My mojo has gone.
Discussion
This is going to be difficult to write for various reasons but I’ll try to keep it clear and pacy. It is going to be a long read but I see no other way. I can only apologise in advance and point out that you needn’t read on - iy's up to you.
Many years ago, I was present when my Dad died of a massive heart attack. I’d already been having issues with anxiety and the associated palpitations it caused. Dad’s death kicked off more anxiety, which turned to agoraphobia and cost me 26 years’ quality of life. Some new therapy made it much better and I got to the stage where I could travel and function alone, albeit with some trepidation.
In the intervening period, I had three severe doses of palpitations (actually ectopic heartbeats or extrasystoles). Though terrifying, these had been diagnosed as being ‘of no malign significance’. So, I carried on, being very wary of anything cardiac in nature. Where my lumpy pulse misbehaved but a couple of Valium sorted it out. In each case, exertion set it off.
By the September of 2014, my alcoholic wife lit out. I’d begun divorce proceedings in the July. Two years on, the messy property battle is ongoing. Then, 2016 reared its ugly head.
Earlier this year, I was given a new antidepressant (Sertraline) to help with depression triggered by the divorce. The evening after starting it, I went to my weekly archery shoot. Half way through, I started to feel very hot, started sweating and felt my strength going-fast. Crossbow in hand (luckily not loaded) I tottered to the door, missed and went down like a ton of bricks. Paramedics appeared swiftly and they found everything was normal. Cue an ambulance trip to hospital (34 miles away) and everything was fine. .I was home three hours later.
Two weeks later, I’d returned home in the evening and eaten. Going up the stairs a bit too fast kicked off another spell of extrasystoles. This time, Valium didn’t touch it and I ended up (via the NHS non-emergency number) with paramedics to hand again. They detected that I was having atrial fibrillation. This was confirmed in hospital; my bloods and chest X-ray were fine. They gave me Beta blockers (Bisoprolol) and everything settled down again. I was back at home – and distinctly rattled) five hours later, around dawn. I was put on Bisoprolol. My GP tried increasing the dose but this was too much for me. I was changed to Half Beta Prograne, which is a ‘kinder’ drug and I could cope with it.
Almost exactly a month after this, I was heading across town to archery again when another trauma hit. Long story short, I had a car crash, caused by a suspension/steering failure on my new car. I hit a parked car and my car damaged itself badly enough to be written off. Police were involved but the possible due care was dropped when I showed them pictures of the broken hardware under the car.
After the fibrillation episode, I saw a cardiologist. He heard a dodgy valve and, after an echocardiogram, I was diagnosed with mitral valve regurgitation and a mitral valve prolapse. I don’t need pills for this and the prolapse/regurgitation is considered ‘irrelevant’. The cardiologist doesn’t want me back unless I suffer atrial fibrillation again for more than 12 hours.
The upshot of these trials is probably not surprising. I’ll bullet them to make this shorter.
Subjectively, I feel I’ve been knocked back twenty years. I’ve given up going to archery, partly through embarrassment after collapsing and partly for fear that the exertion will kick off the fibrillation again.
If I could, I’d undergo ablation and even have a pacemaker fitted so my heart would be reliable and unable to terrify me any more.
Those with psych knowledge (as I have) may see the above as maladapive coping, which it is. Snag is, it isn’t really coping. It also fits a PTSD profile too well for my liking.
I’ll be seeing the GP soon, before which I’ll be having a pre-counselling assessment with MIND. This might fill up a gap. I was receiving counselling from the local Drug and Alcohol Counselling services, to help me deal with my ex-to-be’s frequent drunken abuse. It ended recently.
By now, you may be saying ‘what a wuss’. If you can’t say anything constructive, please say nothing.
For now, I don’t know what to do with myself. As the title says, my mojo’s departed big style. Sorry if I’ve bored you with my troubles.
Many years ago, I was present when my Dad died of a massive heart attack. I’d already been having issues with anxiety and the associated palpitations it caused. Dad’s death kicked off more anxiety, which turned to agoraphobia and cost me 26 years’ quality of life. Some new therapy made it much better and I got to the stage where I could travel and function alone, albeit with some trepidation.
