My mojo has gone.

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lurky

Original Poster:

61 posts

95 months

Monday 30th May 2016
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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.

  • 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).
I’ve lost my trusted companion (ex-to-be) and feel desperately out on a limb, especially as she’s putting me through it with the divorce. I self-referred to the local psychological service but they don’t want to know, as I’ve had so much therapy in the past.

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.

lurky

Original Poster:

61 posts

95 months

Monday 30th May 2016
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Thank you for your replies people. I have an assessment session with the local branch of Mind on Thursday.

lurky

Original Poster:

61 posts

95 months

Tuesday 31st May 2016
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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.)

Edited by meddyg on Monday 30th May 15:06
Wise words, meddyg, thank you. I just replied to this but couldn't submit my response. If this works, I'll try again tomorrow.

lurky

Original Poster:

61 posts

95 months

Tuesday 31st May 2016
quotequote all
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.

lurky

Original Poster:

61 posts

95 months

Tuesday 31st May 2016
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Well, 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.

lurky

Original Poster:

61 posts

95 months

Friday 3rd June 2016
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Just a little update. The assessment at Mind went well and I'll be sent an appointment for counselling in 2 to 3 weeks or so.

lurky

Original Poster:

61 posts

95 months

Saturday 4th June 2016
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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.


Edited by lurky on Saturday 4th June 03:29

lurky

Original Poster:

61 posts

95 months

Monday 6th June 2016
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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!

lurky

Original Poster:

61 posts

95 months

Monday 13th June 2016
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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.

lurky

Original Poster:

61 posts

95 months

Saturday 18th June 2016
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I tried Buspar/Buspirone for a few weeks, up to a dose of 45mg per day. It gave me tiredness, headache and dizziness as regular as clockwork 30 mins after taking it. These side effects would go after an hour or so. However, the only upside was a slight lifting of my mood; as would be expected of a serotonergic compound. The anxiety relief, if present, was minimal.

Today, the GP wouldn't prescribe what I was considering, despite my having been on it for 6 months in 2014.

This, Venlafaxine, is an SSRI antidepressant that was given FDA clearance for the treatment of GAD, panic disorder and social phobia in the US after it came out in 1993.

The doc was concerned about its being associated with arrhythmia. He wants the cardiologist 's opinion. He also said the drug isn't much used nowadays, Mirtazapine is favoured. Been there, tried it...it was very sedating indeed.

The GP who prescribed Buspirone made it an agreed short-term trial and said, 'Consider options if ineffective'. Today, as I expected, it was concluded there were no other options.

I now have a wait (until the 11th August) until I can see a cardiologist again.

In the meantime, I still await a first appointment with Mind.

When taking Venlafaxine and I used to be able to do a 180-mile round trip to see a band with my best mate - I'd also been able to do the same distance, stay over and work on the classic car he's restoring. All this was before the triple whammy of the unexplained collapse, the atrial fibrillation and the car crash. Can't handle such trips now.

I've been doing maladaptive coping for four and a half months now. Life consists of two shopping trips, two evenings shooting the target rifle, some TV watching and lots of sleeping. This is per week. My mate's visited twice and I've assisted at two guest nights at the shooting club.

The new car's just displayed 400 miles...haven't been on any trips, just local stuff. It's sad, driving was my passion for 40+ years. It's proving immensely difficult to get my confidence back in this respect and in several other ways.

My quality if life is decidedly low now. At this point, I'm badly restricted and not at all sure what to do.

lurky

Original Poster:

61 posts

95 months

Saturday 18th June 2016
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67Dino said:
Thanks for posting, Lurky. Sorry to hear things continue to be tough for you, so just wanted you to know there's PHers out there thinking of you and wishing you well.

Appreciate have mentioned the subject before, but if you fancy something to read that might help whilst stuck at home, can wholeheartedly recommend Ed Halliwell's new book 'To the heart of Mindfulness'. Ed talks about his own challenges and how the technique helped him, so thought might be useful. Just an idea.

'This too will pass', so keep positive. All the best.

Edited by 67Dino on Saturday 18th June 04:55
Thanks 67Dino,

It's nice to know there are people rooting for me. I spoke to my best mate and my brother...everyone's been sympathetic and supportive. I,ll be investigating the Halliwell book later.

For now, I can confirm that Buspirone withdrawal effects exist. That's odd with a half life of just 2 to 3 hours. Sleep eluded me for much of last night and I've been nodding off today. Also had some dizziness and a short spell of nausea...gone now. It's not surprising given it's a psychotropic drug that works on the serotonin receptors. Apparently, it only works for 'select' patients, whatever that means?

As you say, this will pass - if I don't firstsmile

lurky

Original Poster:

61 posts

95 months

Monday 4th July 2016
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Another little update as life grinds on. My first appointment with Mind came through and was cancelled ( the counsellor was ill). They can, however offer me CBT input. This takes two assessment sessions before it begins. The first should be on Friday.

Meanwhile, I've an appointment with the cardiologist on the 11th August. Before that, I'll be wearing a Holter monitor for 24hrs, beginning 28th July. Something happening in the right order at last!

Just seen my GP and he's offering Risperidone, after I revealed that the anxiety makes it like being under house arrest.

He wants me to research this drug and let me know if I'd like him to prescribe. There are upsides to having a part - medical background.

