High anxiety

I am a recent recipient of a pacemaker and the process of recovery is turning out to be more difficult than I anticipated.  I have periods of low anxiety and every now and then a panic attack will develop.  I am getting help that is much appreciated but anticipating driving gets me reved up.  I am wondering if anyone has a suggestion that might be helpful?


9 Comments

Yes!

by MinimeJer05 - 2022-03-15 23:36:02

Hello,

Long story short, I've been a pretty easy going person most of my life and never had any anxiety or panic until after my PM. Driving was extremely difficult for me, as I started developing foggy vision one day and ended up pulling over and having to go to ER and then next day I got my PM installed. 
 

It took me months to get semi comfortable driving again. It was very hard in the beginning and I still have moments where I can't help but worry about the driving itself. I can't seem to shut my mind off and just drive with the radio. 
 

As for pointers, for me, turning the AC on or rolling the windows down helps. It brings me a sense of calm to really pay attention to the surroundings (the sound of the roads, the smells, the lights, what other cars are doing, etc.). I also load up a calming playlist of songs and podcasts to try to drown out my worries. Last resort for me is to call someone and talk to them on my drive. And just that simple facts brings me confidence, because my mind/heart/body doesn't know the difference between a call and driving in silence, so I just remind myself, if I can drive home on the phone with someone, then I absolutely can drive home without someone on the phone. 
 

My panic attacks usually involve tingly/numb arms, short breathes, blurry vision and just feeling super hot and warm. I'm usually able to counteract while driving by blasting AC, practicing my breaths and focusing on something consistent (highway exit signs). If it gets bad enough, don't be afraid or ashamed to pull over for your own and others safety, but also try not to build up driving as this "big deal" or else it'll be harder to overcome (at least it was for me at first). 
 

Remember, you'll have good days and bad days. The idea isn't to just overcome them but to learn to be OKAY with how your body reacts and to tell yourself this is normal for now and it will pass. 
 

Take care and keep us posted on your driving efforts -- I hope things go well for you. 
 

Jer

Anxiety

by TAC - 2022-03-15 23:47:12

When I received my PM I felt a great relief, because the PM took away my bradicardia immediately and felt very positive about my future. Perhaps, some very sensitive people might feel anxious after any medical procedure. However, not to the extent of having a panic attack. I don't think so. You probably always had a low treshold for anxiety. Perhaps some counseling or anti-anxiety medication might be necessary.

High anxiety

by AgentX86 - 2022-03-16 00:21:07

I agree with TAC.  I can't know what you're feeling because mine wasn't a surprise (the need was a surprise but it had been on the table as an option for six months or more) so I didn't have that shock.  Again, like TAC, getting the PM was like drinking a gallon of espresso.  I was revved by the time I got to the revocery room.

Again, I can't know what you're going through but it will get better.  You'll soon forget that you have a pacemaker.  You may need some professoinal help to get there.  Cognative behavioral therapy will likely help.  I'd try to avoid drugs.  They can mask the real problem and be habbit forming, if not addictive.

Anxiety

by Gotrhythm - 2022-03-16 13:38:15

I'm glad you're getting help. People who experience pervasive anxiety tend to feel every change in their lives as anxiety producing. And getting a pacemaker is a big change. So it produces big anxiety.

The sad thing is that having a pacemaker should lessen anxiety. It  should be reassuring. Many of the arrythmia issues you had before--that could have made you foggy, or light-headed or pass out at the wheel--are taken care of. You are now a better, safer, more competent driver than you have been in years.

Work with your therapist to change your ideas about a pacemaker. Nothing about a pacemaker makes you less able to drive than you used to be. Pacemakers are incredibly reliable and practically indestructible. You can handle having a pacemaker and start living better than you have lived for years.

With your therapist, I invite you to explore the fact that many of the physical symptoms of anxiety and panic attacks are indistinguishable from arrhythmias, particularly PVCs and tachycardias. Physiclaly they are almost the same, but it is possible to learn to tell the difference.

Once you have a handle on the difference, working on the "real" anxiety becomes much easier.

