How To Settle Panic With Arrhythmia, High Blood Pressure Stuff

[Chava]

I just posted from waiting on results in ER (thanks again @Tippi for noticing that post and the support). I felt HORRIBLE. My panic symptoms have changed and it feels like jolting in my chest (not painful) and my heart is skipping a beat. A premature signal is actually being sent out (benign PAC, premature atrial contraction). First time I went to walk-in clinic for ekg. This time I went to ER because walk-in was closed.

The doctor was very nice and tried to explain the PAC to me. They also kept me on monitors while my blood pressure came down (was really high). But they sent me home with tips on what might constitute coming back...with same symptoms I'd need pain, pulse over 120, or the irregular beats to last for more than 20 minutes (even though they do go on for about an hour...??). So I was assured I'm not dying, but I have a very hard time settling myself and not just getting more anxious when I have these heart feelings. I try to rest, but sometimes it feels more helpful to be still but also exert force, like push against the arm of the couch with my feet...so probably like pent-up fight energy (I'm working on this in therapy but I'm doing badly at it, it feels like, because my body-brain is so jumbled). I can't calm my breathing or even pay attention to it without feeling worse.

I have to NOT SMOKE. I know this (easier said than done, damn it). Whatever little tricks I was finding to work with panic aren't working now. I think I'll stick with idea of "resting" but exerting like slow, steady force somehow...but I feel like I've been doing this is in my body for a couple days, tensing groups of muscles, and now I hurt...(though maybe I needed to be pushing that tension out somehow...I have no idea how to deal with my upper body tension when it's getting crazy).

If anyone can relate to this sort of panic, what has helped? I know we have to sort of figure out our body's own processes, but I obviously failed today and am hoping to just feel like I have more choices if it happens again. It does help to be simply reassured that I'm not having a heart attack.:eek: But I think it's more "fight" energy than my body can manage in an orderly way right now.

Plus the whole going to the ER thing and being alone with strange doctors and no family or friends makes me feel further unreal...and stupid (family far away and they'd think this is pathetic anyway...and i'd be too embarrassed to tell my current friends because they don't have panic problems or weird health problems and I don't want them to think I need sympathy really...just want to feel like someone shows up and I don't know how to ask for that kind of support and am sure I'd be rejected or denied anyway, but that's a topic for another post I don't want to mess with)

 

[littlelostchild]

I am so glad there was no heart problem found, but the panic attack can be a tricky one to turn around.

Have you tried progressive muscle relaxation? You tense your muscle groups one at a time starting at the top and working your way down. This might work because you are already pushing against the couch. If you google it, you should find complete instructions.

 

[Chava]

thank you @littlelostchild ...I have heard of the technique but never really understood or specifically tried it...but it makes a lot of sense. I will look into it more and try out a bit since yes, I'm sort of doing this already, though not in an organized or deliberate way. All day I've been tensing large groups of muscles to help them feel better. But as I was starting to feel icky I was almost yelling in my head, "CALM DOWN!" and afraid to go for a walk or anything that might have been helpful. Just good to know tensing my muscles some, or using some physical effort, probably won't hurt me. Aside from benign arrhythmia the doctor said my ekg looks really good.

Part of the problem might still be that I had different heart symptoms a few years ago...blood pressure dropping while pulse was racing, dizziness, etc. I was underweight and my doctor told me not to over-exert myself because I could pass out or have a heart attack. I don't think she was wrong to tell me that, but I didn't have much help dealing with the pent up energy as I gained weight to get healthier...I was afraid to do much, felt I had to "rest" a lot...and just started having panic attacks and developed chronic pain.

 

[Tippi]

@Chava , I know this is just an awful experience. Anything heart-related is scary. I have been to the ER myself when I honestly thought I was having a heart attack and dying, but it turned out to be panic attacks. I went through a terrible period of time when I got them frequently. I finally was able to find a CD with relaxation music and a woman with a soft, soothing voice giving directions on how to calm down, how to relax each muscle group 1-by-1, and how to imagine a very calming scene in your mind to which you could "escape." (Mine was a very peaceful green meadow with a few shade trees near a babbling brook....and I would imagine myself lying down in soft, warm grass, and listening to the water.) It wasn't easy to do at first. I had to practice it a couple of times daily...I guess it took 30+ minutes each time. But as I did it repetitively, it really did help ease the panic. I despise the feeling of panic, the sweating, the rapid heartbeat, the dizziness, the palpitations, the racing mind.......I just hate it. And I would think you'd have even more panic just thinking about past heart problems a few years ago with the racing pulse and dizziness and all. I can definitely understand why all of this is so unbelievably unpleasant and frightening. And I understand about how hard it is just to tell yourself, "Calm down!" The body isn't in a calm state but is in a hyper-aroused state, with adrenaline coursing throughout. I don't think willpower ever helped me at all. I'm so glad your EKG looked good and the arrhythmia was benign.

