I had a really weird day yesterday. It was the worst case of “White Coat Syndrome” I’ve had yet. I should clarify. Somehow I was able to get beyond all the health “things” that have happened in my life until a couple years ago. My left retina partially detached and the night after surgery to repair it, I stumbled, tearing or severely straining just about everything in my right knee. That meant weeks of constant, awkward positioning and a lot of pain. They were unable to repair my knee until after my eye had healed. I felt a level of anxiety during my multi month recovery like I had never felt before. I’m not an anxious person. I’m an optimistic person. I lean into whatever needs to be done and I just do it. It’s not necessarily like that anymore.
I have had low blood pressure my whole life. Now it trends more into low normal. However, we noticed that when my physical therapist came to the house to help me strengthen my knee, my blood pressure would be elevated. I would have to sit calmly, breathe, relax, and after a few minutes or so my blood pressure would return to normal. This dynamic was exacerbated by my breast cancer diagnosis, and following treatment. We would typically have to take my blood pressure twice when I arrived at an appointment. The first time it would be high. Then several minutes later, it would’ve lowered again. While I found this dynamic confusing, what was even more confusing was the anxiety I felt as I approached these doctors appointments. I know part of it was fear of outcomes, concern that something new might be wrong, what I’ve always called “anticipatory worry”. I’ve never been a big anticipatory worry person, but I seem to have become more and more susceptible to it. Now anytime I go to see a medical provider, a dentist, a dermatologist, my GP for my annual exam, urgent care for a sinus infection, I feel apprehension before the appointment.
The anxiety part of this equation – tightness in the chest, difficulty breathing, activation of my fight or flight responses – seemed to come to a crescendo as we approached the hospital when Andrew needed a minor medical procedure a couple months ago.
After his procedure, I would be his caregiver. I realized that I was afraid I would not be able to care for him in the ways that I wanted to and the ways that he has stepped up for me with all my health issues over the last three years. I didn’t test my blood pressure during this process, but I felt the familiar tightening in the chest, difficulty breathing, and fighter/flight response. However, this time it accelerated. On the way to the hospital I could hardly breathe. I felt pressure in my chest and it took everything in my power to hold myself together. I was literally shaking. I used a box breathing technique; I inhaled to a count of 4, held my breathe for a count of 4, exhaled for a count of 4, held my breathe for a count of 4, and repeated the cycle. Fortunately, I recognized what was going on, that I was apprehensive about what was coming next. I was caught up in a cycle of a anticipatory worry.
But here’s the thing, both Andrew and I got through that entire situation and his recovery afterward like rock stars. I was his healthcare advocate throughout his unanticipated one week stay in the hospital, follow up doctors visits, and even driving him back-and-forth to all of his appointments. (I haven’t driven since my partially detached retina.) So again, it was the anticipation not the actual experience of anything that was causing my anxiety.
Yesterday I had the weirdest experience yet. I had a dermatologist appointment in the afternoon. Just a routine body scan to make sure I didn’t have any areas of concern. My last one was three years ago and except for one small mole they wanted me to watch, there were no concerns. Yesterday I woke up feeling overwhelmed and anxious, a general discomfort and mild fearfulness. It got worse throughout the day. I got crankier and crankier. I felt trapped. When we got to the parking lot for my appointment, I wanted to run. By now, I knew what this was, but it hit me as incredibly strange. In retrospect, I realize that part of the issue was that I had not met this doctor before and skin cancer runs in my family, principally because so many members of my family live in Florida. When we got to the doctors office, I had to fill out all the paperwork again, because, of course, the paperwork I had filled out online had somehow not gone through. I felt my fight and flight responses rising. Then tears welled up in my eyes. I recognized this as anxiety.
When I went back to be seen by the doctor, I shared what I was feeling. And strangely enough, then everything was fine. Just owning my anxiety helped me relax and breathe. It was an easy session. No concerns. No issues. Just awareness that at this moment, I approach meetings with healthcare providers, especially new ones, with anticipatory worry and anxiety. My counselor tells me that this is my body‘s way of trying to protect me in uncertain situations. I’m working on letting my body know she doesn’t have to. I’m fine. I’ve got this. Mostly…
P.S. White coat syndrome can become a serious, health threatening issue. If you’re experiencing anything like this, take it seriously. Talk to your healthcare provider and if you have one, your counselor.
Deborah's Deliberations 