Anxiety and stomach adventures

Since Tuesday afternoon, I’ve been sick. The way things transpired since then has been pretty strange.

On Tuesday I had some chili which I probably shouldn’t have had, and it didn’t sit well with me. I slept, then went to work in the evening. Going to work means biking, and there have been some times in the past where I felt absolutely horrible (physically) while en route, thus triggering panic attacks. I’ve always managed to make it to work despite the attacks, and within about 30 minutes I’m feeling normal again. Tuesday was one of those days. I made it to work, and after about an hour was doing alright, but my stomach was upset and my entire abdomen hurt (a very drone pain, nothing sharp).

At about 0100 I started feeling nauseous, which made it impossible for me to work. I must’ve been back and forth between the bathroom 5 or 6 times, but only had a (normal) bowel movement or two at most. I decided to lay down and see if that helped, but it didn’t, which just induced my anxiety to increase. At about 0400, my co-worker drove me home, since I wasn’t in a good way.

Once home, I still felt horrible. I stuck to consuming Saltines and tea (only later did I remember that tea often contains caffeine, which is a common trigger for agoraphobics). After a few more hours, I felt generally okay, except my stomach would still rumble once in a while, but I managed to go to sleep for 4-5 hours before waking up Wednesday afternoon. Once I woke up, I felt better than I did before (no more abdominal pain), but hadn’t fully recuperated since my stomach itself still felt awkward.

Wednesday night, again I had work, and I managed to bike there without any attacks or problems. I was there for about an hour, and suddenly out of no where, my stomach went crazy like the day before. The nausea was worse this time, and after about 20 minutes of feeling that way, I started dry heaving (vomiting but without any projectiles). My abdomen hurt horribly bad. Going home was the only option, but due to holiday scheduling at work, I really had to remain there. I ended up calling my boss, who had just arrived home in San Francisco, and he had to drive all the way back down to MV to fill in for me. I still feel awful about that. My boss said that he’d consider me sick/out for the rest of the week, which was a good decision on his part. Anyway, my co-worker took me home. Once home, I still felt nauseous, but after some Saltines, water, and 2-3 hours of playing my Wii, I felt better, much like before.

Thursday morning (Christmas), I woke up feeling a lot better. I played Dr. Mario Rx and Mario Kart on my Wii for numerous hours, but I could still tell something was up. At around 1400, I started getting nauseous again; no dry heaving, but definitely sick. That’s when I decided I should go to the Urgent Care facility (not the same thing as an emergency room). I get super anxious having to go to non-regular places (e.g. work and home excluded), and that wasn’t helping things any.

I didn’t manage to get to Urgent Care until almost 1900. Once there I was seen almost immediately. I explained to the doctor, in great detail, my anxiety problem, and my abdominal pains. Naturally she was interested more in the latter, and did some basic pressure tests to see where it hurt. Well, it hurt everywhere, but slightly more on the right side than the left; the pain wasn’t unbearable, but it was definitely uncomfortable. I told her I was concerned that what I had might be some kind of gall bladder infection, since the nausea was coming “in waves”. She disagreed, noting that if I had an infection there, when she applied pressure I would’ve either vomited or fainted or practically screamed.

They took urine and blood samples (and the nurse who took my blood was fantastic — I’ve had blood drawn many times, but this was painless!), then gave me a mix of Mylanta and lidocaine. Yes, lidocaine — the numbing agent that dentists use. Within seconds the back of my throat, my oesophagus, and my stomach were numb, and the level of nausea I had shot through the roof. I had a friend who had taken me there, and we talked; it really felt like I was going to vomit at any moment, and many times I wish I had. I also wasn’t allowed to drink any water, so my mouth was super dry, and the taste was horrible. After 20 minutes the doctor came back in to find out how I was doing. I explained that I now felt worse than I did before. She was interested to know if the abdominal pain I had was gone. I told her I couldn’t tell for sure, because numbing doesn’t remove pain, it just masks it, but that the nausea was really horrible.

She said that part of the lab on my blood had been completed, and everything was 100% normal, including my white blood cell count, indicating no infections. Further tests needed to be done to check for gallstones and other oddities, and she’d call me later tonight once she had those.

Her conclusion was that I was suffering from a form of acid reflux. She felt I had a form of GERD, and I wasn’t in agreement, but I’m not a doctor. I brought up the anxiety thing again, and she re-focused on the acid reflux aspect. I gave in.

I was given a prescription for two medications: Zantac (7 days, 300mg) and Prilosec (14 days, 40mg). Zantac is a fast-acting acid inhibitor, but isn’t intended for long-term use. Prilosec is intended for long-term use. I was to take both together for the first week, and then contact my usual physician to let him know if it was helping (thus deciding if I should continue with the Prilosec or not). If it worked, I was to continue with the Prilosec, and get put on it permanently.

It was around 2030 when I left Urgent Care. The numbness was quickly fading, but the nausea was still there. The prescriptions were being filled at a local 24×7 Walgreens; lots of other people were there wanting prescriptions filled as well. The wait was 30 minutes, and I didn’t feel like hanging out in a Walgreens for half an hour, nor sitting out in the truck. My anxiety was starting to get to me again, and part of me was saying “hey you’re going need a bathroom”, so I opted to go home. Went home, hung out for about 45 minutes, then went back to pick up my prescriptions. For something that should have taken 3 minutes at most, it took another 20. I don’t even want to delve into that part…

Once home, I found a message from the doctor with the results of my urinalysis and remaining parts of my blood test: all 100% normal, no sign of stones or other issues. That was a relief, but at the same time, didn’t explain what was wrong with me.

