What's a panic attack? Did I have one?

[MooseMom]

I seriously thought about taking myself to the ER last night.

I've been feeling wonky in a number of very specific ways, but I suspect my mind is playing tricks on me.  When you have CKD4, any little thing is certain to be kidney related, and if I read about some obscure side effect of renal disease, within hours I will experience it.   For instance, I am convinced that the vastly increased blood flow through my fistula is making my heart work harder (and I think that's true because I've read that that is what happens), but of course, I can FEEL it.

Then I started thinking about some of the posts I read yesterday about actually starting D, and my mind created images of that very first day and what it will feel like.  It's a life changing event, and I may be ready in all practical ways, but I don't think I'm emotionally ready, and the more I thought about how the world will tilt on its axis the moment that first needle goes into my fistula for the very first time, I physically hurt and was ready to drive myself to the hospital.

Is that a panic attack?  I ended up not going because it was a Saturday night and I couldn't be arsed.  Too many people end up in the ER on a Saturday night.

Then we played Trivial Pursuit, I got distracted and my physical symptoms abated.

I realized how much anxiety I've lived with for so very long, and it surprised me.  I thought it was akin to living with the physical symptoms of CKD; your body gets used to a "new normal" which is actually a "new abnormal", and I suppose your mind does the same.

This is my introspective post for the day.  Maybe one of you has something to add.  Anxiety is painful; it leaves you breathless.

[YLGuy]

Oh MM. I am so sorry.  It sure sounds like anxiety to me.  I know you are well read here at IHD but you do know that our imaginations can get the best of us.  I hope your first time is a long, long time from now but if and when it does come it probably will be nowhere near as bad as you imagined.

[Sugarlump]

Moosey, for me the fear of starting dialysis was immense and a lot worse than the actual dialysis itself.
Try not to panic too much and slow your thoughts down. It is ok on dialysis and not nearly as scary as you think it will be.
When I first saw all the machines, with blood going round them, I thought I was going to pass out on the spot.
But within a couple of weeks it was old hat. It is a life changing event but you can stay in control of this, ask a lot of questions, make
them tell you what they are doing and become an informed patient and be an active part of your treatment rather than a passive one.
Knowledge is the cure for fear, well a lot of it ... to control your panic attacks try and slow your breathing rate down and take time apart to relax.
Me, I run a hot bath, light scented candles, put on some mellow music, dim the lights and chill for an hour. You can take your troubled mind to another place x
You may end up looking like a wrinkled prune when you get out, but its worth it.
Take care xxx

    

[Ken Shelmerdine]

Hi Moosemom. That's exactly how it was explained to me that it'smy mind playing tricks on me. I know how it feels because it used to happen to me pre dialysis. It was on my mind alot at that time imagining how the toxins must be bulding up day by day and I'd be waiting for any sign that would indicate trouble.

One day I got up from a sitting position and my BP must have dropped and I became faint and dizzy. I sat down immediately and that's when I think the panic kicked in. It felt like I was slowly sinking...sinking...down... down I suddenly thought is this what sudden death is like!?.Started hyperventilating and into a sweat and it even put my heart out of rhythm.

I was rushed to A&E and over the next few days had further attacks. In between when my heart was back in rhythm ECG tests showed no heart problem. But the thing is that when I eventually accepted that the attacks were brought on just through my own fear, it never happened again and my heart never went out of rhythm again. I hope this can give you a way to rationalise your fears and hopefully stop having the panic attacks.

I think fear of the unknown can be worse than just fear itself. I have found that one of the worse things about dialysis is just boredom. Just make sure you educate yourself as much as possible about your particular type of kidney desease particularly in the area of fluid retention. If you feel that you are passing as much fluid as you always have and are still doing so at the point at which you start dialysis, then my advice is to insist that they dialyse you for toxin removal only and no fluid removal Because unfortunately dialysis protocol is to remove fluid as a matter of routine from the start without a proper and thorough investigation as to if you really need it.   

[monrein]

The only thing I can add is BREATHING.  I put it in caps, not because I'm yelling at you but because big, deep, slow breaths are so helpful for anxiety. Easy to say, hard to do but very effective.  Focus on the breathing.   

