(To be edited for redundancy)
My experience of panic attacks
When I went through the worst period of
panic attacks last year (2012), it was like I had a hundred illnesses coming
one after another. For years, I did not know that I had been besieged by a low-level form of anxiety. I had been anxious of so many things in life. Most people are anxious of a lot of things, but I did not know that my anxiety was of the neurotic sort – it was coming from a deep conflict, which made my fears excessive compared to the perceived threat, making those fears irrational.
Because I refused to deal with my fears, I paid the high price – the fears developed into full-blown panic attacks and phobias. I avoided these issues for the longest time by medicating the pains I was unconscious of, through various compulsions/addictions (caretaking, oversharing, being the goody two-shoes, etc.). I thought, wrongly, that if I resorted to these ‘drugs,’ I would be okay. While I succeeded in curing my anxieties on the surface, I also succeeded in not facing the root causes of these anxieties. Thus I went through a long vicious cycle of fear and medicating that fear. Meanwhile these fears, left unaddressed, continued to be bottled up until they became explosive and unmanageable, and I was forced to confront them. It is strange but I have to thank my going through panic attacks because it finally revealed what had been bugging me for years. But first, I had to jot down the agony I went through.
Most people don’t know what panic attacks are all about. They think it is all about overacting on my part. I did not fare any better, so I was unable to explain myself right when asked what was bothering me. Could it be a withdrawal effect from anything? (But I had given up caffeine and sugar, for example, and yet I still got panicky.) Or could it be a medical side effect? (I have been taking the antihypertensive losartan for about two years, so who knows?) Is it a mineral or vitamin deficiency? (Magnesium deficiency, for one, allegedly causes palpitations.) Is it merely stress due to recent traumatic events, fatiguing my adrenal glands, telomeres, or whatever? (I just lost my job, without any warning.) Is it due to a past trauma, unresolved issues in my childhood? (Well, I used to have tons, but I am confident I have moved on.) Or, horror of horrors, is something wrong with my heart?
Even most doctors are not trained to handle it, always thinking automatically that their patient has an underlying heart condition, which drives the poor patient to even more panic attacks. When they are not finding the patient’s report of symptoms ridiculous, they can not help showing how their patience is strained during consultation. That is at least my own experience of consulting various doctors in Manila: they mostly failed to recognize that the issue could be psychological. Could I blame them? Apparently not, for doctors are not psychologists.
It took a few incredulous friends for me to begin questioning myself about the heart palpitations I often complain about. JJ, in particular, was brash enough to suggest that I see a psychologist instead, although the mere thought offended me at the time. I thought, I might have issues, but I was not about to go crazy yet. I closed myself to the possibility that the problem could have some psychological nature.
When other friends, one by one, began to voice out increasingly the same suspicions, a formidable wall of denial I had built up began to crumble. I should thank Z. for informing me that a mutual friend (name withheld) had or continues to have the same problem. In fact, she reportedly remains on medication. Soon, two other people who had been similarly afflicted in the past came forward to tell me they recognized the symptoms I exhibited as the same symptoms they had while having panic attacks in the past.
What are these symptoms? It’s a veritable list of symptoms bound to rattle any doctor unfamiliar with them. Mine typically starts with palpitations triggered by what I presumed to be a sudden spike in blood sugar. Sugar rush or hyperglycemia, in other words. While it is true that high blood sugar is associated with feelings of being stressed, it turns out that hidden anxiety could actually cause me to palpitate for a duration of a few minutes to an hour (or more) before an attack. The real triggers I was unaware of were anything I perceived to be too horrible to contemplate: tragic news stories/movies/novels, losing my reputation as a good person, losing friends, losing my job and being penniless, losing the trust of my boss, losing any of my loved ones, catching a deadly sickness, growing old alone, being helpless, losing my physical health and mental faculties, and most of all, the thought of death and dying.
No matter which trigger, these palpitations always subside in about an hour, but in the several cases of a full-blown attack, these graduate to a host of accompanying symptoms:
sudden, faint headaches
spike in blood pressure
random body aches and pains
paresthesia or tingling sensation in the extremities
numbness of arms and legs
blurring of vision
temporary memory gap
a thought/feeling of impending doom
Among those listed in medical/psychological literature, the only symptom I have not experienced so far (and I wish never) is hallucination or seeing things that I know are not there.
This set of symptoms, I have learned, comes with other symptoms that show up when I am not having attacks: tinnitus and sensitivity to noise and loud sound, feeling jittery even without having drunk coffee, food allergies (I stay away from fish after I experienced itchiness in my lips one time), and feeling fatigued or stressed out.
The most terrorizing, so far, has been the thought that I might have a fatal heart disease. It used to be that I could not contemplate the very idea. I guess it is a great improvement that I can now write it down.
Needless to say, these bothersome symptoms debilitate me in unexpected ways. They result in complications, or is it intensify preexisting conditions, particularly hypochondria (paranoia over being sick) and agoraphobia (morbid fear of going out of the house) in my case. This has humiliated me, for it renders me overly dependent on my housemates (my younger brothers) for my needs, particularly my day-to-day dietary needs (e.g., who will have to get out to buy what I need to cook and eat?).
There was a time I refused to get out of the house for three weeks straight after coming home feeling faint from a panic attack, then reaching home, palpitating for maybe an hour more.
Many people around me thought I was merely being difficult, and this saddened me immensely. In my moment of weakness, I wrote the following outburst in my online diary:
Saturday, November 03, 2012
Ill and misunderstood
No one understands me, not even those who are supposed to know. They think it's all in the mind. They think I'm just being lazy, that I just lack exercise. They think I'm just lacking in faith. This means they think I am weak and all my spiritual testimonies are just mental posturings -- all intellectualism. So be it. I didn't sign up for their approval, although it is something nice to have. What matters is what's between me and my God. Why would I invent this? No one likes this. I wish I could move around as freely as before, work and 'play' as hard as before. I don't enjoy being afraid. It's no joke when your heart thumps at a speed you've never ever experienced before. It's not funny when you feel faint, hoping you'll fall with dignity, your sense of control intact, hoping there's at least a railing you can hold on to or a spot where you can sit and belly-breathe without creating a scene. So what if I'm terrified of death, especially sudden death, especially dying all alone? Most people are afraid of these. And these things do happen anyway, everyday. I just have to listen to the news. People don't know the past traumas I've gone through -- it's only I who knows, and I'm not even 100% certain of the earliest details, most especially the whys. Something happened, that's why I'm like this now. I have to give myself some credit. This is my way of coping. For now. But I have to forgive everyone who has ever misunderstood me. Misunderstanding is very much a part of the 'deal,' a part of what I have 'signed up for' when I fell ill of this.
Analyzing what went through my mind while I was panicking slowly helped reveal the other underlying fears I had. Listing down my panic episodes in a logbook of sorts also helped me clarify some mysterious matters. Thanks in part to tips from panic attack websites, I found out that the most common thought bubbles turned out to be a series of what-ifs I can relate to very well:
What if I had a serious heart ailment?
What if I suddenly fainted here? How would I look to all the strangers around me?
What if I died suddenly?
What if I died suddenly alone? Will someone be there for me?
If ever, will someone rush me to a hospital? How? I don’t have money for the hospital – what then?
How would my family, especially my ageing parents, take it?
If I died without confessing, will I go to hell?
At first, I was happy and satisfied with these self-revelations, thinking these were all there was to it. What I did not know yet was that these fears had been there underneath my consciousness all along, and that there were far deeper issues involved that I refused to face because they were even more scary.
With my mysterious illness revealed to be part of panic disorder, I was now able to search for treatment. However, being out of a job, which I suspect cemented all the triggers that led to a panic disorder, I could not afford consulting professionals. My friend and counselor A. recommended a psychologist from the Universtiy of the Philippines in Diliman who offered counseling for free, but after contacting her by phone, I learned that she was based in the opposite side of the city.
Another friend, a college professor I know to have suffered the same in the past, mentioned that the book The Dance of Fear by Harriet Lerner was helpful to him. Lerner’s penetrating insights about fear, plus the perspective she gave by painting the big picture, indeed proved invaluable to me in so many ways.
Two websites proved to be equally helpful, with more information I did not know before because I hounded them for a time: Anxietycoach.com and Anxietyguru.net. From these two websites, I was able to confirm on my own that I had panic attacks.
The three or four worst episodes I had were so terrifying because my heart raced to unprecedented speed that I had to take the beta-blocker metoprolol, a drug that had been previously recommended to me by two doctors, the first during a bout of nervousness in front of a stage where I was about to be one of the emcees and the second after a panic attack incident inside a church in Moonwalk Village, Parañaque, where I tried to hear mass for the first time. The doctor at the second incident recommended the same drug to me, saying the drug I had been taking as maintenance medicine for hypertension, which I had been diagnosed with the previous year, was inadequate in addressing my hypertension. (I suspect she misdiagnosed me because she took my blood pressure right after I had a panic episode.)
Physiologically speaking, my major finding from all this, however, is that I am extra-sensitive to palpitations, particularly when these get tachycardic (to use a medical term) or fast (around 100-200 beats per minute), equating their occurrence with impending death due to heart attack. Unfortunately, panic attack symptoms indeed mimic the symptoms of heart attack, although other authors say heart attack has a different set of symptoms. I also learned that I am deathly scared of the slightest bodily discomfort, especially any type of physical pain, thinking these are sure to trigger my sure instant demise. This is consistent with my own diagnosis of hypochondria.
An old rap song I was listening to at random also was of great help. Since the song, entitled “Crossroads” by Bone Thugs and Harmony, is about the death of an uncle, the agonized lines “Why did he have to die?” and “I don’t wanna die!” resonated with me deeply. “Crossroads” revealed how I deeply resented God for inventing death or allowing it at all, for making me and others subject to death, especially four friends whose lives were rudely taken away in their youth.
Because of this song, I was able to write this entry in my blog in October 12, 2012:
Why do I remain scared to death of the subject of death, despite the many close brushes I had with it? I should have been used to the feeling of almost dying by now, after I choked on a lychee alone, after I ran into an oncoming vehicle's path and missing the thing within an inch, after I ate something poisonous without knowing, after I figured in several falls from a tall staircase as a little child, and so on.
Everyday, there is death. It comes as sure as birth. I just have to open the TV or log on to the Internet. Even around me -- babies are born, old people (or not even) pass on. Shoots sprout, and dry leaves fall. Ants lay eggs by the thousands, even as I slap an offending intruder that attempts a bite my skin.
There's this award-winning Japanese movie titled Okuribito (Departures) that points out that, whenever we eat to sustain life, death is there, a life is sacrificed. The rice grains had to die, as do the vegetables, fruits, fish, and beasts. They must all die, so you and I could live.
Again, why am I so scared about death? I will die -- that's for certain. It could be anytime from now or after several decades more. It's okay. It won't be the end of me. There is life after this life. ("Not life after death," or so asserted one college professor of mine.) God's love will see me through.
Meanwhile, I savor life, knowing how precious it is in its frailty. But I shouldn't overdo it, as though manically fearful that my time here is much limited. I'm only human, not God; I can only take so much. May God forgive me for my greed for life, which is perhaps due to my thinking that I almost lost it at birth.
Well, I didn't, and truth be told, I've had a fuller life, compared to most people. (Yeah, I could say that.) Maybe not in the conventional way, but I've gone through my 42 years with so much life -- the many ups and downs of it, I mean. I still have a lot to dream of, such that I am unable to say, "I can die anytime now," but the point is, what more can I ask for, considering everything I've been given? It's true that, had I a choice, I would want to live several decades more, but that choice is not mine to make. All I can do is wish.
