How to stop freaking out about medical symptoms before appointment?
April 19, 2019 7:10 AM Subscribe
I suddenly developed problems swallowing. I have an appointment with my primary care doctor next week. How do I shut up the endless worst-case scenarios running through my head?
I’m terrified this is cancer. (I’ve had issues with heartburn in the past, which can increase the likelihood of developing esophageal cancer). Every meal reminds me of my symptoms, which sends me into a spiral of catastrophic thoughts. I don’t know enough to know if there are non-cancerous causes for my symptoms, and I know searching the internet is a bad idea. I don’t currently have a therapist and it’s unlikely that I’d be able to see one prior to my doctor’s appointment.
Any strategies for dealing with the thoughts would be helpful.
I’m terrified this is cancer. (I’ve had issues with heartburn in the past, which can increase the likelihood of developing esophageal cancer). Every meal reminds me of my symptoms, which sends me into a spiral of catastrophic thoughts. I don’t know enough to know if there are non-cancerous causes for my symptoms, and I know searching the internet is a bad idea. I don’t currently have a therapist and it’s unlikely that I’d be able to see one prior to my doctor’s appointment.
Any strategies for dealing with the thoughts would be helpful.
Without requiring you to do any internet research, I can tell you:
1. There are many, many non-cancer causes for swallowing difficulty, ranging from anxiety to heartburn to other structural stuff to treatable pre-cancerous changes to just being one of those people who is sort of a "super-feeler" who notices sensations that the average person does not.
2. I had trouble swallowing for a while and had a bunch of tests (you may have this opportunity too!) and it was stress plus acid reflux. I was also very freaked out. Paying attention to it was, as you surmise, making it worse.
3. If you are an anxious person, you can absolutely somatize real-feeling symptoms. I do this very skillfully and often cannot tell the difference between "real" and somatized symptoms.
4. The only thing that works for me when I'm anxious is to very firmly, consciously re-direct my thoughts. I find that having a sort of "mantra" like "I will worry about this when I am diagnosed and NOT before" followed by watching a funny video, reading a familiar book, etc is the only thing that works. I also have a very detailed visualization exercise when I'm stressed and trying to fall asleep.
These things work better the more often you do them - the first few times they won't work too well, but the develop their own gravity if you stick with them. The mantra now really does act almost as a switch for my brain, for instance, and the visualization exercise literally makes me sleepy because I've trained myself to associate it with going to sleep. You can start doing them now and build practice.
5. One thing that helps me in general: A long time ago, I thought I had [very serious degenerative condition] because I had some of the onset symptoms. I was always googling "serious condition and symptom" and got the impression that the symptom I had was always associated with the disease. Later, poking around, I realized that the symptoms are associated with a host of minor and benign conditions, one of which I have. It really taught me that in general, the kinds of ambiguous symptoms that you're experiencing have many, many, many causes, the vast majority of which are benign or at least not life-altering.
posted by Frowner at 7:31 AM on April 19, 2019 [14 favorites]
1. There are many, many non-cancer causes for swallowing difficulty, ranging from anxiety to heartburn to other structural stuff to treatable pre-cancerous changes to just being one of those people who is sort of a "super-feeler" who notices sensations that the average person does not.
2. I had trouble swallowing for a while and had a bunch of tests (you may have this opportunity too!) and it was stress plus acid reflux. I was also very freaked out. Paying attention to it was, as you surmise, making it worse.
3. If you are an anxious person, you can absolutely somatize real-feeling symptoms. I do this very skillfully and often cannot tell the difference between "real" and somatized symptoms.
4. The only thing that works for me when I'm anxious is to very firmly, consciously re-direct my thoughts. I find that having a sort of "mantra" like "I will worry about this when I am diagnosed and NOT before" followed by watching a funny video, reading a familiar book, etc is the only thing that works. I also have a very detailed visualization exercise when I'm stressed and trying to fall asleep.
These things work better the more often you do them - the first few times they won't work too well, but the develop their own gravity if you stick with them. The mantra now really does act almost as a switch for my brain, for instance, and the visualization exercise literally makes me sleepy because I've trained myself to associate it with going to sleep. You can start doing them now and build practice.
