Anxiety, Part Four: Blessed Quiet. (Also: My Heart Is Odd.)

So over the past several months or so, I’ve been discussing the physical manifestations of my anxiety. There was one more piece of the puzzle that I assumed was also due to me being full-bodied freakout, but turns out, my body is not a flawless machine in all of its various glories. There are some things that anxiety doesn’t cause.

About six years ago, I was exercising on the elliptical when suddenly my heart decided to throw an EDM party. It felt like a sudden intense fluttering in my chest and throat. I flapped around the house like a demented bird for ten minutes while my brother and his friends looked on in confusion, until finally I drank some cold water and felt like a gun went off in my chest. My heartbeat resumed as normal. It freaked the hell out of me, but I thought it was an anomaly and life went on as normal.

I had always experienced heart palpitations and stress, but this was different. It felt like I couldn’t control it and that nothing I did could prevent it from happening. It would come on and off for the next several years. Sometimes it would happen after I drank too much coffee, but other times I had barely taken any caffeine. Other times it would come while I was exercising, or just changing my position in the classroom. I found various ways to stop it – drinking cold water, holding my breath and bearing down like I was going to the bathroom, massaging my throat.

Last year, it happened twice. This year, I got a sinus infection and since then it has happened four times (I would find out later that sinus infections can trigger a response in my condition). The last time it happened was when I was jogging in Cape Cod. I ducked into a bathroom to try and rid myself of it, but the more I panicked, the more violent my heartbeat got. I finally got rid of it by downing some ice cold Powerade, but the panic remained, and after I sobbed hysterically for an hour the next day to my (INSANELY PATIENT) boyfriend, I got on the phone and called a cardiologist. This is the same guy who makes sure my Dad’s heart doesn’t explode, so you know he’s gotta be fantastic.

My parents had been telling me for years that this heartbeat thing was the manifestation of my anxiety, and I was worried that the cardiologist would tell me to relax (I’m trying), not drink any coffee (I’ve quit) or do yoga (Obviously). My primary care physician, although a wonderful woman, couldn’t do a lot for me in this area, so I feared I would get just a basic consultation and be sent home with at best a monitor and the worry that I would just have to wait for this horrible palpitation thing to happen again before I got my answers. Nothing could be further from the truth.

After an echocardiogram – which was the coolest thing EVER – I sat in a doctor’s office as my Dad’s cardiologist strolled in, shook my hand, and proceeded to listen very intently as I described my symptoms. He nodded throughout, and stopped every once and a while to ask if I knew about Vagal manuevers. When I told him I did, he took off his stethoscope and handed it to me. “You’re going to steal my job!” he joked. I instantly relaxed. He then proceeded to tell me that my heart structure was perfectly normal and that everything they could see in my heart looked fine. That was a relief, as I didn’t want them to tell me I had some sort of enlarged heart or anything like that (the sudden death of athletes like Reggie Lewis terrified me as a child).

Then he told me that my original assumptions – that I had some kind of tachycardia – were correct, and he was officially diagnosing me with av nodal reentry tachycardia. “Basically, where most people have one pathway in their electrical pulses in the heart, you have two,” he explained, complete with doodles on a notepad. “And sometimes, the pathways will get mixed up and the heartbeat will get stuck in a pattern.”

“Like a rotary?” I asked, and he laughed. “Yeah, like a rotary. Or like a skip on a record.”

He then proceeded to tell me that this is a genetic condition, and that nothing I’m doing – nothing I’m eating or drinking or thinking or feeling – triggers this to happen. He did tell me, however, that I should drink electrolytes since this is an electrical thing, to which I responded “I drink a Powerade every day” and he laughed.

So, what’s the next step? Vagal massages (pushing on one area of the throat that will kickstart the heart and make it beat normally), and if that doesn’t work, medication! He prescribed a very small dosage of a beta blocker, to be taken at night. He told me it would possibly cause fatigue, but other than that it wouldn’t hamper any of my activities. He was quick to tell me that if the medication didn’t work, I should undergo a catheter ablation (in which the extra electrical pathway is burned off, which carries a 97% success rate). If I didn’t go on medication or get the ablation, he said, “This will get more and more frequent. It’s not life-threatening, it’s a pain in the butt, and it really interferes with the quality of your life.

“I know you’re a teacher,” he said gently. “And I don’t want you to spend your life terrified that you’ll have this when you are doing a presentation or you’re at a conference. You want to make sure it never happens again.”

“You read my mind!” I exclaimed. I’ve only had an episode of this happen once while teaching and it put the fear of God in me enough that I never want it to happen again.

So I decided to go down the medication route but with the idea that I’d be on it for about a year and then consider the ablation, mostly because I just don’t want to be on medication forever. However, I did some research on the beta blocker he was giving me and realized it was also used to treat anxiety, because it blocks adrenaline. I told my Mom about this unexpected side of the medication and she laughed. “Maybe you’ll kill two birds with one stone!” she said. Could it possibly help?

So Thursday night, after my shift at the bookstore, I lay in bed, opened up the cap of the medication, and popped one. Within ten minutes, I was the most relaxed I’ve been in months. The next day I woke up and did my workout, and was able to do more than I’ve done in a long time. It’s not that I felt numb; it’s that my anxiety was blunted. I just was. At one point my sister asked me if I felt like I was drunk. I responded, “You know how you feel after a glass of wine? That’s how it feels.” I should say that it’s how most people feel after one glass of wine. For me, a glass of wine makes me unable to form coherent sentences.

Several years ago, Wil Wheaton described the feeling he got when he went on anti-anxiety medications as “It’s like I was in a loud room for so long, I didn’t know how loud it was.”

Yes, this medication is being used to treat an anomaly in my heart that I’ve probably had since birth. And I probably can’t drink alcohol or coffee anymore (my medication can cause fatigue and alcohol probably wouldn’t be smart with heart medication, and coffee would counteract the medication’s evening out of my heart rate). But it’s also doing the other blessed gift of helping me with something else I’ve struggled with all my life – my inability to turn off the suffocating noise in my head. This medication is like someone reached in my brain and lovingly flipped the noise to soft. 

It’s not gone entirely, of course. But it’s at a decibel level I can live with. And I’m not afraid of the fall semester anymore. That is an irreplaceable feeling.

If you have any of the symptoms I described in this post – please go get that shit checked out by a cardiologist. I know it’s scary, but it’s not life-threatening and it will honestly save you a lot of anxiety and worry if you get it properly diagnosed. And there’s tons of treatment options, too.

If you are considering going down the medication route for anxiety and depression – of course get consulted first by a professional, but when they are prescribed correctly and in the right amounts, they can vastly improve the quality of your life.

Everyone deserves a calm brain and a good heart. I’m glad I get the opportunity to experience both now.

ally

PS. You have no idea how hard it was to not break into “The Electric Slide” when I was told my heart had an extra electrical pathway. It’s ELECTRIC, boogy-woogy-woogy!

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