I believe it is best to surrender my life to God, no matter what state of completion or incompletion death will find me. God will meet me where I am in my journey.
Dear God, my life is in you. Why am I so afraid to surrender to you? I am not just afraid, I have also been very angry.
Yes, I've been angry at you, Lord! For why did some of my friends had to die like that? Dove, Cesar, Malou, Marc. I don't want to die. Or I don't want to die yet. Or I don't want to die like that -- too sudden and too soon.
Oh, death! Death, death, death, death, death, death, death, death, death, death.
In my great anger, I even uttered a curse at you, like someone possessed. I don't know why I did that, but the reality is I did; I was capable of it. Forgive me, Lord. Forgive me, even more, for assuming, that I am a saint who's incapable of going that low.
I wasn't just afraid and angry at you. I was terrified of you. But why should I be in terror of a supposedly loving Deity? It's probably because I thought, wrongly, that if I died suddenly, I would go to hell because of unconfessed sin. I'm terrified of dying all too suddenly and of dying alone, thinking I would be alone at it and no one would care. I'm afraid of getting sick without the money and health card for the hospital. I'm also terrified of possibly leaving my family behind, especially my parents, and the great heartache that they would have to go through. I'm terrified of dying at this age because I assume I haven't accomplished anything yet. (This has made me envious of people who I thought are accomplished (forgive me, Lord, for my envies). This perhaps means that I'm terrified that, with physical death, I would also disappear into oblivion. This is another way of saying I'm terrified of death of self, the kind that's forever.
Oh, I'm terrified of so many things. And yet I'm not terrified enough of God. Actually I know God should be my greatest terror -- for He is the only one who can send me to hell. Nevertheless, I'm terrified of so many things without bothering to question my assumptions at all. Will I really be gone forever and forgotten? Will I really disappear into nothing? Do I really believe in a loving God? Do I really believe in God at all? Is it possible I could die now or anytime, alone, and suddenly?
But so what? So be it! When I die, I will no longer fear, as my friend Aline naughtily puts it. I will no longer have to fear, ever. I will no longer have to face the burdens of the living -- including life's many little and big terrors, foremost of which I have listed above.
When I die, God will take care of me, because I have commended my spirit to him. That means I will not really die, I will not die alone, I will not die unprepared since it is God who wills my earthly end by calling me home. I will not be forgotten and will not dissolve into nothingness.
Take all of me, Lord, take all of me, like the song said. I surrender my all to you, right here and right now.
Forgive me, Lord, for the temerity of thinking that I am in control, that I can extend my life for one minute with a new-found food supplement or drug. I forget so easily, Lord, that you are the one who's taking charge, that you are the author of everything -- science, medicine, my body. You govern all the atoms and molecules of the universe. My knowledge (which I thought is encyclopedic enough), compared to yours, is nothing.
Sometimes I wish I would never wake up from sleep again, but I know this is more a desire borne of desperation than a leap of surrender in blind faith. If I want to wake up again or 'pass away,' I want to wake up again for God and pass away for God.
Oh, God, please give me hope, be my strength.
I pray that I won't grow old alone or suddenly faint or die of a heart attack, stroke, heat stroke, aneursym, anaphylactic shock, choking, murder, car accident, or plane crash, but in case I do, so be it. Thanks for breaking my will, Lord.
Take all of me, Lord, take all of me. I surrender my all to you, right here and right now.
Despite all the help, however, my panic attacks persisted and even got worse. Ironically, it was when I was reading a book on how to cure anxiety (The Anxiety Disease: New Hope for the Millions Who Suffer from Anxiety by David Sheehan, M.D.) that I went through another surge of scary panic symptoms. The trigger was this tidbit of information: about 70% of people with panic disorder also have mitral valve prolapse, the heart disease often called MVP. This led me to a frantic search on the internet, and I was led a YouTube video that introduced a material I have never read yet: Barry Joseph (or Joe Barry) McDonagh’s Panic Away Program. This, I found, was different because it reverses all the other advice I had read earlier, by suggesting that the terrorized patient invite more of the panic symptoms so that these will wane and stop for good!
Panic Away Program recommends the sufferer to do the unimaginable: Go through the scare of the entire panoply of symptoms, and when one can no longer take it, dare one’s body to give some more: more panic, more symptoms, and presto! The panic attack gives up. I tried this tack, and it seems effective so far!
I have been in counseling and therapy for four years, but my bout of irrational panic attacks has forced me to confront once again the demons of my past, just in case something else remains unresolved. My past trauma therapy findings indicated three major conflicts: I am confused about fear and anxiety, I have a conflict in father issues (which I extend to how I relate to God the Father), and I have a conflict in mother issues (which I extend to how I relate with women).
I thought that, if I truly believed in a good God, in a heavenly Father who loved me unconditionally, then why am I afraid? Why am I angry at Him, as I have discovered, much to my own surprise? (I couldn't believe I was capable of being angry with God.) Why can’t I accept whatever His will is, whatever situation I find myself helpless in, whatever he allows to befall on me? Why can’t I simply trust him and his son Jesus? Why am I so obsessed with control? Those well-meaning friends who criticized me were right, after all.
I profess to believe and love God, but the truth is I doubt Him and I am even resentful of Him at times. My fear of God is greater than my faith to and love of Him. I follow and serve God in church and community because I want to earn His rewards or at least avoid His punishments. Have I mistaken God for being like my father whom I have feared and resented growing up, because I felt him to be distant and thought him to be punitive and his love conditional?
Why am I so insecure? Where is it coming from? Does it have anything to do with the mysterious threat I felt while I was still in my mother’s womb, the sense of impending doom whose cause until now I am not sure of? Is that where my sense of the world as a dangerous place coming from? My utter fear of annihilation? My terror at the sure thought of it, and the slightest danger of physical pain and psychological discomfort?
The answers to all these are all maybes for now, but merely asking these questions have helped me a great deal in reaching clarity.
I know that my parents love me in their own imperfect, even highly flawed, way, and I have stopped burdening them with the past and the tyranny of my own expectations, but how come I am still hounded by these dark things that I thought are long past me now?
I seriously needed to massage my seriously bruised ego, so it helped immensely to know that I was not alone. Most surprisingly, in my readings, I learned that there are notable celebrities that have gone or are going through panic attacks or some kind of phobias: John Mayer, for the longest time, allegedly has been paranoid about going crazy that he keeps Xanax pills inside his pocket. Johnny Depp is afraid of clowns. David Beckham has a phobia for disorderliness. Robert Pattinson is reportedly so paranoid about being inadequate in his acting that he has bouts of panic attack. This does not sound right, for they have everything in the world, but I figure it should be worse for them, knowing the social expectations. (I wish I could cite the names Bronte, Darwin, and Proust, too, but I risk being accused of worldly ambition and megalomania.)
Furthermore, if it is any further consolation, the Biblical prophet Jonah also got angry with God. Jonah even avoided God several times, then after following God's command, he resented the result and went away and sulked.
Henri J.M. Nouwen reminds us that even Jesus Christ had a moment in life in which he panicked:
Many people say, "I am not afraid of death, but I am afraid of dying." This is quite understandable, since dying often means illness, pain, dependency, and loneliness. The fear of dying is nothing to be ashamed of. It is the most human of all human fears. Jesus himself entered into that fear. In his anguish "sweat fell to the ground like great drops of blood" (Luke 22:44). How must we deal with our fear of dying? Like Jesus we must pray that we may receive special strength to make the great passage to new life. Then we can trust that God will send us an angel to comfort us, as he sent an angel to Jesus.
These days, my panic attacks have mostly subsided, and I am hoping permanently, although I am still afraid to go out in the sun for fear of fainting (it is allegedly among losartan’s many atypical side effects, which is beyond my control), which I am afraid would trigger a new round of panic attacks. But compared to three weeks of being unable to go out of the house, wow, anything else is worth a cry of “Freedoooom!” as in that scene in the movie Braveheart.
The many humiliations I had to endure
Now that I am comparatively more sober, I can look at panic disorder and other illnesses of mine more objectively and even afford to dissect it in detail. A panic attack episode, I would learn,
presupposes a state of anxiety (technically called
generalized anxiety disorder) which, over time, comes with an entire
constellation of signs and symptoms:
Signs: indications of the disease that the
doctor finds in the patient
Symptoms: indications of the disease that
the patient claims to observe in himself
Each of the signs and symptoms I listed down earlier seems an illness in
itself, and together, they bring me not just physical inconvenience, but also
As if nervousness due to anxiety was not
enough to excite me the wrong way while dampening my self-esteem, I also had to endure these
concomitant afflictions: a diagnosis of hypertension, on top of my proneness to allergies. If there
are two ailments to make an anxious person paranoid, these are surely two of those.
NOTE TO SELF: RESUME EDITING HERE
My last two annual physical exam at the company where I worked showed negative results on the blood tests; everything was normal except for hypertension (dear God: thank You). I was told to seek the advise of a cardiologist, but since I could not afford that and I was too afraid if I could, I resorted to the nearest GPs around.
The trouble is the GPs gave conflicting diagnoses and, without knowing it, exacerbated the inner tension that had been curdling in me for the longest time. The clinic doctor who said there was nothing to worry about suddenly berated me one day after one BP check-up and said I should have been taking maintenance medicine! Imagine my horror. Another doctor, after finding nothing except a reading of 150/90 (my usual) right after a really bad panic attack, looked askance and advised me to have 2D Echo and Doppler tests. (But I already had an EKG/ECG earlier in the year, and I was not in the mood to argue about the differences). Another speculated that maybe I had a heart blockage, which of course, scared the heck out of me even further. Because of this, particularly the fear, "What if I have a serious heart disease indeed (like my father who had angina pectoris for quite sometime)?" proved to be way beyond my capacity to contemplate at the time, so I avoided doctors almost completely throughout the ordeal to avoid a potent source of panicked thinking. If I had a heart disease, I'd elect to die an instant death than die slowly from the pain of a possible surgery and from anticipating the hospital bill.
Symptoms of hypertension:
In my worst experience of hypotension, it was characterized by slowed heartbeat (around 50 beats or less per minute), which resulted in difficulty of breathing, getting easily tired, and getting dizzy that I had to be seated, if not lie down. When all these were accompanied by chest pain, that's the time I get anxious, if not panicky.
(Theoretically, the long-term side effect of losartan is
supposed to be, according to my doctor friend Renan, coughing. It's the one listed in the official medical books, he said. Or maybe, as in most long-term
drug usage, liver or kidney damage. So far, I don't feel anything odd, and pray I never will.)
Dizziness alone, if nothing else, is enough
to make me feel like I’m dying, a thought that is potent enough to set me up for
a longish panic attack.
After I was able to trace the root cause of my panic attack -- fear of dying instantly and alone, complexed with the fear of dying suddenly with unrepented sin (I being a devout Catholic) -- I was able to accept the inevitability of death any moment, and my panic attacks somewhat subsided.
There was a time I could not endure the mere thought of dying. Any reminder would lead me to steely denials that I heard anything. But even when I got over it by accepting the certainty of death, the
certainty that I would not be spared, something else remained: the hurt,
shame, embarrassment of feeling weak and helpless and, worse, of being thought of
as unmanly or even a sissy. I feared being thought of as weak perhaps because I was supposed to be this model in spirituality.
