Sunday, March 29, 2009

45-year-old Male Presenting with Chest Pains

Reading those words on my own chart in a hospital I had no intention on visiting last Monday brings a flood of thoughts and emotions: fear, mortality and embarrassment. Suddenly the economy, the futility of partisan politics and the AIG hate-fest are meaningless. OK, it’s not a chart on a clipboard like on TV, it’s on a computer screen, but it has the same effect.

A week earlier I pulled a trapezius muscle. Not from working out, playing sports or aerobatic heroics. No, from self-induced whiplash when I accidently hit the cold water in the shower and got a quick ice splash on my back. Like I said, embarrassing. To compound things, because that's what I constantly do, I also strained my neck and back performing an exercise incorrectly I was given by my chiro.

I felt like an idiot, because that's what I constantly do, so my plan was to take some Advil and walk it off, at least figuratively. The pain started to fade (that false sense of quick rebound healing like when I was younger), then came back with a vengeance. By Thursday night I’m not sleeping – I can’t find a comfortable position no matter how I sit or lay. And my breath is shallow because it hurts to inhale (like with bruised ribs after missing a payment to Citibank).

So I try to see my doc on Friday but they’re all booked up. I schedule an appointment for Monday and take some more Advil. By Sunday, I’m a zombie – the no sleep thing is catching up – so I go to a clinic (my vitals are fine), get some muscle relaxants and finally get some rest.

I decide to keep my doctor's appointment on Monday afternoon because the relaxants may be knocking me out but the pain is rock solid. It’s radiating straight through my chest, like William Tell aimed too low and a little to the right. No shooting pain down the arm, no pressing weight on my chest, no indigestion. This is not a heart attack.

They check my vitals as they always do and the blood pressure is up (it's never up) and my pulse is 100. What? 100? Wait a minute, it was fine yesterday and it's never been that high.

They immediately give me an EKG. Great, shirt's off for the ladies, while I'm sitting down, before I've worked off the winter weight. Yes, even in situations like this I can't shut down my vanity gene.

My doctor says my EKG is normal. Whew! But that’s just a snapshot in time so it isn't exactly reliable. And because of the pulse rate and difficulty breathing, she's a little concerned about a pulmonary embolism. A what? Where’s Wikipedia when I need it? It’s probably nothing but still best to get it checked out. Getting a stat CAT Scan at a regular lab is about as likely as [insert fast economic turnaround joke here]. Would I like an ambulance, to call a friend or to drive myself to the ER. The latter is not recommended. Thanks, Regis. I think I'll phone a friend.

Here’s my real problem: I’m an analyst and have an eye for detail. I give so much information during a doctor's visit I confuse even myself. But the pain is real, my heart rate is elevated, and I'm getting unexpected stressful news. I'm on my way to the hospital instead of the office. Now I'm starting to panic. Good lord, what if none of this pain has to do with my hypersensitive startle reflex and poor direction-following? What if there is a blockage of my pulmonary artery caused by a clot that dislodges and embolizes (travels) to the arterial blood supply of one of my lungs? (OK, I wasn't thinking that - I looked this shit up when I got home). But no wonder my pulse is elevated.

No. Namaste. Breathe. This is another bone-headed self-injury. I’m fine. Right?

Right. Five hours later, I learn I am fine. I’m more than fine. I'm ecstatic. They ruled out the scary stuff, one at a time:

  • Check my vitals as soon as I get there - I'm already getting better

  • Another EKG - it's all good. I'll take two snapshots in time

  • Blood work comes back great (enzymes that can be released after a cardiac incident are not found, and organ function is normal)

  • Chest X-ray is taken and looks good from both the front and side angles (thank God because I quit smoking in 1996 and I know it’s not a guaranteed get-out-of-cancer card free but we’ve got the big C on both sides of my family; luckily, we don't have heart disease)

  • Just to be safe, let’s rule out that pulmonary embolism with a CAT Scan. We’ll just inject you with a radioactive solution so we can get a good look. Sign here, please. I’m now Peter Parker but my web slingers aren’t yet active (Yes, I tried). Wait a little while and the results are awesome

  • Go home, take it easy, don’t lift anything, here are some meds better than Advil and stay away from the office for three days (bonus!)

So I’m lucky. I have comprehensive health insurance that covers all of this, a doctor who thinks like I do (better safe than sorry), and an incredibly efficient hospital (Howard County General) right up the street. They were fantastic. They moved me through each station, with some waiting in between back in the lobby and not on a metal chair in a cold hallway. They even apologized for the backup. I thought I’d be there all night. I was out in hours. They were fast.

And just for added kicks, I learned while I was in the ER that my company started laying off 10% of our workforce. We knew it was coming, we just didn't know who or when. It didn't help with my stress but honestly, I wasn't thinking about work. If it was me, they could wait to deliver the news. Turns out it wasn't me. Do they have a pill for survivor guilt?

So why do I share all of this? Because I imagine there are people out there like me who feel like a hypochondriac when describing their symptoms, or rule out a visit because of the inconvenience, a busy schedule, warped priorities like work before health, impatience, money, fear or a dozen other rationalizations of why you won't go. Yet we all know it's always best to get it checked out because the alternative just isn't worth it.

Getting older may not always be fun, but as long as I'm getting older and still here, I'm doing something right.


JessieX said...

Glad to hear you're ok, Mike. And that you survived your company's 10% staff reduction. Hey, Dennis / Wordbones / Mr. Tales of Two Cities had a heart attack a few years back and started a blog about how important it is to check in on such things. is his site, I believe.

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Mike said...

Thanks Jessie. And good memory - that is Dennis's blog site.

And thank you, Middle-Aged Babe Magnet! I appreciate the kind words and have already started checking out your posts.


One Wink at a Time said...

I'm usually not a worrier as much with my own health as I am with loved ones'. And yet no matter how hard you try, after you reach a certain age, aches and pains get your subconscious in a twist and you begin to imagine scenarios...
I'm usually not even aware that I've gotten myself dead and buried until after I find out I'm fine. And then I usually have some post-traumatic stress incident.
Glad you're ok. It's always a bonus when you find out at least a few of your things are in good working order.

Mike said...

Thanks, Wink! I always worry about loved ones and encourage them to check out things and preach early detection.

I haven't blogged about my colonoscopies yet but will because a) it could be funny and b) because you don't f' with the big C.

With the recent passing of so many who are simply too young, it gives me pause - who cares if my doctor thinks I'm a hypochondriac? Then again, I also don't spiral into Woody Allen-like anxiety fits every time I find a new ache. So better to be safe than sorry, and get back to my Yoga and reasonable exercise routine.

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