my "safe foods"

I'm back from vacation. The rest of it was pretty much the same - seeing people and having fun, but all while feeling "sick" and/or anxious. Experiencing anxiety that high almost constantly for an entire week is unusual for me, and it's strange to reflect on it now. Every day I was at some point convinced I was going to throw up, but I didn't. So much of the trip spent worrying about something that never happened. Then I start thinking about how much of my life in general I've spent worrying about it. And it hasn't happened in 16 years. It blows my mind.

The drive home was especially bad. I forced myself to eat and drink much more than I had on the drive there. Which was a good thing. I didn't have to deal with the high anxiety that comes from being dehydrated and light-headed, where everything starts feeling surreal. Plus I'm sure it helped me readjust to eating once I got home. But in the moment, it sucked. I felt "nauseous" for most of the drive.

It's been four days since we got home, and I already feel completely back to normal physically, which is huge for me. I was half-expecting that I still wouldn't be able to eat an adequate amount for the first week or so. I'm still feeling anxiety when I eat, but even that seems to be going away much faster than I thought it would.

I wanted to write about the foods I usually eat when I am having really high anxiety and feel unable to eat. Not that I'm saying they make up a balanced diet. I'm the last person to give nutrition advice - I'm pretty terrible at eating healthy. It's just a list of foods that feel safe to me, because they are easy on the stomach:

1) An egg and cheese sandwich. I heavily rely on these during my bad periods. They're delicious. There are so many different options for the bread part: bagel, croissant, English muffin, toast, biscuit, waffles. If I am feeling really "sick" I usually just go for a plain bagel and sometimes even leave off the cheese. But bread and egg, easy on the stomach, plus (so important when you're not eating well) you're getting protein in there.

2) Luna bars. I ate a ton of these on the trip, especially when I had to eat in the car. I don't eat anything without washing my hands first, which is not really convenient on a long drive. But granola bars or nutrition bars you can hold in the wrapper without touching. With Luna bars, you're getting protein again and also vitamins. The only downside is they're not high-calorie. They're pretty small, which is partly why they always seem manageable to me. Mini-meals.

3) Cereal, toast, pasta. I love all of these simple carbs when I feel anxious. Cheerios has always been one of my super-safe foods. It used to be pretty much my only safe food. I remember one trip I went on where I only ate Cheerios the entire time. So unhealthy, plus everyone around me thought I was insane. Now I try to avoid eating only foods that fall into this category, since they are usually lacking in the protein area.

4) Bananas. I don't love the way they taste, but they're healthy and convenient / portable like nutrition bars. They're in their own little "wrapper" so you don't have to touch them. Plus they're dense / filling, and you can find ripe ones pretty much wherever you go.

vacation update

I'm still on vacation. I have had Internet access but up until now have been either too busy or too overwhelmed to even think about what to write here. I'd love to make this entry have a coherent message, but I'm guessing it's going to be more of a blow-by-blow recounting of events. I haven't gotten the best sleep this week.

The first two days were the traveling days. We drove for six or seven hours each day. We got lost twice, once around NYC, once around Philadelphia. I managed my anxiety pretty well while in the car, except for the fact that I hardly ate or drank, because I felt "nauseous" a lot of the time. It was the first nights in the two different hotels that really threw me. It took hours of reassurance from my wife (that I wasn't going to throw up, go crazy, die, or always be this way) before I felt okay enough to get any sleep.

As is usually the case, two days of bad sleep and inadequate eating/drinking led to me feeling horrible. When I woke up Tuesday morning, I felt slightly less anxious but couldn't get up and walk around without feeling nauseous and dizzy. I decided I needed to cancel all my plans for that day and just spent the day in the hotel room forcing myself to eat and drink as much as possible. It was upsetting / frustrating, but necessary. Sometimes the hardest thing about all this is having to accept that I can't do whatever I want whenever I want. I get jealous of other people who can keep pushing themselves without taking a break, who could have packed a million activities and social interactions into a vacation this long. Sometimes I have to work within my limits, and for now, sometimes that includes missing out on things I was really looking forward to. But I'm sure that won't be the case forever.