Well-meaning friends also hurt me unknowingly whenever
they give me unsolicited advice on my earthly suffering. Essentially, their message is unfailingly one that says, “Have faith,” which of course implies that I am being spiritually weak. “Never
be anxious of anything and trust in God.” Quoting passages such as James 1:9 is especially one giant guilt trip for me, though unintentional on their part: "Have I not commanded you? Be strong and courageous. Do not be terrified; do not be discouraged, for the Lord your God will be with you wherever you go." Of course, this is not lost on me, for such Bible passages are too numerous to count.
So as not to come off as defensive, and
thinking I might benefit from all that good-natured solicitousness, I swallow
everything. I admit I have my own fault in it: I am too impatient to
explain, and I fear I might be probed even deeper for my feelings or my illness if I did.
I certainly don’t relish discussing the details of my sickness with the same
people over and over, and particularly when they are not doctors and thus run the risk of giving the wrong advice. Often, this happens when the friend has or had a family
member who went through the same thing, and they feel it is a perfect time to recount to me what happened and how they were able to overcome it. I am certainly grateful for this gesture, for it helps calm me down, knowing I am not alone, knowing a lot others went through it. Nevertheless, I am embarrassed by it all because, whenever I bump into these friends, there is only one topic that is sure to rise up each time: my sickness and me, and it is sure to dominate the discussion. Maybe it is my male pride acting up; I'd rather discuss my virility. In a way, I can't blame them, for they do not know the full extent of my cross. I admit that, from the outsider's point of view, my plaints look petty.
Then there's also the guilty feeling of being unable, out of shyness, or timidity, to tell these things directly to these friends of mine. If they ever get to read this, I might be accused of slander. I also fear I might hurt them unnecessarily, and they'd stop altogether being nice to me.
When I get dizzy and feel out of breath, in particular –
due to either essential hypertension (hypertension of no known reason) or stress or panic attack or all three (I am no longer sure which) –
I would feel my heart beat faster, or at times slower, than usual. I would then feel
for my chest area, as though doing it would make my heart correct itself by
pumping faster or slower as needed. My most recent boss, who is also a doctor, once advised me to exercise in case of suspected hypotension, which is the reverse of hypertension.
I did try once, but I only palpitated even more. This, of course, scared me even further as it made me feel like my heart was pumping harder and faster than before, and faster and harder than it was capable, that it could burst out of my chest anytime. Instinctively, I would
try to breathe harder and deeper to compensate and to protect my heart from possible complications.
Palpitations deserve a separate discussion,
for these never fail to scare me to death, literally, of course to the point of panic. With
‘palps’ come the image of the heart not just pumping extra-harder but also working double-time. In technical terms, the faster-than-usual heartbeat or pulse rate is called tachycardia. It is also accompanied by the fear of one’s heart giving up or exploding. Palps can
be caused by a lot of factors, and in my case, these seem to be:
Palpitations make me unable to do anything productive, and especially disable me from taking a longish walk or making any physical exertion, for fear of overburdening my heart, making breathing a bit difficult. Fortunately, all palp episodes subside
within an hour or so, even though in the middle of it, they always seem to go
on forever. I have tried all sorts of antidotes, from washing my face with cold
water to making a Valsalva maneuver, from qi gong or belly breathing to accupressure, to taking a beta-blocker or antihistamine to
slow down my heartbeat, but nothing seems to work fine for long. Besides, the drugs always
result in scary side effects as well, adverse effects which I learn from reading the literature online.
Whenever I survive palps, it never fails to
make me feel like I just survived death, that I was just given a new lease on
life. It always feels like going through yet another baptism, like being a born-again Christian again and again. I can plan my life again, I can think of spending good times again, having
acquired a new life extension, etc. Surviving this way again and again drives me to
think of my life more closely:
Am I doing the right thing?
The fear triggered by palps, if they prove
to be beyond the control of my mind through the calming effect of positive thinking that I learned from the Landmark Forum, often escalates to a full-blown panic
attack. This is characterized by a worrisome racing of the heart and shortness
of breath coupled with that familiar feeling of impending doom or death, combined with any or all of the other signs and symptoms listed much earlier.
When I am particularly irritable, the slightest kink at home can make me go ballistic and really test the patience of those around me. I figure the churlishness can test even a candidate for sainthood. As for me, well, an observer can easily dismiss my attitude as un-Christian in character. Ouch.
What a doubly cruel joke it is then that I should
live near the airport, where jumbo jets take off and fly by several times a
day. This worries me in a special way. "Will I grow old deaf, in case I survive to old age?" On top of this, it is hardly a comfort to discover that being exposed to loud
sounds is reportedly bad for the heart: it reportedly raises the level of the stress hormone cortisol
in the blood. Oh, what consolation!
I have good days and bad days, then I have especially bad days. These are
days when I especially tire out after exerting minimal effort or at the mere
thought of doing a monstrous chore for the day, like running that overflowing pile of clothes through the washing machine. This is not very good for my job prospects,
or my chances of staying on a given job -- a thought that, of course, spells job
insecurity for me, and with the fast approach to old age, the dread of obsolescence as well.
The other symptoms of panic attack are no less
frightening, for these can be easily mistaken for an impending heart attack or
stroke. I am specifically referring to the twin plagues of sudden-onset headaches and sudden
shortness of breath whenever I am besieged by the scariest thoughts of the day.
These symptoms come and go seemingly at random, in sudden bursts of energy or a sudden wave throughout my body. These
thoughts could be anything from ghosts and demonic possessions to, like I mentioned awhile ago, the possibility
of going to hell due to unrepented or unconfessed mortal sin. To avoid these, I
avoid watching health shows particularly those that discuss sudden death and heart and
endothelium ailments, the nightly news on TV especially with its sky-is-falling style of delivery, and especially at night, the horror shows and
suspense flicks scheduled on that date. But this studious avoidance strategy makes me further feel
like a wuss. What if war erupted and my service was needed? What if there was an
emergency? What if this cramped village I live in was put on fire? Would I be able to help out, or would I be the patient in need of rescue?
With the sudden headache and shortness of
breath, will a racing heart be far behind? With my heart racing, numbness
in the limbs/extremities is also assured. Since a doctor in a past consultation once
assured me that numbness is one of the signs of diabetes, I have an additional
cause for concern, thank you very much!
An anxious person reportedly have most likely a Type
A personality, which is characterized by a competitive and restless spirit. A
Type A personality, as per the literature, is someone just like me, one who wants to finish things quickly and perfectly, whether it be
eating or slicing a long vegetable for the salad, thereby making himself a candidate for
gastroesophageal reflux and its consequent symptom: heartburn. Those who are
familiar with heartburn know that it is another great mimic of heart disease,
just because it comes as a lingering discomfort in the thoracic cavity. Chest pain! Without proper
guidance from a doctor, one can be easily scared into thinking that one is about to
have a heart attack. Shall I say thank you again for the bonus aggravation?
The long list of interrelated events has
escalated to two kinds of phobias:
Hypochondria – the irrational fear of
catching every disease in the dictionary
Agoraphobia – the equally unreasonable fear
of going outside the house lest I have another panic attack episode or at least a nasty round of palpitations and be
reduced to a very public embarrassment
Little by little, I recovered. Choosing to fight these twin fears incrementally, by either facing
them head-on or refusing to be bogged down despite the worries, even when my reactions were extreme (cold shivers, some trembling, with my hands turning clammy, my feet
turning like a jelly, and with butterflies fluttering in my tummy) paid off. The one thing I could not stand is the seeming breathlessness, for which I had to catch my breath, coupled with the thought that I might have a heart attack anytime and collapse on the pavement.
Sometimes, these fears do get to me to such an extent that I would feel down and out. I think I have reached the stage at which I
have a low-level or mild depression, which I hope is not yet clinical. When I am
stricken by the blues on account of the many deprivations of going through panic
and anxiety, I could neither write nor read, watch movies nor take a leisurely
walk outside, relish food nor enjoy the other usual activities I find enjoyable
(music, talking to a friend on the phone, etc.).
Urticaria or itching, especially of the
face and lips
Choking is especially scary because it escalates fast to asphyxiation, which I have experienced once at the worst possible time: when I was all alone. What scares me the most, however, is the possible
escalation of lip and facial swelling to anaphylactic shock, if left untreated. I especially
dread this quick complication:
Feeling unjustifiably weak and being easily fatigued make me appear lazy to anyone given to rash judgments. I most assuredly have received such comments before, and I would be too sluggish to explain or risk sounding too defensive.
Most recently, I read that allergy could be an indication of a high level of toxins in the liver. How I wish I have not learned that bit, for now I had a new worry: Could I have a liver disease, or at least a toxic liver? Is losartan causing the high level of toxicity?
A word on dermatographis. I am not sure if
this is related to panic disorder, but I have long been suffering, although in a
minor way, the skin disorder called dermatographis. It is a condition in which
a little scratch produces a reddish and mildly itchy bump on the skin. It never
seems to be dangerous, but it’s akin to an allergic reaction, in that this
always happen when I load on too much sugar. It is different from allergy in
that it goes away on its own after thirty minutes or so. It is, however, not a
pretty sight, if it lingers and I have to face someone. People who see me
in the middle of having dermatographis are always alarmed when they see the reddish welts. They invariably exclaim, “Whoa, what is that?!” The response I give is often dismissive, but the truth is I am alarmed whenever other people are alarmed about it.
The lengths I would go through just to cure myself led me to further embarrassments nonetheless. The seriously ill is, I would find out for myself, extra-gullible. Indeed, I have tried everything available in the market, if it's rumored to reduce blood pressure, calm down the nerves, or ease allergy somewhat:
Food and drugs rumored to alleviate nervousness: bay leaf tea, antihistamine (low-dose Benadryl or diphenhydramine HCL, Ativan or benzodiazepine, etc.), and the latest in the news, Tylenol (acetaminophen) to reduce existential fear, though the last two items I have yet to try
Foods and drugs rumored to alleviate allergy: ube and camote (purple yam and sweet potato, both root crops), onion and apple for the quercetin, tomato, pineapple, vitamin C megadoses (with risks of kidney stone formation)
Antiallergy drugs: in case of difficulty breathing, the first-aid antidote is to swallow a spoonful of sugar then drink lots of water; chloramphenamine maleate 10 mg/7 hrs (cough and cold tablets can be used if no other drug is available); diphenhydramine HCl (e.g. Benadryl) 50 mg/4 hrs; epinephrine (using EpiPen injection) for anaphylaxis; for palpitations, propranolol 50 ml
On the matter of drug interaction: The possibility of my maintenance medicine interacting with another drug is high, so this leaves me cautious of what to take in. Naturally, I avoid caffeine, which is said to intensify anxiety reactions. I avoid alcohol, too, which is said to intensify the effect and side effects of losartan. I avoid inhaling nicotine; it might have a deleterious effect as well. As I have mentioned above, I can not eat certain fruits or drink certain fruit juices in particular: grapefruit and allied citruses, including pomelo, I think, because bergamottin might react badly with the antihypertensive I am taking. Who knows what other drugs can have toxic interactions? What if I develop the dreaded Steven-Johnson syndrome?
One can just imagine how I would fare in case I find myself in a party or a private dinner or in a restaurant. Except in restaurants where it is sometimes expected, it will be embarrassing to ask my host what ingredients he used to prepare a suspected dish.
