A Pain in the Neck

Yesterday I found myself back in the chemo chair in a familiar treatment room at Memorial Sloan-Kettering Cancer Center to receive a dose of Reclast to treat my osteopenia, decreased boned density that’s a long-term side effect of my Hodgkin’s lymphoma treatment and radiation. (It was one of the fun facts I learned right around the time I found out about the neuroendocrine tumor so this was put off until after my Whipple procedure.)

Shortly after the nurse hooked up the IV with saline, I felt a little dizzy. Suddenly, I couldn’t breathe. My head felt like it was filling of fluid and about to burst, and I had to move it from side to side. I felt like I lost control of my body. I was sweating and nauseated. My eyes couldn’t focus and everything was blurry, like my eyeballs were in a cocktail shaker.

A panic attack. My first in nearly 10 years. It was even worse than I remembered.

For those who haven’t had a panic attack, it feels like you’re dying and losing your mind at the same time. As I’ve said before, panic attacks are really misunderstood. Some people say things like “I was totally having a panic attack,” but unless you feel like your body and mind are rebelling against you at the same time and you have no control, then it’s probably not a panic attack. It irritates me when people say they were having a panic attack when they were just freaking out the same way it bugs me when people often used to say they were “literally dying.”

Well-meaning people who try to understand will try to soothe you and remind you that there’s nothing to worry about and to be calm. That is nice of them, and it’s true, but it doesn’t help much in the moment. Panic attacks aren’t really necessarily induced by an obvious stressor or worry, even—it’s the body going into fight or flight mode for seemingly no reason at all. One moment, you’re sitting around waiting to get your tire changed and then next moment you feel like your body is shutting down and your brain is trying to flee your skull. When I had my first panic attack more than 15 years ago, I developed panic disorder, meaning that I was so afraid of losing control and having a panic attack that my phobia kept inducing them. It’s essentially a fear of fear, and it becomes a self-fulfilling prophesy, a cycle of panic. After a few years of therapy, medication and research, I finally left panic attacks behind, until yesterday.

I knew what was happening almost immediately. “I’m sorry, but I think I’m having a panic attack,” I told the nurse as I started to gasp for air and roll my head from side to side. “I feel like I’m going to pass out.” She asked if I needed crackers, but then the nausea set in. “I feel like I’m going to throw up.” I remember her putting a pillow behind me and asking if I could move forward, but at that point, I felt like I had no control over my body, and I couldn’t move. After asking what she could do, I think I told the nurse I just had to wait it out. I can’t quite remember. I know she told me that we would wait and that I should call her with my button when I was feeling better.

I know I cried. I felt helpless and I was annoyed with my body for betraying me yet again.

Logically, I knew I would be fine. There are worse places to have a panic attack than a room with your own nurse. I didn’t pass out, but in a weird dissociative state, I don’t remember things. I have no idea how long it lasted—somewhere between 10 to 15 minutes and an eternity. When I started to get my bearings back, I realized I had a plastic bedpan in my lap in case I threw up and I had been wrapped in a blanket at some point.

Even though I knew I would be OK, getting through it was completely miserable experience I could go another decade without—the feeling of losing control of my body, feeling like my head was filling with sloshy liquids, the inability to focus my eyes. A panic attack isn’t all in your head, the way some people think it is. It’s a physical reaction that is out of place. Kind of like an allergic reaction. Your body thinks it’s helping you, but it’s actually creating a problem.

I was nauseated so my body could rid itself of food and flee quickly. The vision changes, the increase in heart rate, the constriction of muscles were all to prepare me to escape danger. It’s something that might be helpful if I were running from a mountain lion, but not necessarily of any use to me when I am hooked up to an IV.

Afterwards, I was drenched with sweat and had a headache. My eyes ached from feeling like they’d been removed from their sockets, inserted into a snow globe and shaken up. When I stood up later, I was unsteady and my legs were wobbly.

Though part of what makes panic attacks so maddening is their random and unwelcome surprise appearances, this one does kind of make sense. I was in a place where I felt safe, but those chemo infusion rooms hold a lot of memories. They are where I started treatment years ago for what I assumed would just be six months. Until I arrived yesterday, I had thought the Reclast would be a shot, and I didn’t expect to be hooked up to an IV. I could see why being there, hooked up to an IV again, my body decided it wanted to flee. After all, the last time I was in that situation, I was essentially being poisoned, even it was for my own survival.

I’ve also said that when you have cancer, people understand what’s wrong to a degree, and offer you sympathy, but when you have a panic attack, people often just tell you to calm down and you feel like a crazy weirdo. Both are instances of a strange body betrayal—a disconnect between your physical being and your will. Both can make you feel helpless, in different ways.

This time, I had the luxury of having only a nonjudgmental nurse as a witness, and I was already at a medical center, a comfort when you feel like you are dying. I hope my days of panic disorder are completely behind me.

I grabbed my bedpan to take with me on the train, figuring that I could put it in my lap if I felt queasy again. Also, maybe people would give me a little bit of elbow room if I had a bedpan, but it’s hard to phase people here.

After several years of my squeamish self enduring tubes, IVs, needles, catheters, surgeries, transfusions, transplants, and all sorts of procedures without panic, I was finally undone by an IV full of something to help me uptake calcium for bone health. At least it seems my body has a sense of humor.