I know I already responded to your other thread. I hope it's okay that I jumped in, again. I also used to smoke, and I know that didn't help with the panic. It's so hard to quit, though. My husband I did quit, finally, in 2009. It took several tries before we finally did it.

If you could do a bit of research and look for relaxation CDs for anxiety or something like that, you just might find that they provide you some relief. I was really helped by them. There was a time that my panic attacks occurred so often that I used those tapes 5 or 6 times a day. I no longer have as many panic attacks, but I definitely remember how frightening they are. I am so sorry you're going through this.

Let us know how you're doing later. I care.

 

[Chava]

Thanks again @Tippi . I used to go to sleep with Pema Chodron CDs but I've sort of worn myself out on her instructions (not that they don't totally apply still). I will look for new things. It IS hard to be still and try to follow stuff like that. I still have a yoga nidra CD I've never really listened to. But something with PMR and accompanying relaxation stuff might be helpful. And just soothing sounds. If I could find something like low chimes or like healing bowls...mmm...

Yes, I seem to need extra reassurance on the heart stuff. Even though I felt stupid, I was so glad the doctor was nice, patient, and even had a little sense of humor and seemed to really enjoy interpreting and explaining ekg's because he's an ekg nerd and really loves that info...and I felt good having an ekg nerd tell me my heart is okay and not dying.

For tonight it might be a sleeping pill, lullaby station on Pandora if I need sounds, cat, dog, and stuffed animal. And I still have my heart monitor stickers on. I'm a dork. But when I wake up in the morning I hope they remind me to just have a piece of Nicorette (it does work for me but I don't like it as much as cigarettes...but it is way softer on my panic, so feels really important to make a better effort tomorrow).

 

[d-art13]

Heart related stuff is really scary....I hope you feel better soon @Chava

 

[Friday]

I don't think I'd know what a panic attack without cardiac involvement would really look like / feel like.

That's my normal/baseline. Crushing and burning chest pain, irregular heartbeat, resting heart rate at about 120-130. Everything else gets added in on top of that.

Most of the time my panic attacks are over in a few hours, but I did have one run solid for about 4 months. And then intermittently (every day, but only for a few hours here and there each day) for another 6 months. Sometimes they'd kick up out of level 1 (above) into level 2 (shakes, rapid emotional cycling, etc.), level 3 (abdominal spasms), or level 4 (full body spasms, writhing, loss of vocal control). But then they'd drop back down into level 1 soon enough.

((These are my levels. Just how I think of them. I don't know if there is an actual level descriptor out there.))

There's nothing I can do about them... So with 1s... I've learned to ignore them for the most part. Grocery shopping, dropping the kids off at school, appointments, etc. It was a little surreal at first, but it's gotten to where I only really notice if it goes away (OMG my heart stopped!!! ;) Clearly, not. But the surge of panic is usually enough to kick back into another panic attack and I can relax. As ironic as that sounds.). Or if it kicks into the abdominal muscle spasms, or full body muscle spasms.

Mostly I simply remind myself that if I can talk, I can breathe.

That's a swimmer's trick for fear of drowning... And I've found that, at least for myself, it means I'm fine, or at least as fine as I can be in the middle of a panic attack. Even if I'm in a 3rd level (abdominal spasms) as long as I can talk, I can talk myself into up and moving about, and going on with my day.

I joke at my heart stuff / level 1s are "exercise for lazy me", and my abdominal spasms are "sit-ups without the work".

I joke a lot. It's my number 1 tool. Just because I have fear and rage chemicals dumping into my bloodstream... I've learned I don't always have to pay attention. This isn't always possible (4s are impossible, 3s are difficult, 2s are 50/50). Instead, if I can laugh at myself, give myself an "out" I may not be able to stop the panic attack, but I can ignore the physical symptoms and keep my head out of it.

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PLEASE NOTE: I am not telling anyone to ignore what may be potentially dangerous cardiac symptoms. I've been dealing with this since 97-98, this is my normal, and I'm in no medical danger. This is what I have learned about myself, working with medical staff off and on over the past 15 years. If you have been cleared, this is just meant as news that even if this becomes your normal it won't flatten you the way it does in the beginning. Just like with everything else PTSD, there are workarounds. If you haven't been cleared by a doctor/cardiologist, do so.

 

[franciemarnie]

It is terrifying to feel like you are dying! Nothing is so scary as a panic attack because you don't know what will help and it feels awful. I hope you were able to become calm and sleep.

