Can we talk about Panic Attacks

September 18, 2014

My Darling Beloved Ron:

“Guilt once harbored in the conscious breast, intimidates the brave, degrades the great.”

Samuel Johnson

            I finally saw the doctor about my Panic Attacks. I’m sure you are well aware of them, since you now see and know all. Very G-d like if you ask me. Seeing all, knowing all, and letting me have free will. Saint Ron. I like the sound and idea of that. My own private Saint that I can come to in times of grief, loss, hurting, despair; while at other times sharing joy, hope and peace. I’m sure I don’t have to tell you that the first four panic attacks were at Fairfield University, where I’m earning my MFA in Creative Writing. Sitting in the small dining room in Enders House, Mystic Seaport area that July day, waves of panic overwhelmed me and I came crashing to an emotional, crying heap.  But, again you know all of this. I think I just need to write it down. Make it feel like I am actually talking to you and getting the unconscious thoughts out of my head, I need to simply say them out loud, and say them to you. My panic attacks involve sudden feelings of terror that strike without warning. These episodes can occur at anytime. When I experience a panic attack I’m convinced that a heart attack or even death is imminent. This feeling of impending seems to have come from nowhere. My doctor said that the fear and terror that I experience during a panic attack are not in proportion to reality and is unrelated to what is happening around me. Most people with panic attacks experience several of the following symptoms:

1.     There is a possibility to have a racing heart.

2.     Feeling weak, faint, or dizzy can be very common.

3.     There could be tingling or numbness in the hands and fingers. So don’t panic if this happens to you.

4.     You could suffer from a sense of terror, or impending doom or death.

5.     Chest pains and breathing difficulties could occur.

6.     And finally there very easily could be this feeling that you have lost of control

            My panic attacks, my beloved, are generally brief, lasting usually no more than ten minutes.  Although my longest panic attack was thirty minutes with symptoms persisting much longer after, even after the shortest ones. Dr. Diane Kreptowski, said today that, “People who have had one panic attack are at a greater risk for having subsequent ones than those who have never experienced one before. When the attacks occur repeatedly, a person is considered to have a condition known as Panic Disorder.” The blue colored walls around me began to slowly spin, and I could hear the sounds of waves in my mind. How it pains me to tell you, that I am suffering from this very curse.  She added that people with panic disorders can be extremely anxious and fearful, since they are unable to predict when the next attack. Panic disorders are fairly common. It affects about 2.4 million people in the U.S., and should not feel ashamed that this is happening to me.”

            Fuck, this is happening to … me! How can this be happening? I thought I had my shit together, facing my life bravely. It is hard to let that sink into my very being. I … suffer… from … Panic … Disorders. Oh my beloved, my heart aches that I have let you down.  I couldn’t be brave, or strong, or fierce any longer than I have been.  Somehow, darling, I’ve lost it.  I have lost the ability to cope. I’ve lost the strength to survive the darkest hours. I have simply lost, lost my way.

            Christ, how did that happen, my heart begins to race in her office. I can hear the waves of the tsunami off in the distance coming toward me. My darling, they are rolling in faster, the waves of water are reaching heavenward and the white caps foaming in violently. I can feel the pressure of the waves, swallowing me. I can sense them. The thunderous roar of the tide, the howling of the wind. It’s all I hear. Spoken words are lost in the lamenting murky waters that looked like wild animals. I can’t look up. The people in the room vanish, even the presence of shadows abandons my senses. I can’t hear or understand what they are saying. My hands begin to shake and my thoughts begin to jumble into a knot. My g-d, I’m having a panic attack sitting right here in her office. I begin to melt, in tears.

            Guilt.

Guilt (gilt) noun

1.     The fact or state of having done wrong or committed an offence.

2.     Responsibility for a criminal or moral offence punishment or penalty.

3.     Remorse, or self-reproach caused by feeling that one is responsible for a wrong or an offence.

4.     Arch. Sin or crime.

Guilt: One can admit it when they had an affair. It can be discovered when we are found cheating on a test. Saying you’re sorry when your hand is in the cookie jar. Sitting in a weekly confessional, “Father forgive me for I have sinned grievously.” We feel it when we have binged all night on Ben & Jerry’s Chunky Monkey ice cream. The ultimate embracing of it spoken by Jesus Christ himself; “My G-d, My G-d why hast Thou forsaken me?”  In the end did you feel guilty for your pending death? For leaving my loving side. That you could not control something none of us can control.   Of course you did. I sensed it.  So, no guilt please, darling. We may be able to prolong life with surgeries, life support, organ transplants and the like; but in the end we all do it.

