thoughts on being overcautious

I'm back. I have something very important to share. Here it is!

Nobody wants to have bad things happen to them, especially if those bad things involve harm to their body.

Which you know, of course. That's obvious. But there are related implications that I find very reassuring and that really didn't occur to me for years. Once I realized what this truly meant, it became much easier to calm myself down in a variety of triggering situations.

You want to avoid catastrophes, and so does everyone else. So does our society in general. This is why so much of our world is designed to be easy to use for, let's say, those who don't have a lot of common sense or don't think things through. This is why you'll encounter warnings like don't drink this chemical, don't let your child play with this plastic bag, don't stop the chainsaw with your hands, etc.

Not only do we get these warning labels for almost any imaginable danger, we also have more common warnings drilled into our head by the people around us, pretty much from childhood. Don't go swimming during a storm. Don't get in a stranger's car. Everyone learns the general scenarios that could lead to danger, and, depending on their personality, respond with varying levels of caution.

Which brings me to you, unfortunate person with severe anxiety. I am guessing you're extra cautious when confronted with any of those scenarios or warning labels. I am guessing you also have a wide range of scenarios you have decided are dangerous all on your own, without anyone else telling you so (or agreeing with you) and are constantly doing your best to avoid those scenarios or take (most likely unnecessary) steps to make yourself safer.

But remember, nobody wants to have bad things happen to them. Especially if those bad things involve harm to their body. And with regards to whatever you fear, ask yourself: if there was an actual danger of this behavior or situation causing harm to my body, wouldn't I have heard about it before? Wouldn't I have heard or read something, somewhere, about it potentially causing harm?

If eating parts of the apple too close to the stem could cause me to get sick, wouldn't I have heard about that?

If this dental procedure I'm about to go through was likely to make me vomit, wouldn't I have been told that was a possibility?

If watery sour cream or watery yogurt was a sign that it was likely to be bad in some way and give me food poisoning, wouldn't that be one of those things that I was warned about all my life?

Those are just a few of my own personal examples.

I don't know how to stop these little worrying thoughts from popping into my head, as they still do, regularly. But I have found this line of thinking to be an effective countermeasure, a way that I'm often able to dismiss the worry.

If anything has a good chance of making you get sick, it's incredibly unlikely you wouldn't 1) already know about it or 2) be warned beforehand.

in remission

Hello friends. How have the last two years been for you?

I definitely did not intend to stop posting here in such an out of the blue way. Life got very busy, or maybe I should say it's been one giant change after another. I feel like if I put the me who wrote the last post and the current me next to each other, in terms of anxiety, in terms of perspective on life, they would not be recognizable as the same person.

I moved to a new place. I started a new job. I met new people. I had to travel a bit for the job. I had to do public speaking for the job. I had to do a lot of things for the job that forced me to power through intense anxiety, which, as you might expect, has led to me being somewhat desensitized to a lot of situations that used to make me panic (or that I would constantly avoid).

My emetophobia is essentially dormant right now. It's still there, it will always be there, but it's the quietest it's ever been. It basically tells me to avoid sick people and make sure I have clean hands before I eat, and that's about it.

I'm summarizing, because this is a blog, and the actual details could fill a book. At least if I allowed myself to go on as long as I'm naturally inclined to.

But I don't want to give the impression that this muting of my emetophobia happened quickly or easily (or even that healthily). I pushed myself way too hard the past couple years. I powered through way more than I should have, for way too long, and the stress broke me down. I am still experiencing a lot of anxiety (it has just shifted and is currently attached to other things more so than vomit) and depression.

So, as much as I wish I could say this is a perfect success story, that I conquered emetophobia completely and am a role model for anyone still struggling, that is laughably untrue. I'll probably never be free of mental illness; it likes to morph into different forms year to year, but it sticks around.

That being said, emetophobia has been one of those forms for about two decades, and I never thought it would (or could) get to the point of having this little effect on my life.

