The best of times and the worst of times

It is the best of times and it is the worst of times. It is the best of times because there is nothing wrong: I have a beautiful wife and four beautiful children, all of whom are healthy and well-adjusted, a great job with excellent pay and benefits, no daily commute, a great apartment and a good landlord, a great team of employees and a great opportunity to advance in my career. 

 

It is also the worst of times because despite it all, I cannot enjoy any of it. I feel detached from it all and empty inside. There’s a pit in my stomach that just won’t go away. I feel like I just snapped one day and have not recovered since. I’ve had good days and bad days, ups and downs, but the demon deep inside always manages to creep back up. And I want it to go away and never come back so that I could go back to enjoying everything I’ve been blessed with.

I don’t want to be numb anymore. I don’t want to feel empty inside. I don’t want to feel like I want to cry for no reason at all. I don’t want to feel unhappy when there is no reason to. I don’t want to go through the motions anymore.  

I want to feel again. I want to be motivated again. I want to be happy again. I want to feel joy again. I want to be me again.

What I fear now is that I may be losing my mind. But I know I’m not. It’s complicated. And it’s only the latest in the seemingly endless string of health-related fears that have triggered the emotions I have been experiencing the last couple of months. And it all comes down to nerves and panic.

To give you some historical context, I have always had some level of hypochondriasis. And I blame my knowledge, curiosity and inquisitiveness for it. The reason I says some level and not full-blown hypochondriasis is because it’s not so much a health-related concern as it is a combination of the mixed blessing or curse of knowing too much about the worst possibilities of any situation, being hyperaware of myself and my surroundings, and having a particular sensitivity for health-related awareness and paranoia. In short, I want to live and be healthy and I don’t want to have a serious illness or die, so I pay close attention to feelings and symptoms, and I imagine the worst possibilities that those symptoms could be indicative of.

I can remember as far back as when I was a young child. I had some chest pains and was absolutely convinced that I was having a heart attack. Call me crazy to think I was going into cardiac arrest before my tenth birthday, but that was how I felt. And what’s worse is that the symptoms combined with the fear of the worst become a self-fulfilling prophecy. The chest pains led to panic which led to more chest pains, which led to awareness of every sensation in my chest, until what probably started as a shooting pain resulting from a compressed rib, resulted in an all-out panic that I was having a heart attack and was about to die. The average child that age does not even know that they have a heart or what it looks like, let alone what a heart attack is or feels like. But I had the curse of knowing that I had a heart, where it was located, and what could possibly go wrong with it.  

My parents took me to the doctor many times, and each time I was sent home after being told that there was absolutely nothing wrong with my heart. Eventually, I was given a medication that I was told would make my chest pains stop. I took the medication and the chest pains did in fact stop. It was only recently that it occurred to me that the medication I was given was most likely a placebo.

Shortly after that I started to have really bad headaches. Naturally, I panicked thinking there was something wrong with my brain. Again the doctor ran some tests and said that there was nothing wrong with my brain. Eventually, after much insistence that there was something wrong, the doctor recommended that I go for an MRI since he could not see inside my head and confirm definitively that there was really nothing wrong. I still remember my parents’ worry over the cost of the MRI and the possibility of the results. I also remember their relief when the MRI was negative.

But that didn’t help me since I was still having major headaches. A few more visits to the doctor resulted in a referral for an X-ray. I remember the radiologist telling my parents that the X-ray showed a sinus infection. My parents took me to a specialist who prescribed a cocktail of four medications, some nasal sprays and some liquids. After a few months of taking the medications the headaches stopped.

As I grew older, major claustrophobia set it. I could not be in any confined space. Whenever I would find myself in a crowded room, an elevator, a doctor’s office, or even a school bus, I would panic inside and would make sure to stay near an exit or have a clear exit strategy. The claustrophobia was debilitating but since I had to go to school and be in crowded or confined places, I put on a brave face and did what I had to do while I dealt with my fears internally. Eventually, the claustrophobia disappeared, although I do not remember exactly how or when.

