Well, this past week for me was far from pleasant. I managed to scare myself pretty darn good, and have found that I have multiple questions for which I am still searching answers.
A couple of Saturday's ago, I was in the grocery store in the check-out area when I suddenly started feeling faint. I hadn't experienced this kind of thing for quite some time, so was a little bewildered. Somehow, I got myself together, paid the clerk, and got myself back home. I immediately ate a few oranges, thinking that perhaps I felt faint due to the fact that I had not yet eaten anything that day (hence the trip to supermarket).
I decided to skip a visit to the gym, which I was likely going to skip anyway, as my back was not feeling up to throwing weights around. Instead, I watched a football match on television at the pub, then had a quiet evening at home.
The next few days were fairly normal for me: regular stress filled working days. The following Thursday evening, I met up with a few friends at the pub. Although Thursday's are Quiz Night, I rarely play along, choosing instead simply to socialize with other non-playing friends and look forward to the coming weekend. At one point, I was outside having a ciggy, and started chatting with a Spanish girl in her native language. She has been in Germany for about two years, so we were comparing stories about our integration into German culture, learning a difficult language, etc. As our conversation continued, her boyfriend and her other friends came outside to look for her, wondering how a short cigarette break had turned into a 15 minute absence. They were all Spanish, too, and I enjoyed the opportunity to speak to several natives in a social environment. It was a good confidence boost, and it was nice to use the language with topics other than work. That is not to say that I don't enjoy working with my Spanish repair partners, but obviously our subject matter tends to be limited to the task at hand.
So, I went to bed Thursday night feeling rather good about things. All that changed Friday morning, however, when shortly before a conference call started at 9am, I had a bit of an anxiety attack. It hit me all at once, and was not too different than the experience I had had the previous Saturday in the check-out aisle. My heart was racing, I had tunnel vision and become all shaky, my limbs were feeling all tingly, and I really thought I was going to pass out.
Fortunately, I managed to pull myself together, and jumped on the conference call, where I felt very, very strange. These kinds of attacks have happened to me in previous years. I can remember perhaps a handful of incidents, and in almost every case, it happened while I was at work. Like I did those times, I told myself that this latest attack was due to work-related stress. I told myself to calm the hell down, and figured I could push on through. The weekend was only a few hours away.
Unfortunately, I had three more "attacks" during the course of the day. All of them came suddenly and brought considerable concern. Why was this happening so many times during the same day? True, my Fridays tend to be pretty busy, but not too much busier than any other day, and as I have mentioned, the stress is pretty much non-stop.
Friday was a bad day, all in all, and as the end of the workday approached, I considered calling my boss and telling him that I was having some troubles, but ultimately decided to wait. I then met up with some friends for dinner, and despite feeling rather surreal and antsy, I got through the evening without further incident.
On Saturday (one week ago), I woke up with the simple weekend goal of relaxing. Almost as soon as I thought that word, I started feeling a bit panicky and nervous. Part of me was reluctant to return to the grocery store, lest I have another attack right in the middle of the produce department.
I really had no interest in leaving the flat, and elected to watch the first series "Spaced," as I am big Simon Pegg fan. I had seen the odd episode many years ago, but I never watched the whole series. For what it is worth, it is a great series, and I watched the complete series one during the afternoon. Afterwards, I felt good enough to venture to the grocery store, where I quickly did the shopping and returned to the safety of home. That night, I went to bed feeling more or less okay with things.
On Sunday, I watched the second series of "Spaced,", which I greatly enjoyed. That afternoon, I decided to slip over to the pub and see if I could manage a couple of pints and be a little sociable. I was still feeling really strange, and somewhat nervous about things, and it didn't help that Monday morning (and start of the work week) was looming. From time to time over the years, I have experienced anxiety right at the end of the weekend as I think about what will happen on Mondays. I was always very anxious the night before the first day of school, and always sort of laughed when the day turned out to be brilliant, and I basically got myself worked up over nothing. I hoped that this would be the case for last Monday.