Because of my bad experience with losartan, I asked Renan if I could switch to another drug, and he recommended that I try felodipine. Unfortunately, felodipine gave me the horrors of a racing heart, so I went back to losartan without telling him (I was afraid he'd recommend another experiment.). I figured I could take dizzinesss anytime over palpitations and faster-than-normal heartbeat/pulse.
Hypertension, aside from being quite a challenge to handle by itself, is also a trigger of anxiety because its
symptoms always make me feel like it is the end of me. Maybe it is really the side
effects of my maintenance medicine, losartan potassium 50 mg, that is the culprit. I am not sure. I can not be blamed, though, for not consulting doctors, for I shopped around.
Even doctor-friends I used to consult for free I studiously avoided, fearing their queries. One friend, a homeopathic specialist, asked me by text message whether I was having chest pains, which sent me having chest pains when I was perfectly calm a few minutes ago. Then she recommended me to have a diet of boiled vegetables for one whole week, which sounded like a death sentence, because I thought my condition was already really, really that bad.
Over time, I
tried to research on my own and figure out which are the symptoms of hypertension and
which are the side effects of losartan, and these are my wild guesses:
Feeling of breathlessness?
Feeling of being stressed?
Pressure inside the head
Dull pain on the nape
Sensitivity to noise
Discomfort in the middle of overcrowding
(I placed question marks after items I suspect to be symptoms of panic disorder as well.)
Side effects of losartan:
Sensitivity to heat/humidity
Tinnitus and reduced hearing ability
Orthostatic hypotension when getting up
from a squatting position
Hypotension (the opposite of hypertension) due to humidity and heat, especially when exerting
Hypotension due to consumption of excess
potassium or potassium-rich foods, such as green, leafy vegetables, citrus, and anything with thick tomato sauce
Impaired sweating leading to risk of heat
Worst of all, there was the thought of being suspected of lying, of faking it, all to protect my comfort zone. But while it’s
true that I have a low threshold for pain and I am quite attached to my numerous personal comfort
zones, I certainly won’t go the extra mile or bend over backwards just to accommodate
the lie. I must admit that sickness is one great scapegoat for faking illness, for malingering: It is easy to claim to be sick and then file a sick leave -- a neat trick to avoid activities I do not particularly prefer to participate in. But the backlash would be too unthinkable for me: guilt, and the hidden anxiety brought about by guilt, ensuring a vicious cycle of future panic attacks. The cost of lying is simply too high for someone panic-stricken like me.
To be fair, my situation is indeed a strong candidate for skepticism. If there's someone who has a low threshold for pain and wants to be rid of it at the soonest, guess who that person is. But who would think there is such a set of fears as mine? Who would believe me when I say, to quote my friend Junrey, that at least one famous philosopher -- Kierkegaard, I think -- exhibited the same degree of photosensitivity/photophobia that he always had to carry an umbrella whenever he went out?
Here is one example that may intensify my guilt, especially if I know it is sent to me as an inspirational text message that was selected at random (meaning, it was never even meant to refer to my illness, so perhaps it was God Himself rebuking me?): "Be strong and courageous. Do not be afraid or terrified because of them, for the Lord your God goes with you. He will never leave you nor forsake you." (Deuteronomy 31:6)
I try not to be insulted, for such is never their aim, but it’s so humiliating nonetheless to be
reminded of the pertinent Biblical passages when these are exactly the things I
teach/preach to people whose faith, I think, is weak. Maybe this is sinful pride on my part, but it does not feel very enjoyable to be taught what you are teaching. It makes me feel small, like a child. And the truth is, though I am not a paragon of faith, I am not lacking in faith, either, for it takes a great deal of faith just to survive each day not losing hope because of a mysterious illness.
In any case, like I said, I do not know what more manning up still needed to be done, given the circumstances I am in. It is not like I do not have preexisting serious struggles to deal with. At the rate things are going, I can say I have tried to be that: Man of Steel -- maybe on my own strength at first, but I would like to think I have long learned my lesson to rely just on me.
If even good people are not a perfect source of consolation, what now? Maybe I am left with a toss-up between the questions of whether I have entered the realm of St. John of the Cross' dark night (of the soul) or have crossed the boundary of clinical depression.
Eventually, the voices of concern do dissipate, and I find some peace, yet over time, this proves to be hardly helpful either. Unless one or two assures me of their continuous prayer, I would tend to feel isolated and experience the spiritual dryness of Icarus, the feeling that the rest of the world turns totally unmindful of my pain. This inevitably brings me to the evil solace of self-pity.
Ah, self-pity! Once I am hooked into it, it's the reverse of "I'm on a roll!" It will most certainly be a downward spiral for me, down to almost the sin of despair. Well, almost, because I manage to refuse to give in at the last minute by catching myself -- or it could be a case of God catching me. At my age, I've grown weary and suspicious of self-pity, for it is capable of toxifying others while reducing me to an emotional vampire. But I am not spared of it from time to time, especially when an irresistible opportunity comes up, such as a job offer in another part of the city or a nice coffee at a favorite cafe, and I could not go.
The last three side effects of losartan (the three types of hypotension) are
the scariest and, therefore, the most embarrassing for me. On top of coming face to
face with mortality, these three side effects also make me feel like I am prematurely on a league with senior
citizens, whose natural preoccupation is, apparently, to discuss their multitude
of aches and pains to each other for hours on end. I feel so old, so advanced, but in all the wrong things.
Sugar rush after eating too much sweets,
soft drinks, carbs, or anything with high-sugar or a high glycemic index
Any form of overeating
Morbid fear (mostly fear of death)
One lingering factor: Could it be hormonal, as in...andropause, as one relative suggested? (!!!)
If not, what should I be doing?
Am I following God’s will? Which means: Am
I living life to the full, i.e., as God originally intended?
What should I do next, in concrete terms?
How can I be a more caring, giving, loving human being?
What exactly do I want to achieve before kicking the so-called bucket?
The ears are especially assailed in this panicky ordeal. Being prone to allergies makes me prone to ear infections too, so
adding tinnitus to this punishment gives me a good dose of purgatorial suffering.
This means two things: hypersensitivity to noise and loud sounds, which makes
me irritable and, if left unmanaged, hypertensive, if not partly hard of
hearing for a short period of time. This means I can not attend any loud gatherings and sit next to the
speaker, be it a mass, charismatic prayer meeting, or any raucous party or
Monitoring my blood pressure readings is also rife with opportunities at self-ridicule. I used to make the mistake of taking my readings at home precisely during those times that I should not: when I was feeling something odd, when I was stressed, when I had just finished a meal, etc. These readings, made using a portable instrument that a friend in community graciously lent me, would unfailingly give high numbers, which did not fail to send me into panic mode and shoot up those numbers even more. When I realized how I trapped myself in a never-ending horror train ride, I thought it wise to discard that gadget of paranoia once and for all.
Devolving to the path of hypochondria, I found out, is distressing. As I felt a new symptom, I was compelled to do an online research. Googling for explanations has been very helpful in calming me down, but ironically, it has also triggered more panic, as every new symptom I read seemed like a self-fulfilling prophecy, for I tended to feel that new symptom the next day.
Hypochondria is a particularly fascinating subject in terms of the complexity of embarrassment it is able to give. I just have to discuss it separately.
My experience of hypochondria
In the affliction called hypochondria, I have devolved into the type that tends to blow things out of proportion. When I get a headache, I’d most likely think in terms of brain cancer and aneurysm. When I suffer vertigo, my mind often leaps to thoughts of collapsing alone on the street and being run over by a speeding car. My mind tends to jump into conclusion like that because I knew people -- relatives, friends -- who actually passed away that way, or that I watched too much news and movies with such scenes.
Apparently, hypochondria is the morbid fear of catching or developing a disease just from feeling the slightest symptoms of possible illness. Because a person afflicted with hypochondria is often labeled a 'hypochondriac,' that's what society calls me. But I much prefer referring to myself as a person with hypochondria. After all, I am not my disease. I am not a disease.
I know it sounds ridiculous to most people, but feeling always like it's the end of your days is not funny to me. But that's how life is to me; to be a 'hypochondriac' is to be constantly the butt of jokes, so I might as well make fun of myself.
A 'hypochondriac' is foolishly obsessed with vital signs. I know that a typical (normative-sized) Filipino male should have a weight of 53-66 kg (116 lb15 oz -145lb 13oz), a body mass index of 20-24.9 kg/m3, or fat index of 17-23 %, and fat mass of 9.9-14.5 kg or 21lb 13 oz-31 lb15 oz. Normal blood pressure (stroke volume X heart rate X peripheral resistance in mmHg) should be 120-129/80-84, even up to 140/90, with optimal BP of over 120/over 80, a high normal of 130-139/85-89, a high (above borderline) of between 141/91 and 159/94. Normal heart rates at rest for adults (age 18 and over) should be 60–100 beats per minute. To quote Mayo Clinic: "For an adult, a normal resting heart rate ranges from 60 to 100 beats a minute. For a well-trained athlete, a normal resting heart rate may be closer to 40 beats a minute. For healthy adults, a lower heart rate at rest generally implies more efficient heart function and better cardiovascular fitness."
I know that a practical test to determine 'heart health' is to go up the stairs (of typical height) and see whether one can 'hack it' without running out of breath. And so on. (Of course I know about lung function test as well, but it can get too technical even for me.) I know what endorphins are: happy hormones you get from exercise. I am intimately familiar with insulin, glycemic index, and sugar rush, adrenaline, noradrenaline, and cortisol and other stress hormones, not to mention LDL, HDL, trans fats and triglyceride. I have knowledge of drug interactions between, say, caffeine and nicotine, particularly how they feed on each other, producing drug addicts, technically speaking. I know that consuming alcohol makes a lot of drugs ineffective.
A person with hypochondria is equally obsessed with RDAs or recommended daily allowances (now called daily values or some other coinage), because he is aware that a deficiency can lead to disease, while an excess might also lead to other diseases. I have memorized by heart the following RDA figures: total fat 65 g, saturated fatty acids 20 g, cholesterol 300 mg, sodium 2,400 mg or about one teaspoon, potassium 3,500 mg, total carbohydrate 300 g, fiber 25 g, protein 50 g, vitamin A 5,000 IU, vitamin C 60 mg, calcium 1,000 mg, iron 18 mg, vitamin D 400 IU (or 15 minutes of exposure to early morning or late afternoon sunlight 3-4x/wk ), vitamin E 30 IU, vitamin K 80 µg, thiamin 1.5 mg, riboflavin 1.7 mg, niacin 20 mg, vitamin B6 2.0 mg, folate 400 µg, vitamin B12 6 µg, biotin 300 µg, pantothenic acid 10 mg, phosphorus 1,000 mg, iodine 150 µg, magnesium 400 mg, zinc 15 mg, selenium 70 µg, copper 2 mg, manganese 2.0 mg, chromium 120 µg, molybdenum 75 µg, and chloride 3,400 mg.
Needless to say, I am a multivitamin pill-popper (especially in days I don't eat fruits and vegetables), not to mention a hound of health websites and an avid consumer of health news reports. On really bad days, though, I fear all reports on health, thinking whatever is being featured is already something I have contracted or been harboring.
A hypochondriac is also stupidly obsessed with antidotes and first aid. I know a lot of factoids that most people don't. I know that the first aid to a severe allergic attack upon ingesting seafood such as shrimp is to swallow a spoonful of sugar and drink lots of water. I know that one extreme allergic reaction to bee sting is anaphylaxis, which is an emergency case (in other words potentially fatal, as it leads to heart attack) that merits an epinephrine shot. I know that OD-ing (overdosing) on something good like Vitamin A can also be dangerous, and can be cured at home by consuming some amount of cholesterol. I figure that, after consuming the wrong drug, one might drink alcohol to render it ineffective, but I am also afraid poisonous interactions could result, so it is best to consult a doctor in this case. Hypochondriacs, not being graduates of medicine or licensed doctors, only give up their illusions of omniscience after exhausting themselves silly.