A short time after that I had the unwelcome opportunity of becoming aware of penile cancer. This knowledge led to me inspecting myself and noticing some brown spots on my penis. I panicked but knew that I could not tell or show anyone out of embarrassment. Luckily, at about that time I was contacted by the person who had performed my circumcision. He said that since I was a chubby infant it was important that he perform a follow-up inspection to ensure that the circumcision took and it did not reverse itself. I used that inspection as an opportunity to show him the brown spots and to ask him if they were a reason for concern. He immediately dismissed my fears, explaining that the brown spots were nothing more than naturally occurring freckles just like on any other part of my body. Thankfully, That put the matter to rest.

Then came the breathing paranoia. It’s obvious to anyone, even a young child, that the primary cause, effect or indicator death is a lack of breathing. So naturally I paid close attention and became hyperaware of my breathing. Every minor variance in my breathing pattern resulted in an all-out panic. The panic, in turn, would result in shortness of breath, which would result in more panic. And the snowball continued. To make matters worse, breathing is, fortunately, a passive activity which takes place at all times and without any conscious awareness of it. This awareness of and attention to my breathing caused me to have to breathe consciously and actively. It took a lot of work and distraction to revert back to passive breathing.

As I grew older and became aware of more possible diseases and illnesses, my fears evolved. And they almost always related to something I had recently heard about. For example, when I found out that a friend of my wife had experienced prolonged flu-like symptoms and was ultimately diagnosed with leukemia, I became convinced that every cold or sniffles was a sign of the worst if it didn’t go away within a day or two.

Then I learned about Alzheimer’s and the ability for someone to “lose their mind”. After having twins and functioning on months of little or no sleep, I began to do strange things like leaving cabinets and drawers open, putting cleaning sprays in the refrigerator, looking for things in the wrong places. I was convinced that I had Alzheimer’s or that I was losing my mind as a result of some other mental disease. The resulting panic led to even more fear, detachment and distraction, which led to more misplacing of things, which led to more panic. Of course, with time, that passed as well and life went on.

Then came the night that my wife and I were laying in bed reading. My wife became tired and asked me to put the magazine she was reading into the night table drawer which was closer to me. I put the magazine into the drawer and went to sleep. The next night, when my wife opened the night table drawer to take out her magazine, she discovered that it was not in there. We both clearly remembered that I had put it in there and I remembered closing the drawer. We emptied the drawer but the magazine was nowhere to be found. At that moment I became convinced that I had sleep-walked. I searched the entire apartment from corner to corner, on top of, behind and underneath every piece of furniture, but the magazine was nowhere to be found. Now I was convinced that not only had I sleep-walked, but I had taken the magazine and left the house with it in my sleep, discarded it somewhere, then returned home, locked the doors and went back to bed. This may sound extreme, but the fact is that I had put the magazine into the drawer before going to sleep, and when I awoke it was no longer there. There had to be some explanation for the missing magazine that was more rational than saying that it simply disappeared.

Convinced that I was sleepwalking, I now worried about what else I was capable of doing in my sleep, especially since I may have gone so far as leaving the house. I worried that I might hurt myself or someone in my sleep or that I might get into the car in my sleep and drive somewhere.

It wasn’t until a year or so later when we moved from that apartment and disassembled the night table that we found the magazine. It had slid behind the drawer into the shell of the night table. So much for getting all worked up about nothing.

One of the world’s biggest blessings and also its biggest curse has been Google, or rather search engines in general. Now, we have a world of information at our fingertips in an instant. Instead of running to the doctor for every little ache and pain, we can simply type our symptoms into a search engine and diagnose and possibly treat whatever ails us. But the downside of this availability of information is just that – too much information.

You see, every symptom that one can possibly feel can be indicative of a spectrum of underlying causes ranging from the most insignificant to the most severe. In most cases, most things are not serious, especially when they are not accompanied by other symptoms, not there for a prolonged period of time, if the person is young, and if the person does not smoke, drink excessive alcohol or abuse drugs.

However, a medical website cannot be dismissive of even the most minor symptoms. They must list any possible cause regardless of the unlikelihood or rarity. That said, when searching for the cause of something as common as a headache which is most likely caused by something as minor as tension, stress, caffeine withdrawal, or fatigue, the website will list brain tumor as a possible, albeit unlikely cause for the headache. This can send anyone into a panic. True, my headache is most likely not caused by anything serious, but who’s to say that it isn’t? That fear leads to panic which in turn leads to other panic-related symptoms which overlap with the symptoms that would indicate that the headache is serious which leads to more panic, a bigger headache, and even worse symptoms. And the snowball effect of the self-fulfilling prophecy takes over until the person with the insignificant headache runs to a neurologist and does not relax somewhat until an MRI confirms that there is nothing wrong with their brain.