Monday morning came, and I started the work day, but things went downhill pretty quickly. Again, I got hit with a panic attack, probably more than once, and finally came to the realization that perhaps I needed to go see a doctor. Ironically, I had already been contemplating arranging an appointment for a check-up, primarily because I had experienced some lingering lower back pain over the past weeks that did not seem the same as the other times in my life when I have "thrown" my back out.
I contacted a Hausarzt whose Praxis I had read about in an on-line community forum for expats. When it comes to medical topics, my German vocabulary is somewhat limited, not least of all because I have never been to a doctor during my time here. Thus, it was somewhat important for me to have a doctor who could explain things in English, should I fail to understand the German explanation. We set an appointment for the following day at 16h, and I felt somewhat comforted that I had taken the first step in understanding just what was happening to me.
Rather than meeting up with friends on Monday evening like I normally do, I stayed at home, feeling extremely tired, anxious, and a little bit scared.
Tuesday morning, I woke up feeling hopeful about my afternoon appointment; soon I would know what was going on. By mid-morning, things were not going so well. A couple more panic attacks had come and gone, and I was becoming more and more worked up. I phoned my boss, and explained the situation, including the attacks I had experienced the previous Friday. My boss was immediately concerned, because he is aware of the colossal levels of stress that go with our job, particularly in the recent months. He was most supportive, and I told him that I would give him an update as soon as I had been to the doctor.
For some reason, I like going to the dentist. The exact opposite applies to visits to the doctor. Thus, I entered the Praxis that afternoon with a certain amount of apprehension. After signing a release form, I took my seat in the waiting area, and a few minutes later the doctor called me in to his office.
Things got off to a very rocky start. I had filled out a little medical questionnaire, including my listed ailments of lower back issues and recent anxiety attacks, which were the primary reasons for my visit. However, I had also answered the questions about alcohol and cigarette consumption, and this is what the doctor immediately focused on. I had hardly said a word in the initial consultation, and he was off talking about how unhealthy I seemed to be. He did immediately write me a note releasing me from work for the next two weeks, then arranged for me to meet with one of his colleagues in the Praxis.
With the second doctor, things went much better. He asked what had brought me to Germany, and asked more questions about why I had come to their office. He, too, initially was of the impression that I was there to get help for smoking/drinking, and I, with a bit of frustration in my voice, explained the recent events of my life. This doctor actually listened to me, and proved this by repeating everything back to me, in a somewhat abridged version.
I felt much more at ease with him, and was glad when he suddenly made a little plan of action: have a physical checkup, have an MRT (for the back issues), meet with a neurologist (about the tingly feelings I was having in my legs, arms, fingers and toes...all over, really...during these attacks) and then possibly meet with a psychologist about the anxiety itself. First, however, it was important to find out if anything was wrong physically.
We quickly made appointments for a physical checkup and MRT for the Thursday, in two days time. Friday morning, I would meet with the neurologist, and then we would consolidate and review the results.
I left the doctor's office that evening feeling comforted with the course of action. I was not completely at ease with the whole "absence from work" thing, since I don't like the feeling of letting anyone down, particularly my employer, my partners, and my customers. However, I reminded myself the importance of not letting myself down; perhaps it was the right time to face the situation for what it was.
Wednesday morning, I read a few work emails, and within a matter of minutes, was feeling overwhelmed with panic. My mind was racing as I thought about all the upcoming things that I was supposed to be doing for work, all the open issue on my current workload. The more I tried to calm myself, the worse things became. Suddenly, I was a completely debilitated.
Several years ago, a friend of mine had a stroke, more or less right in front of me. That was most unfortunate, but in order to find out more about strokes, I did a bit of research, reading medical articles, etc. particularly about the symptoms and the onset of a stroke.
Suddenly, all of this was hitting me at once, and I felt in need of urgent medical assistance. I felt like I was unable to walk, unable to move around, on the verge of passing out. It was as if ALL the panic attacks I had experienced since the previous Friday were all happening simultaneously. Not good at all, and it nearly sent me over the edge. Talk about scaring the fuck out of yourself...
