Anxiety returns

Hi everyone - I had a pacemaker implanted on 1 March, so just over four months ago. I struggled a lot at first with anxiety and depression - my GP put me on Sertraline 50mg/day (I've been on Amitriptyline 25 mg/day for many years and the Sertraline is in addition to that). I've also started counselling which is hard at first but I feel sure will help me longer term.

After 3 months I felt quite a lot better and resumed work - I'm self employed and do contract work from home. I also regained confidence and even managed a 300 mile trip by train to be at a friend's wedding last month.

But in the last week, my anxiety has returned and at times I'm struggling because of it. Even though I appear fine and my heart rate seems normal, I've had a couple of very small palpitations and seemingly that's all it takes to trigger anxious feelings again.

I'm trying breathing exercises on an app called Balance, which helps for a short while before the anxious feelings return. I have a bedside St Jude monitor which is supplying data every day to my PM clinic with no sign of anything unusual happening. I'm also trying to go for a walk every day, not a huge distance but enough to get some fresh air and exercise.

A couple of questions:

Is it normal for anxiety to come and go?

Is feeling like this at four months post-op unusual?

Is there anything else I could do to help manage my anxiety until it subsides again (assuming it will)?

All thoughts and advice welcome - and thanks for reading.


Anxiety Returns

by benedeni - 2022-07-06 17:53:51

Hello JG1965,

I am sorry you are having so many anxiety issues.  I think most of us have had our own adjustment periods.  Stress and anxiety are indeed health concerns.  I was more stressed with the high blood pressure that resulted from my surgery than the actual implant.  Kept me in the hospital an extra day.  

The following may ease your stress somewhat.  I hope it does.  When I had my first and only child there were complications and I sure was glad there was a hospital nearby!  I remember my doctor saying to me, "just think.  If you had been alive during the days of wagon trains, you most likely would not have survived this!  Aren't you lucky?"  Well, you can reach a little further and think boy, if you and I had been alive and had our heart issues during the days of wagon trains, we most likely would not have survived this!  The pacemaker was invented during the late 1950's.

So I just wanted to share my thoughts with you.  You'll get through this.  I have complete heart block so am very very grateful each and every day for the extra time this little device has given me.  Hang in there.  We're all on the same team.  


by Lavender - 2022-07-06 18:03:34

I can relate to your post. I had been ill for three years with various undiagnosed issues with my stomach and gallbladder.  I feared the pain and I stayed home a lot to control what ingredients were in my food.  A series of events caused me to have inflamed rib cartilage at the same time as pericarditis and stomach erosions.  

I react poorly to most meds and was forced to find a way to handle my anxiety with meditation and counseling. One psychologist recommended Michael Sealey meditations that I listened to from YouTube. 

There are several of them on anxiety. It's a way of self talking calm into myself. 

You can listen to anti anxiety tapes any time you choose. Here are a couple links to copy and paste:

I also listened to a lot of Eckhart Tolle on YouTube. His teachings are to stay present and not let your mind think of the past or future-only the present.  We can handle right now. What worries us is the "what ifs".

After getting those medical issues under control and venturing out more, I had my gallbladder removed. During that surgery, I had a complete heart block from the anesthesia.  Ok after recovering from that, I was back doing normal stuff and then I started to faint.  I fainted for six months, two of them included near death experiences.  I became anxious and fearful because no one was figuring out what was wrong, and I was afraid to drive for fear I would pass out.

Another counselor suggested that I listen to calm music every day with headphones, and suggested that I do one thing every day that made me uncomfortable such as going to the store, taking a walk alone, etc.

Once I got the pacemaker, I didn't trust it, or trust medical people after going so long before my issue was solved.  I stuck to home unless accompanied by a trusted person.  I listened to meditation tapes and prayed.  Prayer is my comfort. 

Joshua 1:9 Be strong and courageous. Do not be afraid; do not be discouraged, for the Lord your God will be with you wherever you go.

Isaiah 26:3

You will keep him in perfect peace,

Whose mind is stayed on You,

Because he trusts in You.

You will hear a voice behind you saying, ‘This is the way, walk in it…’ Isaiah 30:21

I have a lot of comfort verses saved in my phone.

