When I was in my mid-twenties I had several concerning but not alarming incidences when I would wake up in the middle of the night with my heart beating rapidly. Not the kind of rapidly you experience after going for a run, or being scared by something. Just out of nowhere, racing, with an accompanying feeling of fear; it wasn’t fear about anything specific in my life, only that I wouldn’t be able to get the episode to stop and maybe something bad would happen, medically speaking. Sudden death, for instance.
I mean, not really. Somewhere in the recesses of my brain, where logic presides, I knew I was alright. This was confirmed by a doctor I saw about the issue, who suggested that what was happening to me sounded very much like classic panic attacks. While I’ve never considered myself an unduly stressed out person, this diagnosis made some sense.
For one thing, around that time my father had suffered a minor heart attack and accompanying surgery. He was doing just fine after the fact. In fact, he was doing great, watching what he ate and boasting to us about how many miles he’d walked that day according to the odometer he’d taken to wearing. “Point eight miles, because I parked farther away than I needed to!” he’d exclaim. I was proud of the way he’d turned his experience into the proverbial “lemonade,” making friends at the rehab class he attended post-bypass and embracing a healthier lifestyle.
But maybe I was internalizing stress about his health and these probably-panic-attacks were the result. They didn’t happen often and when they did I was able, as the doctor suggested, to make my way through them with deep breathing, or sometimes laying my head against the cool tile of the bathroom wall. I was back to normal minutes later.
I never worried about this bodily quirk, but over the past year or so the episodes returned, a little more aggressively than they had in the past. I’d wake up a couple times a month with my heart racing, pressure in my chest, or both. As always, I’d take deep breaths, walk around the bedroom for a few minutes. Sometimes I’d think – weirdly calm about it all – “The hospital is a mere 15-minute drive away if this situation goes south.”
I’d stood by the stress diagnosis all those years, a diagnosis which still made a lot of sense. The last time these “attacks” had begun was right after my father was hospitalized for a heart issue, and this time they’d begun shortly after he died of cancer. In the weeks and months that followed that major life event, J got a new job, I left a job, we bought a house, sold a house, moved and our children started at a new school.
I’d briefly seen a therapist for the first time in my life, explaining to her that I just felt, “I don’t know, really overwhelmed, to the point where I don’t want to do any of the little or big things that would help me stop being overwhelmed.” She’d helped me clarify my worries and suggested how to address them in the very first visit and I was ready to stop seeing her within three, despite the fact that I discovered I really like talking about myself. But when I sat there during our third session, telling her how great everything was, she gently noted: “You seem ok. Are you ready to stop?” and I agreed that I was, and that if I started feeling less so I’d come right back.
Because I love to waste medical professional’s time with hundreds of questions, I asked her if it was normal to feel better after so few visits. She assured me this was perfectly normal for some people, and I felt very lucky to be “some people.”
(Just a short PSA that if you’ve ever thought about going to therapy for any reason, I highly recommend it. Big problems or seemingly small, it doesn’t matter. If you can feel better, then you deserve that.)
Back to the point, I still felt, still feel, like a fairly even-keeled person, not prone to bouts of intense stress.
Yet, if a person was going to have anxiety attacks, the life events I’d experienced from the summer of 2017 to the fall of 2018 would kind of do it, I figured.
I considered other explanations, however, and repeatedly told J that I should probably go back to the doctor about this, just to rule out anything serious. I could be having “tachycardia,” which refers to an abnormally rapid heartbeat that some people are susceptible to (my father had been prone to this, as well) and is usually harmless. Or maybe it was initial symptoms of thyroid disease, which runs on my mom’s family. (Families! They love to give you predispositions for things!)
Or maybe I had an undiagnosed defect that would render me dead one of these days without warning. Probably not, sure, but I’d done some writing for a national non-profit that works with hospitals a few months prior, profiling children diagnosed with a range of diseases, and internalized some of what I’d learned in the process, an unfortunate side effect of writing about rare medical conditions for hours on end. Did I have a potentially fatal heart malformation that had somehow never been identified by a professional? I doubted it, I really did, but I could, I now realized.
Stress, or something more sinister, it did not occupy my thoughts except when it was happening – an annoyance really – and I’d go through the steps. Deep breaths. Cool tile. The hospital is only a short ride away.
We are getting much better at them but weekday mornings are not our family’s strong suit. This is a common problem, I know. Getting young children out of their beds, into weather-appropriate clothes, into clothes at all – into pants when it’s below 40 degrees and you won’t be mortally harmed by wearing shorts, I get it, but all the other parents will be judging me GABRIEL – with packed lunches in their backpacks and permission slips signed last-minute.
There are so many ways to alleviate the madness, like packing up and picking out clothes the night before, which we are slowly – snails-pace-slowly – incorporating into our routine, making mornings run more smoothly. Simple preparedness is one of those proven methods in parenting, really in anything. And still? Still, sometimes we forgo the evening preparations in favor of Netflix. Sometimes = often.