In the intervening period, I had three severe doses of palpitations (actually ectopic heartbeats or extrasystoles). Though terrifying, these had been diagnosed as being ‘of no malign significance’. So, I carried on, being very wary of anything cardiac in nature. Where my lumpy pulse misbehaved but a couple of Valium sorted it out. In each case, exertion set it off.
By the September of 2014, my alcoholic wife lit out. I’d begun divorce proceedings in the July. Two years on, the messy property battle is ongoing. Then, 2016 reared its ugly head.
Earlier this year, I was given a new antidepressant (Sertraline) to help with depression triggered by the divorce. The evening after starting it, I went to my weekly archery shoot. Half way through, I started to feel very hot, started sweating and felt my strength going-fast. Crossbow in hand (luckily not loaded) I tottered to the door, missed and went down like a ton of bricks. Paramedics appeared swiftly and they found everything was normal. Cue an ambulance trip to hospital (34 miles away) and everything was fine. .I was home three hours later.
Two weeks later, I’d returned home in the evening and eaten. Going up the stairs a bit too fast kicked off another spell of extrasystoles. This time, Valium didn’t touch it and I ended up (via the NHS non-emergency number) with paramedics to hand again. They detected that I was having atrial fibrillation. This was confirmed in hospital; my bloods and chest X-ray were fine. They gave me Beta blockers (Bisoprolol) and everything settled down again. I was back at home – and distinctly rattled) five hours later, around dawn. I was put on Bisoprolol. My GP tried increasing the dose but this was too much for me. I was changed to Half Beta Prograne, which is a ‘kinder’ drug and I could cope with it.
Almost exactly a month after this, I was heading across town to archery again when another trauma hit. Long story short, I had a car crash, caused by a suspension/steering failure on my new car. I hit a parked car and my car damaged itself badly enough to be written off. Police were involved but the possible due care was dropped when I showed them pictures of the broken hardware under the car.
After the fibrillation episode, I saw a cardiologist. He heard a dodgy valve and, after an echocardiogram, I was diagnosed with mitral valve regurgitation and a mitral valve prolapse. I don’t need pills for this and the prolapse/regurgitation is considered ‘irrelevant’. The cardiologist doesn’t want me back unless I suffer atrial fibrillation again for more than 12 hours.
The upshot of these trials is probably not surprising. I’ll bullet them to make this shorter.
- My anxiety is back in a big way. The heart issues I’ve feared for four decades seem distressingly close now.
- My driving confidence is shot. I’d got to a stage where I could go to stay with my best friend in South Manchester for a day or two but that’s impossible now. I got back on the horse as best I could with nervous local trips. I put only 300 miles on my replacement car.
- The Beta blocker is contributing to my attempt to sleep for Britain. I usually bed down at 3am and rise around noon, feeling rough as rats. It takes me a long time to get going. I managed not to fall into the trap of taking too much Valium. I’ve been on Buspirone for three weeks now but it isn’t doing much (it affects the Serotonin level and so takes weeks to kick in).
Subjectively, I feel I’ve been knocked back twenty years. I’ve given up going to archery, partly through embarrassment after collapsing and partly for fear that the exertion will kick off the fibrillation again.
If I could, I’d undergo ablation and even have a pacemaker fitted so my heart would be reliable and unable to terrify me any more.
Those with psych knowledge (as I have) may see the above as maladapive coping, which it is. Snag is, it isn’t really coping. It also fits a PTSD profile too well for my liking.
I’ll be seeing the GP soon, before which I’ll be having a pre-counselling assessment with MIND. This might fill up a gap. I was receiving counselling from the local Drug and Alcohol Counselling services, to help me deal with my ex-to-be’s frequent drunken abuse. It ended recently.
By now, you may be saying ‘what a wuss’. If you can’t say anything constructive, please say nothing.
For now, I don’t know what to do with myself. As the title says, my mojo’s departed big style. Sorry if I’ve bored you with my troubles.