I did visit my family briefly that night, because I thought I might get a guilt trip if I didn't make it to their house within 24 hours of arriving in the city. That went well, no anxiety attack there, so I knew I was heading back in the direction of normal.

The next day, finally, was like actually being on vacation instead of in hell. I felt almost 100% better physically. First thing in the morning, I went back over to my parents' house, because now my older sister was there with my 15-month-old nephew. I got to meet him for the first time. He wasn't sick at all. I still worried he might throw up on me whenever he coughed, but he didn't. I spent a couple hours with him, and we played with all his toys together. He is adorable, and I love him so much. Spending that time with him really cheered me up.

I also went to the company I work for and saw all the coworkers I haven't seen in two years, which was awesome. I love them all too and have missed actually being around them. My anxiety got really high again though. I think it was partially because I'm not used to being around so many people who know me and are all looking at me, and partially because I knew some of them had been sick recently. I ended up spending a few minutes hiding in the bathroom until I didn't feel so nauseous and shaky. I didn't even really care though. I was so happy to be there that I couldn't muster up the usual annoyance I feel at myself. Seeing them plus seeing my nephew made me feel certain that this trip was a good idea, that it was all worth it, even though it has been challenging. Besides, I'm almost positive I'm not going to get sick. I took Emergen-C for a few days before we left, I take a regular multivitamin every day, and I'm generally very physically healthy and have a great immune system.

The afternoon was a lot of fun too. I hung out in the hotel room with my wife and an old friend of ours from high school. I went to see my grandmother, who is the sweetest woman in the world. I don't think I know anyone who knows how to love people as unconditionally as she does. In the evening, I went back to my parents' again to hang out for a while. Despite doing all these different things, I managed to eat well the entire day!

Today I'm "embracing" my limits again. Both my family and my wife's family are having Thanksgiving meals / gatherings, but I decided not to go to either. I really wanted to go to the one with my wife's family, because I haven't gotten to see my sister-in-law or mother-in-law very much while here. But both gatherings are in another city, and I know a long drive, lots of people, and pressure to eat is likely going to result in me feeling "nauseous" for hours. I know I could handle it, but I really don't feel like forcing myself to get through something else. So I'm hanging out in the hotel for most of the day and seeing my family one more time tonight after they get back from their party. We're leaving early tomorrow morning, and possibly these last two days of driving will be just as bad as the first two days, so I'm sure it's a good idea to have a "chill day" before that.

This trip has really driven home the fact that there is a lot more work I need to do in order to get to the point where I can function the way I want to. I'm definitely going to be recommitting to recovery hardcore when we get home. Less thinking about and resenting my anxiety all the time and more actually doing the things that will help.

Oh, but the good news is that I didn't take any anti-nausea, anti-emetic, or anti-anxiety medicine on this trip. I either talked to my wife or used word searches and crosswords, my emWave, and affirmations to calm down. I'm really proud of that, and of how well I managed to eat overall despite feeling "sick" for hours every day. I suppose I can go as far as to say that this trip has been a good representation of the "emetophobia shmemetophobia" mentality. Not everything went perfectly, but I bounced back like a badass.

happy thanksgiving!

We're leaving early tomorrow morning on our trip. I'm trying to be excited, but I'm more on the nervous end of the spectrum. I do think we are extremely well prepared. In addition to the regular luggage, we packed two extra bags:

-- an "anti-anxiety" bag. It has my thermometer, anti-nausea medicine, a couple of my anxiety workbooks, word searches / crossword puzzles, and relaxation CDs. I also have 10 affirmations on notecards and my emWave in my purse.

-- a food bag. I didn't want to have to rely on whatever was around, restaurant-wise, both while driving and also when we get to the hotel. So we packed things to eat - some peanut butter sandwiches, chips, pretzels, and Luna bars.

We've got tons of music to listen to in the car. We've spaced out the trip so it's not too busy and overwhelming. I've just been trying to distract myself from my worries about it. If I'm having a hard time doing that, I try to think about it as a series of manageable steps rather than the whole trip at once. The first step is to get through six hours of driving tomorrow. That's it. I can handle that, and once I have, then I can think about the next part.

a visit to the pharmacy

I went to the pharmacy tonight to buy some "just in case" items for the trip. My prescribed anti-emetics are long expired. I have nothing to tell a doctor to convince them to prescribe me more. So I figured I would just get something over the counter in case I get some sickness while on the trip. I ended up buying Emetrol (anti-nausea), some Emergen-C (to strengthen my immune system over the next week), and seven individually wrapped toothbrushes.