The upcoming morning rush was what I was thinking about when, a few weeks ago, I had another one of my never-that-scary-probably-anxiety-possibly-near-death-episodes in the middle of the night. This one, though, this one was different in that there was no rapid heartbeat, just pressure, and accompanying finger numbness in my left hand. I was perplexed. I knew that should I Google my symptoms – something you all know you should never do and which I haven’t done since the ovarian cancer scare of 2006 (which in re-reading really explains a lot) - the search result would be something about a life-threatening condition and calling an ambulance.
And the thing is I knew, with 99 percent certainty, that I was not having a heart attack, or other kind of attack, or dying. I knew with that same certainty that what I was experiencing was most likely physically harmless, perhaps simply caused by the worries that subconsciously haunt us while we sleep.
But I thought about my children and gave myself the same advice I’d give anyone experiencing this type of situation: you should go get checked out.
So I woke up J and told him what was going on and that I thought I should probably head to the emergency room although I really, really did not want to subject myself to that experience in the middle of the night. I told him that I didn’t feel alarmed or scared and that I could even drive myself there, but that if something serious was happening I’d never forgive myself for not going.
And then, because we parents are creatures of logistics, I made sure he’d be able to handle all the morning details himself. Confirming that he’d be able to get everyone to school and to work on time was one of the worries I had about leaving the house for what would inevitably a multi-hour health crusade, probably dealing with an overcrowded and “exciting” scene in the waiting area when I could, instead, stay in my warm bed, possibly, but probably not, dying.
Of course that would be just fine, he said, after asking if perhaps my symptoms were due to the late afternoon cappuccino I’d had the day before plus watching the stressful Netflix documentary “The Keepers” – which is about murder and sexual abuse at the hands of Catholic priests, and you all should totally watch it – just before falling asleep?
In retrospect, yeah, maybe! But in the moment I considered more daunting “what ifs.” So I got up and drove myself downtown.
The hospital felt a little like a spa. This is a crazy thing that can happen when you have kids or a busy life in general: places that are decidedly not spas feel like them (the dentist, a quiet bathroom stall, a solo elevator ride).
I used to try and convince myself that if the dentist felt relaxing, that was evidence I really needed to find more time for myself, and I’d scold myself for not booking that necessary self-care. But I don’t do that anymore. It is important to make time for yourself, but I’ve also learned to own the unexpected versions of it. If the dentist equals peace for me, so be it, and if a trip to the emergency room in the middle of the night was a tranquil getaway, whatever. I mean, there were no relaxing lavender scrub treatments, but it was surprisingly quiet – almost no one in the waiting area – the providers were efficient, compassionate and didn’t even remotely make fun of me (at least to my face) when I walked into the emergency room, clearly not experiencing a real emergency, and told them that I had pressure in my chest and numbness in my fingers and was pretty sure I was just fine, but what if I wasn’t?
They did a full work up and then some. I had an EKG, and was wheeled to radiology for an x-ray. Wheeled there! In my little gurney like some kind of queen! I told the guy who took me that my kids sure didn’t do stuff like that for me, and he didn’t say anything back (my PA, however, hours later, told me I could order lunch and stay an extra hour if I wanted to enjoy the “day off”; she really got me). I was transferred to the “Chest Pain Center” where a cardiologist went over some of the potential diagnoses and procedures they could perform. I could be experiencing any number of things, from typical stress to a blood clot. Their job was to make sure my body, and especially my heart, was healthy.
The verdict? It is. During a stress test on a treadmill, my nurse, who was taking my vitals throughout the process, and who I’d bonded with complaining about the lottery that dictates placement in New Haven’s school system, and another provider, who was observing my physical responses on a nearby computer, asked if I wanted to take this thing up to the highest level, being a runner and all? And I was like HELL YES I DO, I DIDN’T COME HERE FOR NOTHING.
So we did. And I aced it. Well, except for the very end when I was feeling self-congratulatory as we all joked that I was “certainly getting my exercise in for the day” – my hospital gown ballooning around me, my sweatpants, for once in their long career, actually sweaty, and my hair flattened around my face – and I suddenly got a little light headed and told them that, ok, I was all done. I’d been up since like 2 a.m., had had nothing to eat or drink since then, and they concurred that I’d put in my time. And that my heart’s performance on the EKG, x-ray and stress test was excellent.
I had to wait a couple of hours for a final visit from a rounding doctor, during which I devoured the muffin and orange juice they brought me for breakfast, and gave my eternal thanks when the nurse got me a cup of coffee, which they don’t normal serve in that part of the hospital, due, I think, to caffeine’s effect on the tests used to diagnose chest pain. The pressure and numbness had faded in the hours since I’d been admitted. I watched back-to-back episodes of “Friends,” something I thoroughly enjoyed but would rarely allow myself to do at home. I texted J to give him the latest and ensure all was well at home. It was nearly noon by the time I was sprung, the doctor explaining that I should follow up with my regular internist but that as far as they could tell, I was in great health. My heart, my everything, was not at risk. I was relieved. I said goodbye to my new friends, got my car, drove home, took a fast, super hot shower and went to pick up the kids.