I dont think you are being a wuss at all. It seems to me that you are worried about your heart condition and this is affecting your quality of life. It's a worrying thing thinking death might be round the corner at any point.
If it were me - and I am not in any way qualified - I would be explaining to the GP about your worries and asking for a second opinion. I'd probably also try something like hypnosis for the anxiety. I did it recently for a phobia and it was great.
Try not to let it get you down and if you enjoy things like the archery then go back and do them. If people make a fuss when you go it is because they care, no need to be embarrassed.
If it were me - and I am not in any way qualified - I would be explaining to the GP about your worries and asking for a second opinion. I'd probably also try something like hypnosis for the anxiety. I did it recently for a phobia and it was great.
Try not to let it get you down and if you enjoy things like the archery then go back and do them. If people make a fuss when you go it is because they care, no need to be embarrassed.
Hi, I'm sorry to hear about your predicament, might I suggest a few options that you have available to you.
1) increase the dose of the sertraline (unless you're on the max 200mg dose), or try another antidepressant
2) stop using Valium, it's not helpful long term.
3) get some further counselling / CBT if you can.
4) the best thing you could do right now is not to stop your hobbies, as this will only lead to inevitable isolation and further despair. You need to get yourself out, take up old/new hobbies and start a programme of regular exercise (walking doesn't count - needs to be something that gets you out of breath. Exercise won't cause problems with AF/ectopics, in fact quite the opposite, the fitter you get, the less likely that exertion will trigger the AF/ectopics.)
1) increase the dose of the sertraline (unless you're on the max 200mg dose), or try another antidepressant
2) stop using Valium, it's not helpful long term.
3) get some further counselling / CBT if you can.
4) the best thing you could do right now is not to stop your hobbies, as this will only lead to inevitable isolation and further despair. You need to get yourself out, take up old/new hobbies and start a programme of regular exercise (walking doesn't count - needs to be something that gets you out of breath. Exercise won't cause problems with AF/ectopics, in fact quite the opposite, the fitter you get, the less likely that exertion will trigger the AF/ectopics.)
Edited by meddyg on Monday 30th May 15:06
meddyg said:
Hi, I'm sorry to hear about your predicament, might I suggest a few options that you have available to you.
1) increase the dose of the sertraline (unless you're on the max 200mg dose), or try another antidepressant
2) stop using Valium, it's not helpful long term.
3) get some further counselling / CBT if you can.
4) the best thing you could do right now is not to stop your hobbies, as this will only lead to inevitable isolation and further despair. You need to get yourself out, take up old/new hobbies and start a programme of regular exercise (walking doesn't count - needs to be something that gets you out of breath. Exercise won't cause problems with AF/ectopics, in fact quite the opposite, the fitter you get, the less likely that exertion will trigger the AF/ectopics.)
Wise words, meddyg, thank you. I just replied to this but couldn't submit my response. If this works, I'll try again tomorrow.1) increase the dose of the sertraline (unless you're on the max 200mg dose), or try another antidepressant
2) stop using Valium, it's not helpful long term.
3) get some further counselling / CBT if you can.
4) the best thing you could do right now is not to stop your hobbies, as this will only lead to inevitable isolation and further despair. You need to get yourself out, take up old/new hobbies and start a programme of regular exercise (walking doesn't count - needs to be something that gets you out of breath. Exercise won't cause problems with AF/ectopics, in fact quite the opposite, the fitter you get, the less likely that exertion will trigger the AF/ectopics.)
Edited by meddyg on Monday 30th May 15:06
lurky said:
Wise words, meddyg, thank you. I just replied to this but couldn't submit my response. If this works, I'll try again tomorrow.
Following on from this, there are some snags, my first dose of Sertraline is what made me collapse...it's a rare but known effect. This and Citalopram are on my 'adverse effects' list at the doc's.I'm still pursuing my other hobby twice a week. I go target rifle shooting from a bench rest. Technically, I'm cheating. Anyone will shoot better when taking a Beta blocker!