PS I find that stroking my own arm helps too.

[boswife]

oh boy Moosiemom, seems we were just talking about this on another thread and i was so glad to read that at least 'this' was not one of your 'issues'.. I call them 'issues' because that's what im dx'ed with.  Panic, anxiety, ocd  etc.... yea, all bundled together to create a battle of my own.     And yes, it sounds like  an 'attack' is what you experienced.  Of course, and not to scare you at all, but of course you possibly should make sure it's panic/or anxiety and not something heart related, because it surely feels heart related when it's happening and that should be made sure of to further put your mind at ease.. whew,,, a bit long winded there.  .  I went in 3x to ER with what i thought to be heart attacks, and finally was told..... "little lady, your having panic attacks".   Not the dr, but the nurse finally explained.  Oddly enough, like Ken, these stopped once realizing what they were.  WEll, they stoped for a couple years and now, well it's my 'new normal'. They come and go, but i am prone to them if something else is outa whack...  I did learn a 'tapping' method to help with them, and it works wonderfully.  I'll have to see if i can find the name of the method and share it with you.  Zanix about 3 times over the years (1/2 the lowest dose for me..lol  im pill phobic as well and very sensitive to medication) and there great to at least have in my pocket..lol, yep, just knowing they were there could stop the 'need' for one..    All the best for you precious lady that you are.  I read your  writing about "reading something and 'feeling' it within a certain time' and i feel for ya.. Im sure i have EVERYTHING that could be had,,,,,,, well, at least everything i have read about..lol    YUCKY!!

[Hazmat35]

The only thing I can add is BREATHING.  I put it in caps, not because I'm yelling at you but because big, deep, slow breaths are so helpful for anxiety. Easy to say, hard to do but very effective.  Focus on the breathing.   

PS I find that stroking my own arm helps too.

Unfortunately, I have Panic Attacks all the time.  I have a script for Xanaxx, but BREATHING helps you calm down and get back to normal, much sooner. 

LONG SLOW BREATHS IN from your nose, LONG SLOW BREATHS OUT through your mouth.  Repeat several times.  IT works for me. 

[Deanne]

 

That sounds awful! I'm lucky enough that I haven't had panic attacks (yet), so no experience / no advice, but I hope you're feeling better today.

[KICKSTART]

Panic attacks are different things for different people. My breathing doesnt change at all, i get a warning sign of a sense of dread (thats the only way i can describe it) then my heart starts to race and i start to pour with sweat . Some people cant breathe but for me its never happened. Distraction is good , its what ive found works for me. The best thing ive found to stop mine is ..dont you dare laugh ..'bubble wrap' i just sit popping it till it passes ! If you say you actually 'hurt' then it could be your bp. I hurt sometimes with high bp , in my neck and back.

[paris]

I agree, sounds like anxiety.   A full blown panic attack will feel like a heart attack or feel like you are dying.  I have only had 2, both after major surgery.  It would happen the first time I tried to lay flat (instead of propping my head up).  My heart rate raced and I knew if I didn't sit up immediately, I would die.  Of course both times, I had large stomach incisions and couldn't move fast!      It took about 2 months both times before I could lay down in bed without this starting again.   Now I know to avoid that problem.   My brother in law was hospitalized twice for heart attacks but both times they were panic attacks.   Maybe you could try a daily anxiety medication and then the Xanax for the "big" anxiety moments.   Hope it gets better.   

[AguynamedKim]

