Panic Attack

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So, is this it? Is this the madness that has been waiting for me set deep in my DNA just biding its time until pouncing? Is this the anxiety that is palpable, nauseating that others have described to me that I went blank on? Is this how phobias of all shapes and sizes begin and manifest themselves? Does this lead to the next worse and then worse than that level of depression?

 

People call their headaches “migraines” now. It is a routine name and I am not sure if the actual headache severity has escalated in our world or if our pain perspective has been recharted, making all pain worse. I felt that way about “panic attacks” until last week. I figured that, that too, was over-self-diagnosed and that maybe the sufferer was simply anxious about something or even furiously angry. The first time I bought into the idea of actual panic attacks being real was when a colleague and friend of mine, least likely to exaggerate or fall apart, had some full blown ones that completely unraveled her and her set of control tactics that had previously worked well. I became a believer. Through therapy and time, she got better. My turn waited in the wings.

 

My sister and I had not spoken in over a year. We had a close and intense relationship through most of our lives having been raised by a mother riddled with bipolar/borderline personality/depression to name a few. We had a mutually miserable childhood where we took turns trying to mother our manipulative mother and trying to minister to our understandably depressed father who ran away repeatedly. It was no easy task and for me it began at six years old, but for my younger sister at her birth. We were so important to each other because we could validate what was real and true as opposed to what was the nightmare we were in. I remember the exact moment I laid eyes on my new baby sister and the incomprehensible love I felt for her. That has never waivered though we have had envy, misunderstanding, other confounding relationships, unmet needs, and other friction that eroded our precious connections. The hateful things my mother said to me day in and day out caused me to develop a protective shield so when my sister told me the things she did not like about me and said I was a “harsh person” my “run-for-my-life” mode kicked in and off I ran. I regret not finding a way to work it out better instead of seeking the method I knew best from my childhood—“stop speaking, protect yourself.”

 

My sister made a strong and healthy recovery from breast cancer a few years ago. I was in awe as we went together to find the best surgeon and then I visited through her chemotherapy determined to keep her laughing through looking at old photos, laying in bed with her reminiscing with her famous red hair having succumbed to a shining bald head. The red hair grew back, she partied, danced, and celebrated, loving her life and bevy of friends as well as her supportive partner and daughters. The world came crashing last week when she told me that now, there were malignant tumors in her spine, in her hip, at the base of her skull and elsewhere which would be treated but not cured by radiation and oral chemo. She is strong and determined and that will go a long way for her and I have faith in that and always, in her.

 

However, I have not stopped being shocked over and over for two weeks now. It is as if I can simply not absorb this news and yet, I fear if I begin to cry about it, I may never stop. I do not know what my role is in her life now or if I will be given any, but I am willing to play in whatever she needs. Most of all, I need to ensure that she knows how much I love her and have never stopped for a moment.

 

This news came on the heels of our visit to my husband’s sister, Susan in Georgia. Shep’s mother died from Huntington’s disease. Susan has late stage HD. It is the most hideous of diseases and yet not always so well known. Shep’s younger sister and Shep have been quite sure that Susan is the only one to have inherited this. Unfortunately or fortunately, I just finished listening to an audio book about a family with this disease and it completely unnerved me sprinkling fear and doubt in my heart and overthinking brain. So, in the past few days I have become obsessed thinking and wondering, “what if we have not in fact dodged the bullet?” Previoiusly always striking in middle age, there is now what is called, “late onset HD” as well as “juvenile HD.” So, I have begun watching every odd movement, thought, or foot moving that my husband might make, thinking, “Oh God, is this it?” Then, I go to the darkest and most terrifying place wondering about the possibilities of heredity. We have five living sons. This gets me so worked up that I am unable to sleep or see the light of rational thinking.

 

My mammogram was the next day. I have been diligent about going yearly and now that my sister has had breast cancer, I thought even more so. When the radiation tech said, “it’s been 2.5 years since you’ve been seen Ms. Smith,” my mouth dropped. Holy shit. Here we go. Why doesn’t she just tell me the bad news now while I am expecting it and while she is smashing my breast flat. Nope. Gotta wait three weeks. Great.

 

What’s with the repeatedly elevated PSA’s my husband keeps getting. They cause much concern for prostate cancer as we have been scared about for years now. He’s had biopsies, but so far other than “being concerned about the trajectory, no one has definitive answers. Is it just a matter of time? Terror strikes again.