I remain a walking encyclopedia of tips for coping with emetophobia (this will always be the case, I'm sure), and ... that's all. I'm around. I'm here if anyone needs anything, or if there is something in particular someone wants me to blog about. Email (lilandbody@gmail.com). Or leave a comment. Or contact me through tumblr. Hope everyone is well. Love to you all.

marriage, emetophobia style

The other day I woke up to this note on our dry erase board:

"FYI - there's a baggie of carrots for you in the fridge, ready to eat. I removed any w/ spots or that were 'funny looking.' I love you!! <3"

I seriously have the best wife ever. I am so lucky to have someone who understands this phobia so well and is willing to offer constant support.
 

some analysis

**Just a quick warning. I went into some detail about the act of vomiting in the post below (not in the sense of a personal anecdote, just in the sense of dissecting the act).**

It's still really cold and snowy/icy where I live, and I haven't been leaving the house much, so things have been calm. I did see the movie Frozen (it was amazing) and had my usual movie theater experience of feeling "sick" and anxious for about half the film. I was enjoying the movie so much that I kept ignoring my strong impulses to leave because I didn't want to miss a single second. What's funny is that I was incredibly distracted by my worrying and didn't even realize it at the time. I got the gist of what was happening, but when I re-watched the movie later at home, there were so many lines of dialogue and song lyrics I hadn't fully heard the first time - little details that made me love the movie even more.

Other than that incident, I've been doing really well. I'm pretty sure that's the only time in the past month my phobia has been an issue.

I've been thinking about how weird this fear is. Here's what I think is the strangest thing about it: it seems (to me at least) that vomiting would be less terrifying to me if you were to take away any of the individual components that make up the act.

I don't think I'm alone in this. I've seen other people online say things like "if there was no nausea, I could handle it" or "if it didn't taste bad, I wouldn't care that much." We could all be wrong, since there is no way to test these theories, but it's fascinating to me thinking about all the ways the act of vomiting could be slightly different and how any one of those alternatives seems better than what we have in reality.

What if it came out of a different part of our body than our mouths? That seems like it'd be fine. How bad could that be, if it came out of the foot or the elbow? In fact, that scenario would rid us of other components too - the taste and the feeling or fear of choking.

What if it all happened exactly the same except that there was no unpleasant feeling of nausea right before? That doesn't sound so bad either. None of that awful sensation of the sick feeling building up, getting worse and worse.

What if it was completely controllable? If you knew without a doubt you could decide when and where it happened? This is the one I would vote for. I think most of all I hate the idea of the suddenness or surprise of it, and how little control I have over it.

Somewhat related - what if you couldn't have complete control over it, but you did get a clear unambiguous warning sign at least a few hours in advance? Something like the tips of your fingers turning blue, where then you would know there was no going back. A little scary, but at least then you could start planning your next steps. None of that back and forth "will I, won't I, is this in my head?" crap.

What if it always tasted really delicious, like chocolate? I'm unsure of how I feel about this one. I'm not convinced it would lessen my fear that much, but I've seen other people say they think this would work for them.

What if it was all the same, but there was absolutely no social embarrassment that came along with it? I am always afraid of it happening, even when I am alone at home, but I am much more afraid of the idea of doing it in front of other people. If there was no social stigma, no reaction of disgust, or if people reacted to it as calmly as they react when someone sneezes, I think I would be much less bothered in general. Along the same lines, what if it wasn't indicative of something bad happening inside your body? Obviously this is why the social disgust exists, because people know you could have some illness and instinctively want to protect themselves. If it was just something that happened occasionally (like a cat's hairballs?) and wasn't a warning sign that you were sick, extremely drunk, or had some kind of food poisoning, I don't think it could be as big a deal to anyone, either the person experiencing it or the onlookers.

In a way, I find it comforting to take it apart like this and see that it's something that is made up of many horrible things, and it's the combination of all of those parts that makes it so overwhelming and scary. I don't know why. I feel like there is some bit of hope or wisdom to be found in this thought process, but I'm not sure what it is yet.

account of living with emetophobia

I came across this post on tumblr the other day describing what it's like to have emetophobia. It's a really good explanation of the various associated behaviors. My favorite part (so true, and the reason why I think emetophobia is in a league of its own when it comes to phobias in general):

"I’m scared of spiders, but my fear of spiders doesn’t spawn new spiders to come after me. However with emetophobia, my fear of vomiting creates a very real sick feeling."

This is why I wish there was more psychological research being done on emetophobia specifically (and similar anxiety issues, like general health anxiety), because this kind of physiological feedback loop adds another dimension that people who are afraid of heights or dogs or clowns are not experiencing.

infographic / spreading awareness

The Emetophobia Recovery website made this great infographic explaining the phobia, something that is easy to share via facebook, twitter, etc. Everyone should check it out!