Any experience with it anyone? Thanks.

lurky

Original Poster:

61 posts

95 months

Monday 15th August 2016
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Having at last recalled my password, I can update.

I tried risperidone but it didn't help. It gave me insomnia, dizziness and raised my anxiety level markedly. So I've stopped it and have been putting up with a withdrawal symptom - spells of nausea.

I wore a Holter monitor for 24 hrs - nothing more than insignificant ectopic beats recorded. The cardio was very good...an AV ablation isn't indicated. He thinks my problem is down to phobic anxiety and suggests CBT.

Meanwhile, I'm to go back on Venlafaxine, which I've had before. Also, counselling with Mind is ongoing and I've a second CBT assessment shortly.

I'm still being avoidant and my confidence is still bad (esp when driving).

On the rocks and v. Unhappy. It's late.

Note to self...password is 'cheap digital brand'.

Edited by lurky on Monday 15th August 02:03

lurky

Original Poster:

61 posts

95 months

Wednesday 17th August 2016
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Just to make life harder, my CBTassessment appointment has been cancelled as the contact is ill. This has come on top of the cardio's letter not having made it to the docs yet. No Venlafaxine for me yet.
It must be because it's 2016. These things keep happening!

lurky

Original Poster:

61 posts

95 months

Thursday 18th August 2016
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Just a quick bump.

It turns out that nausea and increased anxiety are both side effects and withdrawal effects of risperidone. So, at day 11 of being off it, I've had two days of feeling sick and panicky.

I've checked that the cardio ' s letter is with the doc and that Venlafaxine is a stock drug. Hope it works for me...again.

Seeing doc at 5.50 tomorrow.

lurky

Original Poster:

61 posts

95 months

Thursday 18th August 2016
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Sticks. said:
I'm afraid that's not that unusual with anything to do with health care. I just took two weeks and 3 trips to get a 4 item repeat prescription sorted. And having been told my ortho insoles will be 'a few weeks yet', after a few weeks they then realise they hadn't ordered them FFS.

Just keep at it, you'll get there.
Yep, it's an unfortunate combination of circumstances. Pity it put me in a difficult situation.

lurky

Original Poster:

61 posts

95 months

Sunday 21st August 2016
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Well, I got the Venlafaxine, 37.5mg modified release, one a day. It's now a matter of getting past the starting side effects - tiredness, hot spells and nausea This takes 10 to 14 days (on day 3 now) efficacy in 3 to 4 weeks.

lurky

Original Poster:

61 posts

95 months

Thursday 25th August 2016
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Well, after a week coming off the risperidone, it's day 6 on a Venlafaxine...too early for efficacy yet but the side effects seem to be lessening.

I found out this morning that I'm being offered CBT for my anxiety. Apparently, the waiting list isn't too long.

Edited by lurky on Thursday 25th August 16:46

lurky

Original Poster:

61 posts

95 months

Monday 29th August 2016
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Life,of a sort, goes as I wait for the Venlafaxine to kick in (it's day 10 on it). Still no positive effect as yet but the side effects aren't too bad.

Friday was terrible though. I went to my divorce case conference at noon. I'd had a huge panic attack outside and had to do my best during the hour - long meeting. I had palpitations and tachycardia and I'll never know how I managed. When I returned home around 2, the palps were still going on and my heart rate was 116.
I took 2mg Valium (I'd had 1mg at 11) and went to sleep. Things didn't settle down until after 6pm.

I've been recovering since. It's said the Venlafaxine should start working about 2 weeks in...could be sooner.

I should get notification of a CBT appointment this week. God knows it's needed.

lurky

Original Poster:

61 posts

95 months

Tuesday 30th August 2016
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bigkeeko said:
Lurky. Just read through your first post dated May 30th. Big old list of st to be fair and the first thing I thought of (and I`m no expert either btw) was this. Opening up and telling people how you REALLY feel relieves a bit of pressure, even if it is to anonymous guys on the net. There are loads of mickey takers on here, and I`ve done it myself but there are times when it won't do. ie; your situation.
I was thinking. Who is your best friend? Reason I ask is they may well know more or less your current situation but like most humans it's in one ear and out the other as we all have our own little agendas.
If you showed him/her exactly what you have written on May the 30th it may lighten the load man. Sympathy isn't your goal here it's getting back on track and even banging your script on here is going the right way mate.
For what it's worth my mum died young and so did her dad (my grandfather). I more or less condemned myself to the same fate but that's not how it works or plays out in real life. When I overthought things I found distraction was the key and way out. Any old ste. I took up some fked up hobbies I can tell you. laugh

Stick in. You`ll come good.

Edited by bigkeeko on Monday 29th August 23:48
Well, thanks, especially for the last line.

I've spent years trying to convince myself that I have half my Mum's genes (she lived to 84 while Dad only made 58). And I'm me, not my Dad.

Putting it all on here has been helpful - a little encouragement and support go a long way.

My best mate knows the whole story. I've known him for 45 years and the families were friends too. He's an invaluable source of support in many ways.

I've hopes for the future. The new drugs should kick in any day and I've more treatment to come. Recovering from Friday has taken time but at least I survived.

Thanks again, lurky.


Edited by lurky on Tuesday 30th August 01:28