Thursday, February 3, 2011

Fighting My Demons

The issues I have with my back are very real.  The way that my body reacts at the onset of any back discomfort is not - it is more psychosomatic.  I have come to realize, on my own, that what has been plaguing me is anxiety attack.  This realization was recent, a few days before this past Christmas day.  The first couple of incidents of back discomfort about a year ago happened when I felt like I was in a vulnerable position:  Severe neck discomfort and getting dizzy shortly after my arrival in the Philippines during my visit in December 2009, and back pain and neck discomfort during a short flight from Venice to Wiesbaden in January 2010.  Back then, I did not know what was causing the back pain, neck discomfort, and the lightheadedness.  Along with these symptoms, fear crept in on what would happen to me if I were to pass out.  My body had learned to react this way whenever I started to get back pain -- a reaction that includes lightheadedness, tightening of the neck muscles, heart palpitation, and the worrying.

The doctors in the Philippines indicated fatigue and elevated blood pressure as the likely cause of the dizziness.  I was not convinced.  Shortly thereafter, I saw my doctor in Seattle for a complete physical.  He did not find anything seriously wrong.  He counseled me about losing some weight, and prescribed blood pressure lowering medication.  The doctor stopped the medication after 60 days, after a follow up visit in late February 2010.  In between, while in Germany, I was doing a regimen of walking to work and walking back home in the late afternoon, as well as regular back massages.  This seemed to do the trick. 

During this period, there were no incidents except during a plane trip from Venice to Wiesbaden, and a minor incident in the middle of a haircut in Wiesbaden (I had to tell the barber to hurry up and finish because I felt like passing out).  There were no issues during my one week in Seattle in late February 2010 preparing for my move to Abu Dhabi.  During my 2+ weeks stay in Winchester, VA, for orientation to the new job and while waiting to move to Abu Dhabi, I saw a massage therapist for my back discomfort.  The massages seemed to help alleviate the recurrence of the bouts I had experienced previously.

After my arrival in Abu Dhabi, I experienced several bouts early on.  While in Abu Dhabi, I had been scheduling back massages twice a week for the first few months.  In early July, the bouts with light-headedness returned and occurred regularly.  This spurred a visit to a local doctor.  This doctor had mentioned that it may be anxiety attacks that were causing my lightheadedness.  I discounted what my doctor had said and merely responded that there was no way it was anxiety.  I told him that there was nothing I could be anxious about. 

Just to rule out other causes, the doctor in Abu Dhabi recommended I see other specialists and have a battery of tests performed.  I saw a neurospecialist and a cardiologist.  I had an MRI done on my neck and brain, EEG test for brain response, and EKG test and other tests to my heart.  All the tests showed no abnormality.  You would think that this was enough reassurance for me.  I continued to get recurrence of the lightheadedness, along with the heart palpitations and other symptoms such as tingling and numbness of hands and legs, especially on the left side.

I would have canceled my most recent trip back to the Philippines, but I already purchased the ticket.  While in line for the check in Abu Dhabi for the flight to Manila, I felt weak, enough to kneel down by my luggage for a moment to gather some strength.  Again while in line to go inside the plane, I felt the same.  Once I made it inside the plane, I made sure to inform one of the flight attendant that I was not feeling well.  She gave me two aspirins.  I felt fine once the flight was underway and all throughout the flight.

While in the Philippines, I had several bouts.  The day after my arrival in Manila, I experienced it while at a mall, while waiting for lunch, and during the drive back to my sister's condo.  I had attributed these incidents to the long flight, the busy traffic, and the bumpy ride during the drive.  There were also three other recurrences:  my first night and morning in Tagtagumbao, the morning of the birthday party for my two brothers, and the day of my flight back to Abu Dhabi.  The day of my flight back to Abu Dhabi had not started well.  In Cuyapo, I had already received back massage in the morning because I was not feeling well.  Before the commute to Manila early in the afternoon from Cuyapo, I was already experiencing neck discomfort.  While waiting around at my sister's condo in Manila, my whole left side felt "numby and tingly".  It lasted while waiting in line to check in at the airport in Manila.  Once I was checked in, I felt fine, even during the duration of the flight back.

These experiences spurred on a request for medical leave back to Seattle and my accepting a new work position in Seattle. Even before I figured out what was plaguing me, I thought it would be best that it is taken care of where I was most comfortable, at home.

The 8- day excursions to Vienna, Bratislava, and Budapest via train with a friend was a way to prove to myself that I can still do a trip riding the train for long hours and walk around for an entire day exploring a city and not experience any bouts.  For the most part, it was a success.  I had a few incidents.  While sitting and having coffee at a McDonald's in Vienna, I suddenly I felt a burning sensation on the back of my neck.  I immediately told my friend that it was time to go back to the hotel and call it a night.  In the middle of dinner at a restaurant in Vienna (Thanksgiving dinner), I had to go outside two separate times to get fresh air.  The last morning in Budapest before heading back to Wiesbaden while walking inside the Market Hall I had felt a bit lightheaded.  Otherwise, the weeklong stop in Europe before heading back to Seattle was a success.  I had a great time walking all over and checking out the sights in Vienna, Bratislava, and Budapest. More importantly, it demonstrated that whatever it was that was ailing me, I was able to overcome.