I had discomfort in the left arm and neck and wasn't sleeping comfortable but also taking naps daily.  I was depressed. It took me seven months to feel better mentally and physically.  The meditation tapes helped so much. I pushed myself to focus on here and now-this moment.

One trick Eckhart Tolle teaches is to look at clouds without mentally defining their shape.  Just look. Be still. It's a way of training your mind to not think. Sit outside and use that free tool daily. Wear sunglasses and sunscreenšŸ˜Ž

 One of his quotes:

All negativity is caused by an accumulation of psychological time and denial of the present. Unease, anxiety, tension, stress, worry - all forms of fear - are caused by too much future, and. not enough presence."

I still get a bit anxious when out alone but I force myself because I am not going to curl up in a ball and stop living. 

Some quotes I saved, I believe Gemita may have used the last one(?)

Try not to focus too much on possibilities that may never happen, and probably won't.  That way lies madness.

On the other side of anxiety -Is a life adventure.

Acceptance is the beginning of healing.

Understandable Anxiety

by SeenBetterDays - 2022-07-06 18:19:05

Hi JG1965

I'm so sorry you are feeling this anxiety and can completely understand where you are coming from.  I have complete heart block and had my pacemaker fitted in February 2021. I have found the mental challenges of adjustment just as difficult as the physical aspects.  I quite often have dark days and still have problems accepting what has happened to me.  I think this process of adapting is different for all of us so don't think that you are the only one to go through these emotions.  It is going to take time.  It sounds as though you are taking positive steps to help your recovery, I have found the walking helpful too and talking things through with someone, if you have that opportunity.  I have also started meditation using an app on my phone which is quite calming.  Benedeni is right that we might need to reframe the way we think about the pacemaker - that it is a friend not an enemy? I know that it is difficult to deal with anxious thoughts but remember that emotions are not fixed and that you will pass through those thoughts and come out the other side.  I am sending you much love and hope that you can make peace with the situation.  As I said, you are certainly not alone in feeling this way.

Take care


Living well, Understanding anxiety

by Gotrhythm - 2022-07-08 16:08:37

I don't know if anxiety is "normal" for pacemaker recipients, but it's certainly common--80-90% admit to some anxiety. 

My theory about why it's so common, is that almost everyone feels anxiety when confronted with the unknown--and goodness knows, nothing in most people's experience has equipped them with knowledge about heart rhythm issues or little electronic gizmos that get connected to your heart!

Throw in a sense of powerlessness (in many cases nothing we did caused it) loss of control ( suddenly, something other than our own wishes and plans is dictating what we do) and the need to trust people and technology that we have no prior experience with. Why wouldn't you experience anxiety?

I think,  after getting a pacemaker, people find their anxiety waning over time, because gradually they learn a bit at the time what they really do need to be careful about (practically nothing.) And which signs and symptoms are causes for concern--and what to do if they come up.

I think you need to learn about the palpitations you are having. Find out from your doctor exactly what they are and have a discussion about which ones are dangerous and which ones aren't. Most, even though they're unpleasant, aren't, and aren't a sign your condition is getting worse. But until you know exactly what it is, you don't know if it's dangerous or not.

So have a talk with your doctor. Get down to the nitty gritty. It's a funny thing about fear of the unknown. Most people's anxiety becomes less as they learn what they need to know, even when what they learn is bad news.

Fortunately, most of what there is for us to know about living with pacemakers is good news. Most of us can safely resume living just as we did before. Palpitations after getting a pacemaker are very common. I have them and they're just something I've learned to live with. In my experience, nothing makes them go away totally, but there are things you can try to make them less frequent.

You asked how to manage your anxiety and it's exactly the right question.

Running from anxiety, trying to avoid anything that brings on palpitations, doesn't work. Becoming anxious about palpitations just makes the palpitations worse. It's a viscious cycle. 

Cognitive Behavioral Therapy is an excellant tool for dealing with situational anxiety, i.e. anxiety that is specific to certain things going on in your life. With CBT you can learn which of your thoughts and beliefs are leading to the anxiety and change them to thoughts that are more useful and helpful in getting your life back. CBT is quick. Just a few sessions will often take care of the problem, and you go away much stronger, better able to deal with life's challenges.

I beleive CBT is widely available in the United Kingdom. Ask for a referral.

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