Anxiety

by Julros - 2022-03-16 15:18:44

I think anxiety is pretty common in new pacer recipients. I blame this partly on practioners who don't preprare patients prior to implant, and don't really address one's feelings afterwards.  Plus I have a theory that those of us with bradyarrhythmias have high levels of stress hormones (cortisol) as the body tries to compensate for a slow heart rate. It takes some time to reset that cortisol level, and for me, mindfulness and meditation were helpful. 

I have had good results using a meditation app on my phone, and 3 of the therapists I sought help from suggested breathing techniques. 

 

Anxiety

by AgentX86 - 2022-03-16 17:05:38

Julros, I think you're exactly right about the lack of preparation.  However, it's often not possible to prepare us.  I had months to get it into my head. For those months it would have been elective, until one day it wasn't. It still wasn't a stretch.  I'd thought plenty about it.

I think you'll find that many of those, here, who have had the most trouble were those who woke up one day with a pacemaker not knowing they had any heart issues at all.

That said, doctors often don't do a good job of addressing psychological problems but it's not really in the job description of a surgeon. It's particularly hard because they haven't been there. Perhaps there should be someone trained to deal with anxiety assigned to the team.  Cost is a big problem already.

I have to say that after both my CABG and PM implant, my insurance company assigned a psychological nurse (IIRC) to me.  She called a couple of times a week for some time after my CABG until I was pretty much back in the game, well after I returned to work. That can be done but as I said, it's expensive.

 

Knowledge is power

by ar_vin - 2022-03-17 03:09:44

Each one of us is wired differently so I can't speculate what might work for you.

Here's what helped me deal with my diagnosis of "sick sinus syndrome" and the resultant bradycardia:

- learn as much as possible about my condition (ask questions of EP, read/study about the the cardiac electrical system etc)

- understand possible "fixes" - get a PM! But I was unwilling at first to accept that some one as "young" as me and in such great physical shape would need a PM! It took me a couple of months to wrap my brain around this reality and to accept the fact that I needed to get a PM

- understand the kinds (brands) of PMs, need for settings adjustments, His bundle vs ventricular lead placement, sub-cutaneous vs sub-pectoral implant and on and on!

I'm technically inclined so I dove right in to this new world of PMs, electrophysiology etc

This immersion allowed me to come to terms with my SSS/bradycardia and helped me prepare myself mentally, emotionally, physically for the PM implant and subsequent recovery.

The recovery was uneventful - my EP did an excellent job with the procedure and I was able to get right back to walking regularly and got back to hiking and running in a few weeks.

As much as we like to blame EPs/physicians for not "preparing" us for the procedure and it's aftermath, I believe it's really up to each individual to come to terms with their situation. The EP/medical system can only do so much.

In fact more than anything else it's crucial you understand the underlying condition that the PM is being implanted to "fix". Nowhere in your post or in your profile do you mention it.

Those responding to your post can be much more helpful if you share more about your medical history/diagnosis.

anxiety

by new to pace.... - 2022-03-20 18:49:30

I recently read when you get these panic attacks.  take the time to take some deep breaths and let them out slowly.  Does work as i tried it this morning after  i had a brief A-fib episode.  Avoiding stress helps. 

I also agree with what the others have said.

new to pace

anxiety

by AgentX86 - 2022-03-20 21:22:52

Yes, breathing exercises do work.  With practice it's possible to reduce blood pressure by 20pts, or so.

The sympathic nervous syetem is the "fight or flight" center. It's also the center of anxiety, which makes sense. When activated, it releases a coctail of hormones, adrenalin being one, to heighten awareness and get the body ready for action.  The parasympathic system does the opposite.  It's the "rest and digest" center.  Deep breathing turns back the sympathetic system and turns on the parasympathetic.  The hormones are cut down and the upper brain takes back control from the "fight or flight" reptilian  brain.

<https://www.othership.us/resources/deep-breathing-the-parasympathetic-nervous-system-the-connection>

After my CABG, one of the first things my therapist did was to teach deep breathing exercises.  As a demonstration of their power, she had me measure BP before and after just a few deep breaths (a minute or so).  It was amazing the difference.

This may or may not work with AF. Most AF isn't connected to the para/sympathetic nervous system, rather a clump of unstable cells within the heart attempting a coup. Some, of course is (vegus nerve stimulated AF).

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