This is just my experience but some people, and I am one of them, become more panicked by "calming down" stuff when anxious. When I used to take tranquilizers, just a single one (not a daily thlng), I would feel worse, like I was physically trapped. It was best for me to tense and then not relax my muscles, or simply walk back and forth. Taking some kind of action to let my body/brain know I wasn't trapped helped me most.

Walking moderately every day is best to maintain healthy blood pressure for me. My husband controls his the same way. Arrhythmias are often caused by stress alone.

So glad you went to the doctor. Anyone who would think you are pathetic for doing so is sick.

 

[Springer80]

This sounds familiar. How long have you had ptsd? The reason I ask is that over a period of time I developed chronic vitamin d deficiency. It gave me pretty much all the stuff your describing. It also increases anxiety, memory loss etc. Could you get your levels checked at your regular doctors.

 

[scout86]

That sounds horrible! I've managed to escape panic attacks (so far anyway) by refusing to recognize "feelings", I guess. So, I don't have any advice on how to cope, specifically.

I AM curious, though. When you were in the ER, did you tell them that you have PTSD, or did they have any way to know that? I'm asking because sending someone WITHOUT PTSD home, alone, with instructions like "You're not actually dying from this, try to relax" seems like asking kind of a lot of the patient. When you think about it, asking someone with to PTSD to relax and not worry about those symptoms is almost funny, isn't it?

I have no idea how to deal with my upper body tension when it's getting crazy).

THIS I can relate to! I don't know if it's practical in your situation, but, for me, exercise actually helps. My theory is that it gets the muscles busy doing something "normal" instead of just tying themselves in knots. A friend, who's an osteopath from the Netherlands, showed me that, when a muscle gets really tight like that, there will be a place somewhere in the mid part of the muscle that is extremely sore. He said to push on the spot with my fingers, as hard as I can stand it, until it quits hurting. It DOES quit hurting. Apparently it triggers something that shuts down the muscle spasm. I have to repeat it often sometimes, but things eventually quiet down. I've started to notice that certain muscles get tense when I'm stressed. (So now I have a way to recognize "stress". "Oh, my shoulder is getting sore, I must be tense." LOL)

I hope you're feeling better and are finding ways to cope!

 

[Chava]

thanks everyone...not feeling very good but will try different responses to crazy stuff in body today...

@FridayJones , yeah we probably all have slightly different responses or "levels"...body spasms and vocal problems don't feel very physically threatening to me, so lower anxiety than my arrhythmias, but I don't really have levels as much as really different versions of panic I'm yet trying to sort out.

@franciemarnie thanks...I relate to the NOT calming...and lately holding tension feels better...and lots of muscles together. I just noticed my left hand and leg have been tight for a long time, but they seem to be strong enough to deal with the tension. I tried some swimmer-like kicking this morning when feeling sick, and that seemed to help a little bit in that moment.

@Springer80 ...thank you, glad you got a good eval. They did all the blood work (electrolytes, thyroid, blood sugar) and so far okay. I've had sodium and bloodsugar numbers off in the past but my nutrition is really good. But I hope they aren't missing anything. I do have a history of rough health and I'm just small, still verging on underweight though recovered from eating disorder...as in maintaining an acceptable weight, though on the lowest possible end.

@scout86 No I didn't mention anything about ptsd but said I realized it might be partly panic...I just wanted to know what the ekg said. I guess I wouldn't expect them to know how I should calm down if I can't even figure it out within trauma therapy. An ER doc wouldn't know much more than writing out a prescription for valium or something my regular doc thinks I shouldn't take.

My upper body stuff is such that if I apply pressure, or let a massage therapist or physical therapist do any manipulation, the pain blows up into worse pain + panic...like I feel like I'm dying or I want to kill myself....so pain syndrome responses plus triggers in there. So I tend to not mess with it...but that does help for other muscles...pressing on my feet helps, or massaging my jaw (usually tight muscles in my face)...so still figuring out what helps, what doesn't. It's a pretty sickening game but I don't have other reasonable choices. For tension I kind of feel like kicking a hole in the ceiling today (not possible, but maybe I can imagine!)

I was a little annoyed the ER doc told me to come back if the arrhythmia lasts for more than 20 minutes. By the time I was in ER to have it checked it had been going on for about 1.5 hours. So, probably I'll just end up back there if I can't find ways to settle...and I can remind any nurse/doc on staff that these were my guidelines.

 

[franciemarnie]

I don't think this is what you had, but I will just put this out there too.

There are two ways I know from my body that I need to cry to release body discomfort.

One way is foot pain. When I cry, it goes away immediately. Learned that by accident.

The other way is when it feels like there is a race track around my heart and my breathing gets short and fast. If I can cry, the heart stuff goes immediately away.

Only took me 50 years to learn these things!

Hope you are feeling better today.