We all die. Yours was simply and brutally premature and the pain you felt as you were leaving me in death.  It took me thirteen years to know and understand your pain.The remorse you said you felt before losing consciousness, of not having enough time together, ten years was simply not enough. Your final days were filled with worry of what and how I was to be after you died. I don’t fear dying in the near future, I suffer from something more ominous than death.

            I live in guilt now. This guilt has become woven like thread into the fabric of my being. Pull that one thread and everything unravels, and I’ll be undone. The guilt is so innate that it has left me immobile for years. I wish now I could put words to it, and now just maybe my darling I can. Guilt has become an increasing part of my identity, the only dominating force of my own written narrative. I am tormented with an unending supply of guilt, unasked for and unwanted; it conyving and slimy swarming into every recess of my psyche. Maybe it is a sickness, a familial legacy from the women in my family, a breakdown or craziness intertwined into my emotional illiteracy which forces it to be heard, ravenous in its unending need and beyond my domination. This guilt has destroyed my happiness. No, annihilated is the right word. I know I can’t have what I truly want if I continue to live in guilt. I’m just not sure how to overcome it. I’m not so sure I’m the man everyone sees in me. I fear that this guilt will stand in my way of achieving everything I was meant to achieve. How can greatness be achieved in the depths of guilt, fear and despair? The tide is now drowning me, and everywhere it’s dark.

            Then I suddenly feel a hand on my shoulder. It’s resting gently, fingers caressing my sore muscles. The grasp is firm, sure and the hand begins to gently massage my shoulder. My G-d it feels so good. Words seem to be spoken from deep from within the  depths of inky blue-black water. The water seems to recede some. I begin to hear a voice from within. “Charlie. Charlie. Can you look up? Maybe even look at me? Sweetie, what is going on?”

            I can barely make out the words, sounds just swimming blurred, much like schools’ of fish. I can’t even make out the syllables. It’s all just blue-white noise. The hand begins to massage, the back in firm, yet gentle circular motions. From the top of my neck to my waist, the pressure is just right. I think it’s Dr. Kreptowski talking to me, though she never called me sweetie before. My crying intensifies. I don’t have the words to describe to her what I’m going through. Her right hand caresses my chin and her hand begins to raise my face so she can look into my eyes.

            “Charlie. It’s going to be ok.” I can see the sincerity in her eyes. I can feel the warmth and the compassion that radiates from her. “Charlie. Just breathe deeply now.” She is still rubbing my back as the tears roll down my face. “Have you ever been diagnosed with PTSD?”

            “No.” Even that simple two-letter word stumbles out of my mouth and I stumble over the brief letters. I begin to cry again, and my right hand is shaking.

            “Charlie. Medical and antiretroviral advances have had substantial gains over the years.  We both know this. This means that being diagnosed with HIV/AIDS had a different impact years ago. It’s a whole new field of medicine and survival.”

            “I know. I’m one of five from my first support group to still be alive. There were, originally twenty-five of us.”

            “Yes, the disease has changed from a death sentence to living long-term with a chronic disease. Over time, Charlie, you have dealt with treatment side effects, adjusting to depression, medication adherence and changes of those medications, changes in viral load and t-cell counts, witnessing AIDS related deaths, disclosure of your status, discrimination and finally, community ostracization, at the very least if not more.”

“I’ve never thought of it that way. I just feel like I have accomplished nothing.”

“My G-d, how can you say that? You graduated with full honors and earned your BA in English. You’re pursuing your MFA in Creative Writing. You’ve published a book. You’ve won awards. You have had your story in the newspaper, and more than once I’ve heard. Charlie, if all of that is nothing, the one thing you should be the proudest of is, is you simply lived, when everyone else didn’t.”

“I know that in my head, but I have to get all of that into my heart.”

“I’ll write you a prescription and I’ll give you a referral to a counselor who should be able to help. Just keep in mind that between 13 to 64% of all HIV/AIDS diagnosed persons at some point are diagnosed with PTSD.  That diagnosis however, Charlie, will be up to the counselor.”