 

list of self-help books

I'm pretty sure I've talked about all of these books before in other posts, but I thought it might be helpful to have them all listed in one place.

If you're not able to get any of these, please check out this post where I linked to some great free websites that help guide you through anxiety-fighting techniques.

1) The Anxiety & Phobia Workbook - Edmund J. Bourne

If you can only buy one book from this list, this should be the one you get. In my opinion, it is the best book on anxiety out there. It covers so many different skills, techniques, and exercises. It has information on all the different anxiety disorders, anxiety-related research, types of medication, good nutrition and exercise habits, etc.

The only downfall is that if you're in the middle of an anxiety crisis, the amount of information it contains can be a little overwhelming. If you are feeling overwhelmed, I wouldn't sit down and read through the entire book all at once. It is more manageable one chapter at a time. Each one gives you so much to think about that it is probably better to take breaks anyway, just to let it all sink in.

2) Cognitive Behavioural Therapy Workbook for Dummies - Rhena Branch and Rob Willson

This book was very helpful for me. I was new to trying any kind of CBT work, and it lays out the methods in simple, easy to understand ways. It has tons of exercises to work through (charts to fill out, questions to answer) to understand the faulty/irrational ways you think/act and to help you correct those thoughts and behaviors. It also includes chapters on using CBT to help with depression, low self-esteem, maintaining relationships. I skipped most of that and only worked through the anxiety-focused chapters.

3) Get Out of Your Mind & Into Your Life - Steven C. Hayes and Spencer Smith

I've been meaning to take a second look at this one. I really didn't care for it when I started working through it the first time. It focuses on acceptance and commitment therapy (ACT), and I am a much bigger fan of CBT than ACT. ACT teaches that rather than trying to control your thoughts, you should just accept them and learn to live your life with the anxiety (or other unpleasant emotional pain), still doing everything you want to despite the problems you have.

For one thing, I feel it is possible to control your thoughts and change your behaviors. It's extremely difficult, but I have seen it happen in small ways with myself. For another thing, when it comes to emetophobia, I get confused as to how you can just accept it the way it is and push yourself to live your life. But I don't think I got far enough in the book to be able to say I fully understand their method.

4) Living with Emetophobia: Coping with Extreme Fear of Vomiting - Nicolette Heaton-Harris

I wrote a detailed post about this book after I read it. To summarize, I feel it is a helpful book if you are looking for validation of your issue, a detailed description of your problem and everything you have to deal with, or if you want someone else to understand and you are looking for a book to explain emetophobia to them. The book is about the author's experience of living with emetophobia, and if you have emetophobia too, it's likely you'll relate to most of it. It's also likely that there are some anxiety thoughts that the author has but you don't have, and the book could be triggering in that sense. You could end up acquiring new anxiety thoughts/behaviors, so I would be careful when reading this one, if you decide to.

5) The Miracle of Mindfulness - Thich Nhat Hanh

This book is an in-depth look at meditation and mindfulness, two techniques that can be helpful in fighting anxiety. There is also a lot of Buddhism in the book. I'm not a very religious or spiritual person. But you can skim past those parts. I would say probably the best part of the book is near the end, the section called "Exercises in Mindfulness". There is also a section after that called "Selection of Buddhist Sutras" - both of these sections can give you ideas to help with meditation or mindfulness.

6) Overcoming Health Anxiety - Rob Willson and David Veale

This book is similar to the CBT workbook for dummies. It walks you through CBT techniques and exercises, only in this book it specifically applies them to health anxiety. I have a lot of general health anxiety on top of emetophobia, so I found it really helpful.

The book also contains a chapter dedicated to emetophobia. I didn't think that chapter was as helpful as the rest of the book. I would say the same thing about it as the Living with Emetophobia book described above - it is a good description of emetophobia, but it could be triggering and give you more things to worry about that you hadn't been worrying about before. It had that effect on me, but luckily, by now I think I've forgotten all the new worries it gave me. If I was reading the book over now, I would just skip that chapter. The exercises in the rest of the book can be applied to emetophobia as well as any other health anxiety.

7) Freedom from Obsessive-Compulsive Disorder - Jonathan Grayson

I don't have OCD, but during the time period where my anxiety was the worst, I started having a bunch of horrible intrusive thoughts/obsessions that bothered me even more than my emetophobia. I bought this to try to figure out how to deal with those, and it is an amazing book. I would actually recommend it to anyone with an anxiety problem, even if it's not OCD.