I'm right there with you, Moosemom, on feeling symptoms as you read about them.  In another of my posts I was having some bad stomach pain that I ended up thinking was pancreatic cancer but it turned out to be mild chronic gastritis, a very treatable condition (likely brought on by becoming a vegetarian).  Most recently I was exercising on an elliptical machine and a few hours later, my right forearm went weak along with some pain.  I could barely hold a pen, turn a faucet or hold on to my phone.  And then I remembered an article I read in the Medical Breakthroughs section here at IHD which was a warning about bogus "stem cell therapy" and the poor guy that tried it because he was dying from ALS.  I remember researching ALS a bit after that and remembered that limb weakness and twitching was also a symptom.  I swear to you, not minutes later, I started twitching.  I had a brief panic attack and had to breath slowly to calm myself down.  Upon further research, since my twitching was everywhere, that was not symptomatic of ALS and within a day, all my twitching stopped.  So I keep looking at the internet (like I promised myself I wouldn't do) and end up thinking that it could be MS.  Oh man, not another chronic illness.  I promised to give myself a week to let it heal and then go see a doctor.  At exactly a week I made my appointment and saw a Physician's Assistance.  I thought to myself, what is she going to be able to do except give me a referral to a neurologist?  I truly have the utmost respect for PAs - I just thought that what I had was beyond her realm of expertise and I was still pretty panicked.  So she does her exam, grabs my forearm, twists it, and we can hear and feel a clicking.  She immediately looks at me and says, "Looks like tennis elbow."  Are you kidding me?  Freakin' tennis elbow?  I've been worried sick this whole time (AGAIN) and it's a tendinitis of my elbow?!  I'm now wearing my brace, taking my Tylenol (I didn't want to take the high dose NSAID she prescribed) and I feel great just a couple of days later. 

So that's my long way of saying it's definitely not just you, Moosemom.  I've decided that along with my kidney condition I've acquire hypochondria and am so sensitive to every little thing.  I'm actually going to speak with my doctor about it and she what she suggests (meds, counseling, both?).  I will say that this is the only thing that's negatively affected my marriage in a long time.  My wife and I are really happy together but this has caused a bit of friction lately as my obsessiveness, panic and worry are really wearing on her and causing her to worry.  So I'm going to try to turn my energy towards something positive like researching how to take care of myself best at this stage and think positive thoughts.  If my negative thoughts can cause this much distress, I'm hoping my positive thoughts can help me along. 

[MooseMom]

Thanks, everyone, for all the advice.  Sometimes it just all bubbles up, you know?

Aguynamedkim, I'm sorry, but your post made me laugh.  Well, it made me laugh at myself.  We could both use lessons on "positive thinking", or at least, "How not to think negatively all the time."

I know that information is power, but I am coming to believe that unfiltered information is disastrous.  Unfortunately, I am cursed with an overabundance of curiosity bordering on wonkiness, so I make the mistake of reading stuff like "Handgrip strength is an independent predictor of renal outcomes of patients with Chronic Kidney Disease."  And then I go test my handgrip.   I am such fun to live with.

Maybe I should be stupider.

I'm all for the use of anti-anxiety meds as a concept, but my current med regimen is working well for me, and I loathe the idea of introducing yet another prescription drug.  I do have some Xanax that my neph ordered that I save for that week between having blood drawn and getting my results (which will be next week!!!), but for the time being, I think I'd rather stick with

1. deep breathing (good advice, Hazmat and monrein)
2.  stop reading about the mysteries of hyperparathyroidism and the role of homocysteine in renal patients
3.  blubbing on IHD as per usual.

Thanks again, everyone.

[Sugarlump]

Moosey, you made me smile after a rotten night (for a couple of unrelated reasons I won't go into)
The doc told me yesterday i have hyperthyroidism (overactive thyroid gland) and I've been busy reading up on the internet and have now convinced myself of all the awful things that are going to happen to me (radioactive iodine treatment and cancer at least as well as Hypomania!!!) and following link to link until I'm convinced I'm going mad! The Internet should carry a government health warning!

I'M sooo glad it isn't just me ...
Thank YOU for making me feel better today 

[Jean]

MM, you are not alone in this either. Dang, if there is a medical problem that is related to kidney disease, I am always sure I have it. But I started to have panic attacks long before my heart attack and before the CKD diagnosis also. One time I was in the swimming pool and could not gather the strength to get out. Scared to death, I just hung on to the side of the pool until I could get my breath back. And then, I got some Lexapro from my Dr. Ah, dang, that stuff works so well !!!

[rsudock]

anxiety attacks are a new thing I am dealing with now...as I sit in the chair I feel like my skin is crawling and my heart is ready to burst. I can only think of one thing...get me out of this  chair! then I get home and I can't sleep and I feel ansy so I just pace around my living room...I'm in Hell...

xo,
R

[MooseMom]

MM, you are not alone in this either. Dang, if there is a medical problem that is related to kidney disease, I am always sure I have it. But I started to have panic attacks long before my heart attack and before the CKD diagnosis also. One time I was in the swimming pool and could not gather the strength to get out. Scared to death, I just hung on to the side of the pool until I could get my breath back. And then, I got some Lexapro from my Dr. Ah, dang, that stuff works so well !!!

