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Thursday, November 29, 2012

Vagus Nerve Pain Another Cause for "Heartache" and It's Relationship to Empathy and Healing Through Hope

I know my Coronary Chronicle blog is mostly about my DH's experience with heart disease and healing through a low-fat plant-based diet, but I like to give myself license to talk about other matters concerning the heart and chest pain, as I did in my last post, because it was my interest in the health of my heart that caused my intense study in heart matters a couple years ago.  Plus, it was this interest that enabled me to quickly recognize that DH was having trouble before any heart attack happened,

You could say that my tendency towards worry about health may have saved him from having a heart attack, and if my experiences can help others get to the doctor and get checked out when they have symptoms, I'm glad.

On the flip side of being cautious and getting check ups on our hearts, is the over barrage that I believe we get from the media that can make us overly cautious.  I'm a victim of over cautiousness.  In other words, I have been to the doctor, I have been checked out thoroughly, and I still obsess over the condition of my heart, much more than DH who has a known heart condition.

Part of this stems from working in the health field for several years, working with geriatric patients for several years, and reading too much.  Another part of this stems from the fact that I have always been a "worry wart", a nickname I acquired at a early age.

My new quest has been to treat my worry wartism by learning how the mind and anxiety can promote physical pain.

Elder Dieter F. Uchtdorf has given many talks on the relationship of worry and it's affect on the mind, and eventual effect on the heart.  As I have learned more about the relationship between the mind and physical pain, I am realizing that what our leaders tell us is far more reaching than what we give them credit for.

Elder Uchtdorf, having seen much suffering, and mental illness during his lifetime due to being a refugee, understands this mind/spirit/body relationship very well, and when he talks about the relationship between hope and healing the condition of the mind and heart, he knows a deeper meaning than we might focus on.

As I have studied the result of worry on the physical heart, I have come to know for myself that this is true.

What launched me on this study was the literal heartache I feel when I have negative, worrisome,  or sad thoughts.  I had this pain the day my DH and boys left for a week long trip in Colorado.  I knew DH was sick (and he was, as he was a heart attack waiting to happen), and two of my boys were just recovering from the flu.  Did that set the worry in?  Yes, indeed, and hours later I was popping my omeprazole, and calling my friends in tears due to this ache in my chest.  One dear friend came over to spend the evening with me so I would be distracted from worry.

I discovered that weekend that if I rubbed my back on the corner of the wall that the gripping pain would go away, which I have learned to be a treatment for my "heartache" everytime, or I can asked one of my boys for a hug, or a backrub and it's goes away.

The day that DH was diagnosed, I had my "heartache" the whole weekend that he was having and recuperating from his procedure.  I wanted to take my place in line for an angiogram and get my heart fixed.  Interestingly, the pain would only come when I was able to be quiet and think, but when I was needed for caregiver duties the pain would go away.

This has been consistent.  When I have a worry thought and a rush of adrenaline from that worry thought the pain comes, and when I get busy doing laundry, taking a walk, painting, or something physical, or have the boys distract me with a hug, bye bye pain.

Going to my heart and tummy doctors, to rule out the heart and to discover the stomach problems, made it possible for me to release myself from the primary worry of heart disease, and focus on the mental reasons for my pain which is why I would encourage anyone with chest pain, to just skip the middle diagnostic activities, including going to the primary care provider, unless you need a referral, and just go directly to a cardiologist.

But, now that I have done that, I can get busy on working on healing my stomach, and working on my hope.

So, this past week, I have been praying hard for the Lord to help me figure out what is causing my chest pain.  I know that some of it is stomach, but I've been told that the stomach problems won't heal until I get my nerves under control.

Believing in the mind/body connection, that mind problems can cause physical problems, I wanted to figure out what part of the body is my mind problem messing with, and this morning as I was praying, the thought came to me, "check into the vagus nerve."

Aha!!!!  That made so much sense to me.  The vagus nerve has been my go to guy when I have needed to blame other symptoms on something.  In the past, I had learned that it is the vagus nerve that makes both my reproductive organs, and my stomach nauseated during that special time of the month. It is the vagus nerve that makes me dizzy when I stand up to too fast during those times I have not been drinking enough water, and it is the vagus nerve that I think triggers my SVT's when I have eaten too much or am, again, dehydrated.

Well, so, I did a Google Search and found this discussion....

The discussion is a  psychologist's  answer printed in Scientific American answering the question, "What causes chest pains when feelings are hurt?" by Robert Emery and Jim Coan both professors of psychologic at the University of Virginia.  It talks about the link between emotions, the vagus nerve, and heart pain.

A few weeks ago, I had read an old description of this from an ancient Roman physician, probably Hypocrates, who talked about pain in the solar plexus, that is a network of nerves, just below the sternum than can develop pain triggered by emotions, so this has been on my mind as an explanation, but my pain comes up little higher in the chest right below where my heart is.

Because I do worry a lot, and because I would like to avoid being on medications, I like to look for explanations for sensations that make me worry and make me uncomfortable.

So, I have been praying for an explanation, and praying hard, and the Lord has sprinkled bits of information little by little as can handle the understanding of them.  This morning as I was praying again, the thought came to me, "Check on the mind/body connection of the vagus nerve."

This made complete sense!!  Knowing that I have already discovered the vagus nerve to cause issues with my reproductive organs and my stomach, then why not go right up the line, higher up, and blame it on my heartache as well!!!!  For those of you who might not know the vagus nerve, or wandering nerve as it was anciently called, wanders from the reproductive organs to the stomach to the heart, to the base of the skull.

