Dances with Doctors

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Dances with Doctors

Postby wkitty42 » Sat Aug 08, 2009 8:33 pm

The following post is about my recent adventures with a problem that I was experiencing and what it took to fix the problem.


First a bit of background...

My first episode came on in the wee hours of the morning about 5 or 6 weeks ago (from the time of this posting). I was generally up during the night time hours doing what I do for numerous reasons. This particular night was like most any other. Easy going, no stress, no strife, no arguments... If I recall correctly, I was actually taking a break and reading a book while laying on my bed. Then about 2:00AM, i started getting a weird feeling in my chest that progressed to include the symptoms noted below. I don't know how long it all lasted but it wasn't "fun" and I was unable to find anything similar when I started researching my symptoms the next day. I was weak and my hands had tremors for the next two or three days afterward.

My second episode came on a Monday during the daytime. I happened to be up and on the computer as usual. My father was in town picking up some groceries when this one started. It was very much like the first episode and it took me a few minutes to realize that it was coming on and that it was the same thing. I was able to note that this one lasted about 30 to 40 minutes. After it had been going on for some 10 or 15 minutes, I called my father's cell phone to find out where he was so that we might go to the hospital and try to document this thing. He was on his way home but was still about 15 minutes away. I knew that by the time he got here, the episode would probably be over or would be by the time we got to the hospital which is 20 minutes away. I was right on the timing, too. By the time he got here and we started out for the hospital, the effects were going away and it was pretty much all over with by the time we got 4 or 5 miles down the road. With no insurance and no way to pay for the hospital, I decided to just come on back home since there was nothing going on that anyone would be able to document and there was no way I could justify paying a bunch of money that I didn't have in the first place :?


Now on with the story...

My third episode happened on the Saturday after the one on Monday. This was a bit of a surprise because it had been a few weeks between the first and second ones. This one was only a week later. I was able to get to the ER while this third episode was in full swing and spent a week in the hospital(s). So, now here we are two days after my coming home from the hospital and I'm writing this documentary about it. I'm doing fine as far as I can tell although I do have a very light "weird" feeling in my chest right now (while writing this initial entry) but that may be due to no longer wearing a "nitro patch" like they had me on the entire time I was in the hospital(s)... The end result of these episodes and my hospital stay is that I had to have a stent put in my LAD (Left Anterior Descending) artery on my heart because it was restricted about 1cm... not a full blockage, mind you... just a restriction.

One of the 3 or 4 cardiac doctors that attended me told me that my episodes (three distinct ones) were about as close to having a heart attack without actually having one as anyone could get. No clue as to the trigger mechanism, though. And no pain, either. It seems that the medical industry has some weird ideas about what "pain" is. I always think of "pain" as a burning or sticking or stabbing sensation. I had nothing like that at all. If they had asked me what my pain level was during any of the episodes, I would have been able to honestly and easily tell them it was "zero" because I wasn't hurting. I also wasn't sure if these episodes might have been something brain related since I was having tremors in my hands. It could also have been food related but I was unable to find anything in the foods I eat that I might have developed a sudden intolerance for. MSG was one thing that came to mind and that is easily hidden in the ingredients listings among "spices" but on the day of my third episode, I had only had about 4 to 6 ounces of sweet iced tea and that during the early phases of the episode due to dry mouth. Needless to say, the tea didn't help. I should point out that when I say "I had only had about 4 to 6 ounces of sweet iced tea" I mean that that was all I had consumed all day since awakening and getting up. Right. No solid food yet and only that little bit of tea. But not having eaten wasn't the trigger, either.

As for other possible food related sources, nothing really came to mind. I had not eaten anything new or exotic and, truth be told, I wasn't really eating all that much anyway. Maybe one meal a day and that generally something like beef, pork or chicken with potatoes of some kind (roasted potatoes or baked french fries or tater tots) and possibly a vegetable like corn, green beans or spinach. Sometimes I might also have a salad of mixed lettuce with baby spinach topped with fresh raw button mushrooms, some diced tomato, and Ranch, French, Thousand Island or Blue Cheese dressing. I'm not picky :) I have also been known to have just a salad and toss some diced meat on it along with some shredded cheddar and/or mozzarella cheese.