A friend of mine has an office across the street from my flat, and I phoned him quickly, and asked that he come over and help get me to the emergency room. Many thanks to him, as he soon had us in a taxi on the way to the closest ER. I was particularly interested in having someone there who, in the event it was needed, could explain some of the situation in German, should my ability suddenly fail. The irony, of course, is that I explained all my recent issues to him in German already. Thus, I really didn't need any translation assistance. Of course, when one feels like they are about to pass out, they are not always thinking so clearly.
At any rate, we got to the ER, where I had to fill out a little bit of paperwork and explain that I was privately insured. During this time, I almost lost consciousness, but somehow I persevered. We were told to take a seat in the waiting area, and then we waited.
For the next two hours, we continued to wait. I almost passed out one more time, but then, after sitting for a while, started feeling a little more coherent. My friend acknowledged this, also.
Finally, I was called in to see the nurse, who took my blood pressure, asked a few questions, and then asked me to wait, as "the Doctor will be with you shortly."
OK, that is relative.
We waited another hour, during which time my friend told me that I had effectively (albeit inadvertently) made it seem that he was my "partner" simply in the way I had explained the circumstances. Unlike in Spanish or English, the German word for friend is Freund, and the German word for boyfriend is Freund. Normally in the context of things, these things sort themselves out, but in this case, the nurse understood that we were a couple, and my efforts to clarify this probably did more harm than good. I almost felt compelled to seek her assurance that she truly understood that we are both heterosexual males, but it really didn't matter one way or the other.
Finally, my buddy left (as he had other things he needed to do), and a few minutes later, the doctor came in to see me. I explained the recent events, and he took a blood sample, did a few other tests, and had the nurse do an EKG. Another hour or so passed, and he returned with the somewhat comforting news that there was nothing he found that was physically wrong with me. I certainly was not having a stroke, heart attack, or anything else. He indicated that I should proceed with the upcoming appointments that I had already arranged.
As he was finishing up with me, a female friend of mine came by, and she and I both exited the ER, bidding farewell to the nurse at the desk. I was glad to have company on the walk home, and was more than relieved to have an initial doctor's report indicating that I am physically okay.
We picked up some take-away Thai, then went home to watch a movie. In times of uncertainty and particularly mentally exhausting moments, Disney films seem to help tremendously. Thus, I was able to go sleep on Wednesday evening again with a bit of comfort and relief, albeit with a lingering question of "Okay, if things physically are all right with me, then what the fuck is going on?"
So, Thursday morning, I woke up trying hard to stay as relaxed as possible, which was no easy feat considering I was up for a physical check-up at the doctor's office. I arrived punctually at 10am, and greeted the receptionist. On my visit to the office, two days before, I had initially stated that I preferred to speak English, but that was based on my lack of confidence when it came to discussing various medical topics. Like many places, the staff in this office CAN speak English, but that does not mean that they do it without difficulty. I had found that it was actually better to speak in German until I got tripped up, rather than have them get tripped up from the get go.
Allow me to give an example to partially illustrate this point. When my mother visits Germany, she speaks English, which is normal, as she does not know any German. Usually this is not a real problem, because most Germans have some grasp of English, and in many cases, their English is quite good. However, just because you understand English does not always mean that you understand what is being said. In restaurants, my mother, upon finishing her meal, has a habit of saying to the waitress, "I will let you take that away," while nodding to her empty plate.
More than once, this has created some confusion for waitstaff, because they are not accustomed to hearing such a sentence, even though they literally understand each of the spoken words. The waitress thinks, "Why is that woman telling me that I am allowed to do something which is actually my job?"
It is a context thing, really.
Anyway, there I stood at the reception desk at the doctor's office, and she asked me something in German. I gave her a blank look, and was particularly humbled because I had just said that it was okay for us to speak in German, but I failed to realize that I have never heard the German sentence, "Would you be able to give us a urine sample, please?" in my life. Thus, I was completely confused, and it took me a moment to compute the request. Basically, she need me to go to the adjacent lavatory, print my name on a cup, do my business, then return the sample to the nurse's station.
The positive here, is that I have certainly learned a few new vocabulary words during these recent experiences.