The premise of the book is that for people with OCD (and I would say any anxiety disorder), their main problem is that they are unable to accept uncertainty in life. This is so true for me, and it's something I've thought about frequently ever since reading this. So if I was worrying I was sick, instead of telling myself that it is extremely unlikely that I will get sick and in CBT-fashion using logic to try to prove that, I would tell myself "you might get sick, and you should deal with that possibility because the alternative of not being able to deal with it is ruining your life." I suppose it might be similar to ACT (acceptance of anxiety versus fighting it), but the way the author related it all to the fear of uncertainty made so much more sense to me. The book also focuses on exposure and response prevention, or exposing yourself to your fears and then preventing yourself from engaging in irrational behaviors as a result.

Just a warning, a large chunk of the book deals with specific OCD problems, like checking, counting, etc., and if you don't have those issues, there is probably no need for you to read any of that. I felt the rest of it was worth getting through those (for me) unnecessary sections.                

irrationality, exhibit A

This morning while I was still sleeping (about twenty minutes before my alarm was set to go off), one of the neighbor's kids started coughing right outside the window, and it woke me up. I wasn't alarmed at first, but it kept going on and then started sounding more like choking and gagging. I pulled the covers up over my head, covered my ears, and started humming really loud. I could still sort of hear it in the background, so I hummed until I wasn't catching snatches of it anymore. I have no idea if anything even happened or if the kid just coughed for a while, but I've still had about a thousand worries today related to this 15-20 second event, starting with the ridiculous idea that the germs might come through the wall or window. Almost every real or far-fetched way illness could reach me is running through my mind. I've been doing so well this winter, not obsessing over contamination, and I'm finding it really annoying. I guess I always hope the thoughts are gone, but really it more seems like they just settle down temporarily. Like the thoughts are leaves and anxiety is a wind. The wind's picked up again, so the leaves are flying around all over the place. It's such a pain. Even if the kid did actually get sick, I know I have no more reason to think and worry about this than I do on any other day, days when other kids in other places might be getting sick without me there to see or hear it. It's just been a while since any of my senses have been exposed to it. If it even happened!

And the tune I hummed to myself was pitiful. In my fear, I couldn't think of one specific song to commit to, so what I came up with barely qualified as musical at all. It got me thinking about how maybe I should pick a song now to use if this ever happens again, which then got me thinking about the movie My Girl. Remember Vada and her "do wah diddy" meltdowns? Maybe I'll just steal hers, it's a pretty good one.

Joking, by the way. Believing I'll be able to handle the next situation is probably a better idea than picking a "panic song."

internal weather

At times, this phobia has made me feel hopeless. Only when it is at its worst, thankfully - those periods where I am feeling sick and anxious all day every day. It doesn't take much of that before I feel like I am living in a state of despair and that there may not be anything that exists outside of that state. Then feeling and thinking that way starts to scare me in itself. I spent a lot of time online during these moods, searching for anything that could make me feel a tiny bit more hopeful. I came across this letter one day, which had a huge impact on me, and now I always think of it when I'm having a hard time.

I just love the metaphor of the weather and the idea that the best course of action is to wait it out rather than fighting it. You don't stop living your life when it's raining, but you also don't run out and yell at the rain to stop or try to come up with some crazy involved plan to control it. You don't ever say to yourself, "well, that's it. I'll never see the sun again."

In my mind, I was absolutely convinced that my personal "sun" was gone forever, but it came back, because it will always come back.

happy new year

Happy New Year! I hope 2012 is a great year for everyone. I feel optimistic that it's going to be a better year for me. 2010 was a crazy hurricane / whirlwind of anxiety. 2011 had its intensely bad moments too, but it was better than 2010, so I seem to be heading in the right direction. Also, I am determined to get it together this year and actually do the work I need to do (like eating healthier, doing CBT, etc.). I had to go back to my long list of New Year's resolutions and revise it into a plan that I think is realistically achievable. This is something I've never done before. For some reason, letting go of the idea of "perfection all at once" tends to fill me with a squirmy reluctance to try anything at all. But that reluctant feeling wasn't as strong this year. More evidence of progress!