My beverage of choice has been Coke Zero and I've been drinking it for almost a year now. However I am considering switching away from it to something else that contains real sugar and not HFCS (High Fructose Corn Syrup) or some artificial sweetener like Splenda, Stevia, Saccharin or Aspartame. I don't care what the FDA (Food and Drug Administration) has to say about them. They are man made chemically derived and/or processed and, quite frankly, I don't like them and would much prefer to consume more natural substances. I really wish that "kosher" Coke and other similar beverages were available in my area and that they were available year 'round instead of only during certain holiday periods and only in certain locales. Are you listening? Hello?

My symptoms were:
  • inability to take a normal breath, only small short ones

  • a "cramp" in the center of my chest

  • a "cramp" in my elbows and knees causing me to want to curl up in a fetal
    ball as the episode progressed

  • both hands going tingly numb at the same time
    1. tingly like having hit your "funny bone" in your elbow
    2. just before the breathing problem started
  • tremors in my hands, arms, and legs very similar to a seizure in appearance
    1. came after the numbness started
  • totally clear mind but some things were "backwards" in appearance
    1. eg: I was able to think and "converse" to myself in my mind
    2. eg: chair on left but I had to turn right to go around it
  • sweating although i was "cold" and my skin was cold

  • vocalizations "garbled" (ie: grunts and noises instead of words)

  • no pain. "pain" meaning hurt as in burning or like you feel when you have been
    stuck with a needle or splinter. the cramp didn't not hurt like a leg, hand or
    foot cramp can hurt
The ER (Emergency Room) people had no idea what was going on or wouldn't admit to one anyway. They could not take any EKG readings until after the episode had subsided. I remember some of them telling me that I had to stop hyperventilating. The problem with that is that I wasn't hyperventilating. I was having to take short small breaths just to get any air into my lungs. I could not take a normal or deep breath because when I tried, I felt as if I was wedged between two walls, one on my back and one on my front, and that I only had a half inch of space to move my chest in. One of the nurses "threatened" to put an oxygen mask on me if I didn't slow and control my breathing. My immediate response to her was, "Well what the hell are you waiting for?! Don't threaten me with it. Do it!" Seconds later I had an oxygen feed and was finally able to slow my breathing. My hands still had major tremors in them and I kept wanting to cross them over my chest and draw up my legs but I made a real effort to keep my legs straight. The ER people tried numerous times to take an EKG but with all the tremors and spasms that was an impossible task. EKGs read the electrical impulses and muscle movements are also triggered by electrical impulses. With the tremors and spasms, my whole body was a huge maze of electrical impulses so an EKG reading would have to wait until after the episode subsided.

When each of my episodes were over, it was as if nothing had ever happened. Sure, I would be weak and still have some slight tremors in my hands that would last for a day or two afterward, but over all, it was as if nothing had happened. The ER doctors decided to treat my situation as a cardiac problem and admitted me for observation and treatment. While in the ER, I had been given a "nitro patch" (nitroglycerin paste), 2L oxygen feed and four 81mg aspirin to chew. I was also outfitted with an IV lead in case they needed to give me anything intravenously.

This last episode started at about 1:40PM. I had noted the start time when I took three BP (blood pressure) readings during the first 10 minutes of feeling it coming on. My fingers hadn't gone tingly or numb and my breathing was still normal at this time. Since I wasn't sure if these episodes were cardiac related, I wanted to see if my BP was effected by what was going on. I took three BP readings, each two minutes after the last, during the very first stages. I decided, after the third BP reading to get my father to take me to the hospital. It was about a minute later when the breathing problem, tingly numb fingers and the tremors started. It took my father a few minutes to get ready because I woke him from a deep nap he had been taking but we got on the road about five minutes or so after the episode got going full bore. I don't know what time it was when we arrived at the hospital but I went in under my own power, bent over, shaking and tremoring and staggering like a drunk person. There was no one at the Admitting/Help Desk but I spotted someone coming from the ER and got them to let me in that door to find some assistance. Triage? I didn't need any steenkin' triage. I needed help right then. I have to laugh, too, as I think back over that entrance and someone asking me what was going on. My response was something like "I don't know but what you see is what is happening!" :lol:

After the episode was over, one of the ER people asked me when it had started. I told them and asked what time it was then. That was at 2:20PM and the episode had been over with for only a few minutes. Just like the other two, this one had lasted right about 40 minutes. I figure it was about 3:30PM or 4:00PM when they admitted me and took me up to my room but I might be off a bit on that.