For the next two hours, I underwent various tests, including another blood sample, an EKG, a little test for the lungs, and finally a sonogram on all my internal organs. The nurse was very friendly and helpful, and I was only a bit irritated when the doctor came in to do the sonogram. Again, he was the first physician that I met with (the one who was a bit brisk and quick to jump on the smoking and drinking problems that I supposedly have). He actually was fairly pleasant as he described what we were looking at in my various organs, and I was very pleased to hear that he was finding everything was checking out just fine, without any issues. He did comment that he saw too much citrus in my liver, which I found rather odd. I do eat my share of oranges, particularly at this time of the year. However, I have never heard about this being really an issue. On the other hand, I felt also a bit proud that he found nothing that he could say about my alcohol consumption and its effect on my liver. I certainly didn't expect him to find anything, and since then I have come to find out that I actually erred when I answered the alcohol consumption question; somehow I wrote down a quantity that was about twice as high as what I normally consume.
Upon completion of the morning's check-up, I picked up a vitamin prescription at the pharmacy, then walked around the area of the city a little bit before returning home. The doctor's office is in another district of the city, south of the river. It is a nice little area, but I am rarely down there, so I took the opportunity to admire the surroundings.
That afternoon, I arrived to my next appointment at a radiology institute in another part of Frankfurt, this time fairly close to the European Central Bank. Again, as I arrived to the office, I enjoyed seeing another part of Frankfurt that I have never spent much time in. It hasn't escaped me that these little unpleasant visits have at least brought some sightseeing opportunities, so I am continuing to seek out the positives.
However, having an MRT is not a very fun thing to have. Despite the positive news about my health that I had received in the past 24 hours, I was still feeling most anxious. Lying in a very close tunnel listening to really loud noises is never enticing, and after having damn near lost my sanity in the past days panic attacks, I was very wary of how I would handle this next little experience.
I waited patiently in the Wartesaal until the woman came and took me to a little changing room where she asked that I remove my pants (leaving me in a shirt, socks, and boxers) and wait a couple of minutes. Then, another door opened, and I was invited in to the MRT area. Both the nurses were nice, but I briefly lost my ability to speak coherent German, and one of them switched briefly to English. I almost told her, "I will let you take that away," and nodded at the huge machine, but instead took my place on the little slab, and was grateful to hear the woman say that the process would take about 10 minutes. I closed my eyes, was rolled into the scanner, and I concentrated on not flipping out.
As the noises started, I forced myself to NOT think about the day I had had on Wednesday. I decided to count to myself, and after reaching 100, I switched to German, and practiced my numbers in my head. The bleeps and electronic sounds were pretty overwhelming, but I told myself I was at a warm up show for Kraftwerk, and then continued counting in Spanish. The 10 minutes were long, but I got through them. As the woman rolled me out of the thing, I smiled and said, "gosh, that wasn't so much fun."
I put my jeans back on, and returned to the waiting area, where I looked out the window at the passing traffic on the street below. Personally, I was very pleased that I had not "flipped out" in the middle of the machine, and despite my anxious thoughts, I appreciated the view of everyone going about their business in this little area of the city.
The doctor called me in to her office to show me the results, and she pointed out that she found no issues with my back. I took the opportunity to try and be chatty with the doctor, and while I appreciate that doctors are busy people, just like all of us, I didn't get a totally fuzzy feeling from the woman. In fairness, she was very professional and polite, but not overly friendly. Had the results not been so positive, I might have scored her bedside manner rating somewhat lower. In the end, she responded to my enthusiastic explanation of how I had thrown my back out in the past during weight-lifting activities with a rather pragmatic, "Well, I suggest that you don't do that exercise any more when training."
With that, we concluded the visit, and I left the office and walked to the U-Bahn stop, feeling considerably better about things. Sure, Wednesday had been perhaps one of the worst feeling days I have ever had in my life, but here on a Thursday afternoon, I had had two different appointments with doctors, and both had basically indicated that I was physically okay.
This is not to say that I wasn't feeling exhausted, both mentally and physically. Fuck loads of things have happened in a very short period of time, and I just wanted to go home and rest. Part of me felt like going to the pub for some social time, but in the end, I spent the evening watching a few episodes of the Black Adder, which, similar to Disney films, helps tremendously in rough times.
