Saturday, March 23, 2013

A panic attack story, 'Give Him Nitro'

Give Him Nitro

Not only am I a goddam mouth breather - and I’m not proud of it like I said - but I’m also a bit of a hypochondriac and prone to panic attacks. I’m not sure if one causes the other, and sometimes I’ll wonder if I’m having a panic attack because I’m afraid I have something wrong with me, or am I afraid something is wrong with me because I’m having a panic attack. It’s a crazy escalating effect that goes like this. You panic, you think you’re dying, so you panic more, then breath more, which makes you feel worse and more afraid, so you panic more, almost until the point where you think your heart is going to explode or you pass out. Once or twice I thought maybe my mouth breathing was making me have panic attacks, since it changes the nature of my breathing and when you have a panic attack you hyperventilate and breathe deep like a mother fucker.

     I had my first panic attack when I was ten. I thought my eyes were falling out and was going blind. After over three decades of having them I’ve learned something shockingly new. Amazingly, I can have them while I’m sound asleep.

     Just recently I woke up in the middle of the night, heart thumping, breathing rampant, mouth wide open of course, skin tingling, body shivering, and my mind racing out of control. Since it woke me up I was really freaked out, more than normal, instead of like when I’m already awake and they come on more gradual. Sometimes now I can head those off and prevent them from escalating. I’ve had a lot of practice.

     But this one I had while sleeping was different and caught me totally off guard. I thought I was having an asthma attack, even though I had never had asthma before. No one in my family had ever had any form of asthma, but I was convinced I had it for Christ sakes. I thought my lungs were dissolving or something and soon I wouldn’t be able to breathe at all. I didn’t know what they could do for dissolved lungs; I was certain nothing. The newness of this kind of panic attack convinced me that this time it was real for sure.

     I jumped up with rampant fear, ready to run. I didn’t know where, but I was rearing to go, so afraid that I could have run to the top of Kili - fucking - manjaro. I already had my clothes on because I had been having panic episodes for a few weeks by then and had started sleeping in them so if I had to rush off to the doctor it would save vital time. I headed out the door and got in my car. I was hyperventilating, but I didn’t think that. I thought disintegrating corpuscles were clogging my lungs, making it harder for me to breathe. I thought I’d pass out before I reached the hospital and drive over a cliff or something, but I didn’t. I wasn’t sure how I made the drive without crashing or fainting. When I arrived I got out of my car and lumbered in without hurrying; I wanted to give my brain one more chance to come to its senses, but it never did. “Are you okay?” the clerk asked me.

     “I can’t breathe,” I said politely, which could have been partly from my bad sinus. They sat me right down and called a nurse to come get me.

     “Any other problems?” she asked. Of course I had a whole list of problems: bad sinuses, mysterious pressure in my gut that I was sure was cancer, blurry vision, lack of funds, receding gums, sore back, knees that cracked, and low motivation for starters. But the main one was that I felt like I was wasting my life living in the modern world all the time and I was afraid I’d never accomplish a great adventure, which I thought contributed greatly to my panic attacks. I didn’t like how we all lived in these nifty little houses all lined up right next to each other, like we were all androids kept in these big boxes until we were needed to go do our master’s work and turned on, and off again when we finished for the day. I didn’t like how all our houses looked the same and were so big when the natural areas around them were so small. No, I didn’t like that one damn bit and had spent my entire life trying to figure out a way to sleep under the sky with no house so there’d be more room for natural areas. I didn’t tell them any of this. Instead, I kept it simple.

     “My chest hurts,” I said, feeling like I was making too much of my problem by now. Then, thinking I might be having a heart attack, they really started moving faster. They made me give them an emergency phone number and sign a form, which I don’t know what the hell it said. Then the nurse came in lickity split.

     “You need a wheel chair?” she asked.

     “No, I think I can walk.” Then they led me down a shadowy hall to a room that didn’t have any doors. It just had a wide curtain they slid open and close.

     The nurse made me strip down, and I was a little bashful at first. But I did it quick before I thought about it too long. Then I put on a gown and she had me lie on a bed. Boy, they mean business, I thought. They hooked me up to a cardiogram, put an I-V needle in my arm in case they had to pump me full of life-saving meds, and stuffed an oxygen tube in my nose. I must say I really liked the oxygen. It was blissful, like I was lying next to a cool stream in the summertime with a soft breeze drifting by.