On Monday morning, I was given a "stress test" which i did very well on. This "stress test" is done on a treadmill that elevates and speeds up after a certain time period elapses. They had me on three minute long time periods and I completed the 3rd or 4th phase when they decided they had enough to work with. At this point, I had to exit the treadmill and lay on my left side on a table so they could do an echocardiogram on me. An echocardiogram is basically an ultrasound of your heart just like women get of their baby when they are pregnant. The echocardiogram did show a slight problem with my LAD artery and the front wall of my heart which wasn't expanding as much as it should.

The doctor that gave me the stress test recommended that I have a coronary catheterization to get a better look at my heart function. My attending doctor made the arrangements and scheduled me for transportation to Rex Hospital in Raleigh, NC where the procedure would be performed. A coronary catheterization is also loosely called a "heart cath". The process involves running a line into your heart through a vessel in your groin or your arm. Once the line is in place, a dye is injected into your bloodstream so the flow of the blood through the vessels can be seen via X-Ray on active monitor screens. This will show any restrictions, blockages or possibly even leakages. So Tuesday evening, I was transferred to Rex (about an hour away) and the procedure was done Wednesday morning. I was fully awake during the procedure so I was able to watch the screens and even asked questions of the doctor and nurses there. When all was said and done, I came out with a stent in my LAD. I stayed one more night and was released to go home early afternoon on Thursday.

Now I have to figure out how I'm going to pay for the two hospitals, the ambulance ride to Rex, the doctors, the ER visit, and, most importantly, how to get my Plavix for the next year. Plavix is an anti-clotting agent which is necessary to prevent my blood from clotting on the stent and causing another blockage restriction. This would happen because the stent is a foreign object in my body and this is how your body fights invaders. Over time my LAD's wall will grow with the stent and then the Plavix won't be needed any more. Until then, I also have to be careful about cuts and scrapes because now I will bleed a lot more because of the no clotting aspect of the medicine. Currently I'm taking 75mg Plavix and 325mg aspirin on a daily basis.

Another GoodThingtm that came out of this is that my cholesterol levels were checked which I have never had done before. Cholesterol has to be transported to and from the cells by carriers called lipoproteins. Low Density Lipoprotein (LDL) is the “bad” cholesterol and High Density Lipoprotein (HDL) is the “good” cholesterol. These two types of lipids, along with triglycerides and Lp(a) cholesterol, make up your total cholesterol count. My overall count was 165mg/dl, which was 95mg/dl LDL, 64mg/dl HDL and the rest triglycerides. This is pretty good. My HDL was actually a bit low and the way to increase it is via exercise. My LDL is "ok" and since it is less than 100mg/dl it is viewed as "optimal" but I think I'd like to see it a bit lower. My cardiac doctor at Rex also recommended that I take 2000mg of Omega-3 per day to help with my cholesterol levels. I should also note that I've been a "pack-a-day" smoker for the better part of 30+ years. Funny that I quit smoking just a few weeks before my first episode struck. I'm smoke free today and plan to stay that way for a long time to come ;)

In reading the documentation I have been given, "angina" or more accurately "angina pectoris" seems to be the term for what i was experiencing but of everything I've found, nothing covers or describes all of my symptoms. "Chest discomfort" fits as does "breathlessness" but that's about all. It may also have been a form of "Prinzmetal's angina" which happens "at rest" which fits with my episodes because I wasn't doing anything strenuous and hadn't been. I lead a fairly sedentary lifestyle, these days, spending most of my time at the computer. This is quite unlike my lifestyle 20+ years ago when i was pretty athletic and outdoors hiking and biking a lot. Prinzmetal's angina is thought to be caused by a spasm of a heart vessel and it is possible that my LAD did spasm. What causes these spasms is still up for debate and study. Of course, this thinking about Prinzmetal's angina is only my own speculations and based solely on a quick read of the linked article. If I remember to, I will bring it up with my doctors during my follow ups with them and see what they have to say about it.



There is more to write about this adventure but I don't know if I will add it or not. We'll see what happens. In the mean time, I hope that others can learn from this and if you or anyone you know has any of the symptoms I note above, get to the hospital or your family doctor for a good check out ASAP! Don't do as I did and try to analyze it or wait to be in the middle of an episode before presenting yourself to a doctor. Get in there and get checked out.
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wkitty42
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