I've been using benzodiazepines for forty years but never developed tolerance. This means I can get by with a very small dosage. I'm trying Buspar/Buspirone as an alternative anxiolytic. It'll be 3 weeks on it tomorrow but it isn't doing much as yet.
The exertion/AF correlation is scary territory for me. Apart from the climbing the stairs too fast episode, my AF has been triggered by hand - washing a motorhome and, er, marital interfacing.
The last challenge precludes significant exercise. I'm disabled and must use a walking stick. Latterly, even coping with archery outdoors at a 60-metre range has been a struggle. Just to add to things I have MS too.
Though a wreck in so many ways, I can still thank you once again for your input.
I'm not a medic so nothing to add on that score, just wanted to say I'm sorry to hear about your troubles. Seems to me you're actually someone with a lot of mojo who has gone 9 rounds with some of the toughist issues life can throw at someone, and frankly you'd not be human if you weren't feeling it. It takes some guts to post like you did on PH, so I salute your bravery and obvious determination to find solutions and get better. I hope you do and wish you well. Good luck!
lurky said:
Following on from this, there are some snags, my first dose of Sertraline is what made me collapse...it's a rare but known effect. This and Citalopram are on my 'adverse effects' list at the doc's.
I'm still pursuing my other hobby twice a week. I go target rifle shooting from a bench rest. Technically, I'm cheating. Anyone will shoot better when taking a Beta blocker!
I've been using benzodiazepines for forty years but never developed tolerance. This means I can get by with a very small dosage. I'm trying Buspar/Buspirone as an alternative anxiolytic. It'll be 3 weeks on it tomorrow but it isn't doing much as yet.
If SSRI's did not agree with you, and Buspirone doesn't work, there are many other possibilities, including Pregabalin, Venlafaxine, Mirtazipine etc.. (some may be more or less suitable for you depending on your other medical conditions)I'm still pursuing my other hobby twice a week. I go target rifle shooting from a bench rest. Technically, I'm cheating. Anyone will shoot better when taking a Beta blocker!
I've been using benzodiazepines for forty years but never developed tolerance. This means I can get by with a very small dosage. I'm trying Buspar/Buspirone as an alternative anxiolytic. It'll be 3 weeks on it tomorrow but it isn't doing much as yet.
lurky said:
The exertion/AF correlation is scary territory for me. Apart from the climbing the stairs too fast episode, my AF has been triggered by hand - washing a motorhome and, er, marital interfacing.
The last challenge precludes significant exercise. I'm disabled and must use a walking stick. Latterly, even coping with archery outdoors at a 60-metre range has been a struggle. Just to add to things I have MS too.
I'm sorry, I was unaware of your other medical problems. Even so, there must be some exercise you can undertake, such as an exercise bike, cross trainer, or rowing machine.. it's about finding something you can do, and then starting slow and building up gradually. If you want some assistance with this, they do run Cardiac Rehabilitation exercise programmes throughout the UK, and you may be able to get the GP to refer you to one. That way you can start exercising under supervision, before being confident to continue on your own. The last challenge precludes significant exercise. I'm disabled and must use a walking stick. Latterly, even coping with archery outdoors at a 60-metre range has been a struggle. Just to add to things I have MS too.
lurky said:
Though a wreck in so many ways, I can still thank you once again for your input.
All the bestWell, thank you for the good wishes and great advice.
The GP who extended my Buspar script put 'consdier options if ineffective' on the pill pack label so he must have something in mind. I'm seeing the top gun doc (with whom I'm registered) on Monday afternoon so we'll see - the Buspar is still doing little or nothing.
Made it to rifles this evening and the rifle was in a good mood on two practise targets - scored 98/100 twice.
The GP who extended my Buspar script put 'consdier options if ineffective' on the pill pack label so he must have something in mind. I'm seeing the top gun doc (with whom I'm registered) on Monday afternoon so we'll see - the Buspar is still doing little or nothing.
Made it to rifles this evening and the rifle was in a good mood on two practise targets - scored 98/100 twice.
