after about 6-7 days after I started taking Bioxcin.

So, now what I do in between fruitless Dr visits is basically try to deal with the symptoms as they come with a cocktail of Ibuprofen, Xanax and Albuterol. The Ibuprofen seems to alleviate the swelling feeling I get in my throat and the aching tightness in my chest to some degree. The inhaler is a nice touch, but it only helps to a certain extent. The Xanax is kind of last resort for me. I treat these little guys like they're radioactive (a few years ago I became desperately addicted to benzodiazepines - namely Xanax - and it was a long, hard road getting out — needless to say, I don't want to deal with that again). I usually only take Xanax before I fly, as that can be particularly stressful on my breathing condition or if things get to a point where if I don't take it, I'll eventually just get so worked up that I'll aggravate the symptoms. To give you an idea of how much Xanax I take: I was prescribed 30 .5mg tabs with refills every 30 days. That was about 7-8 weeks ago and I've taken about 12 of them total. In that time, I've taken 3 round trip flights.

Does anybody have any idea what's going on here??

Now, while I appreciate all input on this topic, if your answer is anything along the lines of "panic disorder", please don't waste your time posting. I've dealt the panic my entire life (see: benzodiazepine addiction) and this is not panic. Believe me, I know. However, I will admit that I do in fact panic from time to time when these symptoms occur. But I think it's a natural panic. As in, if I didn't panic sometimes when this is happening, I might need to consider the fact that I'm dead. Imagine laying on your back while 12-year-old kid balances on your neck and upper chest and tell me that wouldn't make you just a little uneasy. In fact, since I've been dealing with this every day for like, 2 months, I've almost become blasé about the whole thing (EG the panicking has all but died off entirely — now I just sort of sit and wait for the attacks to end).

Aside from that, I invite any thoughts or theories you might have. I've seriously considered everything: thyroid complications, asthma, allergies, "valley fever", bronchitis, acid reflux and, yes, even panic.

Some things that might be important to know about me:

* 24 year old male
* Average height, weight, build etc.
* No known preexisting conditions
* Up until these symptoms, I was pretty physically active — however, I've been slowed to the pace of a turtle
* Recently quit smoking about 3 months ago
* Strict pescatarian diet (vegan, except I eat fish/shellfish)
* I've lived in Phoenix for about 4 years (some people seem to think this is important to know)

P.S. A couple of things that I forgot to mention: for some reason alcohol and coffee seem to either aggravate or actually cause these attacks to occur. I can't really tell which. I realize that I might just be a little too analytical but coffee has been one of the only common denominators in all of these attacks. Oh, and I'm also developing a slight cough when the breathing thing really clamps down...so...fun. Anyways, I thought those were all noteworthy. Do with them what you will.

Thanks in advance!