     Then the head doctor came in and gave the nurse a couple of rough orders, which made me think that she was a bit of a tyrant, and I hate tyrants in any form. She gave me a quaint smile, fake as hell, like she was just being polite because she had to be toward the patients. She read my cardiogram on the monitor for a minute and turned to the nurse. “Give him a couple of aspirin.”

     “I already took two before I came here,” I said, which I did sometimes when I thought I might be having a heart attack, you know, to head them off in case they were real.

     “Were they regular aspirin or baby aspirin,” the doctor asked me and how on earth was I supposed to know the difference.

     “I’m not sure,” I said. I wasn’t thinking straight and I didn’t want to think about damn stupid aspirin. I was thinking about dying and wanting to live and not getting to travel around the world and shit like that, not freaking baby aspirin.

     “Were they white or pink?” she asked sneeringly. I wanted to ask her why the hell that mattered, but I didn’t.

     “They were white,” I said. Then she gave me a little condescending lecture.                  

     “Baby aspirin are pink, and adult aspirin are white,” she said in a squeaky sarcastic tone. I wanted to slug her and say who pays attention to the color of aspirin, can’t you see the crippling dread on my face, but I didn’t want to make her mad. She was the one who was in charge of saving me if I were to go down and black out.

     “Give him a nitro,” the doctor said, and then the nurse stuck a little pill under my tongue for it to dissolve, and then the head doctor walked out. 

     “How’s the pain now?” the nurse asked, “On a scale from one to ten?”

     “It’s about the same, a five,” I said. So she gave me another one, and a minute later she asked me the same question.

     “How’s the pain now?”

     “It’s about the same, a four.”

     “Before you said it was a five.”

     “I did? Well it’s about the same,” I said, so she gave me the last nitro that was allowed. Apparently three is the limit. I couldn’t believe she was putting nitro glycerin under my tongue. I wondered about exploding, but that didn’t even scare me like the panic I was having.

     Panic attacks are strange. Sometimes the logic of the person having one doesn’t make any sense, like how I always avoid going to the doctor because I believe he’ll just find something wrong with me. I’d rather not know at all. And if I don’t go then the doctor can’t say if I’m sick for sure. If I do go then there will be a certainty one way or another, and I always assume it will be the worst; that I’ll die and never get to hike in the woods or camp out under the trees and stars again. So I never go to the doctor unless I’m sure I’m going to collapse at any moment and die anyway.

     “How’s the pain now?” the nurse asked again.

     “It’s about the same, a three.” I didn’t know; how could I know when I was in the throes of a panic attack. I was getting cold and shivering badly so the nurse put another thick blanket over me to keep me from slipping into shock. That actually felt pretty good. It was an electric heating blanket that had some weight to it – made me felt cocooned.

     I waited in the bed with the back propped up too high, but I didn’t want to make a fuss and ask the nurse to lower it since I had already told her to raise it. “I can breathe better sitting up,” I had said. But now my back was feeling hunched and tight and I wanted it back the way it was. I hated beds anyway. They reminded me of all that was wrong with the world and how we had become too soft and mindless. At home I was always walking instead of driving because I didn’t like how roads took up so much space and how cars were too noisy and polluted the sky too much – an abomination. I cringed every time I saw a perfectly fine narrow road being made as wide as a fucking football field, so that it would only encourage people to drive more when they should be walking more. Did you know that Americans are the fattest they’ve been in human history and that for the first time children are expected to have shorter life spans than their parents?

     At this point I was starting to suspect I was having a panic attack and that the pain I was feeling was just the tingling and shooting that comes with one. The attending doctor came in to examine me. He looked at my feet and scraped a metal instrument across the bottoms of them. “Any pain in your calves?” he asked.

     “No, they seem fine,” I said, wondering if it was normal for them to hurt or not. Then he looked at my abdomen and thumped on it with a small hammer. It sounded hollow and I didn’t know if that was good or bad. I assumed very bad of course.

     “That looks good,” he said. Then he asked me if I had ever had anxiety and I told him I had - if he only knew. Panic had made me do a lot of bizarre things over the years. Once I stayed up all night because I thought if I went to sleep I thought I’d have a stroke. A panicking brain will try anything to save itself. Then he listened to my lungs and found nothing. He listened to my heart and found nothing. “They sound okay,” he said and continued on and finished the exam. “We’re just waiting on your blood tests. That will tell us everything. Just sit tight and relax.” Then he and the nurse went out and I was alone for a long time growing so terrified about what the results would be that I actually started thinking about sneaking out and leaving so they couldn’t give me the news and I would never be certain one hundred percent that I was dying – just the usual ninety percent that I had lived with off and on for years.