Incidentally, as I write this, I am at the time of the month when the reproductive area and the stomach complain together, and I am realizing that I am having a constellation of pain, with all four sites, reproductive, stomach, heart, and neck in pain, but I have been focusing on the heart pain because of the mode of life I am in right now, caring for someone with heart issues.

Let's say that some of this might have to do with empathy.

So here is what the answer from the professors says...
"Heartache is not the only way emotional and physical pain intersect in our brain. Recent studies show that even experiencing emotional pain on behalf of another person—that is, empathy—can influence our pain perception. And this empathy effect is not restricted to humans. In 2006 a paper published in Science revealed that when a mouse observes its cage mate in agony, its sensitivity to physical pain increases. And when it comes into close contact with a friendly, unharmed mouse, its sensitivity to pain diminishes. "

My DH often tells me he has never met another person that has more empathy than I do.  I do suffer a great deal  mentally, and physically, when others are suffering.  Even now as I write this, it prompted me to think of a friend that I have who is suffering right now, and I noticed that my chest was hurting again.  

I'm not equating myself to the Savior at all, but these thoughts did cause me to think about the scripture in John 11:33 when Jesus saw Mary weeping after the death of Lazarus.  It states, "When Jesus, therefore, saw her weeping, and the Jews also weeping which came with her, he groaned in the Spirit, and was troubled."

When that scripture comes to mind, I see the empathy of the Savior, and the uncomfortable sensations that empathy caused for Him.  The dictionary says that groaning is a deep sound in response to pain.

Should we try to suppress the pain of empathy?  For us worry wart types, I don't think so necessarily, but I do think it helps us worry warts to understand it's mechanism better so we can see it as a positive response to what is happening around us.  To see that we are experiencing this due to empathy and know that it is a result of sharing with another human being, and not a health problem, helps immensely, and can help us deal with the stress response.

The professors say that there are ways to minimize this pain once it is recognized, and that is was I was seeking for.  So, I'm saying to myself through this time of knowledge seeking, "I have this pain, is there something I can do about it?"  And the answer is, "Yes!"   The professors report.....

"Soon after, one of us (Coan) published a functional MRI study in humans that supported the finding in mice, showing that simple acts of social kindness, such as holding hands, can blunt the brain’s response to threats of physical pain and thus lessen the experience of pain. Coan implicated several brain regions involved in both anticipating pain and regulating negative emotions, including the right anterior insula (which helps to regulate motor control and cognitive functioning), the superior frontal gyrus (which is involved in self-awareness and sensory processing) and the hypothalamus (which links the nervous system to the endocrine system)."

I experienced such a thing the other night that perplexed me.   I had read about Oprah's (benign) breast cancer scare briefly, and having walked through a friend's breast cancer experience that led to her death, I immediately began to feel pressure in my chest.  While trying to process this pain caused by empathy, I did "feel for" what she had been through, I received a very sad and disturbing phone call from a person going through great suffering.  In my effort to comfort, I noticed the pain was gone.  Based on the explanation from the professors an act of kindness lessened the pain.  This is why I started praying about this emotional connection.  I wanted to know that I was not crazy, that there was a physical explanation to what was clearly an emotional trigger.

Now I know that it's okay for me allow myself to put myself into the path of suffering, to suffer with others, but that I also need to recognize that I can and need to pull myself out of the uncomfortable physical sensations created by empathy, and worry, by getting myself into action and do an act of kindness, or even seek for  an act of kindness from loved ones, by getting a back scratch or a hug.  

So, what is the physical mechanism that causes pain during extreme emotion?  The Professors Emery and Coan report that it's a part of the brain called anterior cingulate cortex that increases the activity of the vagus nerve during times of emotional stress, and that this activity causes a "cascade of biological" symptoms.  

To me this makes perfect sense and gives me great comfort to know, and explains my experience very accurately.  

It supports what Elder Uchtdorf has gently told us for years, that if we allow ourselves to lose hope, we will make ourselves sick, and that if we hold onto hope, it will heal our hearts - not just our spiritual hearts, but our physical hearts.  Why, because it is all connected.  The vagus nerve responds to negative emotions in a negative manner.  Lack of hope creates negative emotions.  Hope and charity (acts of kindness) heal us and  keep the activity of the vagus nerve down and heals minds, our spirits, and our hearts.

It's the Christmas season now.  In four days, my DH will go through another heart procedure, and it will be a stressful time,  a time that could produce a lot of worry and stress, if getting ready for the holidays were not enough; but it is good to know that I can still take care of myself while I'm taking care of DH through caring for him.  He provides an opportunity for me to redirect my worries to acts of kindness towards him.  

Christmas also provides that opportunity.  Now that I know that the stress and worry I have been carrying have triggered a uncomfortable physical symptom that is not a medical emergency but feels like one, and that that symptom can be controlled by redirecting my thoughts and actions, I think I will actually be able to handle this stressful period better than I did when he had his last procedure.

Just before I end here, I'm not trying to minimize the pain that anyone would have by saying, "Just be kind and you'll get rid of your pain."   There are many causes for pain, not just emotional, obviously.   I'm just comforted to know by this information that this is an explanation to the literal heartache that I feel when I worry can be lessened with a positive action related to the human touch.

I am grateful for prayer.  It has been my greatest tool during this time of unusual stress, and I'm really glad that my son directed me towards Elder Uchtdorf's talks that have been cycling around in my head leading me to expect healing through greater hope, and I always think it's pretty neat that science often supports what our church leaders have been telling us all along!