5. One thing that helps me in general: A long time ago, I thought I had [very serious degenerative condition] because I had some of the onset symptoms. I was always googling "serious condition and symptom" and got the impression that the symptom I had was always associated with the disease. Later, poking around, I realized that the symptoms are associated with a host of minor and benign conditions, one of which I have. It really taught me that in general, the kinds of ambiguous symptoms that you're experiencing have many, many, many causes, the vast majority of which are benign or at least not life-altering.
posted by Frowner at 7:31 AM on April 19, 2019 [14 favorites]
You’ve made responsible arrangements for taking care of your health (scheduling a doctor’s appointment) so anything you can do yourself is already taken care of. If the worst is true, then you’ll find out shortly after your doctor’s appointment, and you’ll be feeling the same feelings of worry, fear, sadness then. Why spend an extra week in that place? If you spend this week believing the best case scenario is true, then in the worst case scenario, you’ve spared yourself a week of misery, and in the best case scenario, you didn’t devote a week to worrying about nothing.
posted by sallybrown at 7:32 AM on April 19, 2019 [2 favorites]
posted by sallybrown at 7:32 AM on April 19, 2019 [2 favorites]
The two statistically most common causes of difficulty swallowing are:
Anxiety
and
Swollen glands
You are ninety-something-big percent likely to be having this symptom because of anxiety and your worry about cancer is additional evidence of that. If you were thinking, "huh, probably not cancer but this has been going on for awhile, better get it checked out" it would be more likely to be cancer because you aren't getting distressed, but you are getting distressed, so that adds to the probability of anxiety being the cause.
Prod your neck and throat gently up and down and try to find sore lymph nodes. If you can find sore lymph nodes then it's probably an infection. Sore lymph nodes are not a symptom of cancer.
Have any of your friends, family, co-workers or acquaintances come down with mono, snotty colds, throat colds, flu or colds in the lung? If so, you are probably about to develop more symptoms, or they will magically disappear. In any case, treat yourself like you are about to come down with the yucky-uckies, drink hot soup, take vitamin C and echinacea, zinc and throat lozenges and get some boxes of kleenex out. Focus on the fact that you will likely soon be a snotty dribbling mess, but if you look after it you can do fine and not miss school or work.
Take a benedryl. If there is any reduction in symptoms you know that some of the problem is a histamine reaction and you don't get those with cancer.
Does your mouth taste nasty? Look up tonsil stones on the internet.
Find some deeply absorbing but silly movies to watch. Binge watch them. Find somebody to hang out with. Invite them over for a movie binge. Find problems to solve, along the line of moving a dresser and rearranging the furniture that will require you to figure out best methods of moving wthout scarring the floor and if it will actually fit in that corner, and make you take everything out of the drawers and put them back in again.
Go do something strenuous. Cortisol levels can be reduced by long distance running, or pruning aggressively, or playing dodgeball.
Consider if there is something you want to say, but are forcing yourself not to say, something like, "I hate you and your damn dog! Do something about his barking!!" The struggle not to say something like that and end up in a feud with your neighbour can cause a blocked throat feeling.
Consider if you are trying not to cry, that behind everything is the urge to have a crying jag, deep body shuddering sobs, walking around the house howling. That too can cause a tight throat and a feeling of panic. You're an adult. Of course you don't cry. No. The hell with that. A crying jag is a good adult stress release mechanism. It beats somatizing, hating yourself, quitting a job in the middle of a shift, or spending your life pretending you are not upset.
Be aware that whatever happens internet strangers care and you are not utterly alone.
And let us know the results after you get it checked out.
posted by Jane the Brown at 7:34 AM on April 19, 2019
Anxiety
and
Swollen glands
You are ninety-something-big percent likely to be having this symptom because of anxiety and your worry about cancer is additional evidence of that. If you were thinking, "huh, probably not cancer but this has been going on for awhile, better get it checked out" it would be more likely to be cancer because you aren't getting distressed, but you are getting distressed, so that adds to the probability of anxiety being the cause.
Prod your neck and throat gently up and down and try to find sore lymph nodes. If you can find sore lymph nodes then it's probably an infection. Sore lymph nodes are not a symptom of cancer.
Have any of your friends, family, co-workers or acquaintances come down with mono, snotty colds, throat colds, flu or colds in the lung? If so, you are probably about to develop more symptoms, or they will magically disappear. In any case, treat yourself like you are about to come down with the yucky-uckies, drink hot soup, take vitamin C and echinacea, zinc and throat lozenges and get some boxes of kleenex out. Focus on the fact that you will likely soon be a snotty dribbling mess, but if you look after it you can do fine and not miss school or work.
Take a benedryl. If there is any reduction in symptoms you know that some of the problem is a histamine reaction and you don't get those with cancer.
Does your mouth taste nasty? Look up tonsil stones on the internet.
Find some deeply absorbing but silly movies to watch. Binge watch them. Find somebody to hang out with. Invite them over for a movie binge. Find problems to solve, along the line of moving a dresser and rearranging the furniture that will require you to figure out best methods of moving wthout scarring the floor and if it will actually fit in that corner, and make you take everything out of the drawers and put them back in again.
