I don’t want to go to A&E but I’m so bloody anxious

[ifindyouveryattractive]

Health anxiety - manifests itself in heart palpitations. I’ve been having them all ruddy day.

I spoke to an OOH GP earlier who said she’s fairly certain the trouble is panic attacks and to do a bit of deep breathing, and take PRN meds, which I’ve done. She went through my notes, I had an ECG just a fortnight ago and she said that was fine. She said A&E will be chaotic, stressful, and reinforce that there’s something to be concerned about.

I’ve been told the same in CBT before.

I’m beyond exhausted. I’m still getting fluttery heartbeats every so often. My anxious brain is saying to go to A&E and ask for another ECG, the teeny tiny sensible part is saying that I don’t need to go there and it won’t help.

I don’t feel safe going for a sleep and ignoring the feelings I’m having but I’m
so bloody tired.

💐🙏

I can empathise.

When I'm having panic attacks and anxiety I get very real physical symptoms as well. What I have found to help is a physical distraction, so I force myself to have a real physical feeling. Typically if it's in the evening or even middle of the night I go out into the garden barefoot and walk on the grass. It's freezing and forces my body and mind to focus on the cold grass under my feet. It helps.

I hope you feel calmer soon.

Oh bless you I’ve been there and it sucks. No brilliant advice as I struggle with the same worries but a normal ECG 2 weeks ago would be very reassuring for me. Xx

Read, or listen to, the book by Dr. Claire Weekes, "Hope and Help for Your Nerves: End Anxiety Now". It really helped me when I was having panic attacks.

Could you get one of those home monitors to reassure you? They work with an app and do a basic ECG. Some are built into wristwatches also.

@StuckintheUSA I also read Claire Weekes books or listen to the audio, just listening to her bracing posh Australian voice (she's passed away now) used to make me feel like I was doing something. I also read two of her books endlessly. They are very reassuring, especially if you have physical symptoms of nervous anxiety.

Op is there any way you could order the book or download on Kindle, or listen to the audiobook? Just as something to distract you. That way if you can't sleep, you will still be doing something productive towards your panic/anxiety.

i get them frequently too but i know for me they aren't anything to worry about and its usually worse when my thyroid is out of kilter..however i know its really difficult to reassure yourself, i do hope your GP has previously given you a thorough health MOT to exclude things like thyroid problems (which also often creates increased anxiety). i would really recommend trying mindfulness techniques if you struggle with breathing type exercises, sometimes it takes a fair while of practise to start to see an improvement.

I'm not a HCP, but most palpitations are completely harmless and you've had an ECG two weeks ago so extra reassuring.

They have, they’ve done a lot of tests - I’ve been back and forth to hospital and GP a lot and they’ve checked everything thoroughly. I’m a bit gassy/heartburn tonight so not sure if that’s not making the palpitations worse. The OOH GP that called said worst case I could go and see someone at minor injuries centre, but said she thought that was pointless too.

I’ve heard of Claire weekes before yes, have listened to bits of her work - will see if I can find her on YouTube. I’ve got the dare book too.

Ive got FibriCheck app, which keeps showing isolated ectopics, which I keep being told are harmless, but they scare the hell out of me. Every time I settle to sleep again another one happens.

Op try this.
It slows heart rate, eases panic and reduces stress by 60% apparently. If you get out of y if a bit you may be able to go to sleep and rest.

OP how old are you?

I called ambulance on two occasions for mine.

Full examinations revealed no heart problems.

A GP later identified it was peri menopause. Each hot flush triggered a massive rise in temperature, heart rate and a feeling that something was dreadfully wrong.

https://www.medicalnewstoday.com/articles/317700

Ectopic beats are normal OP particularly when you’re anxious. I would focus attention on getting help with your anxiety.

I get the feeling I'm having palpitations my fit bit disagrees turns out my heartburn makes me feel like I'm having palpitations speaking of which I'm off to grab my gaviscon

And I'm peri menopause too

Hey. Been there. (As it’s an ongoing process will probably be there again at some point) Keep up the CBT. Keep doing breathing exercises. Agree with the poster above mindfulness. Mindfulness: Finding Peace in a Frantic world by Mark Williams and Danny Penman is particularly good. It’s evidence based and goes by NHS guidelines. You can get it with the audio cd or find the guided meditations on Spotify. I particularly recommend the mindful movement one. The book has a lot of good suggestions to try around grounding.