I then took my prescriptions with some water. I also decided to keep a diary of what transpired after that, because I had my doubts about the doctor’s prognosis. Another friend of mine showed up unexpectedly and hung out right after I took them. Within 10-15 minutes I started feeling like vomiting; it would come in waves, subsiding for a minute or two, then coming back stronger than before. I sent my friend home and reviewed the medicinal documentation I was given to see if I was supposed to take these with food or not. The Zantac was intended to be taken after eating. “Wonderful”, I thought, “I haven’t eaten in like 8 hours”. Here’s the diary entries:

2200 — Took both meds (had not eaten prior)
2215 — Started feeling nauseous; stomach churning, way worse than before I went to Urgent Care
2238 — Ate two Saltines, drank water
2242 — Bowel movement; mostly yellow liquid, some stool; movement was short in duration
2244 — Stomach churning has decreased slightly, nausea is still there
2246 — Decide to lay down; difficult as stomach and intestinal area hurts and churns in this position. Laying on side is easier, but not great
2252 — Decide to sit on toilet due to bowel feeling uncomfortable
2258 — Intestinal churning of some kind; left side of abdomen making audible noises
2259 — Anxiety is sky high; great feeling of helplessness, continual thoughts of “when will this end?”, occasional hot/cold flashes. Nausea still there, but less severe than at 2215

At this point, my mind couldn’t relax. I was thinking about all kinds of off-the-wall things: having my friend take me to the hospital ER just so I could get a different diagnosis (long story short, going to the ER is a bizarre thing for me to consider, since I had a horrible experience there in 2003), taking one of my pills of Paxil (see below), and even suicide for a brief moment (which quickly resulted in my logical brain replying “are you fucking kidding?! This is not a situation that warrants killing yourself, get a grip!”). And for the record: I do not have suicidal thoughts regularly or even occasionally. My point here is that my brain was completely buggered.

Another part of my brain was telling me the same thing it does every time I get anxious: “you’ve been through this kind of thing a million times; job interviews, daily stressors, whatever. You’ll make it! Besides, you can see your doctor next week, get put on some new meds, and probably feel better”. But the physical effects I was having were making it very hard for me to calm down. This scenario is common during panic attacks, and is referred to as a positive feedback loop, where the effects of one thing increase the severity of another, which in turn increases the effects of the first, etc… literally spiralling out of control.

Six weeks prior, I had come off of Paxil (40mg). It took the edge off of minor anxieties (those minor stressors during the day), but it didn’t do anything for my agoraphobia. All it did was upset my stomach constantly, increasing my stomach acid levels to the point where I could almost burp acid. Once I came off it, all that stopped. The sexual side-effects also stopped, which was an added perk.

Anyway, earlier in the evening, the wife of the friend who took me to Urgent Care mentioned that she had some Xanax (0.25mg) left over from a few months back (before she got put on Paxil, which works for her), and that it was fast-acting (30 minutes) and worked wonders for her panic attacks. She got prescribed some after having an attack which was so bad that she started vomiting — this really hit home with me.

I went back over to their place and got the remaining Xanax pills she had. I took one and tried to sleep. Just swallowing the pill itself gave me a sense of hope, which was weird. I remember thinking the same thing when I got put on Paxil, but the results were sub-par.

Here’s my diary entry from that point onward:

2307 — Decide to ask friend if I could have her Xanax, to help relax me + take away anxiety
2310 — Took one Xanax pill (0.25mg)
2323 — Increased feeling of fear (not same as anxiety); worried pill will cause additional complications, or react badly with Zantac or Prilosec
2325 — Try to calm self by breathing slow and telling self “even if this doesn’t work I can see doctor next week and get put on something else”
2330 — Strange feeling in brain, lasting a few seconds; sudden feeling of increased calm. Realisation that pill must be working

That was the last thing I wrote before falling asleep… for 10 hours. :-)

The smiley there at the end of the sentence is important: I haven’t been able to sleep linearly for more than 4-5 hours at most (usually only 2-3) for a few weeks. Sleep is the one thing in my life that I absolutely love, and as an introvert, I need a lot of it. Thinking about it now, I wonder if my crummy sleep over the past few weeks is what triggered all of this? Not sure.

I woke up around 0930 this morning. I remember opening my eyes, and immediately focusing on how my stomach felt… I felt normal. There was no drone pain, no strange awkward feeling. How did my mind feel? I felt relaxed, but more importantly, I felt in control! This was the first time in almost 5 years I’d felt that good after waking up.

I stayed in bed. After about 15 minutes my stomach churned a bit… but unlike the night before, it didn’t hurt when churning. Was this the result of the Zantac, or the Xanax? I’m still not sure. The churning was audible, but the feeling reminded me of hunger pains. Being as I hadn’t eaten anything other than a few Saltines for the past 3 days, I can imagine my stomach wanting something normal.

It’s almost noon, and the only feelings I’ve been having are my stomach occasionally churning for a second or two, saying “Hey man, I’m hungry”.

So it seems benzodiazapines do have an effect on me. This shouldn’t come as a surprise, given that they’re commonly prescribed for agoraphobics. Why do I think I have agoraphobia? Because yesterday afternoon I spent about an hour reading this fellow’s site. Some of his situations are literally things I’ve been through, down to the last detail. It’s incredible. I’m absolutely certain that’s what I suffer from, and I’m going to provide that information to my physician next week. Of course, I’m left wondering if he’s going to be pissed off at me for taking a schedule IV prescription-only medication without his approval. On the other hand, he might be thrilled to know I found something that actually works, and that helps narrow down the kinds of long-term medications that can work for me.

I just hope this comfortable feeling lasts. Part of me feels like taking on the world, but I know I’m not ready for that yet. Being able to go back to work and stay there without feeling sick would be enough. :-)