 

My birthday is coming in a few days. No matter how hard I try, I always hate my birthday and this is one to hate more than most. Yes, I know I should be grateful and believe me, I am obsessed with “grateful.” I am grateful for the damned dishes I wash after a meal, the car starting, the bed being comfortable and safe and every other possible thing including and especially the gift of being mother to six fabulous, beloved sons. But perhaps, over 20 years ago when my “kind” mother phoned me to say, “Today is the worst day in the history of the world. It is the day you were born,” has managed to stay in my heart no matter how many thousands of hours of therapy I have spent trying to undo it.

 

I worry. I worry and worry and then worry about worrying. I worry about money, about meeting the needs of my clients and their babies and I spend inordinate amounts of time worrying about my sons, each of whom has his own demands and dragons that they each try to slay. I worry about my husband’s health and my own and the terrifying thought of either of us losing the other. I know none of us “is getting out of here alive,” but that doesn’t make it any less frightening.

 

At times when my world feels like it is crumbling seems to be the time I am least of all able to find God. Isn’t that crazy? So, I begin searching for him like mad. “Oh God, hellllooooo, hey, where are you? I need you so badly. Please hold me. Please rock me. Please protect me, guide me, help me. Help, help, help!” And nothing. Can’t find him, even in church. Even at the communion rail. I know he will get back to me, but when? Is he just too busy right now or is my mind so congested that I cannot see or hear him through the fog?

 

And then, it crashed. I felt odd and prickly Thursday morning, having not slept much. And I had this fear of crying which most of the time, I would indulge in and find relief. By the time I got to my office, my heart was pounding so hard I thought I was in cardiac arrest. I waited. I thought, “Hey, get it together. You’re okay. Stop it.” Obsessive thoughts prevailed and screamed louder and louder over and over and would not stop. “Hey you have been through some pretty bad things. You can control this. Do it. Reel it in babe.” Nothing. Now it feels like blood is rushing and crashing through my head. Great, I’m going to have a stroke. I have a client to see in a few minutes. What if I faint in front of her and her baby? What to do? Go outside. Breathe. Can’t breathe. Face is flushed. Salad I ate an hour ago is sitting in my throat. Then, I throw up and as much as I hate that, I feel like it will make this all stop. It doesn’t. Everything is pounding more. Client is here. Please God make this be an easy one, one that I can do with my eyes closed. Of course it is not. It is one of the more complicated cases I have had. Cannot concentrate, checking in and out, missing entire sentences that she is saying to me. “C’mon, get it together. You can do this! Stay focused and it will help!” I can’t. It doesn’t. Shit. Help!

 

Finally, I drove home though I do not remember driving and dove into bed. I am thinking. This will help. Pull up the covers. Stop shaking. I am safe now. It doesn’t. I throw up again. Now, my thoughts are racing so non-stop and so destructively that I am designing an entire new life for myself which is making me more panicky but I CANNOT STOP! Later, I am able to talk to my husband who I am angry with, but then sobbing, deep wrenching sobs, which are likely the stopping point for me. I am exhausted but have to get up and sew patches onto my twins’s uniforms! Here is where some reality sets in. The cammo fabric, the sewing machine, the bobbin and the thread are tactile and real and ask for nothing except for me to avoid sewing my finger. I do it. The patches are on and straight. I can still do my motherly duties.

 

The day ends and I sleep fitfully that night and all the nights since. The worst of the total panic has passed but the residual fear remains. My wise friend says that I was weakened by one of the events and then all the others came upon a soul knocked over, with me laying in water as they tide rushed in. I don’t know how to swim. Never have learned. Normally strong me stood no chance against the other waves coming, coming and coming. And I am still rocky to say the least, still feeling quicksand below my feet.

 

So yes, I do believe. I do know the reality of panic and panic attacks and I will never doubt again. I also want to find a way out and hope to never go back into that terrifying place. But, you know, “never say never.” I won’t. I am a believer now.

The Sometimes Ungraceful Grace of God

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Susan Smith came to work in the British Airways boutique I managed in the 1970’s. Someone she knew in the Duty Free operation got her the job as my assistant. I was stunned when I first laid eyes on her teased and sprayed solidified black hair, her thick black doe eyed shaped eyeliner, layered foundation on her face, her tight mini skirts, and her tough demeanor. My initial reaction was, “Welcome to The Keyhole Boutique and this is going to be interesting.” But she was a hard working Priscilla Presley look alike and a faithful employee who was most helpful to me.

