Tuesday, March 24, 2015

Anxiety, Avoidance, And Possile Solutions: A Work In Progress

Warning: This is a longer post than normal, so bear with me.

OK. This post has been a long time coming. Two months or so actually. Anxiety. I've always been anxious. Since I was a kid, I was always worried about something. Up until about 10 years ago I've been able to deal with it fairly well. Over the last 10 years, but particularly the last two or three, my anxiety has increased. I've had more panic attacks, and I've let that anxiety and fear hold me back from doing things. If you've ever had a panic attack, you know how frightening it is. You can't control your breathing, your heart starts beating out of your chest, you start shaking, sweating, and your mind goes in a thousand directions at once.

I know what triggers my panic attacks, and unfortunately this cause is a reality for people with cerebral palsy. Falling. I've talked about my fear of falling before, and for the most part I do deal with that well. There is however one instance that my anxiety goes through the roof when it comes to falling. The dreaded shower. I've talked about my scary shower incident several years ago, and I honestly don't think about that day very often. That's because I know that day will not repeat itself because I no longer use the suction cup grab bar. I have a safety bar screwed into the wall now which is way safer. I take all the safety precautions I can think of when it comes to getting in and out of the shower.

I'm going to go into detail with my shower anxiety not because I really want to, but because I hope my experience will help someone else out there who might be dealing with the same thing. Whether you have cerebral palsy, multiple sclerosis, any other type of disability that makes it hard to balance, or if you're just getting older and have lost some stability, I hope my story can help you attack the problem head on and move forward.

Let's start at the beginning. How I get in and out of the shower...past and present. Over the years, I have experimented with different ways of getting in and out of the shower.

Childhood Strategy:

As I kid, I used to use my parent's shower which is a big wide-open space. To get into the shower, you have to go down a small step. In my early childhood, my mom helped me in and out. For the longest time I was able to stand up and move around while I showered. I don't remember how old I was, but around 11, 12, or 13, I started getting in and out on my own. While I was in the middle of washing, I slipped and fell on my behind. I didn't get hurt, but I was startled. I can't remember the length of time, but I slipped and fell two more times over weeks, months, I don't know. After the third time I said enough was enough and I just sat on my butt and showered that way from that point on.. I also started getting on the floor and scooting down the step when I got in.

College Strategy:

Moving on to college, I had a private bathroom that I shared with three other girls. It was a tub style shower, so I had to get in and out of a bath tub. We put on a safety bar that clamped on to the side of the tub. Once I got into the tub, I would get on my knees and shower. Then somehow managed to flip over onto my butt so I could shave. Then get back onto my knees, stand up and get out using the bar. I never had any problems with that back then.

WA State Apartment Strategy:

I had my first shower chair in 1999 or 2000. That helped a ton. My husband and I were living in an apartment in the Seattle area, and we had maintenance come over and install a safety bar inside the tub shower. I did well with that for the most part. Every now and then I would get nervous getting out of the tub. I think it was because the bar was on the inside and I had nothing to hold onto with my outside hand. But I dealt with it just fine.

Current House Strategy:

Moving on to the house we now live in. It's once again a tub-style shower. You already know about the suction cup bar, and that I now have a safety bar on the wall outside of the shower. I still have a shower chair, and to avoid slipping there's a thick bathroom rug on the tile floor so there's no danger. This is the tub shower in which I've experimented with different ways of getting in and out. I used to get in and out standing up the entire time. I'm not sure when it was , but sometime in the last three or four years I started to sit down on my chair part way through the getting in process. I'd put my left leg in, sit down, and then swing my right leg in after. I'd reverse that process to get out. That's worked well for me the last several years.