So the last book I ended up reading in 2011 was Living with Emetophobia by Nicolette Heaton-Harris. I bought it months ago, maybe around September, but I have been putting off reading it, because I had heard that it was mostly a long description of emetophobia, and I had a feeling it would only end up upsetting me or triggering me in some way. I figured it would not be helpful at all but might add more irrational thoughts or behaviors to my list. A few times, reflecting on that, I thought about never reading it. But since it is pretty much the only book on emetophobia out there, and I am writing about the same topic on a regular basis, I had to check it out.

All the reviews I heard were correct. The book mostly explained emetophobia in depth, all the different thoughts or behaviors an emetophobic person might have. I could relate to most of it. Some of it made no sense to me. (Am I the only emetophobe that doesn't feel compelled to look at someone who may be getting sick? When I see a car parked on the side of the road, I shut my eyes or look away and feel no urge to witness what I fear might be happening.) In addition to the explanations and personal stories, there were about four pages of advice on how to cope, including nothing more advanced than deep breathing, distracting yourself, and taking small risks whenever possible to try to expand your comfort zone.

But as bad as I felt it was objectively, I am hesitant to really criticize it, because it exists, at least. It's something that takes emetophobia out of just the Internet world, and I have to think it has had some positive impact in giving the problem more weight / attention. Also, if what an emetophobic is looking for is validation of their issue and the knowledge that they are not alone, the book does provide that.

Unfortunately, I'm way past that. Thanks to the Internet, I've known for years what the name of my issue was, and I've read stories from and talked to many people who are also dealing with it, and I'm betting that's the case for most of the emetophobes of my generation. It's not enough anymore. I'm not looking for someone to swap horror stories with. In fact, I generally feel like it might not be a good idea for me to ever meet another emetophobe in person. The idea of emetophobia support groups all over the country raises some doubts in my mind. Would we not just feed off each other? If half of us in the meeting felt nauseous from anxiety at being at the meeting, and the other half found out about it, wouldn't we all just be scared one of us might be legitimately sick? I don't know.

My real issue with the book is that I felt a little damaged and hopeless after reading it, and that feeling stayed with me all night. I rang in the New Year with a vague feeling of sadness at knowing that this phobia touches every part of my life and that there is no cure for it. I don't think the author meant to leave the reader with that impression, at all. But I feel like she spent 95% of the book talking about all the ways emetophobia manifests in a person's life and then ended the book with the message that it could be contained but not cured. It's hard not to focus on the bad parts of that instead of on the ray of hope that is "containment."

This morning, though, post-sleep, I felt better and able to see it all in a more positive light. Containment may be settling, but that doesn't mean it dooms me to a life of unhappiness. Everyone is settling for something in their life. Like someone might have a bad ankle because of an injury when they were young. Of course it would be better if they didn't have to deal with that, but they do, and they work around it. I know from experience exactly how contained emetophobia can be. In college, it was there, but I rarely felt upset about it. I wasn't doing anything special to contain it. It was just out of luck, I guess, or maybe because I had so much going on (schoolwork, friends, events) to distract me from it.

So that's my hope for 2012, that I can get my phobia as contained as possible. With the knowledge about managing anxiety that I have now, I should be able to reach a level of containment even better than the one from college.

And if I want to be wildly optimistic, I have heard of some emetophobes who have been able to cure themselves. Plus with more research into it, maybe a cure that works for everyone will be discovered / developed. It's possible.

dream-sick

I decided to keep a dream journal this year, just for fun, because I love dreams and attempting to analyze them. I also kept a tally of how many times I dreamed about a particular person or thing. So, for example, I dreamed about my mom 97 times this year, I dreamed about being at work 52 times, etc. That I can remember, anyway. The other night I got curious about emetophobia-related dreams and reviewed every dream I had about vomit. I dreamed about it 29 times (it ranked 33 in my list of 143 people/things).