I should feel better now, but I don't. I don't usually do things like this. I don't have an emetophobia kit, I don't carry medication around with me all the time, I don't even bother with immune system boosters. Because taking any of those precautions always makes me feel like this, like crap. I have way more doubts and anxiety thoughts now than before I went into the pharmacy. Shopping for an anti-emetic leads to visualizing myself in a situation where I would need it. I'm happiest when I try not to think about any of it as much as possible.

I hold myself to very high standards, and I'm embarrassed, and I guess a little ashamed, that I bought these items. It feels weak. It's a big deal to me to be mentally healthy as well as physically healthy, and letting myself indulge in these safety behaviors always makes me start worrying about the mental health side. I want to be in control of my life. I don't want to be limited. That bottle of Emetrol I bought for no good reason is just a symbol to me of a downward spiral to a point where I won't be able to live in any meaningful way.

I'm probably being too hard on myself. It's only one trip, and it's the most stressful thing I've done in over a year. I can have an emetophobia kit just this once, and it's completely irrational to think that having these things will jinx me in some way.

When we get back home though, I am done with all of this. I'm throwing it out. I don't even want it in our apartment. Thinking about that makes me feel better. I'm not going to allow this to take over my life any more than it already has. This will probably take the form of New Year's resolutions. No more anti-emetics around, no more thermometer. I don't know. I'll make a firmer list later on. 

emWave2

I have the greatest wife in the world. She bought me an emWave2 for Christmas! She gave it to me this morning. She wanted to give it to me early so that I could practice with it and then use it on our upcoming trip.

I've been thinking about getting one of these for months, but I kept hesitating and putting it off, because it's pretty expensive. I haven't actually charged it or gone through the instruction booklet yet to see everything it can do, but my therapist has one and showed me the basics a few months ago. Basically, it's a biofeedback device that measures your heart rate and breathing rate, allowing you to better see what is going on inside you. Then you can practice achieving relaxation through various methods and see which methods work best for you, work the fastest, etc. You can also download what's on the device to your computer and then look at your information over time, review your progress.

I'm sure I'll write more about it later. I don't think I am going to have much time to play with it today though. Since it's our last weekend before leaving, there are a ton of chores and errands to do. I'm going to be spending the whole day cleaning.

swallowing pills

I know a lot of emetophobes have trouble swallowing pills. I had this problem for most of my life. In high school, I used to dissolve Aleve or Midol in a glass of water and then drink it. There are no words to explain how disgusting this tastes. You will just have to try it and see for yourself. Or on second thought, don't ever do this.

Now I have a method that works most of the time. Very similar to the method people use to trick their pet into eating a pill. I chew up a bite of food that I know I can swallow all at once, then put the pill in my mouth and maneuver it into the middle of that bite. As long as I can't feel it there at all, I can then swallow the bite of food and the pill along with it. Thus, it works best with foods that are more solid and don't dissolve in your mouth, nothing like pudding or applesauce. For a long time, I had the most success with cereal, but now I can use practically anything. The only time I have trouble is when I'm so tense with anxiety that my throat feels closed up. Then it's hard to swallow in general.

I still prefer liquid medicines or chewable pills, and luckily, you can usually find them. But sometimes they're not available, and at those times, it's nice to not have to choose between pain and painkiller-flavored drinks. Ick.

general health anxiety

It's been an intense week. It seems pretty clear that as this VA trip gets closer, I am going to be dealing with every anxiety thought in my big fat collection. I was in near panic mode two nights in a row, thinking I had cancer or some other life-threatening disease, because of an irritated throat and all my muscles being incredibly sore. Actual causes? I'm thinking the throat thing is (...still...) our heater (hoping this will possibly maybe sink in sometime soon), and the muscle soreness was from lack of sleep and anxiety. I'm feeling fine now and don't know how I managed to leap from those incredibly benign symptoms to "I'm probably dying."