Go do something strenuous. Cortisol levels can be reduced by long distance running, or pruning aggressively, or playing dodgeball.
Consider if there is something you want to say, but are forcing yourself not to say, something like, "I hate you and your damn dog! Do something about his barking!!" The struggle not to say something like that and end up in a feud with your neighbour can cause a blocked throat feeling.
Consider if you are trying not to cry, that behind everything is the urge to have a crying jag, deep body shuddering sobs, walking around the house howling. That too can cause a tight throat and a feeling of panic. You're an adult. Of course you don't cry. No. The hell with that. A crying jag is a good adult stress release mechanism. It beats somatizing, hating yourself, quitting a job in the middle of a shift, or spending your life pretending you are not upset.
Be aware that whatever happens internet strangers care and you are not utterly alone.
And let us know the results after you get it checked out.
posted by Jane the Brown at 7:34 AM on April 19, 2019
My go-to with medical problems that could be disastrous but could be benign or not that big of a deal is this thought:
"Either it's going to be a catastrophe or it's not. If it is a catastrophe, I'm going to regret wasting my time worrying instead of enjoying what may be my last days/weeks/months before my life is ruined. If it's not a catastrophe, I'm going to regret wasting all that time worrying over nothing."
It's easy to say, not as easy to actually believe, but you can do it with enough practice. I often catch myself slipping back into anxiety and catastrophic thinking and have to repeat this to myself multiple times, but it does really help me calm down. It helps that historically, every time I've had a weird medical symptom, it has not been a catastrophe, and I have historically regretted wasting all that time worrying over nothing.
Another angle is: "I am worrying about something that does not exist. The thing I am afraid of has not happened, and may never happen. It is not real. Could it become real? Sure. So could the reality where I am perfectly fine. But neither is real right now, and while I should think about and plan for the future, I should not get invested in either reality until I have strong evidence that one is more likely than the other."
This is thought challenging, common in cognitive-behavioral therapy, which YMMV on. Some people prefer the acceptance and commitment approach: "I am having these thoughts, and it's fine and normal to have them. Everyone worries and has bad feelings. But they're just thoughts and emotions. They don't mean anything. All that matters is is what I do." I have trouble with this, but some people find it helpful to accept that the thoughts are there and just ignore them rather than try and challenge them.
posted by brook horse at 7:44 AM on April 19, 2019 [5 favorites]
"Either it's going to be a catastrophe or it's not. If it is a catastrophe, I'm going to regret wasting my time worrying instead of enjoying what may be my last days/weeks/months before my life is ruined. If it's not a catastrophe, I'm going to regret wasting all that time worrying over nothing."
It's easy to say, not as easy to actually believe, but you can do it with enough practice. I often catch myself slipping back into anxiety and catastrophic thinking and have to repeat this to myself multiple times, but it does really help me calm down. It helps that historically, every time I've had a weird medical symptom, it has not been a catastrophe, and I have historically regretted wasting all that time worrying over nothing.
Another angle is: "I am worrying about something that does not exist. The thing I am afraid of has not happened, and may never happen. It is not real. Could it become real? Sure. So could the reality where I am perfectly fine. But neither is real right now, and while I should think about and plan for the future, I should not get invested in either reality until I have strong evidence that one is more likely than the other."
This is thought challenging, common in cognitive-behavioral therapy, which YMMV on. Some people prefer the acceptance and commitment approach: "I am having these thoughts, and it's fine and normal to have them. Everyone worries and has bad feelings. But they're just thoughts and emotions. They don't mean anything. All that matters is is what I do." I have trouble with this, but some people find it helpful to accept that the thoughts are there and just ignore them rather than try and challenge them.
posted by brook horse at 7:44 AM on April 19, 2019 [5 favorites]
Try to keep as busy as possible and as social as possible until your appointment. Have Game of Thrones parties, invite people for dinner, Have potlucks.... Have debates over who will sit on the Iron Throne... Play Poker with your buds... These will keep you busy and engaged which in turn will mean your brain will have less resources to devote to empty random worry until you get to your check up.
posted by fantasticness at 7:52 AM on April 19, 2019
posted by fantasticness at 7:52 AM on April 19, 2019
I already have cancer, so I want to address the possibility of more serious news. If you don't have cancer, getting diagnosed seems like it would be the end of the world, which is why words like "catastrophe" come up. However, there are many different kinds of cancers and types of treatments. Some treatments are very good and not terribly debilitating, and people can live a long time with cancer or even be considered cured. It's no fun to have cancer, but even if you do, it's not the end of the world. It's very unlikely that you have cancer and I sincerely hope you don't, but even if that happens, you will be able to deal with it in ways that might surprise you. One thing I've learned is that I'm stronger than I think, and I've no doubt that you are too.