When I've seen other emetophobics talk about their vomit dreams on forums/blogs, usually they say the dreams cause them a lot of distress, that they are nightmares even. I wonder if this is the "norm" for emetophobics or if those people are just the only ones who talk about their dreams because of the fact that they are in distress over them. It's not the case for me. I think I dream about vomit pretty frequently, but I don't usually feel upset about it, either in the dream or after I wake up. I wouldn't consider any of the dreams I had this year to be nightmares. These are the categories I could divide them into:

-- seeing vomit or mentions of vomit on a sign, in a book, online, or while watching TV (9)
-- hearing someone is sick, has vomited, or might vomit but don't actually see/hear them do it (6) 
-- someone I recognize vomits - people I know or "dream friends" (5)
-- a stranger vomits (4)
-- my cat vomits (3)
-- I vomit (2)

I will feel anxiety in the dream, but it's like a muted "dream anxiety" that is really more shown by my behavior in the dream than actually felt. I will cry, hide, run away, obsess about it, avoid anything I think may be contaminated, etc. All the standard behaviors from reality. But the anxiety doesn't wake me up or cause me to feel upset after waking up and remembering it. It's maybe more like a general rehearsal, since I so rarely encounter vomit in reality.

Also, in dreams where I get sick myself (and they are so rare that even having two this year seems excessive to me), I usually don't feel sick. Sometimes I am doing it intentionally (for example, in one I was engaged in a vomit competition with someone), and it's easy and laid-back. It always feels like liquid spontaneously appears in my mouth without actually coming from my stomach.

This really has nothing to do with coping with emetophobia. I'm just sharing out of nerdy curiosity. I'd be really interested to hear what themes or patterns other emetophobics have encountered in their dreams.

wisdom teeth

Not much has been happening. My anxiety has been extremely manageable since we got back home from the trip. I'm amazed - I definitely wasn't expecting things to go this well. But since they are, and I have nothing new to report, I'm going to post an old story. I got my wisdom teeth removed about two years ago. It was an experience I was dreading, because I felt sure it would put me in danger of throwing up. But it actually turned out completely fine, and I consider it one of my greatest successes ever. I'm so glad I didn't chicken out, because now I know I don't have to worry about them ever again.

So it started out with a consultation with the dentist who was going to perform the surgery. That part was awful. He was definitely not skilled in dealing with anxiety issues. I had envisioned that the consultation would be in a quiet back room with a closed door, but it was in a little examining room right next to the front desk, and he left the door open the whole time. And he talked incredibly loudly. I was of course trying to get all my points across the same way I had rehearsed them earlier, but after I mentioned the phobia, he started talking (shouting) about the possibility of me getting sick and how I was afraid of getting sick, and I was very aware of the fact that the people at the front desk could hear every word. I guess dentists don't expect you to be self-conscious.

He didn't have any comforting information either. He said that even prescribing me a strong anti-emetic might not keep me from getting sick, because 1) most people get sick immediately after the procedure before they've had a chance to take it and 2) people won't usually take it until they start feeling nauseous. Plus if they are going to sedate you, any kind of sedation makes you nauseous, so he said they already add anti-emetic to the drip and that none of it is any guarantee. Then he said 5% of people or 1 in 20 will throw up, and usually it is from the pain medication. He recommended sedation for me, based on my X-rays, and he said he thought everything would be uncomplicated for me. But obviously he didn't see the vomiting thing as a big deal, no matter how much I tried to make him see it that way. He prescribed me two anti-emetics, a regular one and then a more expensive one that he said was super strong. This was my first experience with prescribed anti-emetics. I later found out the super strong one was Zofran. Of course I planned to use that one, because I wanted the strongest one possible.

I was pretty freaked out when I walked out of there, but it still seemed like I could possibly avoid getting sick. I decided I would take the anti-emetic before the procedure, I would not be sedated, and I would not take any prescribed pain medication.

The morning of the procedure, I took the Zofran before even leaving the house. It dissolved on my tongue easily and tasted okay but had kind of a bad after-taste. I didn't notice any bad side effects from it either. I also had three 45-minute Kathy Griffin comedy routines on my iPod so I would have something really hilarious to distract me during the surgery.

The first thing they did was put two giant Q-tips in my mouth with a bad-tasting goo on them to start numbing my mouth. Pre-numbing to get me ready for the long needle that really numbs you. Then the doctor gave me about eight shots with the long needle. I only felt an uncomfortable pinching sensation. After that, they told me good job, I had gotten through the worst part of it. I did not believe them. But it was true. I felt no more pain after that.