I think I'm going to start doing some serious CBT work again to keep myself from getting stuck in this negativity. A while ago I bought and read Overcoming Health Anxiety by Rob Willson and David Veale. There are a ton of CBT exercises in it to combat health anxiety, but I haven't done any of them yet. I just read the book straight through first. Now I am revisiting it, so I figured I would share my general thoughts about the book here.

I specifically bought it, because I heard there was a chapter devoted to emetophobia (a whole chapter!). But that chapter was a huge disappointment to me. It was late in the book, and emetophobia was basically laid out as an example of a type of health anxiety. So the book up until that point had already covered health anxiety in general and had provided several different techniques to help cope with or overcome it. At the end of the emetophobia chapter, they listed ways to cope with or overcome emetophobia, but they were the same techniques given in the earlier chapters (just reworded to show how they related to emetophobia). There was nothing new. There isn't anything wrong with that really, but it bothered me, because the rest of the chapter was only a description of our usual neurotic thoughts and behaviors. So at the end of the chapter, I was left feeling more anxious than I was before reading it.

The authors even included a list of conditions or situations that can cause vomiting that emetophobes don't usually worry about, as a way of pointing out how irrational we are by selecting certain risks to focus on and ignoring others. In what scenario did they imagine that information would be helpful? For some emetophobes, their current goal is only to become the safest / healthiest emetophobe they can possibly be, no matter what abnormal behaviors that goal leads to. This would be almost a challenge to them! For those that are trying to cut down on abnormal behaviors, they are just left with more information in their heads to try to ignore.

I consider myself to be in the second group, which is why I'm never going to post an entry here talking about 1) what foods have been reported to cause the most food poisoning, 2) which anti-emetic is the best to take before going on a long car ride, 3) "full-proof" ways to make sure you never get a stomach virus, etc. I don't consider any of that helpful and try to avoid reading anything of that nature on other emetophobia blogs or forums. It's my hope that this blog will not make other emetophobes worse.

But back to the book. That chapter aside, most of it was really amazing, and I would recommend it, because any of the CBT exercises can be used with emetophobia. One of the exercises is to write down the symptom (or physical sensation) that you are worrying about, write down your "catastrophic misinterpretation" of the symptom, and then write down all possible alternative explanations for the symptom. My experience a few days ago probably would have been better if I had used this exercise to remind myself how many possible alternative explanations there are for muscle soreness.

When I read these self-help books, I sometimes don't take the time to actually work through the exercises, by writing down responses or repeating ideas to myself on a regular basis. I have tended to think that just reading through them is good enough - especially because most of it is very logical or common sense. The rational part of my brain tells me "that's obvious and easy, and I'll remember it." It's funny, because a bunch of the books even include a warning NOT to think this way and stress how important it is to do the work. When the anxiety disorder takes over, there is no logic or common sense anymore. Reading through all those exercises did not stop me from feeling terrified that I had cancer. It doesn't stop me from worrying that I am going to throw up. I need new thoughts to compete with the negative thoughts I've been rehearsing my entire life, and they won't be there if I don't practice them and drill them into my brain. Sometimes it's as dull and tedious as studying for school, but it's worth it.

dry hands

The cold weather just started, and already my hands are all dry/rough and red from washing them so much. This is an issue I run into every winter. Eventually they get so bad that the skin cracks and bleeds. I try to keep putting lotion on them, but since I'm bound to wash it off within a half hour during the day, it basically only helps to put it on right before I go to bed. Plus most lotions seem inadequate in the face of the damage emetophobes inflict on their hands. The one I have found that helps the most (if I remember to put it on every single night) is Vaseline Intensive Rescue. If anyone else has found anything that works well, I'd love to hear about it.

practice trip

We took another practice road trip this past weekend. We went to the same restaurant, and this time, I got something that I considered to be "unsafe" to eat while out in public. After eating, we drove around the area. We were looking for a particular store, but we never found it. We just kept driving around and got kind of lost in a semi-busy area. Driving in an unfamiliar area and traffic and being lost are all things that make me stressed out, but I didn't start feeling really "sick" because of it, which is exciting to me. I think I am ready for the VA trip. I actually feel like I can handle it. There were many times during the past year when I felt like I might be stuck here forever because of my anxiety, so I am looking forward to getting far away.