 

Susan had a boyfriend named Tommy who was a Corrections Officer right out of an Al Pacino movie. His hair was blacker than hers and he was one scary dude. I was grateful to not be one his prisoners on Rikers Island and felt nervous whenever he was around. Susan loved this guy and his family.

 

Oddly, Susan and I became friends. We were both single, about the same age and each living alone in Queens, NY. Susan’s living room wall was covered in empty Marlboro cigarette packs. She smoked, a lot. But, I smoked too, so that was okay and in the 70’s it was de rigueur. She had turned the entire bedroom into a closet for every item of clothing and shoes she’d ever owned and slept up in a loft above the living room. What was not so okay was that her entire pantry and refrigerator offerings consisted of cocktail onions, maraschino cherries, and Kraft’s Macaroni and Cheese. Yuck. She carried her beloved Yorkie, Scottie everywhere out and about in her dark green Maverick, circa 1970, smoking constantly.

 

Susan took me to visit her family in Rockville Center, NY where I met her mother in their beautiful home. It would be the one and only time we’d meet. Oddly, when I’d spoken with her mother on the phone a couple of times I concluded that she was drunk. When I met her in the upstairs kitchen of this beautiful home, that thought was validated. Her mother did not stop moving and her speech slurred so badly that I could not understand her. I was polite and observant. When we left, Susan casually mentioned that her mother was not drunk, but had Huntington’s disease, which I’d never heard of.

 

Months later, I found myself at Susan’s mother’s funeral. Her younger sister, Holly was there along with her cousin, Lauren and others. There was a lot of smoking and laughing downstairs on a couch outside the bathrooms of the funeral home and I felt clueless. I also met Susan’s brother, Shep for the first official time although I’d met him briefly at one of Susan’s parties in her apartment with his girlfriend, Maureen.

 

As you might be suspecting and if you know me, you already know – Shep and I began dating in 1976. Susan was not happy about this and at Jones Beach one day she told me in no uncertain terms that I was NOT to marry her brother. We had been out on one date so it seemed irrational at the time, but years later it made sense in that she felt threatened by the potential loss of her best friend and her brother all at once. This was not a girl with a lot of friends and quite frankly she was difficult socially. I frequented several Queens bars and discos in those days and bringing Susan with me was always a liability since she crossed her arms over her chest and became cold and nasty to anyone attempting to start a conversation as opposed to me, who’d talk to anyone.

 

As has been my nature over the years, I kept trying anyway and kept bringing Susan with me. There were some scary Susan moments though. We had agreed that since we lived alone we would each have a copy of the key to our apartments and that if there were no answer on the phone after a couple days, we would go and check to see if all was well. This was pre-cell phone era. So, for a few days Susan had not answered her phone and I finally headed over to her place. I knocked and then put the key in the door and instantly realized that Tommy’s gun was pointed at me, as they were both in bed on the pull out couch facing the door. I slammed the door and ran out screaming into my car vowing to never enter Susan’s apartment alone again.

 

When Shep and I were dating we talked about his mother and the disease she’d had, her hospitalization in a state hospital and how she ultimately died from choking on a cup of coffee. It was an awful and clearly traumatic life event for Shep that only got worse when he mentioned the hereditary nature of this disease and that he had a 50/50 chance of developing it. He then added reassuringly that he was told he had “no tendencies of the disease” which tends to strike in middle age. The test for this did not exist until 1993. I really didn’t know what to make of it and in later years when we became engaged we talked more about it but always rather peripherally. My mother (always drawn to the unfortunate or bizarre) became intrigued by this and kept telling me that this was a problem that I should stay away from. That might have been the one and only time she’d ever offered any anticipatory guidance to me, which I paid no attention to anyway.

 

Shep and I married in 1978. Susan and Holly moved away from Long Island to Alabama. Susan was usually a night auditor in various hotels and by moving away she began healing from her breakup with Tommy. Her style was never really updated from the one I first saw and she maintained her aloof manner. Holly married and moved to Las Vegas and Susan ended up living in Georgia. A friend of hers called Shep one day and told him that Susan was in dire straits, had not come out of her home in some time and was in bed, not eating and extremely depressed. Shep drove from North Carolina to Georgia immediately not long after the devastating death of our youngest child. He arrived to find Susan living in filth, uncared for, malnourished, curled up in her bed surviving mostly on coffee with a lot of sugar. He quickly had her admitted her to a psychiatric hospital nearby. While there, she met Tommy (a different one) an odd, very southern, unusually tall and skinny guy and at 50 years old, Susan married for the first time. They lived in a mobile home in the depths of Georgia where smoking and drinking to excess was an ongoing situation and things deteriorated quickly.