I’m not fully sure why this guilt developed and this manic-ism began, except I feel guilty that I –––––––– simply lived, when so many did not.  My darling beloved, regret leads to guilt, shame breeds it, and reproach feeds it.  It grinds me down, eats away at me and crushes my very spirit until I am sure insanity is not far behind. I cannot understand those who do not suffer from guilt. They unnerve me and yet they amaze me, s they will never fully understand me before they just roll their eyes and walk away. They will never know the crushing, and all consuming tsunami that drowns me from the minute I wake to the moment when I sleep. The only person who hears those words are my beloved, for I dare not say them to anyone else.

It’s 7 o’clock in the evening and I can hear the ambulance in the near distance. It’s coming for me. My heart is pounding through my chest. It feels like a jackhammer is pummeling my body into bits. I am stuttering so badly that the words have no meaning, expect for me. Flashing red lights in front of my living room window. The lights threating to bury me even deeper into abyssing despair. Four tall, strong, vibrant beautiful male paramedics help me stand on my feet, swing me around and get me to a stretcher. I lay my head on the pillow, crumbling into the fabric beneath me. My eyes feel heavy as they bring the heavy material straps over my arms and legs. I hear a click and the stretcher is raised off the floor. My front door opens, then the porch door and I can feel the wheels hit the uneven sidewalk. One bump over the berm, and we are on the red brick road, which weaves past the front of the 110-year-old Salt Box home that I live in. I can vaguely hear the whoosh of the ambulance doors open before the wheels of the stretcher thump me into the back.

“Mr. Dale we’re going to hook you up to an IV. We’re on the way to Affinity Hospital in Massillon.” I nod my head.

“Can you open your mouth Mr. Dale? I need to take your temperature.” I do as I am told.

There were few on staff on that night. The streets outside were dirty, and was there blood on these floors? The nurses and doctors are told to be on the ready. There goes a fast moving gurney; another patient rushed into Trauma One while others sit bitter from waiting so long. There’s a policeman taking a statement from the victim of a rape, who was ushered through the electronic doors. Her blood stained clothes were put into a bag. The moment has arrived, “Nurse could you prepare the rape kit?” It’s continuous emotions and commotion that are slamming shut, the sound echoing down the hall. The nurses’ morphine-laced fingers finally bring relief and my pain will subside once they make their round while sleep shies away from florescent lighting. They’re taking care to do their best. I hear a voice beyond the bedrail, “Good evening Mr. Dale. What seems to be the problem?”

An EKG, CAT scan, MRI, a heart monitor, blood tests, x-rays, ultrasound on my neck, a two-day hospital stay and all the tests find nothing. No TIA ––– short for Transient Ischemic Attack, also known as a mini-stroke. Dear G-d, they think I’ve had a mini-stroke. The images of my mother, after her series of four mini-strokes in five months, surge through my thoughts. How she remembers the past more than the present. How she rarely speaks anymore, when she would always be the conversationalist. She barely looks up while we are talking to each other, when she looked me in the eyes all the time. She is physically sitting there but seems to be absent on every other level ––– it is so painful to see her like that. How can the All Knowing let this happen to me? I’m not even forty-eight years old yet. What will happen to my brain? How will I ever be able to write again? How will I ever be able to stay in college? It just can’t be a mini-stroke. I don’t have the time for this kind of shit. I am meant to graduate with an MFS, goddamn it! I’ve gone long enough without anything, struggling to survive. I deserve a full rewarding, enriching life. I want the life I’ve worked so hard for these last five years.

            The doctor in the emergency room explains that the common symptoms of a TIA may include: Sudden numbness, tingling, loss of movement in your face, arms, legs and especially only one side of your body. Sudden vision changes, sudden trouble speaking, sudden confusion or trouble understanding simple statements, sudden problems with walking or balance and, or a sudden, and severe headache that is different from any past headaches.

            There was no minor heart attack. No brain aneurism. No infections. No Bell’s Palsy. I had never heard of Bell’s Palsy until that day. I didn’t even know what it was. The hospital had to explain it to me, as I am the curious type.  Inquiring minds and all of that even then I didn’t have it.

            “So what is it then?”

            “Mr. Dale, we have no idea. All of the tests have come back inconclusive. You’re going to be released later today. I need you to try to get some rest. See your HIV/AIDS Specialist, your general practitioner, and in three weeks I would like to see if you in my office for a follow up visit. I want to see  if any of these symptoms persist after your release and we will go from there.

            My beloved, I ask that you watch over me. I ask that if they find something wrong with me that it is nothing too serious. I ask that somehow these symptoms just simply go away and never return. For now my darling, I must end this note to you. Know that I love you still, more than anything else in this world.

Eternally yours,

Your Charlie ––