Monday, I had to wake up very early. My flight wasn't until 9:50 AM, but since I had to take a bus and two trains just to get to Philadelphia International Airport, I had to wake up at 4:30 and be out the door as soon as possible. Naturally, I was paranoid about over sleeping and ruining my whole trip so, in addition to my alarm clock, I asked my mother to phone me at 4:30 to be sure I'd wake. As fate would have have it, my body's internal clock woke me up at 4:20, followed ten minutes later by the alarm clock and mom's phone call. I was soon out the door and the public transit went smoothly, so I arrived at the airport with time to spare.

Like last year, I had a lot of anticipatory anxiety about my flight. I don't really have a fear of flying (actually, I enjoy it), but I worried more about claustrophobia (that dreaded "trapped" feeling) and had a nauseating case of emetophobia (vomiting anxiety). Since I seldom fly, I'm never sure how I'll react to the experience. As many anxiety disorder folks know, our anxieties can wax and wane in unpredictable ways, so we're never very sure how we'll respond to infrequent situations. Naturally, I took some extra Xanax to keep my anxieties under control (about three times my usual dosage of 1-mg). I simply had to be sure I could make this first flight, and expected all would be easier shortly after takeoff. I did get on the plane, and I made certain an air-sick bag was handy should my stomach turn against me.

As expected, I felt fine after being airborne for about twenty minutes. I was even comfortable enough to read some of my new Endocrinology book as I flew to Cincinnati for my connecting flight to Los Angeles (LA). Unlike last year, however, I again felt a lot of anticipatory anxiety before my connecting flight to LA! Somehow, I just wasn't conditioning as well as last year. Yet, again, after being airborne awhile, I was fine.

Once in LA, I connected with the bus that took me to Pasadena in half an hour. I checked into the Pasadena Hilton hotel by mid afternoon. My room was on the 14th floor; actually, the 13th floor, but I didn't mind as 13 tends to be lucky for me (grin). Later that evening I relaxed by soaking in a bubble bath while sipping wine, smoking cigarettes and listening to classical music; certainly a blissful contrast to the day's numerous tensions. I slept very well that night.

Tuesday, I had plenty of time to kill. The only event planned for the day was a PDI social gathering at the hotel bar 7:00 that evening, and the conference wasn't until the next day. So I dared to explore a new shopping mall just a few blocks away. I ended up eating lasagna for brunch at the mall's food court. Not being much of a shopper (downright frugal actually) I returned to the hotel, spent some time reviewing my presentation notes and watched a movie on TV. Getting hungry again, I decided to go back to the mall to retrieve some terriaki chicken for dinner. Amusingly, I found a maintenance person repairing one of the hotel elevators; good thing I'm not elevator phobic (grin).

At 7:00, I entered the hotel bar for the planned PDI social gathering. At first, I saw no sign of any gathering at all; just a normal hotel bar that was sparsely populated. Then, almost psychically, I walked up to one woman and asked her if she was there for the PDI conference. She replied yes. We were the first two people to show up and began talking. Gradually, more PDI people entered the bar, including Dr Shipko and Dr Stuppy. Soon we had pulled several tables together and roughly a dozen of us were carrying on several conversations. Openly, we chatted about anxiety disorders as sport fans might debate and reminisce about a game. We enjoyed each other's company for about two hours. A few of us retreated outside for a smoke (by law, bars are smoke-free in California). Someone, I don't know who, paid for my two glasses of Chardonnay while I was out. Knowing tomorrow would be a big day, we wished each other good night before the night grew late.

Returning to my room, I enjoyed a second bubble bath before bed.

Part 2 - The Conference

I don't remember eating at all the day of the conference. Even with plenty of Xanax, I was simply too nervous to eat and I didn't want emetophobia to haunt me that day. Mostly, I was nervous about presenting my own talk; which, this year, was the last talk of the conference. In other words, my anxiety was in overdrive most of the day. But, I can't complain too much since I was the second speaker at last year's conference. Fortunately, there were plenty of friendly people to chat with before the conference, and the hotel conference hall was rather comfortable. And this year we had conference T-shirts! I was impressed enough with the T-shirts that I bought four of them (see title graphic at top of this page).

Please excuse my sparse recollection of the conference, as I was rather anxious throughout the day.

The conference started around 9:30 AM. Dr Shipko (director of the PDI) began the conference with a brief talk about the many facets of panic disorder. He provided a prelude to later talks about bile reflux (Gastro-Esophegial Reflux Disorder, GERD) as it related to anxiety, and foreshadowed other talks.

Next, William Stuppy, MD, presented his talk regarding daily cycles of GERD related pH and Heart Rate Variability (HRV). In regard to HRV, he presented dramatic data showing how patients with panic disorder differ from patients without panic. He also suggested new diagnostic and therapeutic strategies regarding the medical aspects of panic disorder.

Lucy Cosentino, RN, then discussed her personal experience with panic disorder. From the perspective of a nurse, she expressed her frustrations with a medical community that did not understand her condition.

We then had a break for lunch. I spent the break in a hotel courtyard, chatting and smoking with fellow anxiety/panic friends.

After lunch, Matthew Finerman, MD, presented his talk on GERD and related medical issues. His talk seemed similar to the talk he presented at last year's PDI conference, although I must admit I had to leave during his talk (the medical diagrams were triggering my PTSD).

Next, Kathy Wilson described a distressing experience of her own. She had undergone a hysterectomy which also involved removal of her ovaries. This resulted in serious hormonal disturbances; including acute panic and depression. She strongly felt that her doctors were undereducated and misleading in her case.

Lastly, I presented my study of Anxiety and Panic on the Web. As usual, I was terribly nervous, but my talk was well received.