Yes, it is good news to me too. However, as I’m preparing to work more with the GP, a little peep into the wonderful world of chronic anxiety may have two positive effects. It may give you an insight into how the condition plays dirty sometimes. On the other hand, it may be cathartic for me to air it a little. And ‘air’ is an appropriate word here.
I used to follow the work of the late Dr. Claire Weekes, an Australian psychologist who specialised in phobias and anxiety. My favourite quote of hers is, ‘Through the years, I have seen every shade of every trick my patients’ nerves have played upon them.’ I know this quotation well and I know the feeling only too well – personally.
In February, I was put on a beta blocker after my spell of atrial fibrillation – as I mentioned above, it settled things down. My GP had me take more but I found that even a tiny increase in the dose caused me to feel really bad. My heart rate plunged to 46 beats per minute and I started experiencing ‘air hunger’. The dose was reduced and I went on to half –beta prograne (active ingredient Propanolol in slow release form).
All seemed fine but a new trick reared its ugly head. My heart rate is stable at 46 to 50bpm and my blood pressure is under control. The ‘but’ is that for the last two weeks or so, I’ve been waking with dyspnoea – shortness of breath. I’m not breathless as in puff-pant, it’s more that I’m air hungry, getting a deep breath seems an effort for a while after waking.
Here’s how the anxious mind works…
“OK, Propanolol can worsen asthma.” (But I’m not asthmatic and my chest X-ray was clear.)
“But you take Valium and that can cause respiratory depression.” (But I take very little and it’s never caused a problem in forty years’ use.)
“One of these mornings, you’re going to be unable to breathe, just like your Dad couldn’t, ten minutes before he died.”
I counter this with known facts. (My feet/ankles aren’t swollen so there’s no evidence of a heart issue. I don’t have cyanosis (blue lips) and I have no chest pain or arm/neck pain.)
“Nor did your Dad, until the end.”
The bottom line is that both over and under-breathing are characteristic anxiety symptoms and both can upset the blood’s carbon dioxide base and lead to the feeling of breathing difficulty – it’s highly subjective.
Even with the medical knowledge I have (I worked in a medical school for two years as photographer/imaging tech) and an MSc in psychology, it’s difficult to rationalise such things.
I know that the GPs will be considering an alternative to the Buspirone anxiolytic (unless it starts to work) and I’ll do what I usually do before I see my GP on Monday. I put together a single-page document with the information for the consultation. This just describes what’s happening, when it began and any significant changes. I’ve yet to meet a doc who didn’t appreciate this approach.
Anxiety is a bête noir with which I’ve crossed swords many times. As you can see, it can be an unfair fighter and the medications’ side effects (poor sleep pattern, tiredness, dizziness) don’t help. The good news is that there’s no sleep apnoea going on – I’ve a snore-recording app on my smartphone. This points still more convincingly to anxiety’s being the root cause.
I hope it might be a little less taxing when I awake – perhapsmy having composed this will make it so. Even so, his has helped me in the perspective stakes. Thank you for reading.
I used to follow the work of the late Dr. Claire Weekes, an Australian psychologist who specialised in phobias and anxiety. My favourite quote of hers is, ‘Through the years, I have seen every shade of every trick my patients’ nerves have played upon them.’ I know this quotation well and I know the feeling only too well – personally.
In February, I was put on a beta blocker after my spell of atrial fibrillation – as I mentioned above, it settled things down. My GP had me take more but I found that even a tiny increase in the dose caused me to feel really bad. My heart rate plunged to 46 beats per minute and I started experiencing ‘air hunger’. The dose was reduced and I went on to half –beta prograne (active ingredient Propanolol in slow release form).
All seemed fine but a new trick reared its ugly head. My heart rate is stable at 46 to 50bpm and my blood pressure is under control. The ‘but’ is that for the last two weeks or so, I’ve been waking with dyspnoea – shortness of breath. I’m not breathless as in puff-pant, it’s more that I’m air hungry, getting a deep breath seems an effort for a while after waking.
