Medication

Hi @wiseowl, it's been a few years since I saw a doctor also (I try to keep away from them if at all possible) There are two Medical centres here, one in this village and one in a near-by town. That's the one I go to.
There are many pharmacies also, which are helpful out of surgery hours, and for general enquiries.

I suppose it's difficult to keep up with a growing population, but it is growing fast here too, they're throwing hundreds of 'houses' up in the most unlikely and inappropriate places.
I say 'houses' in inverted commas because they are actually nothing but wooden boxes, all in sections and slotted together like the toy models I made when I was little.

 

Although most people think anxiety is entirely a mental state, it certainly is not.

Sure, anxiety starts in the mind, but it has very physical effects on the body. I learned all this because I've had the emergency ambulance round a few times because of it, where those around me thought I was having a heart attack. In my case it took a little while to get to the bottom of it. I'd start sweating and breathing erratically, go dizzy and confused and my arms and legs would go weak or numb. After the third of fourth event, I'd try to tell people it would pass, but all the saw was a confused disoriented person sweating profusely for no reason and unable to coordinate himself. It's understandable they panicked and called the ambulance.

Each time, when the ambulance arrived, I'd go straight onto the ECG, blood oxygen monitor on my finger and blood pressure band on my arm. Each time, it would show the same thing. Blood pressure swinging wildly, but blood oxygen and ECG readings normal, except for my heart beating faster than it should. But each time, once in the back of the ambulance, all my stats would quickly normalise, leaving me feeling slightly embarrassed and guilty that I took up paramedic time unnecessarily.

The good old NHS took it seriously, and I was invited to the hospital to do an exercise stress test. Basically they wire you up to an ECG, have emergency medics on standby with all their equipment handy, then they put you on a treadmill and gradually increase the intensity until you physically can't continue, gathering vital data throughout. I was complimented on my performance. I was told they usually only see stats like mine in athletes and serving military, yet I was still having these occasional episodes so they wanted to know more.

Over the weeks that followed, I had more tests and more consultations, culminating in a meeting with a cardiac specialist consultant.

The conclusion was interesting. Firstly, there was nothing wrong with my heart or circulation. My vagus nerve was the culprit. The vagus nerve is massive. It runs the whole length of your torso and carefully monitors all sorts going on in your digestive tract, as well as blood pressure and blood pH. If it misreads the signals, it can trigger your brain to respond to a potential heart attack. This is why my arms and legs would go numb and I'd go dizzy and confused and sweaty. Basically, erroneous heart attack signals trigger a physical change, dilating arteries closer to the skin to provide more routes for blood to flow, causing a sudden drop in blood pressure, then the heart speeds up to compensate, and the whole system gets itself messed up. The human body is a fantastic machine, but it's not perfect.

What I've learned over the years since I've been managing this is that the vagus nerve is very sensitive to activity in the gut. There's a growing body of evidence that gut health is linked to all sorts, including mental state and blood pressure and heart rate. I'm not going there because I don't fully understand it, I'm just sharing what I've learned. But I found that if I focus on gut health, my anxiety episodes are far less frequent or intense, and it's been 5 years now since anyone last called the ambulance on me.

 

Interesting, not a cause/condition we have heard of, though can well understand something like that.
While you mention gut heath, that can present with many various conditions, have you found removing any foods/drinks or keeping to a particular diet more helpful ?

 

I have always thought our gut and nervous system are linked. That's why we get 'butterflies' in our stomach when we are nervous. And that's why people say something scared the s h i t out of them.

 

In my case (everyone is different), I don't seem to have any allergies or intolerances so for me it's not really about removing foods. Drink is a different story. I've had to stop drinking proper coffee (I drink decaf). Proper coffee wasn't a trigger as such, but it did make me more sensitive to other things. I still drink proper tea which has caffeine in it so it's not the caffeine per se, but I once read that at a molecular level, the caffeine in coffee is more readily available than in tea, whereas in tea it's bound to other molecules so not absorbed as fast.

In terms of food, nowadays I focus on two macros. Protein and fibre. Protein does so much more than it's stereotypical use of building muscle. It's used in various functions of the digestive system, and plays a key role in regulating hormone activity. The NHS idea of a healthy diet is dangerously low in protein.

Fibre is something we all know plenty about, but an often overlooked point is there are many different types, with different roles. They fall into two broad categories, soluble and insoluble. Insoluble is what my grand parents generation referred to as 'roughage', things like bran. Soluble dissolves in your system (or in your food). Beta glucans are a biggy, found in oats and barley. You need both. Insoluble regulates cholesterol and soluble feeds the good bacteria in your gut. It doesn't need to be complicated though, whole grains and pulses tend to have both, with pulses having the added benefit of also being rich in protein, so if you fill up on beans, peas, lentils etc you're getting plenty of both fibre and protein, and as you probably eat those things with other foods, you'll probably hit a good balance.

I don't care much for fat, and micronutrients like vitamins and minerals, because if I tick the boxes of getting enough protein and fibre, and getting it from a variety of foods, then it's a safe bet that I'm also getting enough of the micronutrients and fats.

For me personally, that looks like lentil based broths, barley broths, beans, peas, and a bit of meat, eggs and dairy.

I used to avoid fibre, because it would upset my guts if I wasn't careful. This added to the anxiety, because I'd have to meticulously plan my food intake based on what I was doing that day. I remember once going out and doing a full day building someone's garden fence, on an empty stomach, because I didn't want to suddenly need the loo. But I came to realise this was a terrible strategy. Catch 22. I didn't eat because I was worried about my guts, but because of my terrible approach to food, I was actually damaging my gut health. The key point here is that any changes should be gradual. A sudden total overhaul of the diet is going to seriously shock the system. Give it time to adapt.

 

The interaction between the human body and the inhabitants of the gut (gut flora or gut microbiome" is incompletely understood. The gut microbiome appear to have an effect on the brain affecting mood, has been mentioned in relation to bipolar disorder. There is also a link between the gut microbiome and the immune system.
Faecal transplants have been used to treat long running gut infections with C difficile and similar, sounds horrible but seems to work and is becoming more common.
As for diet: mine is pretty much what I grew up with, mixed, seasonal local, plenty of veg, butter, full fat milk, cheese, tea and coffee.
I don't use a lot of salt or sugar I also avoid so called "ultra processed food" with a lot of additives and messing around; in part I don't like the idea, but when I try it I don't like it.

 

I have been very aware of gut health these past couple of years since I had e-coli in my replacement hip. I tripped up the step in our lounge and knocked the stem through my femur. When I went to have revision surgery, the Surgeon discovered infection in my hip and thigh so my hip was removed for five months and I was on daily antibiotics during that period of time. I asked my Infectious Diseases Doctor how I got it and he told me it lives in our guts and when it saw something unnatural it headed straight for it. My Surgeon was concerned it might head for my replacement knee but it did not. After the five months my new hip was put in with a 30cm stem ... it is a couple of inches away from my knee replacement so metal from hip to below knee. Since then I eat healthier and also take a probiotic capsule daily.

 

Just to point out there is a 1% chance of this happening!