Image by wadem via Flickr
So yesterday I talked about my fear of death and the "death realization" episodes that seem to occur as I fall asleep. I shared that I had an insight, where I realized that these episode might be the result of my multiple physical health problems and NOT the effects of psychological trauma from my cancer experience. I admitted that I might have put the cart before the horse.
So here is the thing:
I've known for a while that my dysautonomia causes tachycardia or fast heart beating. I've noticed that episodes of fast heart beats happened to me at any time and in any place. That includes when I am in bed. When I started taking a beta-blocker back in 2007, one of the first things I noticed was that I was no longer getting woken up in the middle of the night from tachycardia.
More recently, my doctor prescribed for me the synthetic marijuana drug Cesamet for my fibromyalgia pain. Unfortunately, I was only able to take one dose because of one major side effect: my old nemesis, tachycardia. The drug really helped my muscles relax and made me sleepy, but after what seemed like a few minutes of sleep I awoke with shortness of breath and then realized my heart was pounding.
You see, when your heart is racing, it gets kind of hard to breath. I learned all about this heart rate/shortness of breath connection in the hospital at the end of my failed attempt at Hepatitis C treatment in September, 2007. They actually thought I had had a heart attack because of these symptoms. That hospitalization lead to my doctors starting to treat my dysautonomia symptoms with a beta-blocker.
Granted, I tried Cesamet a few weeks ago, but I guess I needed that time to percolate this insight:
- Dysautonomia > since 1988 > a late effect from my cancer treatment (my chronic Hepatitis C infection may also be a co-contributor) = tachycardia at any time or place
- Tachycardia (especially when it is bad) = shortness of breath
- Fibromyalgia > since 2004 > makes my dysautonomia symptoms worse
- (interesting factiod: one of the first things my rheumatologist did was send me for a test that definitively diagnosed my dysautonomia, but then he left it unaddressed & untreated)
- Sleep apnea > diagnosed in 2006 > an associated condition with fibromyalgia
- so now I am forgetting to breath at night = tachycardia
- So tachycardia since 1988 and sleep apnea starting in 2004 = disrupts sleep, wakes me up, makes me feeling shaky = I panic & I think I am dying = the prefect recipe for creating a death phobia
But then here is the missing puzzle piece: dysautonomia, et al. can cause this chain reaction WHILE I AM FALLING ASLEEP.
I don't know how I missed this last little piece, but it fits with the "death realization" episodes I've been having since my cancer experience. The fibromyalgia and sleep apnea are just making everything worse since 2004, which is only reinforcing the whole death phobia thing even more. Oh, and add in that another medication I tried a few months back for my fibromyalgia, Topomax, that actually gave me full blown panic attacks as a side effect, and now I am being reduced to neurotic mess.
I cannot say this enough: you can't be diagnosed with mental health problems without ruling out all physical problems first. If there are physical problems, the association between the physical and the mental needs to be emphasized: panic symptoms secondary to dysautonomia. In a prefect world, everyone would realize that dismissing real, physical symptoms and labeling them "depression" or "anxiety" ignores my true health problems.
I'm not crazy, I'm sick. For me, knowing this is an instant sanity check. Sure, I might still be afraid of dying, but thanks to finally getting treatment for my dysautonomia and sleep apnea, I won't actually be dying in bed anytime soon.
I bet my husband is glad to hear that!