Panic Attack

I wake up, can’t sleep, toss and turn. I’m sleeping in my daughter’s bed because I’ve had a mild disagreement with my husband. It’s the last straw of the day. I’ve been up since 5, done laundry, and a host of other domestic chores, made dinner, even a pie my husband requested. The argument feels petty. And this should be a red flag. Petty doesn’t drive us to separate beds.

It’s hot. I’m tossing and turning, can’t sleep. Now I get up and go back to our bed. He is awake and reaches for my hand. We say sorry and settle down to sleep. It’s 12:30a.m.

At 1 I start to feel weird. I’ve felt like this before. My heart starts to beat more rapidly, I can feel it speeding up. There’s a rush of feeling on the left side of my body, in my chest cavity, and I feel light headed. I think I’m having a heart attack.

But maybe not. Maybe I’m overreacting. I focus on my breathing.

Hacking my Vagus Nerve

My husband brings me water. I get up and kneel by the open window and keep my focus on diaphragmatic breathing, longer exhales than inhales. I know from pranayama practice that this tactic will hack my vagus nerve, turn up the volume in my parasympathetic nervous system, improve heart rate variability (HRV) and slow. things. down (through acetylcholine release).

After a while the feeling subsides and I crawl back into bed, propped up with pillows, eyes closed, still focused on breath. I start to feel a little better.

Bodily Betrayal

Almost immediately the feeling in my chest returns. Like a rush of heat on my left side, followed by palpitations. Some tingling in my arms (one arm? both arms? it’s hard to say now, my skin is crawling). My legs start to shake and I feel scared. We decide to go to the ER. Did I decide? Did my husband suggest it? I can’t remember but know that it feels like the right thing to do. I’m comforted by the decision. The making of it. I go to the bathroom and my bowels empty. I’ve read this is what happens to people before they have a heart attack but now don’t know whether it’s an apocryphal story or is rooted in science. I take this experience as another sign that I should go to the ER.

I shake in the car all the way on the 20 minute journey. We get to the entrance and it is eerily quiet. We mask up. No other patients are waiting, which is good for us. We are clerked in quickly. I’m shaking the whole time and my husband is holding me up with one arm and signing electronic forms with another. he doesn’t complain, just pays attention to the necessity of the tasks, the holding on, the propping up.

Off with my pajama shirt and on with the revealing gown. A delightfully sweet technician positions the 12-lead. She is apologetic because she has to touch my boobs. This hand- to-breast contact is the least of my worries. And anyway, I trained as nurse, nothing about the body phases me. That is, someone else’s body. At the moment, I feel betrayed by mine.

“The World is Imploding”

A nurse inserts a cannula and begins to draw blood. When she hears my accent she gets very excited and tells us she is going to Scotland in May 2021! And Ireland, London and Paris! She’s older than me and has a disability and I wonder how she can feel so cavalier about an 11 hour flight. I wonder how she can feel so excited about travel in a COVID-impregnated world. Then I wonder how she can insert a cannula, draw blood, and talk about travel all at the same time.

The EKG is done and the blood is drawn. Now we wait for the ER physician. It’s noisy in the corridor as the Saturday night crowd ramps up. Drunk people who’ve fallen over and hurt themselves or hurt someone else. Bipolar folks who’ve come off their meds. Drug users who’ve had too much or not enough of their substance of choice. All noisy. All terrifyingly loud. The nurse tells us to stay in our cubicle no matter what happens.

The ER physician arrives. She’s youngish. Maybe 35 Although I can’t really tell age any more. She listens to me, looks right into my eyes, pats my lower leg with her gloved hand. She is attentive and kind. Everyone is. She asks if I’m under any particular stress—apart from, as she put it, “the fact that the world is imploding.” She’s pretty certain it’s not a heart attack but will wait for the bloodwork to come back in an hour or so to know for certain.

Am I under stress? For sure. In the last 18 months I’ve experienced a breast biopsy for suspected breast cancer, the death of my sweet and adorable mother-in-law, a previous ER visit with the same symptoms, a stroke in one my close family members who is still on the recovery pilgrimage, COVID…but I am a Stoic, and pride myself in being. able. to. cope. Weathering the storm. Being resilient. Knocked down but getting straight back up.

We wait again. My husband reads the news on his phone. I try to nap. I weep. I try to nap again. I feel frightened and foolish and wonder how I would manage if this man was not beside me, shepherding me into the car and into the hospital gown. Waiting with me and reading out loud nuggets from the endless cycle of news that I really don’t want to hear.

The ER doc returns after about 90 minutes. The bloodwork is good, no signs of heart attack. She thinks it’s a panic attack and mentions that she’s seeing more and more otherwise fit and health people coming to the ER with similar signs and symptoms.

It’s a sign of our times.

Sign of our Times

Yes, it absolutely is. Approximately 30% of us will likely experience panic attack at some point in our lives. The likelihood of a panic attack is higher for women than men, especially for postmenopausal women (like me). The experience of stressful life events, especially those involving loss, threat, or illness, can trigger panic attacks, as well as the presence of vulnerability factors (e.g., genetic factors, childhood adversity, and anxiety).

Oh, and global events, like pandemic.

The ER doc offers anti-anxiety medication, which I don’t accept at the time but will eventually discuss with my primary care physician as a helpful backup plan. (A few additional panic attacks later, I’ve now learned how helpful such medication can be).

Yoga, Meditation, Pranayama

You know what else it helpful? Yoga, meditation, and pranayama. I knew this going in(to the ER). I’ve for been practicing these elements for years and I’m grateful for the pre-loading that regular practice provides. Even though it’s challenging to focus on breath in the moment, I know that this practice has filled my bank and made it possible for me to make several withdrawals without penalty in the last week or so.

Yoga, meditation, and pranayama practice help me slow down, tune in, and respond to the experience from a place of relative self-knowing versus from a place of fear. To practice presence (which is mindfulness with intention in the presence of anxiety), build resilience, and surrender to what is, knowing that whatever is now, is temporary.