I've heard that a person on the verge of collapsing from a possible stroke can be helped by applying ice packs below the back of his head and moving his four limbs in circular motion.(Er, the truth is I am just repeating what I heard from a friend of a nurse.) For caffeine intoxication due to overdose (overconsumption), I know that one just needs to double the dose of his usual food intake to counteract the excess. (I heard this from a friend who has a relative who's a doctor, and the suggestion worked for me.)
Palpitations are a special problem for me because they set me off very badly, sending me thoughts that I am in the middle of having a heart attack (the associated symptoms -- shortness of breath, numbness or tingling in the extremities, dizziness, confusion, sometimes fainting -- unfortunately mimic an impending heart attack). Whether the palpitation is caused by caffeine intoxication, gluten intolerance, consumption of certain mushrooms, or simply sugar overload or hyperglycemia (a thyroid problem may be an additional culprit), palpitations can be especially frightening, but I know it is best to sit down or lie down and breath hard, inhaling and holding in the air for ten counts/seconds, then exhaling forcibly. I know a Valsalva maneuver may also be done, and it seems to relieve the stress somehow, whether or not it's just a placebo or psychological effect (they say the maneuver relieves an irritated vagus nerve).
Of course, I have also heard somewhere that bangungot, or the mysterious death in the middle of sleep, which happens to a lot of Asian men at the prime of their life, is not pancreatitis, but arrhythmia (abnormal heartbeat), and that, to prevent this fearsome incident, one must keep awake two to three hours after one's last meal. (I actually heard this piece of medical advice over AM radio from Dr. Elisa Perez-Francisco of St. Luke's Hospital.) Some people, however, blame eating noodles before sleep as the culprit. Yes, I am prone to the latest medical canards.
Someone with a compulsive fear of illness also has a religious devotion to home remedies, especially herbals, because he has grown distrustful of pharmaceuticals due to their side effects. Hypochondriacs are natural fans of naturopathic or alternative medicine. For instance, I know that herbal home remedies for hypertension include an entire range of kitchen ingredients, namely bay leaf, lemongrass, moringa oil, king of bitters tea, potassium-rich banana and orange and, as alleged, lemon half sliced in 100 g water every two hours, tomato, apple, bottle gourd, banana stem juice, papaya, mint leaves, cucumber, unpeeled boiled potato cooked in salt, watermelon, mango and milk, peach, honey, three-day fruit and steamed vegetables fast, coconut water, celery, cayenne pepper in water, onion and honey, garlic and raisin, fennel seeds plus cumin seeds, grapefruit (this may have a dangerous interaction with hypertensive medications, though), katuray or corkwood tree (Sesbania grandiflora), and fresh potato juice. ...I mean, these home remedies may be taken only as a supplement to the following: GNC-7 Dash Plan diet (a low-sodium, low-fat diet), yoga, 2 cups per tub seasalt bath, water cure (4 glasses of water upon waking up, for 3 months), deep breathing, and positive-thinking, not to mention weight reduction, regular aerobic exercise, such as brisk walking for 30 min. for 4 days a week, moderate alcohol, and quitting smoking.
However, I tend to over-research by Googling each illness I have, and thus stumbling into separate medical opinions such as Dr. Johann Georg Schnitzer's, which says overconsumption of protein and processed carbohydrates is the real cause of hypertension (see http://www.dr-schnitzer.de/hypertension.html), which, of course, leaves me confused and suspicious of the diuretics, beta blockers, calcium channel blockers, angiotensin receptor antagonists, ACE inhibitors, or combinations thereof being marketed.
A hypochondriac like me is ridiculously paranoid, as I have said, that when I see a plane, I see a plane crash next, and when I see a car, I see a potential car accident. Naturally when I see a ship, I am immediately consumed by the thought of sinking. Whenever I see food, I see either medicines or sicknesses. What's worse, to the food-paranoid like me, the line between food and poison is ultrathin, and the prayer after meal is often, "Thank God I didn't die (of choking or anaphylactic shock)." This is what I call the great hypochondriac logic.
If I pop two or more pills together, I automatically fear an attack of the dreaded Steven-Johnson's syndrome. I believe I should never try to be a doctor, for the more I know, the more I surely will fear. I especially should never have the ambition to be a pharmacist, for each and every drug I get familiar with is certain to have a matching affliction that my wild imaginings will anticipate.
But don't I sound just like a nurse or a doctor all the same? You could say all I needed to be legit is a license. But no -- I am, in fact, one person who makes nurses and doctors and drugstores rich, and one who keeps them gainfully employed. If I notice that I tend to doctor myself too much, I give myself a warning not to self-medicate but to consult a doctor (but in cases when "symptoms persist, to insult him").
The truth, however, is that I am deathly afraid of doctors and nurses. Whenever I see one, I see the specter of Death himself prescribing my very end. Though hospitals are places I frequent, they are also places I dread and hate with my guts.
A 'hypochondriac' is not just afraid of illness; he is afraid of death itself; he is afraid of extinction and oblivion of the self. I know something in my past had brought me to this. I already have an idea, but I don't want to dig it up completely right now, because I am afraid I have gotten so used to this. I've heard that the cure to all this is to find the root and to expose myself to what I fear, but I guess I am not ready yet for the confrontation.
Because of this fear, I live life from day to day. Because of this morbid fear, I've become closer to God, although it's a closeness that comes with the consistent fear that He might take my life any moment (right, as though I am in control).
You might think I am enjoying it and even using it to my advantage when 'necessary,' as when I need to be absent from work out of laziness. But no, I am not a compulsive malingerer (or feigner of illness).
It's funny, but if you happen to be young and a hypochondriac at the same time, you are sure to be preoccupied with mortality and be one with the elderly in their end-of-life issues and concerns at a laughable age.
But hypochondria is no joke. May no one else be visited with this misfortune, because it is like facing the firing squad every time even though I am not sure where exactly my executioners are positioned.
Now, let me discuss agoraphobia, too, but briefly this time.
The first week I knew I had agoraphobia was a week I refused to step outside my gate for fear of fainting from palpitations due to another panic attack like the last one I had. Being unable to go out is like being jailed. Although the siblings I live with tried valiantly to be understanding, they were nonetheless incredulous. At times when I had to request for one of them to buy me something (usually food I like), I could sense their annoyance at the situation. That's one full week of being a jailbird.
When I finally got exhausted being panicked at the mere thought of going out, I tried to go out on my own little by little, first to the nearest convenient store, then to the nearest street corner, then to the barber, then to the nearest wet market. I kneeled down in thanksgiving for surviving each attempt, right away after the moment I step inside the house again unscathed. Seeing the outside world again was like being a born-again Christian.
The worst part of agoraphobia for me, being a devout Catholic, is not being able to receive the sacraments (from where I draw my spiritual strength) in person, confined as I was to the 'healing masses' on TV.
Overall, I was seriously debilitated by these twin fears for around two months.
One sign I know I am depressed is that I routinely
wake up in the middle of the night, not just to take a leak, but to be wide
awake for about an hour or more. There is even a technical term for this type of insomnia: maintenance or middle-of-the-night insomnia or nocturnal awakenings. I would often wake up with undefined thoughts that
unsettle me. It could be all about loneliness. Sometimes, I would be given to questioning my state of life, concerning myself with the
future, thinking of how lonely I am, of why I am stuck in this place, how long I will live, who will be there with me when I
get sick and old and penniless, and so on. I try to counter these evil negativities with
prayer, the rosary in particular, perhaps because the mantra-like sound of repetitive Hail Marys has a calming effect on my nerves.
Like I said earlier, allergic attacks are another inescapable complicating problem for my panic attacks. This is due to the ever-present risks of:
Angioedema or swelling
Choking due to phlegm stuck in the throat
Difficulty breathing due to constriction of
airpipe or bronchospasm, for it would indicate an advanced state of angioedema, which could
lead to heart attack or cardiac arrest due to deprivation of adequate oxygen or asphyxiation.
(By the way, nothing cuts to the quick than the thought that food can kill. It is inconceivable how what God meant for life leads to death instead.)
Sometimes, or oftentimes, I am not sure what exactly causes the allergy, or is it really just a case of food sensitivity. It is hard, even
almost impossible, to pin down the culprit, given the variety of foods I eat everyday. It is taking me forever to determine which exactly causes the problem, which is a problem because, right now, I can not afford a decent allergy test, which is said to set me back by at least Php6,000 if I am lucky.
If it is
just food sensitivity (particularly sensitivity to caffeine, certain mushrooms,
and gluten in wheat/flour, not to mention the extra salt (above 2,000 mg per day) that gives me hypertension), the punishments are comparably milder but
nonetheless equally unwelcome:
Feeling like I am ugly due to a bloated face and dark eyebags
Weakness after exerting a little effort
Fatigue even without exerting an effort
Pruritus or mild itching everywhere
Dermatographis (red bumps) if I scratch my itchy skin
I have not even touched on the food deprivations I have to go through, out of the desire to avoid another allergic episode, on top of the sad deprivations of avoiding certain foods due to hypertension. It means I had to try my own version of the Paleo Diet or Caveman Diet: keeping myself from anything with high sugar including sodas, processed carbs like the flour in pasta and bread, and cooking oil, on top of avoiding all instances of caffeine (goodbye coffee, tea, and chocolate, unless decaf!), mushrooms (except ear fungus), and the top suspects of histamine/allergen source, fish and seafoods and anything with egg and nuts.
By the way, as a food reviewer, which was once a part of my job as a magazine writer before, I had to skip certain items and relied on the photographer assigned to me for evaluation. When an editor discovered my allergies, she probably relayed the crucial information to the publisher. I felt like a fraud for not volunteering the information beforehand. I did not receive invites to review food again, except when the publisher was gripped with amnesia.
Foods rumored to alleviate hypertension: lemon and other citrus fruits (except grapefruit, which contains bergamottin, a substance that interacts badly with antihypertensive drugs), coco 'water', cucumber, pineapple, papaya, moringa leaves or any leafy vegetable, luffa, katuray flowers, tomato, bay leaf and other spices, bitter gourd, herbs like king of bitters (Andrographis sp.), banana, and other potassium-rich foods.
(This unexpected dilemma about eating reminds me of the first time I went to a famous EENT specialist in Tarlac after an ear infection when I was in grade school. The doctor forbade me to eat anything that was matamis (sweet), maanghang (spicy), maalat (salty), and malansa (fishy). To someone brought up in the Pangasinense culture, which loves bagoong, buro, dalag, hito, bangus, sweets, and some chili in certain dips too much, that was like telling me to go to hell or be dead quick.)
Having no car and being at the mercy of Manila's chaotic commuting system, which assures three things verboten to someone hypertensive and panic-stricken, namely, heat/humidity, noise, and the stress of chaos/confusion, assured me of extremely limited movement. My restricted movement simplified my life to absurdly funny levels. Even the caveman ventured out of the cave, pursuing livelihood and life, and here I was moving only within the confines of home and the immediate vicinity.