Despite the weekday morning insanity, there are parts I truly enjoy. One of these is drinking coffee in bed with J, which we do fairly regularly as the children begin to stir. We often linger too long, discussing the day or how to decorate the house. It’s great for my mood and our relationship, but sometimes bad for the morning’s timeline. Oh well.
Another is that sometimes Gabriel and I take our dog Maisie for a walk around the block. This has a clear positive impact on our day, and definitely on the dog’s. She gets plenty of exercise otherwise, but this early morning walk is special. Gabe’s been eagerly learning the names of the other dogs we meet while we are out. There’s Lucky. There’s Duncan. There’s Bridie, who a 16-year-old spaniel of some sort, and who our dog, who is two and clinically insane, likes to greet with untapped gusto, despite her older friend’s decorum and timidity.
Gabe and I take treats with us on the morning walk as the dog trainers we met when we first got Maisie taught us to do. When she walks calmly by our side, non-reactive to all the dogs and squirrels and ghosts, or whatever the hell she’s spotting every two seconds, she gets a treat. I’ve been trying, over walks and walks and walks, to get her to sit calmly when she sees another dog before being allowed to greet it.
And during one recent walk we took on a finally-chilly morning before school, we saw Bridie and her kind owner, a cheerful gentleman who has lived in the neighborhood for most of his life, and who we’ve gotten to know on our strolls.
Maisie spotted Bridie, happily trotting along by his side, paused, then sat at my feet, looking directly up at me and awaiting her reward.
“Look!” I told Gabe, and her owner and everyone within earshot, in disbelief. “That is exactly what she’s supposed to do!”
I tucked my hospital visit away after the fact, not thinking of it much except to regale friends with my tale, and hearing their own stories. Some had experienced the possible diagnoses I mentioned above, and some had dealt with anxiety.
I made a follow-up appointment, as instructed. Beyond assuring me that I’m in good health, which provided some immediate relief, the hospital trip was a good reason to find myself a general doctor, which I hadn’t done since we left our old insurance plan after J finished his post-doc last year.
When I went for that visit a couple weeks later, my new practitioner’s proclamation was swift. Pressure? Numbness? Yes. Rapid heart beat? Yes. Has anything happened over the past year that has stressed you out? Yup, quite a few things. It only happens at night? Only at night.
“It sounds like textbook anxiety,” she said. “Really?!” I asked. “I don’t know why, but that makes me feel so much better.”
Although after thinking about it a bit, I think I do know why. Beyond being pretty certain I don’t have a harmful health issue (if this persists and I can’t control it, I’ll revisit it with her, of course) diagnosing this as stress, or panic attacks, even though I’m not feeling panic when they happen, was like an allowance. Like saying that it was not only ok to have had a hard year - a fun, exciting, rewarding but also sad and difficult time of it after experiencing a number of life-altering events – but that my body was just gonna deal with it in the way it was gonna deal with it. There was something, ironically, soothing in that idea.
Also, I told J later, it felt like real license to go to an actual spa. A spa that is not the Chest Pain Center at Yale-New Haven Hospital.
As I said before, I don’t feel unduly stressed in my daily life. And my primary purpose in writing this post – these many, many words, good god, learn to self-edit Cara – wasn’t in order to gain sympathy. It wasn’t an effort to be more “real” in what I share with people, although I do think that’s important. I really miss my dad and – on a totally different note – it was very stressful for me when we were selling our house this summer, while also managing the kids, and finding work, and all the rest., I think it’s healthy and positive and life-affirming for us to find camaraderie in the struggles we all experience.
I think that what I was more struck by in this experience, was the immediate relief that came with doing the right thing: addressing something that was worrying me for quite a long time.
I am also annoyed that now I’m one of those people who went to the emergency room and it turned out they were having an anxiety attack. I’m not putting that in bold on my resume or anything.
The primary lesson I took away, though, was how well the treatment helped the problem.
I haven’t had another of those episodes. If I do I know the steps to take. I’ve learned them well by now, and am comforted by the added knowledge that my heart is strong and healthy.
After we talked about my stress diagnosis, my new doctor asked if I wanted a flu shot. I said yes, then we complained about people who claim that the “flu shot gives you the flu.”
“That’s not how the science even works,” she said, quietly. I really like her.
I told her, as she got the vaccine ready, that I felt a little ridiculous having gone to the emergency room for nothing, really, although I’d felt I had to in the moment, and she assured me that it was exactly what I should have done. My hospital visit meant I’d had all the tests necessary to exclude anything more serious, and exclusion is the only way to diagnose it as anxiety.
I’ll take it, I thought. The early morning adventure, quiet gurney-wielding hero and my comfortable hospital gown. Nothing discovered except a capacity for internalizing stress and knowing with full certainty that if you take the right steps, the experts will assure you that all is well, or that it isn’t always, and that there are infinite ways to move on from there. New insights, like how truly funny “Friends” is and that there is, in fact, secret coffee in the Chest Pain Center. And I now know who to ask if you want to get it.