I was left alone for a while, and my mouth, lips, chin and even the sides of my face up to my ears got extremely numb. Then the doctor came back, and he and an assistant went right into the procedure. It all started so fast I hadn't had time to start my iPod, so I was fumbling with it while they continued shoving tools in my mouth. I finally got it playing, and as soon as I did, I shut my eyes really tight because I knew it would be bad to see anything that was going on. They started drilling, and the drill was so loud I couldn't hear the iPod anyway. I was just catching snatches in-between, and I couldn't really concentrate on it, because I was focused on the pressure and the sounds and wondering exactly what they were doing to me and marveling at the idea that they were hurting me extremely badly, but I could not feel a thing. They were having a pleasant conversation the entire time. I wasn't really paying attention, but they were laughing and talking like they were just sitting down having coffee.

I only had two wisdom teeth, both on the bottom. They started with the right side, and after probably three to five minutes at the most, they stuck a wad of gauze in there and switched to the other side. I wondered if they were done but couldn't really believe it could be so. They spent the same amount of time on the left side, and then they stuck a wad of gauze there too and said I was finished. I "said" (mumbled) "really?" and they said yes, and the doctor said that I definitely wasn't a patient that needed to be sedated, and that most people needed to because they couldn't handle the stress of it. I was shocked by all this, shocked that it was over, shocked that I was pretty comfortable the whole time, shocked that they were making it sound like I was one of their least anxious patients.

That was it. Then the assistant gave me a speech about how to take care of my mouth and what I should eat that day (cold, soft foods). I had a bunch of questions I wanted to ask her, but I couldn't speak. I don't remember what they were, but I guess they weren't that important, because it all turned out okay. Later on, when the anesthesia wore off, my mouth felt extremely sore, but it was not the terrible pain I had heard described by other people. I think I took some Aleve for the pain, nothing else.

The end. I know the experience will be different for each person, but I wanted to share my happy ending. Everyone I had ever talked to about it had made it sound like a nightmare of excruciating pain and unavoidable sickness. Maybe I got lucky, or maybe people just love to exaggerate this type of story in a bizarre "whose life sucks more" competition. I couldn't say for sure. With all the horror stories, it was only my fear of facing worse problems in the future from not getting the teeth removed that pushed me into it, but I'm really so glad I got it over with.

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. 

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.

winter

We had our first snowfall this past week, and it snowed again last night. There is still some left on the ground this morning. It's beautiful, but it signals the start of winter to me, or as emetophobics refer to it, the season of illness. So it's leaving me with a general feeling of dread.

I haven't been sick at all in the past two years, not even a cold. Which is not normal. I used to get a cold per year like most people, and I'm guessing the reason for my healthy streak is that I started working from home two years ago, so I'm no longer in an environment like a school or office where illness spreads around like crazy. You'd think it would be reassuring, but I just keep worrying - will I get sick this year, and will it hit me harder than usual since it's been a while? I am taking that class now, so I'm back in contact with the notoriously unhealthy college crowd. Plus I've been trying to force myself to go out places as much as possible. Which is of course a good thing, a great thing. It's sad that I keep having to remind myself that it's not worth trading all life experiences to avoid a mild illness once in a while.

I've been reading other emetophobia blogs out there, and some of these people have so much more contact with vomit than I can imagine having. This woman Robin in particular amazes me. It seems like she has to deal with vomit frequently because of her kids, and she also has gotten sick herself due to morning sickness and a stomach virus in the past few years. She has survived and even kept a positive attitude throughout all of it. It makes me start to think brave thoughts like 'wow, does this even matter? I'm sure I would survive it too. Why am I so worried about this all the time? I should just never think about it again.'

But then an hour or so goes by, and I feel something "weird" in my body, and everything brave or rational goes out the window. I keep getting a scratchy throat (from our heater, I'm assuming), and even though I know it can't be from illness, I still worry that it is. I try to ignore it, but it actually causes my appetite to go away. Then I have to force myself to eat, and when I do, I feel anxious the whole time. If I try really hard to focus only on my stomach, I will realize that I feel absolutely nothing there. But emotionally, I feel like I am moments away from throwing up. It's bizarre.

emetophobia survey

Friday night of a hectic week. Sounds like a good time for a survey, followed by a lot of lying around and not working for two days. I've seen this posted a few places - not sure where it came from originally.

1. Does your family know of your Emetophobia? I don't think so. To make a long story short, we have serious communication issues in my family.