During the peak of my panic episodes, life felt like it was just literally passing me by. The following is a survey of the many opportunities lost, reminders of what significant things I had to let go of with much regret:
Reunion with college batchmates
A rare dinner invite from an old college friend and his wife (Renan and Sheila)
Monthly confessions at Greenbelt Chapel or Baclaran Shrine
Healing mass at Landmark, Makati
Friends' (JR's and JC's) wedding, where I was specially invited
Two nephews’ and niece’s christening
A brother’s (Rommel's) marriage in Liliw, Laguna
Several travel writing assignments within Metro Manila and beyond
Other office-based job opportunities
My friend Marc's wake
My friend Alma's mother's wake
Pilgrimage to Lipa
Retreat in Bicutan
End of an important leadership talk
As a christening sponsor/godparent to Helen and Zaldo's daughter
As a christening sponsor/godparent to Vicky's daughter
Bible study sessions and other activities in my lay religious community
Several important prolife activities
Reunion with former Quorum and Asec officemates
And so forth
I felt so unproductive, economics-wise, wasting time in long stretches. I eased my guilt by finding something, anything, that would occupy me: cleaning a dusty corner I did not notice before, editing an essay I had long forgotten, watching obscure movie titles on YouTube, etc. I realized from awful losses, however, how much social life I've been blessed with. In fact, I began to question whether or not I was having way too much of it.
If not for the radical faith I choose to cling on to, these past memories would have been too bitter to recall.
In retrospect, could it be that the vitamin B deficiency the result of my decision to reduce my food intake, particularly vitamin B-rich meats, after being diagnosed with hypertension? Possibly. It could also be a hormonal, genetic, or ageing-related thing. A cousin's wife actually suggested I could be having andropause, which embarrassed me no end. (At age 42-43?) In case it is physiological, indeed hormonal, not psychological, then perhaps I am entirely not to blame.
But all these are biological or natural causes. Through supernatural or spiritual eyes, I see some other cause. Looking back, I was struck down tremendously while I was also in the middle of serving God at various fronts:
- I was back full-time in community, and particularly active/committed as a Music Ministry member.
- I was serving dozens of young professionals from Smart and other companies through a Bible study and witnessing/sharing/testimonies every Thursday night at the Smart Tower in Ayala, and I willingly spent for taxi rides to and fro because of my condition.
- I was serving the youth in our outreach in Meycauayan, Bulacan, sometimes as a speaker.
- I was active in the prolife movement, particularly in fighting the 'Reproductive Health' Bill.
- I was active in anti-LGBT (lesbians, gays, bisexuals, transgendered) activities by helping spread the truth about homosexuality and the evils of the homosexual lifestyle in my own little way.
Could it be that the devil was terribly displeased with me that he unleashed all the powers at his disposal to scare me? If so, how come God even allowed it? He could have prevented such an attack, Why did he not spare me? What could be His aim?
How would people react if they knew this part of the story? Would not they be discouraged to follow and serve God? Surely, they would be scared to serve, knowing such a risk as mine?
Feeling imprisoned by the handicap, I was seized by the thought that I was doing time for past offenses, which I have many. Some souls, they say, are doing their purgatory here on earth. Could it be that I chose to be one of them? To quote one funny viral video, "How come I was not informed?"
At the back of my mind, I knew this attack on me, if not on any random member of my family, would come sooner or later down the road. I am not new to this, after all. I am a veteran of spiritual warfare. I hope I will not sound unseemly boastful, but I think I have earned my stripes when it comes to battling life's sufferings on account of some intercessory prayer for certain souls. I, too, am not immune to family members having problems that can sadden deeply to the point of disturbing: separation, accidental pregnancy, penury, unemployment, under-employment, sudden wedding, unpreparedness for wedded life, bodily ailments, etc., all of which bring with them all sorts of new griefs. Yet I still felt unprepared and overwhelmed when it did come. I could say I even lost my focus at times by questioning or doubting the love of God for me, in my momentary forgetting that this could all be the enemy's handiwork. All this is spiritual speculation, of course, but I can intuitively feel the truthfulness of it.
In terms of massaging my seriously bruised ego, it also helps immensely to know that I am not alone. In the purgatory of panic attacks, I am in the good company of certain friends and celebrities. (Because I owned up to having panic attacks, five friends admitted to have gone through panic attacks without shame or embarrassment.)
Furthermore, it is no mean consolation that the Biblical prophet Jonah also got angry with God. Jonah even avoided God several times, then after following God's command, he resented the result and went away somewhere far and sulked.
Henri J.M. Nouwen reminds us that no less than Jesus Christ had a moment in life in which he panicked: "Many people say, 'I am not afraid of death, but I am afraid of dying.' This is quite understandable, since dying often means illness, pain, dependency, and loneliness. ... The fear of dying is nothing to be ashamed of. It is the most human of all human fears. Jesus himself entered into that fear. In his anguish "sweat fell to the ground like great drops of blood" (Luke 22:44). How must we deal with our fear of dying? Like Jesus we must pray that we may receive special strength to make the great passage to new life. Then we can trust that God will send us an angel to comfort us, as he sent an angel to Jesus."
My biggest enemy in this fight is myself, my imaginative brain in particular, especially the way it jumps to conclusions by connecting A to Z in split seconds. I am supposed to be a smart guy, but here I am feeling like I am the dumbest person in the world. In this most awful story of mine, it seems my supposed smartness is working against me more than it is working for me.
The 'healing priest' Fr. Fernando Suarez, whose work is a remarkably miraculous one, often says the following point during his homilies: Whenever a person is ill, he tends to over-think:
He feels useless, and so he has very low self-esteem.
He feels bad about being a burden to his family and friends/community. ("I am already hard-up; do I have to get sick as well?")
He fears the future ("What would happen to those I will leave behind?")
He may also blame himself for his 'fate.' (Maybe I am guilty of having brought this misfortune upon myself, through my unhealthy habits or, spiritually speaking, my sins.)
In Christian evangelistic terms, someone who is ill like me finds it almost impossible to attract others to Christ, as commanded. Knowing most people, what they will surely think is this: "Whatever he is having, I don't want to have any of it!" While it's true that an incredible display of faith in the middle of misfortune is capable of inspiring others, it is also capable of leading others to think that the ill and indisposed is going through some punishment, which in euphemistic terms, may be called purgation or purification.
And in case I am indeed being punished, then what exactly for? What is the exact sin? Punishment is even more absurd, even harder, when you don't know the reason why.
Someone who's ill like me is, therefore, most likely seen by most people as accursed, someone who has fallen out of God's favor, never mind the thought that suffering could have a deeper purpose, or the thought that those who go through extreme suffering has greater intercessory power. In case I had been suffering for others' redemption, what now? In the wild scenario that I am a saint in the making, my volunteer mentor-tormentors would be written off in salvation history as my persecutors who were ironically also my confreres, my closest spiritual intimates. In effect, my life will have been just a repeat of the lives of gruesome suffering of many a tormented saint.
One great problem posed by the thinking that the sick is being punished by God for something wrong he has done is that it gives the picture of a God who is a vengeful God, causing His subject to become a bitter subject. Given this thought, the next line of self-questioning is inevitable: Am I really that evil? I know I am capable of evil, but how am I exactly worse off than the next guy? I've met quite a number of messed-up people, so I am privy to the lowest nadirs in human character. I have had a glimpse into what humanity is all about: inherently good, yes, but also helplessly, hopelessly evil without God. In short, after all is said and done, I end up with the totally predictable plaint: "Why me, Lord, why single me out? What exactly have I done that many others have not? Why me, and not them?"
Furthermore, the image of a vengeful God runs in contrast to the very image of the Divine Mercy, He whose "ocean of mercy" is supposed to be fathomless, bottomless, abyss-less. Which God is which? Will the real divinity please stand up?
Then again, I think I have already figured out long ago this particular spiritual Gordian knot: the connection between sickness and punishment is not cast in stone, for as Luke 13:4 puts it,
"Or do you suppose that those eighteen on whom the tower in Siloam fell and killed them were worse culprits than all the men who live in Jerusalem?" (New American Standard Bible, 1995)
The message of the passage, plus another similar passage involving a man who is blind from birth (John 9:1-12), is clear: Some people suffer because their suffering has a higher purpose: to glorify God (to put it bluntly).
The other answer I got is: My suffering is for me to become more Christ-like:
1 Peter 2:18-25 (New International Version): "Slaves, in reverent fear of God submit yourselves to your masters, not only to those who are good and considerate, but also to those who are harsh. For it is commendable if someone bears up under the pain of unjust suffering because they are conscious of God. But how is it to your credit if you receive a beating for doing wrong and endure it? But if you suffer for doing good and you endure it, this is commendable before God. To this you were called, because Christ suffered for you, leaving you an example, that you should follow in his steps. “He committed no sin, and no deceit was found in his mouth." When they hurled their insults at him, he did not retaliate; when he suffered, he made no threats. Instead, he entrusted himself to him who judges justly. “He himself bore our sins” in his body on the cross, so that we might die to sins and live for righteousness; “by his wounds you have been healed.” For “you were like sheep going astray,” but now you have returned to the Shepherd and Overseer of your souls.
Wait, there is a further answer: My affliction could have been meant to encourage (in faith) those who are similarly afflicted:
2 Cor1:1-7: "Paul, an Apostle of Christ Jesus by the will of God, and Timothy our brother, to the Church of God that is at Corinth, with all the holy ones throughout Achaia: grace to you and peace from God our Father and the Lord Jesus Christ.
"Blessed be the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all encouragement, who encourages us in our every affliction, so that we may be able to encourage those who are in any affliction with the encouragement with which we ourselves are encouraged by God. For as Christ’s sufferings overflow to us, so through Christ does our encouragement also overflow. If we are afflicted, it is for your encouragement and salvation; if we are encouraged, it is for your encouragement, which enables you to endure the same sufferings that we suffer. Our hope for you is firm, for we know that as you share in the sufferings, you also share in the encouragement."
The question I should be asking is, therefore: What is God up to? How exactly am I to glorify God with all these shameful embarrassments? Since this line of questioning is unanswerable, I guess it is best left hanging in the balance of faith.
Amazingly, I've been through all of the above mental-emotional scenarios recounted by the healing priest, and oh, what a grand roller-coaster ride it all was! At least I can say I have had such an enriching experience, and, boy, by the sheer grace of God, I survived them all!
In my experience of panic disorder, I never expected to go through the wringer by running the whole gamut of emotions throughout the trial: the shame, embarrassment, failure, regret, loss, longing, fear, fright, panic, grief, anger, rage, bitterness, envy, discontentment/bottomless want, greed, lust, addiction, depression, numbness, confusion, guilt, irrationality, paranoia, hopelessness, despair/desperation... In panic disorder, the horrific, the humiliating, and the hilarious converge like strange bedfellows.
But the feeling of healing, when it does finally come! When I went home in the country to recuperate during the Christmas holidays, I have learned from my mother that she had also been through panic attacks before in recent years, and she was told it was due to vitamin B deficiency in her diet. She said she was advised to take a vitamin B supplement. She claims to have felt better after about a month, so I tried the pill myself. Unless it was all placebo effect, the panic episodes seems to have subsided a lot, thank God!
Maybe, too, this is one of those countervailing forces to keep me grounded, after attaining this great achievement of facing the demons of my past, which are legion (a long story that should be separately discussed). Whichever the case, the confusion and uncertainty is certainly not reassuring. All I have are questions, unanswerable questions, at this point.
