In this article I hope to explore my own cardiac anxiety as a heart attack survivor in hopes that it will help others become better at differentiating anxiety from symptom. If I’m very lucky, maybe, help turn the page with some of you and get back to where we take back some of ourselves in the process.
Many of us experience anxiety, some on a next level than we can imagine. As cardiac survivors it’s common for this to take the form of daily, sometimes constant, fear of another event. I want to share with you the tools I’ve picked up that help me perform first a self-assessment when I realize that cardiac anxiety is occurring and then how I work through it.
Looking back over the past 14 months I feel like I went from a 33 year old guy, in my head at least, to a 48 year old heart attack survivor in a matter of 48 hours. There is a subtle emotional fault line that collides with reality when we are forced to face a life threatening situation. Something that very nearly puts a period in the last chapter of our book… and when it doesn’t we are left with the intimate knowledge that our killer is a built in feature of our bodies.
Reflecting on some of the stories I’ve shared, and heard from others, I feel like these can begin to sound like postcards from Sunny Florida. “Hi, things are sunny here on the beach! I survived!” There is usually a deeper subtext to these stories. The other side of the coin so to speak. A much darker one as it becomes something you carry with you at all times… like a worry stone in your pocket.
It’s been 14 months since my first heart attack. During that time period I have worked with my health care providers to take the rabbit by the ears and dive head first into it’s rabbit hole. Between my cardiologist, my family Dr., the cardiac rehab team, a meditation teacher, a therapist, and a small army of friends/family/co workers I have explored more about myself than anyone should in one 14 month period.
I felt lost just after I was released from the hospital with a bright shiny new stent in my LAD region. Without the benefit of the lessons to come, I dealt with anxiety using only simple tools. One of which was to set my focus on something in my immediate future and part of my lifetime routine. For me this was getting up early, and in the quiet hours of the day, making a pot of really strong flavored coffee. The kind that makes you think of black paint. Of course I switched to decaf but it still has the same place and function in my life. Something that has not really changed. Something I could look forward to… something I could look at while averting my attention from fear. It’s a simple distraction technique but it works. Whatever that is for you, set your sights on it and put 100% of your attention on it in moments of anxiety. As the months progressed after cardiac rehab I turned to running which gave me the most peaceful release from myself, possibly because keeping myself moving with enough air in my lungs ruled out a lot of the normal mental static I normally experience. Physical activity, of any type, is a great way to dim the effects of cardiac anxiety. Another is meditation, which I’m terrible at because of my mental make up. 1000 thoughts a minute sometimes here. That said, I’ve got my practice down to moments where I can sit down, close my eyes and visualize an elevator descending from your head, shoulders, heart, stomach and hips. Stopping at each point, doors opening, fresh air rushing in with your breath and then making a return trip to your head. It takes all of 5 minutes but practiced daily can help calm the mind. The benefits of both physical activity and this style of meditation is that you don’t have to be good at it… you just have to do it and you get the benefits.
I picked up this next technique later in 2015, when I sought the assistance of a professional therapist to help me try to process the fact that I have heart disease. I know many others who have been heavily impacted by various heart conditions. But the one thing I have found we all are faced with is anxiety and or depression. Dr’s say this is it’s own stand alone risk factor and is primarily caused by the cardiac event. I had a more mild form of this experience but I had to face it, just the same.
There were times when I’d find myself completely consumed with the possibility of another event and tricking myself into feeling ill as a result. My head literally would get the better of me and I’d lose sight of the things in life that made it meaningful. My first trip to ER was on the day I was to fly out to Portland to be the best man in my buddy’s wedding. I woke up feeling anxious, and none of my tricks were able to shake it’s grip. That was at my six month mark from the day I had a heart attack. The second time was at the fourteen month point.
When is it time to go to the ER? The answer is anytime you are unsure about your symptoms be they mild or severe. I made the right choice in both cases. Thankfully both were false alarms. Again to be clear, when you suspect your body is telling you that it’s suffering heart attack symptoms…call 911. The reason I am writing this post however is to hopefully share some of the techniques I use to self assess and find my truth.
