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Am I Having a Heart Attack or a Panic Attack?

On Monday, Dec 4th I woke up to film a project I've been working on for low/moderate intensity exercise (I'm super stoked about it).

I was SO sick to my stomach, which is not uncommon for me when I get really nervous. I like things to be "perfect" or as-perfect-as-possible. There were a lot of details, and I wanted to nail it.

I was nauseous literally all day long. I had to repeatedly swallow hard, trying my best not to lose it. This was some intense nausea.

I have bizarre opposing parts of my personality. I LOVE tackling big projects that truly challenge me. Working hard, working late, and trying something new excites me. On the other hand, I hate feeling exposed and vulnerable.

Putting my projects out in public makes me feel incredibly anxious- which isn't something you would expect because I am naturally fairly outgoing.


I started the morning off with a cup of coffee as I did my hair and prepared to get all glammed by Kara Deitrich (she is wonderful.)

Dr. Brene Brown describes trust as choosing to make something important to you, vulnerable to the actions of someone else. That is so powerful. I inherently struggle with this. A lot. I'd rather do it myself, crush it, and show no one.

Do you ever feel like you'd rather keep things close to you without sharing them for the judgement and criticism of other people? I'm working to get better at this. It never bothered me in academia because your ideas and professionalism were under the microscope, not your personality, creativity, or beliefs.

This project has made me nervous for quite a while. I didn't initially want to do it. I searched to find if it already existed so I could send my patients/family/friends there instead of having to create it. Filming is one of the most humbling experiences, ever. If you've ever felt eloquent, intelligent, or like you had even an ounce of charisma.... you can kick those feelings out the window with cameras and whole crew staring at you.


When I watch myself on film, my eyes automatically see every little thing I would like to change.

I still have not watched our Ab's, Core, and Pelvic Floor videos. I just couldn't bring myself to do it, and it felt like I could protect myself from it by simply dodging it!

I see every slurred word, darting eye, awkward stammer, fill-in words, twitches, and nervous habit.

In advance, I practiced and practiced to make sure that I didn't leave out anything important.

I didn't exactly nail "charming and concise". It should be a form of punishment to watch yourself on film. It's the worst.


On Monday morning, I had everything ready to go: the scripts, the perfectly steamed Lululemon outfits (which I had been waiting to wear because I wanted them to look fresh), the decor, the team in place.... ready or not, here we come. The day went great, and while I wasn't perfect, I felt really good about how things went.

I packed everything up at the location, said goodbye to so many people who helped to make it possible, drove home, and walked through the doors of my house.

By that time, my heart was racing so hard I was having a hard time breathing. I laid on the floor, trying my best not to vomit, and both of my hands were completely numb.

My heart felt like it was being stabbed. In the line of work that I'm in, we don't take chest pain lightly. Internally I knew that this was more psychological than physiological.

I regularly teach about cardiac health.

As this is happening, I'm mentally running through the signs of cardiac distress:

  • Heavy chest pressure = check

  • Light headedness / dizziness = check

  • Pain in one or both arms = check

  • Shortness of breath or difficulty breathing = check

  • Unusual fatigue = check

  • Nausea / vomiting = double check

Oh boy.

History- I've had one other panic attack before. I was driving at the time, and it was unbelievably scary. I actually almost drove to the ER because I thought I was having a medical emergency. I wasn't, but it took me a few hours to get myself together. My EKG is perfectly clean, excellent blood work, no cardiac issues here.

Clinically, I know what to look for, however, reading signs and symptoms, and experiencing them for yourself are two completely different things.

I sent a message to my family "Would you pray for me right now? I think it's just a panic attack, but I'm not feeling well." I laid down (I was really tired), force fed myself some bread (I only had coffee all day), drank some water (because I exercised for hours without drinking), put some heavy blankets over me, and turned on my favorite song of the moment "Peace Be Still" by the Belonging Co. *Side note- This song has helped me stay the course when I've wanted to bail out.... so many times. Listen to it. It just speaks right to me.

About 3 hours later I start to feel significantly better. Panic attack over!

It's easier for me to do nothing, never reach, never try, but I also feel a bit dead when I do that. It just isn't in my DNA to do bare minimum. I'd rather face it and have a panic attack than skip it.


To just do a quick recap- I CHOSE to put myself through this. No one forced me. An incredible amount of people showed up to support me- in person, in text, in email, with their time, effort, and energy. I could not ask for more. My silliness and unwillingness to confront my imperfections does not help anyone.

I like to think of myself as a strong and courageous woman. Curled up on the floor, crying, gasping to breathe, just does not fit in that picture I hold of myself. But if those are the steps I need to take to grow, then so be it. Brutal, yet beautiful.

Two years ago I just decided to be a bit gutsier. Someone (I honestly don't remember who it was) shared this thought with me: people who are less qualified than you are doing what you should be doing. The only difference is that they have the guts to do it. Hello, wake up call!

Here's what I've determined:

I can feel uncomfortable and still be okay.

I can survive a panic attack. Even though it feels scary, it isn't.

I can hang in there and watch myself on film, and think kind thoughts.

I can suck-it-up and get over any barrier of my own perfectionist tendencies.

I refuse to let my own emotions, fear, concern, embarrassment, shame, or guilt keep me from doing things that are important to me.

If you've wanted to do something that freaks you out too, I encourage you to take a big step and just go for it. Even if you find yourself crying on the floor with numb hands, it only lasts for a moment.

Making a difference lasts forever.

Sending you a little extra courage today (we're in it together!)

With my love,

Dr. Monique Middlekauff


In Case You are Wondering, Here is More Information on the Project:

So many people are missing access to high quality instruction that is appropriate for their fitness level. If you don't like yoga, pilates, or water aerobics, you may really struggle to find a good program that is inexpensive for low to moderate intensity. So many programs are made by people who aren't qualified, and often do more harm than good.

Too often people don't know what to do in a gym or at home. They may start at an intensity that is too high, they get super sore and injured and throw in the towel on exercise all together.

A ton of our patients didn't qualify for our services (Lifestyle Medicine) or struggled to physically make it to our fitness classes due to location or schedule. The most common feedback I get is that people wish I could just come to their homes and exercise with them... so I decided to make that possible.

Insanity, P90X, and other similar programs are just the wrong intensity for most people.

I just love teaching, and I really wanted to make something that actually made a difference. This isn't a big business idea. Financially, its incredibly expensive to make this look professional and top notch. I'd love to break even and continue offering high quality instruction so people can improve their fitness systematically. I may add additional intensities in the future if I decide to torture myself through another filming session.

The exercise videos are full length so you can completely follow along and I teach throughout each one so you know "why" you want to do each exercise. Alternatively, you can use the printed sheets if you like to exercise at your own pace. The video topics are: 1) Strength, 2) Mobility, 3) Cardiovascular Endurance, 4) Stability and Balance, and 5) Core Training. I wrote the instructions book over the summer, and I am stoked at how it turned out. The cookbook is still in progress. The online community on Facebook already warms my heart and just makes me smile because we could all use some extra encouragement and support.

In case you'd like to follow along:

Website (still being built) Instagram: fitnessforus_monique

Facebook page at:

The website/film is being done by Dark to Light Productions. The graphics and book layouts are done by Chantel Miller.

Photos by Makayla Madden Photography.

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