I was rather exhausted after the conference. I can't even remember if I had another bubble bath that night. Nonetheless, I felt the conference had gone very well. Kudos to Dr Shipko.

Part 3 - After the Conference

Thursday was truly the oddest day of my travel schedule. Because I needed to catch a 6:20 AM flight on Friday, I had to check out of the hotel on Thursday and spend the night hanging out at the LA airport. But amongst all that craziness, I had a rather interesting day.

Dr Shipko and I had planned to have lunch together that Thursday. Conveniently, Dr Shipko and the PDI were within walking distance of the hotel. So, after checking out, my backpack and I strolled through the streets of Pasadena to an attractively restored Victorian house that was home to the PDI. I arrived somewhat earlier than planned, but Dr Shipko was happy to greet me and showed me around his offices. We then walked a few blocks to a classy cafe for lunch. I'm not sure my newly brandished PDI T-shirt fit the dress code (grin), but no one seemed to mind (this is, after all, California). Dr Shipko and I spent several hours together and discussed many things.

During my discussions with Dr Shipko, what most impressed me was that him and Dr Jacque Bradwejn (the Canadian pioneer of CCK anxiety studies) had just begun sharing knowledge via phone conversations. As some of us know, the chemical messenger (hormone and neurotransmitter) Cholecystokinin (CCK) is very important in the understanding of biological anxiety disorders. For the most part, Dr Bradwejn's research has focused on CCK's affect on the nervous system. On the other hand, Dr Shipko, Dr Stuppy and colleagues have studied CCK's role beyond the nervous system; especially in regard to gastrointestinal (GI) effects and GERD related to anxiety disorders. Together, Dr Shipko and Dr Bradwejn have much potential for advancing our understanding of the biology of anxiety and panic disorders.

Nonetheless, Dr Shipko and I didn't spend all our time grimly discussing technical issues. Anyone whose met Dr Shipko knows he's a very friendly and understanding person. I very much enjoyed my visit with him. And, just before I left, I was impressed to see him speaking in Spanish with someone over the phone. With a friendly hug, I said good-bye and headed for the LA airport.

My return to the LA airport was less than ideal. I got very sweaty in the California sun and felt emetophobic on the bus to the airport. As I mentioned before, I was committed to spend the night at the airport to catch an early flight the next morning. Yet, once at the airport, I suddenly learned that the airport was closed from midnight to 4:30 AM! It seemed I would have to spend the night sitting on the street curb! Fortunately, I talked to some airport people who informed me that the "International" terminal was open all night. So off I went to spend the night at the international terminal.

Actually, the international terminal turned out to be a decent place to spend the night. The furniture was a bit more comfortable, and there was a coffee shop and McDonalds open all night. Furthermore, I enjoyed the cultural diversity. There's something pleasant about being surrounded by the sounds of various languages, and I even helped an Australian aborigine find the gate to his flight home. In some ways the international terminal reminded me of the Internet, except you're actually face to face with people who are usually far, far away. Even if you can't speak a common language with someone, you can at least share friendly smiles and gestures.

I managed to stay awake that night without much discomfort, and I caught my early Friday flight. This flight took me, again, to Cincinnati, but my connecting flight was not to home. I had planned to visit a friend on my way back from the conference; my friend Jen from alt.support.anxiety-panic (ASAP). So, from Cincinnati, I was scheduled to catch a flight to Wisconsin.

While waiting for my next flight from the Cincinnati airport, I dropped into an airport bar where I could smoke (ahhh, true civilization!). While hanging out at this airport bar, I started talking to a person or two. I was still wearing my PDI conference T-shirt from the day before, and one man asked me about the conference. I briefly explained. The man mentioned he was a combat veteran from the Vietnam War. He, himself, didn't suffer any anxiety disorders, but his wife did. I wrote down some URLs for his wife. We spent the next half hour discussing PTSD; mostly in regard to his combat friends with PTSD and how he somehow avoided PTSD. All too soon, I had to interrupt our conversation to catch my next flight. I shook his hand and said I felt honored to meet him.

My next flight was a bit of a surprise. I was used to flying in big jet liners, but this next plane was a small twin-engine prop (i.e. propellers!). Not only did the plane feel much more claustrophobic (maybe twenty passenger seats), but the flight was much noisier and more turbulent than I was used to. Again, I struggled with emetophobia for at least twenty minutes. As usual, however, I eventually acclimated and enjoyed the experience.

Once I arrived at the Wisconsin airport on Friday evening, Jen was there to greet me. She hugged me and gave me a delightful pinwheel, and I gave her one of the PDI T-shirts I had brought back with me. I was warmly welcomed by her family and given a very comfortable guest room at their beautiful home. They treated me to a wonderful weekend and we spent much time talking about everything under the sun; including some hilarious family stories (LOL!). The only worrisome moment was when Jen's daughter had a high fever on Saturday; but the fever rapidly came down over the next day or so. Otherwise, I greatly enjoyed my time with Jen and her family. They introduced me to tasty Cincinnati Chile and treated me to a terriaki chicken barbecue the next evening.

I had to leave for Philadelphia on Monday morning. It's always sad to leave good friends when you know you wont see them again soon. I felt sad leaving Jen and her family. I felt sad leaving Dr Shipko and everyone I met in Pasadena. I could only wish we all lived closer together; but at least we have the Internet.

Returning home was the worst part of my trip. My flights back had been fine, but my ride from the airport to my house had gone afoul. I ended up taking public transit home, and got stuck walking two miles through a pouring rainstorm in my best clothes. Once home, however, I was happy to see that my cats were lively and healthy (thanks to my friend Craig). Overall, I felt the trip was very much a success and I was glad I went.