I'm glad you found something that works for you!  It must have been awful to live with anxiety like that.  CKD is hard enough, thank you very much.

[MooseMom]

anxiety attacks are a new thing I am dealing with now...as I sit in the chair I feel like my skin is crawling and my heart is ready to burst. I can only think of one thing...get me out of this  chair! then I get home and I can't sleep and I feel ansy so I just pace around my living room...I'm in Hell...

xo,
R

Ah God...that's just awful.  No one should have to live like this.  I am so sorry.   

[natnnnat]

I'm not wriiting about panic attacks here, but I've been really amazed lately at this very thing you comment on: 

Anxiety is painful; it leaves you breathless.

Gregory has been really having trouble with heartburn lately, and the doctor says its anxiety.  Like, really really having trouble.  Can't sleep, mad diarrhea, chest pains, headaches, can't lie down, considering not going to work type heartburn.  I guess its the changes in medications, the big illnesses, and the loss of his mother.  Physical manifestation as pain.  I really hope it eases for him soon.  It doesn't happen to him all the time, and when it's not happening, he gets straight back to business as usual. 

Hopefully you get some relief from these useful sounding suggestions others have posted.  I've tried helping Gregory to breathe deeply when he's anxious in bed at night.  It kinda goes down like a *** balloon.  Meanwhile his version of deep breathing is like, about a millimeter. 

[kristina]

Hello, Moosemom,
 
It always helps me to take a hot bath,
and I listen to my favourite classical music whilst in the bath
and concentrate on my own breathing.

The good thing about listening to classical music is,
that many composers also had terrible struggles
with their own health and – just like us -
they  struggled on and tried their best.
 
In their music they often convey
their feelings and their struggles,
yet, whatever they went through,
how ever bad it was,
and sometimes it was very difficult for them,
they kept composing and it is this tenacity
which if one thinks about it can give the listener
some strenght to carry on with their own struggles.
 
All that always calms me and puts everything in context again.

Good luck from Kristina.

[jbeany]

I just get queasy, and the tape playing in my mind goes on auto-repeat. 

What-if-I-can't-get-a-job-and-then-I'll-have-no-insurance-and-I-think-I-did-that-assignment-wrong-and-if-I-get-one-bad-grade-with-only-a-limited-number-of-credits-to-average-then-it's-going-to-bring-down-my-whole-GPA-and-who-would-want-to-hire-me-then-and-it's-not-like-I'm-not-old-enough-as-it-is-and-what-if-they-won't-hire-me-because-of-my-health-problems-and-now-while-I'm-rerunning-this-crap-in-my-head-why-not-go-over-the-disaster-that-was-my-marriage-that-ended-because-of-my-health-and-his-cheating-and-am-I-ever-going-to-be-able-to-trust-anyone-again-and-even-if-I-could-who-the-hell-wants-someone-with-chronic-health-problems-and-gruesome-scars-so-I'm-just-going-to-have-to-do-it-by-myself-and-be-able-to-pay-my-own-bills-without-help-but-what-if-I-can't-get-a-job........

My current treatment plan:

Pet the cat, sing bad 80's pop tunes, bake something (as long as I'm taking it elsewhere after so I'm not adding stress-eating to my problems), go make something in my craft room, clean my closet and try on different clothes combinations, sing bad 90's pop tunes loudly enough to annoy the cat, dust, scrub the floor, give up on not stress eating and have some chocolate, talk to the cat, starting singing bad 70's disco tunes, vacuum the floor while terrifying the cat, and end back at petting the cat to get all her fur to lay back down. 

In other words, anything I can think of to distract myself from that voice in my head.

Whistling in the dark....