I've mentioned the whole "jerk move" feeling I get from time time. Sometimes when my neck is out of alignment in just the right way, I get the sensation of being pulled back and to the left. That feeling plays a big part when I get in and out of the shower. I feel very unstable, and that causes me to doubt myself and hesitate. For the most part that feeling is gone, as long as I get my back and neck adjusted regularly. For the last month or so, I've been having a hard time getting my right leg into the tub, even when I'm already sitting down. My left leg tends to tighten up and my left knee goes inward and blocks my right leg from coming in (if that makes sense).

I discovered the tub floor was the culprit. My left foot would slip when I lifted my right leg up. Now I'm sitting down you understand, but it still feels like I'm going to fall off the seat. Is that even possible, to fall out of a chair? I suppose if you lean far enough over to one side you'd eventually fall off. Or if you lean forward (which I tend to do in order to not fall backward) enough and your feet slip out from under you. But is that realistic? To stop my left foot from sliding, I'd put a hand towel under my left foot. That kind of helped, but it was still precarious.


Onto the avoidance factor of this post. About two months ago, my anxiety about getting in and out of the shower got so bad, I unconsciously started to delay showering. I would avoid exercising because if I exercised, I would get sweaty and need to shower. The less I exercise, the harder it is to move around. It was a viscous cycle. And when I absolutely had to shower, I would get so anxious, that I would not be able to move. Every time I tried to get out of the shower, I would panic. It got so bad one day, I had to call my husband (I started bringing my phone in with me after the suction cup incident) to help me out.

A little over a month ago, I decided to take a Xanax an hour before I took a shower, to let my mind calm down, relax my muscles, and to let myself know that it is possible. Before that could happen though, I went into the bathroom that morning, not knowing there was water on the floor. I went into the bathroom and slipped on the floor (the tile floor we have is deadly, I hate it). I didn't fall, but came pretty close. My panic went through the roof. My anxiety had been building up for several days, and I was anticipating my shower later that day. I managed to get back into the bedroom before the full blown panic attack hit. Then my body just did its thing. Hyperventilating, sweating, shaking, heart and mind racing uncontrollably. My husband came in when he realized what happened, and calmed me down. He told me to take a Xanax right then and there. I remember saying in a squeaky voice "I'm thinking about it". He laughed (not at me but at my reluctance to take a pill) and told me to take one. My reaction is exactly the reason to take one. So I took one and I felt better after about 10 to 15 minutes. The shower that day went smoothly also.

Solutions (on-going):

After that panic attack, we made another adjustment to the tub. First we tried sticky tape on the tub floor. That didn't cut it. We then tried a wooden bath mat. That's been working well so far. That helps my left foot from slipping. I'm still dealing with the falling feeling while sitting though. That's been a problem for a while now, and I don't know what to do about it. I'd blame it on the "jerk move", but it's not the same sensation. It feels like the falling sensation you get when you're just about to fall asleep. I get that feeling when I'm awake too. More often now than I used to. It's weird. Maybe my neck is out, who knows. All I know is I'm tired of being anxious when I have to shower.

Here are some pictures of my current set-up.

Shower Safety Bar

Shower Chair And Wooden Bath Mat (and the rug I use still draped over the side of the tub)
(photo credit: Me)

I'm doing my best to not fixate on it. I have a tendency to hyper focus on things that make me nervous. I have to practice the mindful thinking again. Focus on the present moment, and not worry about something until it's time to deal with it (and even then, just go with the flow). Hard to put that into practice though sometimes. I'm actually thinking about taking a Xanax today before I shower. I've been getting more and more anxious about it again. I just feel like I'm going to fall off the shower chair now. And my left leg is still blocking my right from getting in and out. It's a work in progress that's for sure. I'm hoping that by taking one today my confidence will rise, and I can go a few weeks without fear. If I let my anxiety build and build I'm headed for a panic attack for sure. So I need to cut it off at the pass.

This post is a huge one, but I hope this may be of some help to others who have anxiety, whether it's shower related or not. To those of you who read the whole way through, thank you! It does help to get it all out there. And to those of you with an anxiety problem, just take in one minute at a time (rather than one day at a time like I used to say).

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