RLR
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Well Hello and welcome to the forum. Listen, you're going to be just fine. I promise. Let's spend a few minutes talking about your concerns.
The first concern I want to address is what you are feeling during these fluttering events and what's actually happening. Sensation can be a very deceiving event. Many persons describe what they feel as a buzzing or fluttering of their heart and state that during the event, it also presents them with sort of an overall numbing effect that feels as though they've been briefly shut off from the world around them. It also has been described as is things are in a state of being turned off, so to speak, which is largely what brings about a state of fear, panic in some cases.
The heart, however, is not actually being prevented from doing its job in any manner. Blood is still pumping just as it needs to and the heart's normal pacer is unaffected. What you are experiencing is a parasympathetic spike and it's why the consequence leaves you with the sudden urge to evacuate. Let's look at some physiology to see why this is the case.
The vagus nerve, as you've been reading, is the largest mixed nerve in the body and extends from the brain all the way to the GI tract, where it innervates the area more commonly as the gastric nerve. But let's back up a little so we can see what this nerve is and how it does its job. The nervous system is divided into the sympathetic and parasympathetic tracts. You can think of the sympathetic nervous system as the gas pedal. It's responsible for accelerating the heart rate, respiration, altering blood flow and importantly for this discussion - diminishing GI activity. You see, all of these changes are necessary in response to something known as the fight or flight response, an innate mechanism that prepares the body for either combat or escape from what the brain has perceived through feedback to be danger.
Think of the parasympathetic nervous system then, as the brakes. It's responsible for slowing the heart rate, respiration, returning blood flow to base level functions and again importantly here- increasing GI motility. Fight or flight responses occur quite regularly in all humans at various points in time, with the caveat that this frequency is most typically associated with a salient event with a close temporal relationship. What I mean by that is that something in the immediate environment that is detected by the senses produces feedback to the brain that signals danger, ie a bad dog running toward you with its teeth exposed. The eyes see the dog, the ears hear it and most importantly, the mind has already been trained to such an event, either first-hand or by watching it occur through another medium like television. These sensory inputs immediately invoke the fight or flight response so the body can fend off the dog or run from it.
At this point, the sympathetic nervous system is in full swing and your heart may be racing, you may feel a sinking feeling in your stomach and a sense of extreme vigilence or alterness to the danger to the avoidance of all else around you. Now let's suppose that the dog is suddenly called by its owner and turns the other direction. Now the parasympathetic nervous system is invoked by feedback that you now see and hear taking place. You may experience a pounding heart, a tightening sensation in the throat, and a sudden need to void. Surely you've heard folks exclaim in the presence of such an event; "That nearly made my heart stop!" or "my heart skipped a beat!"
Sound familiar in any way? Well, it should because what's happening to you is derived through the exact same process, the fight or flight response. Imaging that, an entirely normal physiological process that is engaging when there's no bad dog around. How is that possible?
It's quite simple, indeed. Under considerable stress and or anxiety, the body begins to undergo physiological changes that are approximations of the fight or flight response. The brain is receiving feedback that is being interpreted as danger. This typically happens in the patient with health anxiety because they've interpreted these changes as symptoms of something serious. This is not an unreasonable conclusion to derive because they are unable to logically associate it with a salient event, ie a bad dog or similar stimulus. For most patients in this predicament, it's usually the heart that becomes the focus. It's the pump that keeps everything else going and if it's demonstrating even the most subtle change, it's a sign that something is about to go terribly wrong, but with the added feature of absolute unpredictability.
In cases where palpitations have not yet arisen, many life conditions can create anxiety sufficient enough to produce physical symptoms associated with the fight or flight response and others including poor sleep quality, aches and pains, changes in vision, GI disturbances, etc.
If the anxiety event is capital enough, it can predominate one's daily thoughts, turning them more into ruminations that remain fixed in an unpredictable state. In the case of your husband's unfortunate heart attack, it might represent concerns that life that you experience with him could end at any moment, or at least uncertainty about your future together. It's a sense that one's control over their present destiny is being challenged.
CONTINUED IN PART II
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