And that is the story of my life. I was “blessed” with a mental search engine scanning for the worst possibilities well before the internet became popular. Now, with the popularity of the internet and Google, I now have access to an even greater bombardment of information, possibilities, worst case scenarios and horror stories. A line in the show Sex and the City summed it up best. There is an episode with a scene in which Miranda tells the girls that she’s been trying to diagnose herself on the internet. When Samantha asks in amazement “you can do that?” Miranda responds “just type in your symptoms, hit enter, and wait for the word cancer to appear.”

So I decided to stop all Google searches for symptoms. If you feel something, I told myself, try to ignore it and realize that it’s most likely nothing serious. If it something, you’ll know. If it’s something that you feel you want a doctor to look at, then make an appointment. Googling will not help. It will only add stress and anxiety when none is warranted. Regardless of how minor the symptoms are, it is a virtual guarantee that a search will yield the possibility of the symptom being a result of something serious. Then the symptom will either go away and the anxiety was pointless and unnecessary, or you will go to the doctor who will either dismiss it as nothing or who will diagnose you with a common, minor virus or infection. Or, worse, the anxiety will enhance the symptoms, real or imagined, as well as create more symptoms and more anxiety.

This decision worked great. I stopped paying attention to minor bodily sensations and, when I did notice any, I did not Google the symptoms. I was under a complete Google blackout. And I never felt better. The nights of searching for symptoms and reasons for swollen lymph nodes were over. And those were the worst. You see, a swollen lymph node is a classic example of why Google is so dangerous. That’s because a lymph node can swell for reasons ranging from something as petty as a canker sore to something as serious as lymphoma. In nearly every instance where a person is concerned simply because they felt a swollen lymph node, there is absolutely no reason at all for concern. They either have a small cut in their mouth or they have, are about to get, or are recovering from a virus or infection. So the first thing to do is to not actively look for swollen lymph nodes. The second thing to do, is to realize that if you didn’t look for it but you can feel the sore node, then it’s probably nothing serious, as when it is serious it is not painful. The third thing to do is to look for any sores in or around the mouth, face and neck that would have caused the node to well as it reacts to the infection or injury. The next thing to do is think about whether you have or recently had a virus or infection. In most cases, the node will recover within a week or two and it will be completely forgotten. And life goes on.

And that’s where Google comes in to ruin everything. Instead of not finding the swollen lymph node or feeling it and not becoming alarmed by it, a person may search Google for “swollen lymph node” and, voila, the search results show that it is most likely due to an injury or infection, or, you guessed it, in rare cases it could be a sign of a life-threatening illness.

The reason they list all of the possibilities is because it would be inappropriate for them to dismiss your symptoms as most likely nothing serious, since there does exist the remote possibility that it is something serious. So they tell you everything and try to make it clear that the more serious possibilities are extremely rare and unlikely. But we don’t seem to get that part. We zone in on the serious possibility and we begin to fret about it and panic, thinking that we may have the worst case scenario. True, it’s most likely nothing but what if it isn’t just nothing?

So gone were the node checks and Google searches. And in came some peace of mind. That is, until the skin inspections began.

It started innocently enough. I was standing in front of the full-length mirror on my bedroom door after coming out of the shower. A small spot on my right side toward my back caught my eye. I don’t remember seeing that before, I thought to myself. It doesn’t look like a typical pimple or freckle. It’s not round and it’s not brown or red. And the panic ensued. I asked my wife to look at it and she was confident that it was nothing more than a pimple. But that would not assuage my fears. I began to pick, poke, prod and analyze the spot until it became bigger and more irritated and increased my anxiety even further.

To make a long story short, after a few weeks what in the end was nothing more than a small pimple subsided and some tranquility resumed for some time, until one day while I was trimming my beard I noticed a small black dot on my neck. And the roller coaster started again. My wife inspected it and assured me that it was nothing more than a freckle with an ingrown black hair in it. But of course that was not enough for me. I began to look up dermatologists and, finally, after having it inspected by three different doctors who assured me it was nothing more than a freckle with an ingrown hair, did I relax and move on.  

And then came the heart palpitations.