When I was diagnosed, my therapist said something that's been very helpful to me ever since: You don't know what's going to happen. This applies to you now as well as me. It's hard to live with uncertainty, but it's important to remember that there are many, many possibilities and whatever happens, you will figure out how to handle it.
posted by FencingGal at 7:58 AM on April 19, 2019 [9 favorites]
When I was diagnosed, my therapist said something that's been very helpful to me ever since: You don't know what's going to happen. This applies to you now as well as me. It's hard to live with uncertainty, but it's important to remember that there are many, many possibilities and whatever happens, you will figure out how to handle it.
posted by FencingGal at 7:58 AM on April 19, 2019 [9 favorites]
I recently had problems swallowing. It was sudden, dramatic, and scary. Now pretty sure it was related to post-concussion syndrome from a whack I had taken to my head 4 days prior to symptoms. They've completely resolved now.
This is to reiterate what FencingGal said - you have no way of knowing what is causing your symptoms, but you will figure out how to handle it.
posted by heigh-hothederryo at 9:32 AM on April 19, 2019
This is to reiterate what FencingGal said - you have no way of knowing what is causing your symptoms, but you will figure out how to handle it.
posted by heigh-hothederryo at 9:32 AM on April 19, 2019
One thing that helps me when I’m anxious about something is to ask myself “Is there literally anything I can do RIGHT NOW to solve [whatever I’m anxious about]?” Since I’m usually worrying needlessly about stuff coming up in the future, the answer is often no. And if there’s literally nothing I can do about it, being anxious is kind of a waste of time. You’ve made a doctors appointment, you’ve asked for help here. As far as I can tell, those are the only two actions you can take, and you’ve already done them! Good job!
posted by Weeping_angel at 12:56 PM on April 19, 2019
posted by Weeping_angel at 12:56 PM on April 19, 2019
I have difficulties swallowing in times of stress at work. My explanation is that stress depletes my magnesium level. Apparently, it can indeed be a symptom of magnesium deficiency, as is anxiety BTW. A cure of daily supplements does the trick for me already after a few days.
posted by bluedora at 1:17 PM on April 19, 2019
posted by bluedora at 1:17 PM on April 19, 2019
The comedian Steve Agee did a great episode of The Mental Illness Happy Hour podcast where he talked at length about his anxiety-related swallowing issues. Could be worth a listen.
posted by Ursula Hitler at 3:26 PM on April 19, 2019
posted by Ursula Hitler at 3:26 PM on April 19, 2019
Had difficulty swallowing due, I believe, to an antibiotic I was taking and the only thing that made them go away was the d***ed endoscopy I underwent in order to diagnose its cause. Had all the same worries you did.
posted by Peach at 5:31 PM on April 19, 2019
posted by Peach at 5:31 PM on April 19, 2019
First of all, it’s very unlikely to be cancer! I understand you jumping to that conclusion because I’m the same way, but in my experience there’s almost always another, less scary explanation for scary symptoms. Bodies are weird!
For me, the thing that has helped most during health scares is just telling myself that I’m gonna feel shitty for a while, and it sucks and it’s unfair, but it’s not forever. This, at least for me, is a lot easier than telling myself I’m not going to worry till I get the test results, which just adds another layer of stress and self-judgment when inevitably I can’t stop worrying.
The main thing is, don’t beat yourself up for feeling bad, just try to distract yourself, hang out with friends, do things you enjoy, and accept that even if you do all this stuff you still might not feel a lot better. It’s only temporary. You’ll get the results, which will probably be fine, and then you’ll be able to move on.
Oh, and stay off the internet!
posted by aaadddaaa at 9:18 AM on April 20, 2019
For me, the thing that has helped most during health scares is just telling myself that I’m gonna feel shitty for a while, and it sucks and it’s unfair, but it’s not forever. This, at least for me, is a lot easier than telling myself I’m not going to worry till I get the test results, which just adds another layer of stress and self-judgment when inevitably I can’t stop worrying.
The main thing is, don’t beat yourself up for feeling bad, just try to distract yourself, hang out with friends, do things you enjoy, and accept that even if you do all this stuff you still might not feel a lot better. It’s only temporary. You’ll get the results, which will probably be fine, and then you’ll be able to move on.
Oh, and stay off the internet!
posted by aaadddaaa at 9:18 AM on April 20, 2019
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posted by pinochiette at 7:19 AM on April 19, 2019 [2 favorites]