Anxiety caused by the AN tumor or vice versa?Basically I think the inquiry is
“what is the cart and what is the horse?â€- here.
Firstly I want to point out some “physiological facts†that I know about the tumor I had -which was an XXL.
The brainstem was pushed over. Here is a link that explains what the brainstem controls
http://en.wikipedia.org/wiki/BrainstemQuote from that website
“The brain stem provides the main motor and sensory innervation to the face and neck via the cranial nerves. Though small, this is an extremely important part of the brain as the nerve connections of the motor and sensory systems from the main part of the brain to the rest of the body pass through the brain stem. This includes the corticospinal tract (motor), the posterior column-medial lemniscus pathway (fine touch, vibration sensation and proprioception) and the spinothalamic tract (pain, temperature, itch and crude touch). The brain stem also plays an important role in the regulation of cardiac and respiratory function. It also regulates the central nervous system, and is pivotal in maintaining consciousness and regulating the sleepâ€
And
“Physical signs of brain stem disease
Diseases of the brain stem can result to abnormalities in the function of cranial nerves which may lead to visual disturbances, pupil abnormalities, changes in sensation, muscle weakness, hearing problems, vertigo, swallowing and speech difficulty, voice change, and co-ordination problems. Localizing neurological lesions in the brain stem may be very precise, although it relies on a clear understanding on the functions of brain stem anatomical structures and how to test them.â€Please know that AN tumors do not grow into the brainstem but grow in a way that can PUSH the brain stem over. Most of us from the “XL, XXL and XXXL tumor club†can attest the brainstem being was squished into the shape of the letter “s†– visible in MRI’s (and that the shape does go back to normal after the tumor is out)
I was very aware I had something “physically†wrong with me when I could not sleep and I was having major constipation issues (colonoscopy showed that things were fine in there)… the most frightening in the last year before removal was my speech issue. (That and the sensation of water dripping on my head- gone now). I knew what I wanted to say but I could not form my words and kept running out of wind through the airway. These are functions, controlled by the brainstem, and were not working. (Note these resolved as the brainstem slowly resumed shape after tumor removal…)
Please know when a person cannot sleep or poop they are going to mentally NOT function well (not to mention they will feel very toxic most of the time if the are “baked upâ€)… no doubt having them behave in an anxious (and grumpy) way. (Please note it is totally ok to talk about “poop†on this forum- and this is a popular post op topic especially for those one pain meds such as Percocet or Vicodin)
Sleep issuesHere is an article worth a read.
http://www.adaa.org/gettinghelp/FocusOn/Sleep.aspQuote from that
“Does an anxiety disorder lead to a sleep disorder, or does a sleep disorder cause an anxiety disorder?
Either is possible. Anxiety does cause sleeping problems, and new research suggests sleep deprivation can cause an anxiety “disorderVisual evoked nystagmusI used to drive a school bus with no issues (in my 20-30’s). Prior to having the tumor discovered (age 44) I was having all sort of anxiety issues on the road… as some driving situations were causing me much anxiety. I was not feeling in control- particularly at night (now I am fine with night driving.) The Key issues were passing large vehicles such a semi trucks (known that there is a large air pressure and vibration being sent to your vestibular system as you do so) and I was bothered when going over bridges… suspension bridge being the worst for me. Now after much vestibular testing I know that I have some nystagmus (caused by the AN tumor) … and probably had this before surgery, as there was so much pressure behind the eye- before the tumor removal. The repetition of vertical lines, from bridge cables, road side posts etc was setting off visual evoked nystagmus for me …Actually I still have this but have learned to cope with it and not look out- just at the car in front of me or the lines on the road I need to stay within.
For some people this can actually set off hyperventilation. I feel I had my tumor as a teenager. Interestingly at track meets, as a teen, I almost always suffered from hyperventilation after my races on a track (with lines etc) ….But not during cross-county meets in an open outdoor area. Here is an article that supports that hyperventilation can be relate to out vestibular issues. (Know that nsytagmus is related to vestibular problems)
http://www.neurology.org/cgi/content/abstract/53/9/2158For those of you have never experienced vestibular testing for nystagmus this is how it is done
http://video.google.com/videoplay?docid=-6201505057633350143&ei=5BMhS8zoDILsqAONmpX1Dg&q=nystagmus&hl=en&client=safari#Visual stimulus nystagmus video
http://video.google.com/videosearch?client=safari&rls=en&q=nystagmus%20testing&oe=UTF-8&um=1&ie=UTF-8&sa=N&hl=en&tab=wv#client=safari&rls=en&q=nystagmus+testing&oe=UTF-8&um=1&ie=UTF-8&sa=N&hl=en&tab=wv&qvid=nystagmus+testing&vid=-5038892984980860575Silly news story (Gotta like the anchor man- what a cutie) that talks more about this…
http://video.google.com/videoplay?docid=-6201505057633350143&ei=5BMhS8zoDILsqAONmpX1Dg&q=nystagmus&hl=en&client=safari#docid=-7533593846990658301Those of us who have the cerebellum squished over will exhibit coordination issues… and even speech issues. If the tumor interferes with the flow of the Dura fluid (cranial spinal fluid) there can be issues too- and yes these may be “cognitive†as a patient tries to focus but has so much pressure inside their skull- they cannot. They can exhibit symptoms similar to hydrocephalus. (There were days before my diagnoses that I felt I was performing much like my former ADHD students, I taught, and my thought, attention span and focus was ALL over the place. Now I am fine)
What is hydrocephalus?