After my first week back in Seattle this past December, I took a day trip to Portland, driving on my own, not only to visit the city where I had lived for five years in the mid to late 1990's but to reassure myself that I can do a long drive without worrying about back issue recurrences (or anxiety attacks, which I did not know at that time).  I enjoyed my drive to and from the city, and had a great time walking around the city on a cold, cloudy day.   During most of my stay in Seattle this past December, I did not have the energy to get out, but I forced myself to do it.  I had joined former colleagues from Port of Seattle for lunch on three different occasions.  The first lunch was "iffy" sitting on the edge of my seat wondering if I was going to have an attack. This was before I realized that they were anxiety attacks.  The second and third times went perfectly fine.  I went to the movies three times.  The first time with older nieces and nephews, and the second time with younger great nephews, I felt uneasy during the first couple minutes of the movie.  The third time, with a friend, I was fine.  I also forced myself to go for walks after waking up.  The early morning walks around my neighborhood were refreshing and calming.

Before I realized it was anxiety attack I was experiencing, I went to see my doctor in Seattle who said that he could not really do anything about the backache.  He offered that I seek assistance thru other means such as massages, chiropractors, or acupuncturists.  Back massages are always beneficial.  I had four sessions of acupuncture.  I am not sure if they helped or not.

On my second visit to the doctor before heading back to Abu Dhabi, I revealed to him that I had an inkling that what I had been experiencing were possibly anxiety attacks.  He probed me with further questions and he agreed with me that these bouts were likely anxiety attacks.  He indicated that there were medications and psychological therapies to address this problem.  He recommended neither of these things for me for now.  He said to try to control the problem on my own.  He said that if my condition did not improve by the time I return to Seattle, we can look at other options.

It was a couple of days before Christmas when I came upon the realization that it was anxiety attacks that I was suffering, triggered mainly by back discomfort after piecing together a few recent incidents.  I had hosted a birthday party for a brother the Saturday before Christmas.  The following morning while cleaning the house, I felt some back discomfort.  It was shortly thereafter that the neck discomfort, heart palpitations, and feeling ill followed.  I was ready to call a neighboring niece to take me to emergency.  She stopped by my house to pick up her kids that morning.  I even walked to her car in the back alley, in my pajamas, ready to ask her but I held back.  A nephew and his wife had a Christmas party scheduled that afternoon.  My nephew had called me earlier that morning and told him that I probably would not make it.  After a few hours I had felt a bit better.  I called a niece who planned to ride with me to the party that I had changed my mind and wanted to attend the party.  I was going to a party hosted by two registered nurses (my nephew and his wife) and they had several friends invited, who were also RNs  and who would be attending the party.  Another registered nurse niece was going to be at the party.  So I reasoned that if something were to happen to me, I was going to a place where there were people who can help me.  The drive along the freeway was fine.  Once I took the exit headed to the nephew's house, I started feeling a bit uneasy again.  There was a bit of traffic on the way and each prolonged wait in the traffic, I was ready to ask my niece to take over the driving.  She was wondering why I was putting the shifter on "park" while we were stopped in traffic.  It was my way of ensuring that the car does not move if I were to pass out.  Anyway, I made it to their house fine.  But once I arrived, I immediately asked my nephew's wife to take my blood pressure reading because I was not feeling well.  The bp readings were a bit elevated.  It only stands to reason that it should be elevated because I was going thru one of my anxiety attacks.  But this was before I realized that it was anxiety attack that I was experiencing.  Anyway, I was miserable for most of the time during the party.  I had asked another nephew, trained to do massages, to give me a quick back massage to ease the discomfort.  The massage helped me the rest of the day.

The following morning, I scheduled a back massage appointment.  The earliest they could schedule me was for an early afternoon session.  I had a few hours to kill.  While driving around killing time, I experienced another attack.  I happened to be near the clinic where my primary doctor practices.  I don't think this was by coincidence.  So I parked my car nearby walked in the clinic coffee shop to get orange juice and muffin.  There was also a self-help blood pressure reading machine station.  I took my bp readings several times to confirm the elevated readings.  The high readings fueled more worries about my condition.  After calming down and looking at this situation rationally, I realized that, yes, I should have elevated bp readings because of all the worrying.  I also realized that it was silly of me to hang out at the clinic for the sole reason that if anything ever were to happen I was at the right place.  I thought about the incident the previous day while at the holiday party at my nephew's house.  And it was very similar to what I was currently experiencing.  My thoughts during these attacks were getting irrational and focused mainly on my impending doom.  These would get me more anxious, setting off the vicious cycle.

