Who Will Buy the King Cake?

I have anxiety. I can freely admit it and even laugh at myself now that years and years separate my terror from my present. I can acknowledge that it is better for me to stay on an SSRI consistently after several starts and false stops over the past two decades.

I have always gone to work and cared for the children and put one foot in front of the other and put on a brave face. But I have been nearly convinced at different times over the years that I had congenital heart disease, lymphoma, esophageal/ovarian/breast/brain/pancreatic cancer, hemochromatosis, heparin-induced thrombocytopenia, multiple sclerosis, and leukemia. Sometimes I joke, “I’ve had every kind of cancer there is, even testicular cancer.” As ridiculous as it sounds, my racing mind could find a way for that to be so even with my complement of XX chromosomes.

Sometimes I have had understandable triggers for mental misery: a devastating college breakup; two miscarriages; a medical malpractice suit. At other times the panicky thoughts seem to come out of nowhere — noticing a tiny purple skin lesion or a sharp pang within my abdomen fast forwards immediately to my untimely death and my motherless children left in the hands of their father. Who will remember to make their dental and medical appointments? Who will celebrate their half-birthdays and buy a King Cake for Mardi Gras and stuff two extra plastic babies inside so each kid can “find” one? Who will take note of the days that they can wear sweatpants or green shirts or funny hats to school and make sure that they all have something clean that checks the box?

I have projected my anxiety on my kids at times, mostly on my middle child, my only son. It makes sense, really. After my oldest was born without difficulty, I had two consecutive miscarriages before conceiving Charlie. The pregnancy was fraught with anxiety — when would I start bleeding and lose this baby too? What should I do about my new diagnosis of MTHFR compound heterozygosity? Lovenox or not? After hitting each pregnancy milestone I would imagine what could go wrong with the next step, including horrific delivery scenarios. When Charlie was born at term and appeared healthy, it seemed too good to be true.

I stared at tiny Charlie and watched his breathing and his jerky baby movements obsessively. We had a trip to the Emergency Department when I listened to baby Charlie’s heart and counted the rate at greater than 200. Once I was reassured by EKG and echo that my son’s heart was normal, I turned my attention to his brain. I identified clonus when I held his ankles for diaper changes. I woke with every myoclonic jerk and fast forwarded to a diagnosis of infantile spasms. I even got all the way to a tiny white coffin sometimes.

I can now recognize when I am veering into irrational hypochondriasis – usually. I am a definitely a worrier but can generally avoid spiraling into the obsessive thought patterns.

The only silver lining of this situation is that I can also recognize anxiety in others — in co-workers, in resident physicians, in adolescent patients, in the parents of my youngest patients. I can gently suggest that perhaps talking to someone or considering medication might help, or at least relay my personal experiences and de-stigmatize mental health issues and SSRIs.

Lisa Sieczkowski
Omaha, Nebraska