Here’s how the anxious mind works…
“OK, Propanolol can worsen asthma.” (But I’m not asthmatic and my chest X-ray was clear.)
“But you take Valium and that can cause respiratory depression.” (But I take very little and it’s never caused a problem in forty years’ use.)
“One of these mornings, you’re going to be unable to breathe, just like your Dad couldn’t, ten minutes before he died.”
I counter this with known facts. (My feet/ankles aren’t swollen so there’s no evidence of a heart issue. I don’t have cyanosis (blue lips) and I have no chest pain or arm/neck pain.)
“Nor did your Dad, until the end.”
The bottom line is that both over and under-breathing are characteristic anxiety symptoms and both can upset the blood’s carbon dioxide base and lead to the feeling of breathing difficulty – it’s highly subjective.
Even with the medical knowledge I have (I worked in a medical school for two years as photographer/imaging tech) and an MSc in psychology, it’s difficult to rationalise such things.
I know that the GPs will be considering an alternative to the Buspirone anxiolytic (unless it starts to work) and I’ll do what I usually do before I see my GP on Monday. I put together a single-page document with the information for the consultation. This just describes what’s happening, when it began and any significant changes. I’ve yet to meet a doc who didn’t appreciate this approach.
Anxiety is a bête noir with which I’ve crossed swords many times. As you can see, it can be an unfair fighter and the medications’ side effects (poor sleep pattern, tiredness, dizziness) don’t help. The good news is that there’s no sleep apnoea going on – I’ve a snore-recording app on my smartphone. This points still more convincingly to anxiety’s being the root cause.
I hope it might be a little less taxing when I awake – perhapsmy having composed this will make it so. Even so, his has helped me in the perspective stakes. Thank you for reading.
Edited by lurky on Saturday 4th June 03:29
Sparkzz said:
Sertraline is a very dangerous drug. It is often wrongly prescribed to people with anxiety disorders. Can cause manic behaviour and blackouts and collapse. Nearly killed my friend when we went for a few pints.
Sorry I can't be of more help. You should continue the archery though.
Im not sure I understand your comment. Sertraline is 1st line for generalised anxiety disorder, so I'm not sure it's "wrong" to prescribe it. Sorry I can't be of more help. You should continue the archery though.
meddyg said:
Im not sure I understand your comment. Sertraline is 1st line for generalised anxiety disorder, so I'm not sure it's "wrong" to prescribe it.
. I did my research on this matter (I usually do) and found out some interesting facts. I actually feel my problem is more panic disorder than G.A.D. but I knew that Sertraline has an anxiolytic effect. Like most drugs, Sertraline has a screed of side effects. Syncope (fainting) is among them but web searches revealed it's more common than the available information led me to believe.In any case, since I had adverse reactions to Citalopram too, both compounds are off my prescriptions list.
I went to see my GP this afternoon and he decided it would be worth my trying the buspirone at a higher dosage for another ten days. He's put me on 45mg/day (I've been on 30mg/day) for four weeks. Buspirone works on the sertonin level so it can take 3 to 4 weeks to start working - I've been on it 4 weeks in total so far.
I had the first of the increased doses at 7.30. Interestingly, the usual side effects (bit of dizzines and some yawning) didn't materialise - they're usually over with less than an hour after taking the dose.
We had a quick word about possible options too. He checked and found I'd been on Venlafaxine for six months in 2014. I hadn't experienced any particularly bad effects and my diary shows I was doing a lot at that time. However, this was before the triple whammy that kicked all this off - I was on it to help me cope with the divorce.
I'm wondering what the increased Buspirone dosage will bring, if anything. Just waiting for the priomised thunder to clear the air after this hot, humid day. Having MS means I don't do hot well!
Just a short update (you'll be relieved to hear). Several weeks' use of Buspirone at 45mg/day has proved it does little for me - it doesn't help everyone.
I'm awaiting my first counselling appointment with Mind and it's back to the doc on Friday.
I don't know what options he'll offer (if any).
Meanwhile, I'm still being avoidance, though I've kept up with the rifle shooting.
I suppose time will tell.
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