It was my therapist who helped me cultivate a technique to personify the anxiety. I chose to think of it like my mom- when I was a 15 year old boy. She was always there taking care of us and helping us to make the right choices… or at least not hurt ourselves on a good day. So when I felt the cardiac anxiety take hold of me I’d face it as if it were mom. I’d perform a self assessment (we’ll get to that in a moment) and then after I decided I was OK, I’d tell her I was fine and that I needed to get back to what I was doing.. which is living right now. It took time but as I practice this more I have been able to regain more control of my day to day anxiety. Don’t get me wrong, I think about having a heart attack every day. But not so much in fear, more like a compass. Keeping me as centered on the road as possible, guiding me through the rest of my life.
Not only did the therapist give me this useful tool to deal with anxiety he also opened my eyes to the fact that this is a classic grief model. One where our goal is to embrace heart disease, or whatever diagnosis or life crisis, and accept it. The good part about that is once you have done so, you have your life back. Changed yes. But it’s 100% you in your head not grief, depression or anxiety. And that’s work worth doing.
I mentioned that I do self assessments earlier. These are something that my meditation teacher used to help me wrap my non meditative head around the practice of meditation. She kind of freaked me out because she was a super-hippy type. Very in touch with herself and disturbingly peaceful. I darn near think she could levitate if she simply regarded gravity, accepted it, and then decided she wanted to sit on top of it. Yeah… she’s that person. All in all an excellent example of life providing the teacher you need not the one you think you want. So, she taught me how to sit and listen to myself breath in a mindful way. It was perfect for me as I’m a problem solver for a living and my head tends to be a train that is hard to stop. I told her this and she said that’s OK. “Just regard those thoughts and let them be. Keep breathing and focus on those.”
I lived in a high rise in a historic building in Downtown Dallas for many years. When she introduced the idea of the elevator meditation I was better able to do this using the Davis Building elevators as imagery. She used this to show me how to breath my way down my body by “focusing” on your head, throat, shoulders, chest, arms, hands, stomach, hips, legs, feet and then back up. I do these now in tandem with my anxiety exercise to manage those feelings. It’s the results of the assessment that give me the answer that anxiety is asking of me. “Are you OK?” So far the answer has been yes. And that’s a powerful feeling.
It was a colleague of mine who sent me a rather hefty email detailing his history with heart attacks and that of his father who had a series of 13. These guys are real men in my book. Anyone who can battle through all that and maintain hope and forward motion… well, that’s someone to look up to as a role model. It was one technique they use that caught my attention. It’s called the “4-7-8” breathing exercise. It uses diaphragmatic breathing in no particular rhythm really to lower your heart rate, improve oxygenation and clear your mind. Careful though, and while this has never happened to me, this can allegedly put you to sleep in 60 seconds. There are plenty of resources including video content on You Tube you can find by the 4-7-8 keyword in any search engine.
Wrapping all this up I wanted to impart my struggle with cardiac anxiety and the tools I have found to manage it. If you are struggling it’s OK to ask for professional help. With his or her guidance it may be determined that medicine may be a good course of action. You may be able to simply work through it or use some of the techniques I employ on a daily basis to manage it. Whatever it is though, take it seriously. Learn how to control it and live a long(er) healthy life. Always trust your body even though you may still be learning about new signals it’s sending due to heart disease. Go to ER if in doubt. Trust and truly partner with your cardiologist and family Dr. These folks are our allies along with the medicines they are putting at our disposal. I’m in regular contact with my team with questions about side effects, dosage, supplements, nutrition and exercise. Make sure you take advantage of these resources and make informed choices with help. Above all… don’t go it alone. Find support. In the absence of a network, know that you are not alone and that we are all out here fighting the same battle together.
It’s possible to take back our lives. All we have to do is use our heads, follow our hearts, make good choices, allow for failure but learn from them and, above all else, don’t look back.
As a footnote to that first ER trip… I was able to make it to Portland the next day. It was a beautiful ceremony celebrating two people very much in love. After that I climbed Mt Hood and Saddle Mountain and nearly drowned in the Columbia River.
In the end, that’s how I want my postcard to read… “Just wanted to say hi! I’m having a crazy time, riding rainbows wearing a cowboy hat and jumping through rings of fire.”