I also pieced the previous incidents for the last few months and they were all very similar -- at the onset of back discomfort, I would go through lightheadedness, neck discomfort, and heart palpitations.  On certain times, I would also feel tingling in the head, left arm, and left leg; numbness of the left side of my body; and any other irregular sensation felt would be magnified.  I constantly had a bottle of water with me because a sip of water would alleviate the situation.  An Advil pain relieving pill every 3 to 4 hours would also seem to help.  It got to the point where I had to have a bottle of water with me and a regular supply of Advil readily available at all times because these items would offer relief when I had the attacks.

I also realized that I had sought out situations where I could take some control (e.g. me driving instead of someone else, taking outside seats in restaurants and theaters rather than being blocked by another person on an inside seat, and choosing aisle seats during a flight).  These would provide me an easy out, to be able to get up and walk about, if I were to experience an attack.  I could easily stop the car at a safe place if I were driving.  I could easily get up or go to the restroom, if I had an outside or an aisle set.

I had been avoiding doing things and going to places to avoid experiencing the bouts.  Once I was assured that there was nothing physically wrong with me and realized that they were anxiety attacks I was experiencing, I forced myself into situations that were causing anxiety in the past -- crowded situations, taking the inside seats in restaurants and theaters, leaving the driving to someone else.  Also once I had figured out that they were anxiety attacks I was experiencing, it seemed like the attacks were now more frequent and were triggered randomly.  I had an attack while receiving a back massage, but I was able to control it and it subsided after about a couple of minutes.  I went to lunch with a couple of friends from the Port of Seattle and I took the inside seat.  That same afternoon, I went to watch a movie with a friend and took a middle seat.  I went out to dinner with family members several times and purposely took the inner seats.  I went to several malls before and after Christmas without any problems.  I had been on a few short drives as a passenger with no problems.

I had planned to do overnight trips to Victoria and Vancouver, Canada.  But due to weather and scheduling issues, the plans did not materialize.  Also the lack of energy and excitement that I usually have on going on these types of trip was lacking.  On my trip back to Abu Dhabi after the new year, the 4 hour leg of the trip from Seattle to Dallas and the 9 hour leg of the trip from Dallas to Frankfurt both were fine.  I had a 4 hour layover in Frankfurt followed by a seven hour flight to Abu Dhabi.  It was during this time, while waiting for the flight, that I felt started feeling ill.  I felt a bit dizzy and my body was experiencing symptoms similar to a flu.  I took Advil and bought a bottle of water.  During the flight, I did not touch the meals that were served.

I got back to my apartment in Abu Dhabi fine, but I was still feeling under the weather.  I went to work the following morning still feeling slightly under the weather.  During the drive to work, I experienced a minor anxiety attack but it quickly subsided.  The second day of work, Thursday, was a bit better but still felt a bit ill.  The feeling I get is a lack of energy.  During that second day back to work, I had another anxiety attack while waiting at a lunch line.  I have had minor attacks in this same situation and location a couple of times about two months ago.  I was able to control it and it subsided away fairly quickly.

Even an innocuous short trip down to the hotel cafe or bar was a struggle because I have had anxiety attacks while in these locations.  I did not know then that these were anxiety attacks; I thought then that they were manifestations of my back discomfort.

I have been assured by several doctors that there is nothing physically wrong with me.  These assurances help me during the anxiety attacks.  Now, I don't worry as much during these attacks.  They still occur.  They are still debilitating, to the point of making me physically ill and weak.  I will need to condition my body to stop the attacks or at least react to it without the physical effects.  I don't wish this condition on anyone.  It is the worst feeling in the world when going thru these bouts, especially before I figured out that these were anxiety attacks.

I am still fighting my demons, but I am slowly overcoming them.  I am still experiencing the attacks, no longer just triggered by back discomfort, but at any time and any where.  There does not seem to be a way to control the onset of the attacks, but I am able to control the severity and duration by knowing that this is only an anxiety attack not the start of a fainting spell, heart attack, or a stroke.  I have enjoyed the past month without any major attacks.  I still experience short, minor attacks now and then.  I experienced one minor attack while at work last week.  This was after about two hours in front of the computer after I was feeling a bit of back discomfort.  I merely got up, stepped outside of the building, and walked around a bit.  A couple of minutes later, the anxiety attack symptoms disappeared.

I have taken the last couple of Saturdays off, giving me a two day weekend instead of the one day I have been doing while in Abu Dhabi.  I am getting my old self back, bit by bit.  I feel significantly more energized than the way I have generally felt for past six months.  I am doing most of the things that I stopped doing during the latter part of this past summer.  I am doing day trips, driving around the desert, and exploring interesting areas in the UAE -- things I enjoyed doing my first couple of months in the UAE.  Along with the increase in energy level, my spirit and enthusiasm have also been boosted.  I have a few trips planned that I am really looking forward to and excited about before my move back to Seattle.

I am slowly, but surely, overcoming my demons.  I know I will get over this completely, over time.

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