Another technique I’ve found helpful especially for health anxiety (I think based in mindfulness too) is to do a really repetitive everyday task like washing up or taking a shower and try to spot/feel/hear anything you notice about the activity you are doing. If you find your mind wonders (which it will and that is normal) or you are thinking about your body and checking your symptoms then you just take notice of the fact and say to yourself something like ‘my mind has wondered, that’s ok, now back to thinking about shower etc’ Just keep doing this throughout the task. The point is not to get to a place where you aren’t distracted by unwanted thoughts but to build up the mental practice of noticing the unhelpful or intrusive thought and being able to acknowledge it and move on from it without getting sucked into the spiral and the physical fight and flight symptoms. You practice a few times a day for a few days and it gets easier and relieves the need to check your body for signs of illness and gradually gives your brain a break from the intrusive thoughts and gradually helps calm your nervous system. Last time I was having a bad anxiety relapse I started doing this and it really helped.It’s so tempting to keep seeking reassurance from docs or fam etc but this is part of the problem for health anxiety sufferers. I suppose enabling is the word. Being checked by the doc is a big relief for a day but it all gradually creeps back. It’s very important to try and resist this. (As long as you have had whatever the problem was thoroughly checked out in the first place) Hope it improves for you soon 💐

How are you today OP?

I have had it checked out yes, I’ve had dozens of ECGs, three holter monitors, treadmill tests, dozens of troponin blood things, chest/abdo/pelvis CT, an ultrasound of my heart a few years ago. All sorts. They said I need the ultrasound/ecg regularly for life due to family history (3-5 yearly) but I’m a few months over 5 years now, and worried about it. The last one was done in 2018.

I feel very slightly more settled this morning. I’ve to see the psychiatrist at 2, and I’ve run out of my beta blockers and diazepam so need to go to the chemist to pick them up too. Will do that on the way to the appointment.

The trouble is I won’t do anything that might cause palpitations and as soon as I feel them I go to pieces. Which means I hugely limit activities such as doing the dishes, taking rubbish out, folding washing, tidying up, anything that raises my heart rate as that’s when I start feeling them. Either when I raise my heart rate or lie down at night to go to sleep. It’s bloody horrible.

I’m dreading seeing the psychiatrist. I’ve seen two before and they were no help at all, my CPN said this one’s lovely but I’m scared, don’t know what they will suggest.

My mum spent her entire life at the GP. She went so often she was banned from booking her own appointments. She was on first name terms with all the local paramedics and spent the majority of her adult life in and out of hospital. I see a hell of a lot of her in me and that panics the hell out of me. I don’t want to get like my mum. She never had the chance to live her life without crippling anxiety. I’m phoning 111 daily at my worst and I hate it. So desperate for it to stop.

How are you today? I hope your psychiatrist appointment went well?

How old are you?

Only asking because perimenopause can do weird things to mind, body and brain.

Hate to say it but maybe it isn’t anxiety but something like paroxysmal AF. Your ECG might not be picking up episodes of it.
I got told for several years ‘it was anxiety and perimenopause’. Mmmm well no, partly due to a very low ferritin which docs hadn’t bothered to check and then a cardiac condition for which I’m now on meds (all my scans and ct angio were squeaky clean but Cardiologist in despair started me on specific meds which funnily enough have worked for me). Sick of docs seeing middle aged woman and automatically presuming anxiety/ menopause.

This.

So very true. Get something with a constant HR monitor (FitBit HR Charge etc) to find out whether or it sends you AF alerts, and if it does, download traces and send to GP.

OP, I randomly had this a few weeks ago, out of the blue. It was horrible.

I put on some headphones and used the headspace app to force myself to breathe and calm down. Breathe in for 4 seconds, hold for seven seconds, exhale for 8.

32 so I hope not peri, I’ve got a mirena coil in as well. I do have a family history of heart disease (various types) but normally in relatives over the age of 50.

Psychiatrist went reasonably well, he wants me to reduce my mirtazapine antidepressant to 30mg, add in sertraline in the morning and once much more stabilised come off diazepam as they think that’s not helping (I’ve been on it since November, so they said now physically/psychologically dependant). I’ve also been referred for an autism assessment - he said chances are that’ll be filling out a form and then the team that deal with that will discuss my answers and let me know if they think I’m autistic. He said he strongly suspects I am, he’s not the first person to say that to me.

Still really panicky this morning. I’m due to go out to the supermarket at 3.30 with a support worker but I’d really, hugely, rather not go, I’m shattered and know if I go out shopping I’ll come home even more anxious for a while after.

you should have said what anti-depressants you are on...have the psychiatrists never linked up your cardiac symptoms with your meds???!!! you really do need to have a discussion with them about how distressed your physical symptoms are making you feel ,especially if they are adding in sertraline as SSRI's are commonly linked with arrythmias /palpitations. Mirtazipine is an older drug but can likewise cause QT prolongation which likewise you would experience as palpitations.

ask your psychiatrist if you can take magnesium and calcium supplements. Most people are deficient in both minerals and a lack of them can cause heart arrhythmias. I am sure there is an anxiety aspect to your arrhythmia as adrenalin can set them off, but having good stores of both minerals will help calm down any triggers.

I was going to stay the same, correlation between ADs and irregular heart rhythm.