Today, I can relatively endure the day's horrible news. I can watch again health features or read health articles. In most days, I can walk around the neighborhood unassisted, or without resorting to prescription drugs. I no longer panic as much as before. The tinnitus is still there at certain times, but at least I can endure loud sounds better. Whenever a jumbo jet passes by, I burst into a "Salve Regina" and other high-pitched songs thto help calm me down. I still get hypertensive during certain stressful situations, particularly when it is humid and the place is noisy and crowded. Compared to the year before, I have much improved this year.
Last Saturday night, I finally was able to attend anticipated mass on my own after walking the three blocks to the church unassisted. This alone is a cause for celebration! I had no serious debilitating palpitations this time! I had to find the best spot, though, the one most comfortably away from the speakers to avoid possibly being aggravated by loud sound.
As for food, I found out I can eat most fish because I was able to trace the causes of my food sensitivities/allergies in the form of itchiness: strong spices such as turmeric, ginger, chili, onion, and pepper and maybe excessive egg consumption. Fish paste, fish sauce, and probably most other fermented fish products still give me lip and cheek swelling or facial angioedema, however.
Looking back further, I think what contributed to my full-blown panic attacks is the sudden loss of my full-time job at Innodata in September of 2012. It left me not only financially crippled, but also psychologically panicked, because my worst fears in life were intensified to an unprecedented magnitude. If I did not have a job, who was I? I thought, wrongly of course, that I would be worth nothing.
Since I lost my heath card, I could no longer afford to consult a doctor these days whenever I wished, unlike before. As I noted earlier, Googling proved to be a helpful alternative, but this also came with the risk of being sent back to the hell of panic attacks, no thanks to an imagined heart attack after learning something horrible that I had not encountered before. What I do is avoid online research as much as I can, in which case, ignorance is really bliss. In place of that, I resort to the healing prayers and homilies of Fr. Fernando Suarez and Sr. Raquel Reodica on YouTube, which are quite numerous and which I have, of course, watched one by one. In case I do kick the bucket (and I pray to God not too soon), let it be quick, fast, and painless.
Lastly, I am very much humbled by my dependence on other people, mostly my two younger brothers, for financial help. This is a litmus test of my pride, I who never asked my siblings for anything, thinking it was I, the family's prime beast of burden, whom they always asked for something.
My experience has taught me the truth inherent in some cliches ("live life moment by moment," "live life in gratitude," etc.), but alternately it also brought me to bursts of incredulity. "Wow, God, what is this?! What do I do now this time, God!? Are you testing my faith, cleansing it, purifying it of whatever selfish motivations that remain?" This self-introspection is inevitable: "Is my faith pure? Is my service for real? Am I serving God because I was hoping all along I would get rewarded with earthly blessings, specifically success as my parents and family and the rest of society define it? Or perhaps because of the fear that I might get to hell if I disobeyed you? Is my faith just another kind of fear? (How awful it is, if so!)"
In case of the latter, I treat the new crisis as a radical call to trust, a new opportunity to hold on to my faith, hoping that I was "struck down for the sake of Christ," paraphrase the Bible, more than because of own my (wrong)doing. I choose or decide to man up, because frankly, contemplating about your death all the time can get tiresome, a lousy option.
Yes, this part bears repeating: When nothing and no one is left to console me, or so it seems, the only thing left to do next is to be like Job at the height of his long string of misfortunes: be scourged and then carry the cross, maybe in heroic endurance, or maybe with much complaint (like Jonah and Elijah) and lamentations for heaven's intervention (like the Psalmist often did). After that, I have proven to myself there is still another choice left when things still prove to be too much to bear: Do the counter-intuitive thing and, by sheer act of the will, praise the Lord. This is what that memorable song number, "In Moment Like This," in Joseph the Dreamer is all about:
In moments like these, I sing out a song
I sing out a love song to Jesus
In moments like these, I lift up my hands
I lift up my hands to the Lord
Singing, I love You, Lord
Singing, I love You, Lord
Singing, I love You, Lord
I love You
There is also one song in the charismatic movement that stuck out for me in this great and terrible trial that befell on me: "I Will Joy in the Lord," which is based on Habakkuk 3:16-19:
Though the fig tree blossom not, nor fruit be on the vine,
Though the fields produce no food,
And though the flock be lost,
I will joy, I will joy, I will joy in You, my God.
I will joy in your salvation.
You set my feet upon high places.
You make me run like a hind.
Oh, Lord, be swift to answer.
I will wait, I will abide.
I will joy, I will joy, I will joy in You, my God.
I will joy in your salvation.
This must be what hoping against hope, or "theological hope," means or tastes like: bitter at first and in the end irrationally sweet -- irrational because there is no compelling reason to feel good, save for the last thread of thought that one is assured of Christ's salvation. It is equivalent to O. Henry's last leaf, even if that image of the barely-hanging leaf seems self-deceptive to the outsider.
This may yet be the single greatest discovery in my spiritual journey: that I can indeed choose to be happy, or to be more technically accurate, joyful, even if I seem to have lost everything. I can still have joy even while crying in pain. Hardly a new major pronouncement, I know, for I am rehashing the great St. Teresa de Avila's oft-quoted line, "Solo Dios basta" ("God alone is enough.") But the breakthrough is I am not saying this intellectually, but experientially. I have been through the ordeal, and personally know what it is like.
Now this is not to harbor any illusion that I could still regain the strength I had during my prime. After all, I am 42 going on 43. There, too, is the additional horror of things taking a turn for the worse, against which my future prayers are arrayed. Whatever the outcome, I pray I will have the courage to say "Thy will be done" and believe every word, if not embrace it.
Apart from all these, plus of course the daily word of God and the decision to focus on what I have and what else I still can do instead of mulling over what I lost, I also rely heavily on this singular thought for strength: From experience, I know that terrible trials always precede tremendous blessings. ...At which point I will let one of my favorite contemporary spiritual writers (Henri Nouwen again) to say it better for me:
"Critical Events Can Reveal Divine Purpose"
"Life is God's initiative and can end or change suddenly, unexpectedly, and unpredictably. When we humans are ready to give up hope and resign ourselves to inevitability, God intervenes and reveals completely new beginnings. The resurrection of Jesus is God's sign breaking through every form of human fatalism and despair. In every critical event, there is an opportunity for God to act creatively and reveal a deeper truth than what we see on the surface of things. God also can turn around critical incidents and seemingly hopeless situations in our lives and reveal light in darkness."
In closing, I thank God for these unexpected blessings in the middle of this difficulty:
The ambulant vegetable vendor who supplies my daily dietary needs
The ambulant fruit vendor who supplies my cravings for apples, oranges, and other fruits
The ambulant snack vendor, from whom I get my supply of a dessert I find hard to skip: bilo-bilo
The four sari-sari stores and two groceries nearby, because I don't have to make that trip to the mall (I miss malling, though.)
For the two turo-turos eateries nearby, for freshly cooked viands, in case I am too lazy to cook
My brother's monthly supply of rice
My younger brother, who I can run to for money for all of the above
My cousin's apartment, the rent of which I am unable to pay last year and this year
Sunday healing mass on TV when I am not confident of making the 400 or so steps to the parish church three blocks away
The Internet, Blogger, Google, YouTube, Facebook (I wouldn't survive without all that distraction!)
I also will never forget the people who, in my moment of trial, helped me in deed and not just in thought and word:
Kuya Monching, for giving me most surprising visits at home, in two unexpected times even though he knew parking for his brand-new SUV was a problem and a great risk.
Alfie, for visiting me every now and then, to check on me, and for plying me with movies worth watching during my confinement.
Ian, for doing the same, for keeping me company at one of my lowest points, Good Friday.
Gelo, for supplying me with reading materials in .pdfs (he knows roughly the materials I will find interesting).
Jocelyn, for her 'foresight' in gifting me with a Kindle.
Kuya Ed for texting me if I needed anything, which was enough consolation
Kuya Mel for inviting me to a chat over coffee, not just once or twice, but thrice.
Ate Mitz and Ate Agnes for giving me sacramental objects (a Divine Mercy rosary bracelet and a St. Benedict necklace, respectively) to wear to ward off the evil of fear in me
For Kuya Rey and Ate Odette for ferrying me in their van whenever I decided I felt well enough to travel to Vito Cruz for the community assembly
Other brothers and sisters in community and beyond who personally voiced out their desire to visit me at home, even though they failed to do so for one reason or another, chiefly because they had no guide to my car-unfriendly place (they know who they are).
Anonymous community members who gave me cash
Other friends who promised to pray for me, specifically Stef, who included my petitions when she went on a family pilgrimage to Fatima (Intercessory prayer, if delivered as promised, is what I appreciate the most these days, even if ironically it seems to be the most effortless help possible.)
The biggest culprit about irrational fear, or panic, or anxiety, I have found from this experience, is the refusal to recognize the fear at all, the stubborn refusal to face, or the mere thought of it. This refusal feeds the fear into a self-perpetuating debilitation.
Facing one's fear -- what a very easy thing to say. In practice, it's altogether a different ball game. But it is the only way out I know, in my case.
I am a bad logbook writer, for I failed to note the exact dates. Also, I wrote the following entries from memory, not right after each fact. I am also certain I have left out a few events, but the ones below are the most significant and memorable.
- Prior to having full-blown panic attacks, I had been suffered on and off, for years, from frightening palpitations, often from too much caffeine, dark chocolate, button mushroom, Chinese food (maybe due to the high MSG content), a certain food supplement that was touted to detoxify the body, and from certain bodily exertions at the wrong time, like when I had just eaten bread, pasta, or anything with flour.
- I was walking around Greenbelt 4 after lunch with Alfie when I experienced the worst palpitation I had ever. I thought I was about to die of heart attack. For lunch, I had Sprite and spaghetti at KFC, then I had brewed coffee and blueberry cheesecake at McCafe. I sweated profusely, trembled a bit, and had some difficulty breathing. I had to ask Alfie to buy me a bottle of cold mineral water. The attack appeared to be a severe case of over-stimulation due to caffeine combined with sugar rush. Minutes later, I felt weak, groggy, and hungry. We had to repair at the nearest place with rice and chicken: Wendy’s. I felt better, but I had difficulty breathing in my walk to an appointment that night.
- I had a full-blown panic attack at Moonwalk Church in Paranaque around 9:30 AM. I remember having a breakfast of leftover monggo beans and rice, plus a dessert of dried peanuts, which I suspect to be rotten. I feared dying suddenly and alone around total strangers. I asked for help from one of the women serving the priest, and she referred me to a volunteer doctor at the back of the church. The doctor took my BP, which was 150/80. She said maybe the maintenance medicine I was taking was inadequate. She never mentioned the possibility of panic attack. When I gathered enough strength to walk, I nervously braved the sun and luckily caught a taxi several meters outside the church. I took a pill of 50 mg metoprolol to calm me down, as the doctor recommended.
- I was supposed to meet my from Junrey at Inasal at Iba Pa restaurant after lunch at the corner of Merville Access Road, when I palpitated at the mere thought of walking under the sun at noon. It was not like the palpitations I usually have. It was tachycardic, or faster than normal. Nervously, I told Junrey to proceed to a nearby eatery instead. I remember having an overly sweet and sugary breakfast and lunch prior to this: syrupy taho, six pieces of longan fruit, and leftover rice and monggo beans. I panicked because of the thought of fainting in the heat and collapsing under the sun due to heat stroke. I took metoprolol.