 

Unbeknownst to family members, Susan’s severe depression was early evidence of the disease that had already invaded her body. Shortly after she married she tested positive for Huntington’s disease. In addition to depression, there were events of complete paranoia with Susan running away and hiding “for safety.” There were violent episodes with her flailing her arms across a table with a brand new flat screen television bringing it crashing to the floor. Self care and home care became minimal or non-existent. And in time, the ugliest of Huntington’s symptoms, Chorea began to rear its ugly and constantly in motion, head. As a truck driver, Tommy was not home often and Susan began needing more supervision as she began falling down regularly At the time, she still worked in Kmart part time and told me that she could hear coworkers laughing behind her back at her jerky movements, thinking she was drunk. It broke my heart.

 

As God would have it, one door is connected to another room and that room is typically connected to another door. One just has to keep opening each one, which we so often overlook doing. We get lost. Behind one of the doors lay Tommy’s well educated, successful sister, Genia whose husband was in late stage terminal illness. When he died, Genia took Susan to live with her in her beautiful Ethan Allen-like model home for longer and longer periods until finally it became full time. Genia is beyond capable in an amazing way as well as being the supreme caretaker of all family members. It is quite something and for Susan, it was an absolute stroke of luck as she was well cared for, for five years until recently when her needs escalated to skilled nursing home level. Even still, Genia managed to choose the best of the best as nursing homes go for Susan who she has come to love. As well, Susan is beloved by her in-laws, Lou and Blue (though I can never figure out which one is which) and she only sees Tommy occasionally.

 

This past week, Holly and her husband, Joe along with Shep and I made the trip to Covington, Georgia to visit with Susan.Watching Holly’s tenderness towards her sister nearly moved me to tears. We spent time in the SNF as well as taking Susan out and about for driving around, eating in a German restaurant, and a shopping spree in a Good Will store. Her disposition seems sweet, grateful, resigned. She is wheel chair bound and difficult to understand, particularly on the phone. Choking is a constant hazard so eating with her is anxiety producing. She wears diapers, doesn’t always change her clothes and hasn’t put her dentures in for a long time, so she has very few, very yellow front teeth. Her chorea movements seemed milder this time than last, which may be related to medication changes. It is a precarious life that is limited but stable at the moment.

 

Oddly, when the four of us would leave Susan after a day spent together and head to restaurant or the hotel room, we would find ourselves in uncontrollable hysteria. The slightest thing would tip us off and we would be laughing so hard we could hardly breathe! I suspect that this was an outlet at the end of a tightly wound, stressful, poignant day and it was the relief of the tight jaws we all found ourselves with. But most of all is the phrase repeating ad nausea in each of our heads. “There but for the grace of God go I.” Followed by, “What if?” Followed by, “How was this deck dealt?” Followed by, “Susan had no children. Holly had one child. We had six children. Oh God, oh God.”

 

No one’s off the hook completely. Huntington’s typically strikes in middle age but it can also be “late or early onset” at random. I have never been more aware of the ramifications of this dreadful disease which resembles a combination of ALS, Parkinsons, and Dementia all in one. If Shep and Holly do not have the disease, their kids can’t get it. If they do, their kids each have a 50/50 chance. I am reading the book that Holly recommended to me called, “Inside the O’Briens” which deals with just this situation and it is terrifying me even more. It is written by the same author as “Still Alice.” Lisa Genova. Cheerful subjects this author chooses, eh? But, it is enlightening.

 

Susan seems quite with it. I send her stories and cards as I can and she reads novels continuously. She requested cheese sticks and Bugles, which we brought. Clearly her diet has never become the least bit healthy, which is of course insignificant now. In the end, one lives ones life as best as one can, not ever knowing what lays ahead, how we will cope with it, what end it will come to. As they say, “love is all there is” but in fact there is also a random, roulette style sequence and a mystery that remains until we leave this earth ourselves and hopefully, get to ask all the unanswered questions.

 

 

Huntington’s disease (HD) is a fatal genetic disorder that causes the progressive breakdown of nerve cells in the brain. It deteriorates a person’s physical and mental abilities during their prime working years and has no cure. HD is known as the quintessential family disease because every child of a parent with HD has a 50/50 chance of carrying the faulty gene. Today, there are approximately 30,000 symptomatic Americans and more than 200,000 at-risk of inheriting the disease.