Early yesterday morning, I woke up feeling somewhat rested, and glad that I had not looked at any work emails the previous day. I took a risk and logged on to my work email, and very quickly started feeling a bit antsy, again. Similar to when I am on vacation, or even during evening hours or the weekend, I find it hard to switch myself off and ignore work. (start the alarm bells....perhaps we are coming to realization as to what the nature of this problem happens to be?)
Around 9am, I checked in with my boss to give him a quick update on how things had been since we last spoke. Obviously, some things were very good, like not having any physical issues that were causing my problems. On the other hand, I was still jittery about the fact that I am officially on medical leave, and as a result, am leaving my boss and some colleague in the lurch, as they have to try and cover for me. On top of this, I have had no contact with my repair partners or customers during this time. I have just taken myself out of circulation (Kreislauf), but as I have said, this is not easy for me to do.
My boss was relieved to hear about things so far, and likewise reminded me to simply stay switched off. His words were very helpful, just as the words and showings of support from other friends have been during these past few days.
My final appointment for the week was in yet another part of the city, and, because I felt that time was short, I ended up taking a taxi to the appointment. My taxi driver was a nice guy, and we had a pleasant conversation as we drove the 25 minutes across town. On the way, I started feeling very anxious again, mainly because I was concerned that I would be late for the appointment, and I was momentarily worried about another panic attack hitting me. Again, how interesting (erm, unpleasant) would that be had I entered the doctor's office, only to suddenly flop around on the floor because all my limbs stopped working?
We did make it on time to the neurologist's office, and when the doctor called me in to his office for our initial discussion, I found myself completely at ease. He was very affable, and I described once again how my last week had gone. He scored high marks for his "bedside manner," and I felt very like he cared about my situation. He did a couple of quick checks, then I met with two different nurses, who performed various tests. Both women were also very pleasant, and they patiently explained the process as they went through their preparations of attaching electrodes to my head and running the tests.
While I cannot say that it was uncomfortable, or even unpleasant, the process is not something I am keen to do again. At the start of this past week, I had no idea that I would undergo so many different things in such a short period of time. True, my last physical was back in 2005, before I left Texas for Spain. Having that physical was a requirement of the Spanish government before I could relocate to the country, and as many readers might recall, that was a rather stressful time, especially when the doctor initially believed that I had a heart problem, only for us to find out that that was absolutely not the case.
In fact, it was that experience that led me to avoid doctors over the past decade. One might argue that my rationale might have been a bit immature, but, as I have lived the past 10 years in Germany without any incident, I have felt my reasoning was just.
Until now.
After the women finished the tests, I met again with the neurologist, who explained that the results all looked good, and in his words, all the "hardware" checks out good. Again, I was pleased that he was candid and appreciated my sense of humor with the experience. Not least of all, it is very reassuring to hear that everything physically is okay. We agreed that I would meet next week with my primary doctor, review all the results of the past days, and determine our next steps.
Finally having physical check-ups (extensive ones, at that) goes a long way to help my feelings of well-being, and that certainly is also reassuring to family and some close friends, particularly those who have encouraged me to get regular medical check-ups. I am glad that I finally have done it as well.
After my appointment yesterday morning, I took a long walk back to a tram line that would get me back to my side of town. Despite the anxiety, I was still able to appreciate the cold, sunny day, and that I will find a way through all of this.
I had a couple of beers and a few tapas at a little Spanish restaurant with a friend last evening, and it was a decent ending to a pretty tough week.
Of course, there is still quite a bit of uncertainty, as it is not clear
what has brought these attacks of anxiety. Extreme stress has always
been a part of my job, and somehow, I have always managed to get
through. Many of these posts have related just how tough the job has
been and how it has impacted my life, both for the good and the bad.
While I always use humor to help get through the rougher moments, it is
not always as easy as it may seem.
Sure, I am still concerned about how things will go forward. Have I
exceeded my limits and pushed myself too hard? Have I finally worked
myself to burn-out? Or, am I simply just a little wound up about a few
things?
I believe next week I will get a bit closer to these answers, and I look forward to it.
see you out there
bryan
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