- I was about to send my friend Marie and my high school classmate Melvin emergency cash of Php1,000 each at the nearby MLhuilier. I am not sure what I ate this time. My palpitations seemed to be due to the thought of losing money or maybe the thought of MLhuillier being attacked by goons with guns. On top of these fears is the fear that I would be making a fool of myself at this place while panicking, or I might not be able to make it as I walked my way home.
- Ironically, it was the celebration of the birthday of the Blessed Virgin Mary during my community’s assembly at Kassel Condo near Vito Cruz cor. Taft, with a replica of the miraculous statue of Our Lady of Mediatrix from Lipa City as our special ‘guest.’ I even touched the statue for healing, yet I was still attacked by irrational fear as lunch neared, because the thought of going home under the hot sun raced in my mind. For breakfast, I ate siopao from 7-11, which I learned is made of flour, not rice, three pieces of Calasiao sticky puto/ricecake, and three slices of guapple. Obviously, I feared collapsing while walking under the sun, even after hitching a ride with Kuya Rey and Ate Odette. This is where three people recognized what I was going through as panic attack because they had been through it, or at least someone they know did.
- I got dizzy after being seated the whole day in front of the speaker during a leadership conference in community. I panicked because it was so strange, for I felt okay the rest of the day. The panic symptoms refused to subside even after hitching a ride with Kuya Rey and Ate Odette. I had to call my brother Ronnie for help and, even though embarrassed, had to ask Kuya Rey to kindly drive me all the way to gate 3 of our village. I feared I wouldn’t be able to take the tricycle then walk the two hundred or so steps to my place.
- I chatted with former officemate A. about my situation, and I learned she shared my problem! I panicked at something she said which escapes me now.
- I had a similar chat with another officemate M., who, incredibly enough, also went through the same thing and even got confined to the ICU because of mitral valve prolapsed. Naturally I panicked at the mere thought of catching the same due to the high probability of it happening.
- I emailed a doctor about my problem, and her response scared me to death. After giving an advice on how to relax (“Be seated and drink one glass of cold water”), she told me to see a cardiologist. I know this is ridiculous, but the mere thought sent me to breathless panic.
- I couldn’t watch the movie Extremely Loud and Incredibly Close straight through because I found the hysterics literally breathtaking. I had to take a pause in between palpitations. The memory of the unmentionable horrors of 911 was just too much.
- I survived Joan Didion’s detailed memoir of her husband’s death, but not without palpitating upon paragraphs that vividly describes the heart attack. I had to face my fear in this case, and I think I won to a significant extent.
- In comparison, I couldn’t bear watching the TV series Deadliest Catch episode featuring Josh’s and Jake’s father figuring in a stroke and dying at the hospital. That was so terrible, for it reminded me of my friend Malou dying of aneurysm. To this day, I can’t muster the strength to see that episode. Okay, I lost.
- During the high school reunion back home, I palpitated under the sun after some 30 minutes, then I felt faint. Luckily, help was on hand. I took refuge in an alumni’s air-conditioned car, and a classmate handed me a bottle of water, restoring my sense of (false?) security.
- When I reviewed my friend Weng’s paper after she asked for help, I felt suddenly tired even when I hadn’t done anything yet. I think I had a sudden fear of losing the ability to work and dying from hypertension.
- Was all this a result of nicotine withdrawal? Side effects of maintenance drugs? Effect of vitamin+mineral supplement I was taking? Nutrient deficiency? Stress due to recent events? Past traumas and unresolved issues? I don’t know. What I know is that I can’t stand palpitations and fast/racing pulse/heartbeat! Maybe I just can't accept the truth that I am hypertensive, and these are all symptoms of hypertension that I will have to learn to live with or at least manage.
- At least three Facebook notifications sent me to panic hell, with one incident so bad it stretched to maybe more than an hour. I thought I’d die that I had to take metoprolol again. It’s maybe about the fear of being found out or being rejected for expressing the real me. In one case, it was clearly exacerbated by what I just ate: decaf coffee but with sugar, two pieces of raw plantains, one whole Tagaytay pineapple, rice and lots of okra boiled in leftover monggo beans.
- I was again attacked by panic at MLhuillier as I was sending money to my mother at home, but this one is strange: I panicked even after dieting by reducing my rice consumption and eliminating coffee and sugar. The questions that raced through my mind were: What if I collapse alone and don’t make it home? How much money I have left? After several months, I realized the fear could be springing from this then unconscious thought: What if robbers attacked this place? I surely would die in a cold-blooded exchange of gunshots.
- While hearing Mass at our parish in Kalayaan Village, I had palpitations and, strangely, tremor. I thought of dying suddenly and alone at night, and all my siblings were out of town. Would someone rescue me, just in case?
- I was one of the emcees during our high school reunion back in the old hometown. Minutes before starting, I was palpitating and, according to witnesses, looked pale. In other words, I got so nervous about speaking in front of all those people whom I knew and who knew me well. One alumna who’s a doctor gave me a tablet of metoprolol. This was my first time to take this drug, although I’ve read about it several times in my online research.
- I was reading Dr. William Douglass’ newsletter regarding the danger of hypertensive medicines and chlorine in drinking water. I couldn’t take what he’s taking, because I felt like I was about to have a heart attack from having drank all that chlorinated water for decades.
- Now this is really the worst of all: I panicked big-time while reading The Anxiety Disease: New Hope for the Millions Who Suffer from Anxiety, Dr. David V. Sheehan’s book on anxiety, because I stumbled into a page discussing the mortality rate of anxiety patients with mitral valve prolapsed. I don’t know how I was able to lull myself to sleep without taking anything while my heartbeat refused to go back to normal. The trouble is the next morning, I would wake up to my heart thumping after remembering my last thought: I could die from mitral valve prolapsed right about now. What saved me were the videos from YouTube which offer ways and means of managing panic attacks, including qi gong or belly breathing and avoiding certain diet. This is where I discovered a book that somewhat ended the terrifying kind of attacks. Barry Joseph (or Joe Barry) McDonagh’s Panic Away Program is the one that advises me to face my fears once and for all, by inviting my body to exhibit more panic right in the middle of a really nasty attack.
- Okay, the truth is there's really something worse than the above. It's when our area in Pasay was hit by a major fire. It was round 6 PM, when a girl in the neighboring house told her grandmother in an alarmed voice that there was fire nearby. I went out of the house to check with the grandmother, and in an even more alarming voice, said, "Yes, there's fire, and it's near Tambunting," which meant the fire was right in the block! What would a guy going through panic episodes do but tremble in panic? I scrounged around for a change of clothes, nervously located my wallet, and that's it -- I planned to run to the church where I thought it might be safer. While trembling and catching my breath, I checked the house one last time to make sure I wasn't cooking anything or no faucet was open. I locked the house and was about to flee when the woman who lived in front of house learned of the fire by this time. She rapped my gate hysterically and yelled, "Anybody here?! Call the fire station! Anybody!" I answered her, what's the phone number, and she yelled even louder, at the top of her voice: "I DON'T KNOOOOOOOW!!! I told her I would run to the barangay hall. While racing to the barangay hall, which is right beside church, I saw two little girls sobbing while carrying a box each of their house-clothes to safety. This intensified my nervousness. But what set me really panicking was my neighboring woman named Odette. When I came across her down the road, I asked her, "Is the fire near?" She said in a maniacal, high-pitched voice: "YES, CAN'T YOU SEE IT? LOOK!" pointing to the heavens above. Verily, I looked and true enough, the fire was visible from afar and it seemed to be reaching up to heaven. My heart must be thumping like crazy by this time. I don't know how I mustered enough strength, but I made it to the church somehow. It must be the adrenaline. But a few meters to the church, my heart was racing too fast, probably faster than my worst case, and the pounding wouldn't let up for an hour or so, right through the entire length of the ongoing mass. Oh, I can't remember what or how I prayed, but I prayed hard. I am sure I also complained, asking to know why God would humor me with this when he knew I was in the middle of dealing with my anxiety issues. I also remember creating a little scene while the mass was going on: I constantly asked the guy who's leg was amputated and who was seating on a wheelchair behind me whether the fire would reach our place, our village. I couldn't understand how he could stay calm and composed through it all. Meanwhile, some survivors started pouring into the church entrance ground; of course, their mere presence was not a comforting sight to me. At the end of the mass, I had to ask one of the lady servers for a cup of cold water because, I told her, I need to take my medicine (metoprolol) to slow my heartbeat. She obliged, while visibly absorbing the tension from me. I'm not sure how I survived after, but I did, and strangely, it made me realize that my heart could take such a hit.
An hour after of spirited texting everyone I know who could rescue me from this hell, I would learn from another neighbor that the fire was actually razing the informal settlement in the opposite side of the road, not on our side. The fire, it turned out, never crossed our side of the street, because it was under control when speeding firetrucks doused it. Among the establishments lining that side of the road where hundreds of houses turned to ashes, only one was eaten up by fire. Ah, women.
It was already 12 midnight, yet I still couldn't sleep. I could smell a trace of the smoke, and fine ash particles floated in the air outside. To help me get to sleep, I took a tablet of diphenhydramine HCl 50 mg. Honestly, I was expecting to die, but luckily I am still here.
When I got depressed, no one -- and I mean no one -- could console me. Every comment was potentially offensive, no matter how innocent or well-intended. Examples abound:
You should surrender yourself to God./You should meet Jesus. --> I have surrendered my life to Jesus, and yet this still happened to me.
"Relax! Learn to relax!" --> If I knew how to end this through relaxation, I would've done so a long time ago. If there's someone who wants to know the cure to anxiety and panic attack, that is none other than me. I would do anything, go to the moon, move heaven and earth even, just to have some peace of mind.
"Have faith." --> This implies that I lack faith, or worse, I have none. Here I am endeavoring to love and serve the Lord with my all -- for decades, and I end up feeling abandoned.
"Eat right. Exercise." Etc. --> If there's someone who wishes for me to get healed as soon as possible, that guy is me. If you get an idea how much I spend on fresh imported fruits per week, and that's only on fruits, maybe you'll cry a bucket and eat your words.
"You should live life to the full." --> If you really know me, you wouldn't say that. I can't say I have lived my life to the full -- definitely not. But I am lustful when it comes to areas of my life I am passionate about, like writing, birdwatching, architecture, travel, food, etc.
"I refuse to live in fear." --> This. is. not. my. choice. Trust me.
"I will die in battle with my bootstraps on." --> Oh, I think I'm slowly getting it by now: I'm an such a coward. I have surrendered in battle. Is that what you mean? Then good for you, Braveheart!
"It's better to die serving God." --> This presumes that I have stopped serving God. False and very offensive.
"Everyone goes through something in life. Other people have it worse." --> So you're basically saying I'm selfish or self-centered. At any rate, that doesn't make my pain feel less painful.
"Prayer is not enough; you also have to do something." --> This implies I am not doing anything. False. I tried walking while praying the rosary. In 2014-2015, I could continue walking up to the third mystery only; by 2016, I could make it to the fifth mystery, and I was so very happy knowing that I improved even just a little and with the knowledge that perhaps this is not heart disease I am battling with.
The only remarks that I didn't find offensive were the following:
"I've been through that too." --> I am automatically all ears. I want to know your story whether it is the same case as mine.
"I know someone who went through the same and she's ok now." --> This gives me hope that I too can recover, allaying my suspicion that I'd get stuck with this for life.
Surprise: the third one also works if delivered right:
"Everyone goes through something in life. Other people have it worse." --> This not only gives me the feeling that I am not alone, but also that I am not going through the worst punishment from God.