2. Do your friends know of your Emetophobia? Yeah, probably all of them do. I'm pretty open about it.

3. Would you tell a stranger that you have Emetophobia? I guess it depends. I think the only strangers I have told are doctors / dentists so that 1) they would prescribe me anti-emetics 2) they wouldn't prescribe me anything with nausea or vomiting as a main side effect. It doesn't usually come up in normal conversation for me.

4. If you are currently in a relationship, how long did you wait to tell your partner? We were friends for a while before we started dating, so she already knew all about it.

5. Are you scared to have kids? Of course. But underneath all the fear, I don't think I want kids anyway, so I'm not too concerned about it. My life is pretty stress-free compared to the average person's life, and I have a hard time handling that tiny amount of stress. I can't imagine adding the stress of raising children to that. 

6. If you are a mom who suffers from Emetophobia, how do you deal with the struggles of your kids being sick? N/A, but I'm sure I wouldn't deal with it well at all. I feel panicked even when our cat throws up and usually run to hide in the next room.
 
7. What age did you discover that you had a problem? I was around 11 and found a website describing emetophobia. I can't remember if I was actively looking for an explanation. I had recently had some problems with missing a lot of school because of "feeling sick," so maybe.
 
8. What type of methods have you tried to reach recovery? I've never really believed I could get rid of the phobia completely, but to cope better, I have tried just about everything. Exposure therapy, talk therapy, CBT, ACT, affirmations, all the basic relaxation techniques (meditation, progressive muscle relaxation, deep breathing, visualization), yoga, mindfulness, and hypnosis. Most of this I still do, because I find it all helpful. The only thing I haven't given a fair chance is long-term medication. The side effects scare me too much, so both times I tried it, I stopped after the first dose. 
 
9. When was the last time you have thrown up and why? I was nine years old, and I'm pretty sure it was just a basic stomach virus.
 
10. When was the last time you saw someone else throw up? I'm not sure I remember. I've done a really good job of avoiding seeing it, even if all I could do was shut my eyes or turn my back on it. I feel like my last "direct experience" with it was December 2007 when I went into a stall in a communal bathroom in my college dorm building and then heard the girl in the stall right next to me start throwing up. I ran out right away.

11. What type of foods do you avoid? I don't think I avoid any food all the time, it's more situational. I avoid cooking any raw meat myself, because I don't trust myself to do it right, plus I don't want to deal with that kind of "contamination" stress. I hate trying anything new, so usually I make my wife try it first, and if she doesn't get violently ill from it (she never does), I might have some. I'm afraid of restaurants I've never been to before, so I try to stick with chains. Same for groceries - I have my safe "brands" and hate buying a different brand or the generic brand. When I know I have to go out somewhere, or when I am already in public, I try to go for simple / bland foods only like sandwiches or pasta. Oh, and I always avoid alcohol. The only alcohol I've had in my life was a tiny sip of champagne when I was really young (New Year's Eve).

road trip

In a month, we're going to be taking a trip to Virginia to visit family. We'll be driving, and the drive down there takes about 12-14 hours. I'm starting to get really nervous about it. The last time we took a road trip, it was to a city about three hours away. I had a horrible anxiety attack during the drive, and the stress of it not only ruined the trip, but it stayed with me for months even after getting back home.

As a test run, we are taking another smaller trip this weekend to upstate Vermont. This drive will only be one and a half to two hours, nowhere near the length of the VA drive, so maybe it isn't the most challenging test run possible, but that's probably a good thing. I think what I really need is some confidence-boosting, and hopefully this is small and easy enough that it will be a complete success. Plus we're going to be eating breakfast once we get there, in a diner that I've never been to before, so that will make the whole experience a little scarier. My goals are to eat a small snack before we leave, eat a normal-sized breakfast at the diner, and keep my anxiety down as much as possible.

It's already starting to get cold here, and we have had to turn our heat on a few times in the past week. Not being used to it, I got a mild sore throat for a couple days, and ever since then, I have been on edge about every tiny little thing happening in my body and have convinced myself several times that I am coming down with some illness. I'm seriously frustrated with myself. I don't think I have been working hard enough at fighting these irrational thoughts. I've been neglecting affirmations. I'm going to take a list of them with me on this car trip so that they will be easily accessible if/when I get anxious.

"I don't need these thoughts. I can choose to think differently."

online study

I think I may be the last person in the online emetophobic community to come across this, but just in case that's not true:

www.emetstudy.org

It's an online treatment program / study. I signed up for it, and I'm really excited.