[MooseMom]

What-is-going-to-happen-once-my-son-gets-a-job-and-can't-come-to-see-me-anymore-but-who-will-hire-an-autistic-kid-so-maybe-it-won't-matter-will-he-ever-get-married-or-will-he-die-alone-and-how-can-I-find-meaning-in-my-life-while-waiting-for-my-kidneys-to-finally-fail-I-am-surely-being-punished-for-something-and-my-husband's-mother-is-batsh*t-crazy-and-am-I-going-to-die-soon-my-fistula-arm-has-been-sore-for-days-now-and-I-don't-know-what-that-means-and-now-I-have-tinnitus-and-I-hate-all-of-this-and-I-have-to-think-of-something-to-make-for-dinner-but-what's-the-point-since-I'm-not-allowed-to-eat-anything-anyway-and-the-world-is-continuing-without-me-and-people-are-mean-and-my-ex-couldn't-find-a-flight-for-my-son-at-Easter-so-I-won't-get-to-see-him-until-summer-but-I-may-be-on-dialysis-again-and-then-I-will-be-trapped-here-which-is-my-biggest-nightmare-come-true-repeat-repeat-repeat.

Maybe I need a cat.

Or a bath.

Or some Bach.

[boswife]

ok ya-all        heres a great book for you....  rewind, replay, repeat  by jeff bell.............. yep, something i read (only nearly all the way through due to getting destracted with Dialysis digging desire)  and i 'think' got a lot out of.  Im not saying that you are dx'd with this as i am, but you are *saying* or *wording* the same thigs that i go through having ocd so mabie it could help.  If nothing else, it really gave me a bit of comfort knowing "im no alone" in these things...

[Sugarlump]

What-is-going-to-happen-once-my-son-gets-a-job-and-can't-come-to-see-me-anymore-but-who-will-hire-an-autistic-kid-so-maybe-it-won't-matter-will-he-ever-get-married-or-will-he-die-alone-and-how-can-I-find-meaning-in-my-life-while-waiting-for-my-kidneys-to-finally-fail-I-am-surely-being-punished-for-something-and-my-husband's-mother-is-batsh*t-crazy-and-am-I-going-to-die-soon-my-fistula-arm-has-been-sore-for-days-now-and-I-don't-know-what-that-means-and-now-I-have-tinnitus-and-I-hate-all-of-this-and-I-have-to-think-of-something-to-make-for-dinner-but-what's-the-point-since-I'm-not-allowed-to-eat-anything-anyway-and-the-world-is-continuing-without-me-and-people-are-mean-and-my-ex-couldn't-find-a-flight-for-my-son-at-Easter-so-I-won't-get-to-see-him-until-summer-but-I-may-be-on-dialysis-again-and-then-I-will-be-trapped-here-which-is-my-biggest-nightmare-come-true-repeat-repeat-repeat.

Maybe I need a cat.

Or a bath.

Or some Bach.

Bath is good. Light a candle. Or two. Put music on.
Close your eyes and float. Take yourself away to a good place ...
Cat is good too  *stroking lowers blood pressure* but not in bath ...     

[jbeany]

ok ya-all        heres a great book for you....  rewind, replay, repeat  by jeff bell.............. yep, something i read (only nearly all the way through due to getting destracted with Dialysis digging desire)  and i 'think' got a lot out of.  Im not saying that you are dx'd with this as i am, but you are *saying* or *wording* the same thigs that i go through having ocd so mabie it could help.  If nothing else, it really gave me a bit of comfort knowing "im no alone" in these things...

Oh, yeah, fully aware I'm tipping over into OCD with some of this.  Anybody ever note a connection with prednisone and an increase in OCD symptoms?  I've noticed mine seem to have gotten much more persistent since the transplant. 

Of course, the constant encouragement from my transplant team to become germaphobic is part of it, but it's not just germ stuff.  It's also everything back in it's place, and readjusting the picture three times before it's straight enough, and checking to see if I've put all the right textbooks in my bag at least twice if not three times and the urge to get up out of bed after I've just gotten in to double check that I've done something. 

I know it's really mild, and that no doc would ever diagnose me with OCD, but I do find it interesting how much more I do it now.  I can't figure out if it's the meds or just that I finally have enough energy to actually care what my surroundings look like.

[Sugarlump]

Actually caught myself lining up the tins in the tin cupboard the other day, so that all the labels face the front neatly! Oh no ... do you remember that film Sleeping with the Enemy ?