http://www.ninds.nih.gov/disorders/hydrocephalus/detail_hydrocephalus.htm
I think it is very important to know the balance between physiology and psychology not just for patients… but also for doctors. Please know that 10+ years before my MRI revealed a 4cm tumor I did see my PCP and specifically brought up the ringing in the ears and “vertigo†(I used that very word and he questioned as to if I even knew what the word meant… he was so condescending) I asked for a referral to see an ENT and he declined – alternatively he offered to send me to a “stress therapist.†(Ok Ok I think he was also a bit of a chauvinistic so-and-so too.) Know that if my tumor had been found THEN I could have been a candidate for radiation … but then 10+ years later, when I switched doctors, it was discovered WAY too late in the game …and I did not qualify. I have had surgery complications that may have been avoided if I was diagnosed and treated earlier – with radiation.
I think it is important that medical practioners study psychology, as many physicians really need to understand people and their behavior better. (Some of them simply need to also to learn better compassion and people skills that a psychology course would teach them …to which some did not learn in Neurosurgery 101.
) However there also needs to be a balance as when medical practioners, patients and care giver start dismissing issues as “Psychosomatic†… this can be VERY dangerous if this is done. Too much psychology here can be detrimental here. WAY too many people are given mood altering drugs, anti-depressants etc., in the medical system I am experiencing to be economically motivated by the pharmaceutical industry -when more effort needs to be placed on indentifying “the root causeâ€. However I do identify that if a patient has “clinical depression†these pharmaceuticals can be vital for treatment.
This explains the thought of what psychosomatic illnesses (or medicine) are
http://en.wikipedia.org/wiki/Psychosomatic_medicinePlacebo studies have their place in ruling out certain patients but also know that there are REAL medical conditions ignored as too many medical practioner are so caught up into the “psychology†of the patient. There needs to be a balance.
Often AN patients complain of bruxism (grinding of the teeth), insomnia, neck and back pain… and often these were dismissed as symptoms of “too much stress and anxietyâ€. I truly feel that many of us grind our teeth at night due to the tinnitus aggravation…
This explains
bruxismhttp://en.wikipedia.org/wiki/Bruxism(Note that all my molars on my AN side have had to be crowned as these were cracked… caused by bruxism… I think the cause of my bruxism was not stress and anxiety but the constant aggravation of tinnitus -over the many years.)
I feel much calmer since the removal of my tumor. However know that when I woke up from surgery I had hyperacusis in the good ear.
This explains that condition
http://www.hyperacusis.net/hyperacusis/what+is+hyperacusis/default.asp&
http://en.wikipedia.org/wiki/HyperacusisKnow that loud social environments are actually physically painful for me “if†I do not have an earplug. (Ie I have devised coping mechanisms)… because these can be so “physically†painful… Yes I can appear anxious and aggravated because truth is I am in pain and loud sounds “physically†hurt. Any soccer player off to the side with an injury will also appear anxious… this is no different.
If I do not have my earplug in a loud situation I am anxious… anyone around me can see that.
I do NOT believe that the anxiety I felt constantly for the years, prior to the FINAL accurate diagnose, was “psychologicalâ€. I refused any mental mood altering meds as I was convinced there was a “physical†attribute to this and I was determined to find “the causeâ€. Please know that “I†requested an MRI more than once … and it took a while until I was referred to someone who would order one for me.
Now that my brain has resumed its shape… 2 years later …I can actually say that I do not feel the constant anxiety I had before. My sleep patterns and bowel movements are now normal… (Yup sleeping and pooping just fine now!)
I have very little patience now with doctors -that use way too much psychology (and some appear to me do be just darn
flaky and
quaky if you ask me
) … or doctors who are not being proactive in assisting getting help for me (or family) and dismiss symptoms as “stress†and/or anxiety.
There is no doubt that people who do not have stress and anxiety under control are more prone to physical health issues. (Proven with many studies) But the key thing is to indentify when something “Physical†is actually THE cause.
Know that the 1st year immediately after my surgery I had
anxiety but that was because I was in pain, had synkenisis kick in … and there was much fear of the unknown.
“Is my tumor coming back?
Will I ever smile again?
Will I ever blink or close my eye again?
Will I ever be able to ride a bike again?
Will I live to be there for my kids? (I was freaking out as I and was dealing with CSF leaks during that stage and was fearful and ANXIOUS of meningitis getting in)
Now that my brain shape looks normal, in the MRI, -truth is I actually feel more normal. (Finally)
I think that the HORSE is the Acoustic Neuroma tumor… and the CART is the anxiety and stress that it induces. We do not know “the cause†of acoustic neuroma tumors (I theorize that mine started with a head injury at age 12 followed by a 1970’s level radiation level skull x-ray)… but the truth is hormones produced during “times of stress†could be a factor that contributes to the growth of one. In truth there are no conclusive studies to that yet… We do not know “the cause†of the Acoustic Neuroma tumor. I think “if “we keep the dialogue up here many MAY conclude that that an acoustic neuroma can cause physical anxiety (not just psychological) in the brain… However some may not be convinced until there is a conclusive study and they see the paper from some reputable institution.
(EW ah- I can just see some lurking med student seeing an opportunity for a research paper, and grant, here…
)
Here is to a stress and anxiety
free day.
Cheers,
Daisy Head Mazy