     While I was lying there waiting, this thing on my arm kept inflating automatically every fifteen minutes taking my blood pressure. I was afraid it was going to get stuck in the inflated position and ruin my arm for good, but that didn’t worry me nearly as much as the fear of death, or the fear of my panic attack. I still wasn’t sure which one I was experiencing.

     I was sure my blood was bad, infected as hell with all sorts of diseases; the worse they had ever seen, from aides and cancer to hepatitis and jaundice - all the fatal ones of course. In a matter of minutes I would get the news and it was all I could do to remain in the room. I wanted to run away. I was sure I was a goner. I had so much left to do with my life. I wanted to hike across Borneo. Who was going to take care of my dog?

     Suddenly, the doctor came back through the curtain and looked at me with a straight face, and before I could brace myself he already let the news slide in there. “Your blood looks okay,” he said quickly, without even pausing to give me a serious look.

     “What,” I said with a shocked face, my nose and eyes all scrunched up. What, impossible, I thought. He didn’t even give me a chance to get more worried.

     “Your potassium’s a little low, but everything else looks fine. It all checks out.” He said I was free to go and told me to see my primary doctor, which I didn’t do because I was too afraid. Besides, I didn’t have a doctor, since they’re too expensive and I usually didn’t have insurance. The only reason I came here was because I thought I was going to collapse and be unconscious. He gave me a handout on anxiety, but I already knew everything in it, inside and out, and a lot more that wasn’t in it. Hell, I could have taught a class on the subject. I was an expert on panic attacks. I just couldn’t figure out how to get rid of mine or prevent them. They can come out of nowhere with no warning, in any place or situation, last for minutes or weeks, and be just as debilitating as any real illness. They’re vicious and the literature the doctor gave me still didn’t help.

     “That’s the thing about a panic attack,” I said to the doctor. “When I’m having one I never know I’m having one. I always think I’m dying, for real.”

     “Oh they’re real. I don’t want you to think they’re not. But I think you should see your doctor and get it checked out.” I wasn’t sure why I had to do that when three people had just got done checking me out.

     So the doctor left the room and I was free to go. “I’ll give you some privacy so you can get dressed,” the nurse said. She wasn’t very friendly or personal, just doing her job and not really caring who I was or what dreams I had, or even if I had any. She didn’t act like she had any dreams, or if she had, they had been beaten out of her somewhere along the way in her life, or so it seemed. Before I had my shoes on she came back and started stripping the bed I had lied in, and before I got my jacket on she was done, ready for the next emergency.

     “At least I know my blood’s okay,” I said. For someone with panic attacks, this was a huge stress reliever, like the weight of the world had been lifted off my shoulders. The nurse walked me all the way down the hall to the main desk to fill out a few more forms. Then she told me to have a good night and I left.

     I walked out the door of the hospital alone and into the darkness, shuffling along, baffled that they didn’t find anything wrong with me, but thankful that I was clean slated. It was still a little scary but I felt like I had second chance at life - good as gold. The doctor had told me so. Well, not in those exact words, but close enough. “Everything looks good.” That was what he had told me. It had all checked out, and that was good enough to get me feeling a little normal again, like I had a chance to live a long life and that maybe I could keep hiking in the woods.

     I smiled and then strolled back across the parking lot in the black of night, passing a young woman whom I assumed was on her way to work the morning shift. She kept a wide birth and avoided eye contact. She was quite pretty and I didn’t stare at her too long. I didn’t want her to think I was crazy, even though sometimes I wondered, because no one else in the world seemed like me; someone who would throw away a perfectly good job, move out of their house, and go walk around the wilds of Alaska for months at a time. I wanted to feel good again about those things that were beautiful in life.

     I had been in the hospital a couple of hours so I had to scrape ice off my windshield before I could leave. I started my car, and sat for a couple of minutes until it warmed up. I wasn’t in a hurry now since I felt cured, and since the inside started to feel warm and cozy, I didn’t seem to hate it anymore. Then I put the car in gear and drove home just before the dawn light. I wondered if my panic was gone now, or would it come back tomorrow night, or would it wait a year and give me a lucky break. I needed a long break; panic attacks were really starting to piss me off.