What follows is the complete recounting of my recent health issues and treatment received. Its a long story….
On January 22nd 2012 I watched the 49ers play the NY Giants. I didn’t realize how emotionally invested I had become in the outcome until the game was almost over and I began feeling my heart going into an overtime of its own. I wrote a semi-autobiographical piece based on the experience here. I already had 3 stents placed in arteries over the last 12 years.
I should have gone to the ER or called my Doctor following this, but I thought it was probably a one time event which would not likely repeat since the niners were now out of the playoffs. Over the next few days I experienced a few less intense versions of the same heavy heart beat. I was about ready to call for an appointment when I got a call from the clinic. My primary care physician wanted me to see their new in house pharmacist to review my medications and make sure there were no combinations with bad interactions. They were able to get me in the next day for this appointment.
The woman that introduced herself as Doctor ‘x’ seemed a bit young and I thought it was interesting that a Doctor would be doing the work of a pharmacist but no worries. As we reviewed my meds I told her about the problems I had been having with my heart. The first sign of trouble came as she picked up my metformin bottle and told me that it was similar to glyburide, a drug which helps the body use the insulin it produces better. I told her my understanding was that metformin reduced the amount of sugar the liver released into the blood. She assured me I was wrong and offered to print out an information sheet which would confirm her understanding of how the drug worked. What she eventually gave me did not have any information on our disagreement and when I googled at home I confirmed that I was correct. As we moved on and finished with the med review I asked her what I should do about my heart issue. She asked me if I had nitroglycerin and had I used it at the time of the trouble. Good questions; I told her what I had was old and I should have taken some even so, but I had opted to take my metoprolol and it had eventually seemed to work. My concern was that the issue was ongoing. She said she would get me a fresh supply of nitro and hopefully that would solve the problem. She said whe would go type up her notes of our meeting and I asked her to include in them a request for a consult with a cardiac doctor.
As I left the clinic I was a little mystified that the person who reviewed my medicines had no clue about how at least one of them worked. And she was willing to let someone with a history of heart disease and the story I had told her walk away so easily without at least suggesting a more urgent response.
That same evening as I sat at my computer I felt an iron fist grab my heart and squeeze. It slowly grew in pressure and pain and had me reaching for the old bottle of nitroglycerin I located and kept nearby. I put one under my tongue and leaned back in the chair. A couple minutes later a second one and a couple minutes later the pain was subsiding. As the pain diminished I considered what to do next. I picked up the phone and dialed the number for my health care provider. I was only able to get to an operator who told me they did not have advice nurses any longer and I should just go to the ER or the express/urgent care next door. I called my daughter who came and drove me there.
Express sounded good to me and so we found out where it was and headed in. I told the nurse who took the initial paperwork my story. Told him the pain was still present and only a 3 or 4 now where it had been a 10 at the time of the trouble and he said take a seat. After 45 minutes I went up to the triage nurse and mentioned I was still having chest pain and asked how much longer it would be. That got me next in line for triage and 15 minutes later I was brought in for an ekg. The doctor who talked to me after asked why I had come there since I really belonged in the ER and I explained about how I called and I suppose misdirected myself based on the information from the operator. He said I needed to go to the ER and get my situation worked up. Shortly thereafter someone showed up with a wheelchair and wheeled me over to the ER which was jammed. There was not an open seat to be found. The person who brought me over told me she would let them know I was there and it shouldn’t be too long.
I had been feeling weak and exhausted ever since the chest pain started. I found a seat and closed my eyes and waited for my name to be called. As I opened my eyes from time to time I noticed someone watching me. I had used my iPhone to let my daughter know what was happening and call me paranoid but I was sure this kid was just waiting for me to pass out so he could grab my bag with the phone and bolt. The point is stress was building up in me the longer I sat there waiting and my chest was starting to burn. I walked up to the nurse who was checking in a very long line of people and mentioned my pain and distress. She said she would look into it once they had processed the people waiting. Another 45 minutes and I heard nothing. The line had pretty well diminished so I asked another nurse there who did look but couldn’t find me in the computer. She said she would try and find out why. After another half an hour I walked out of the waiting room and sat down on a desk in the lobby outside. The stress and the pain began to diminish almost immediately and shortly thereafter I called my daughter to come back and get me. I had concluded at that point it would be better for my health to get away from there.
Two days later I had an appointment scheduled with my diabetes clinic. As we reviewed my blood sugar history and related issues I told my sad story beginning with the 49ers game and finally the nightmare in the ER a couple days before. This doctor got me an appointment the following morning with the clinics urgent care doctor. After telling him my story, he ordered some blood tests and I went home after having the blood drawn. When I got home I fell asleep for a few hours. When I awoke and checked my phone I could see I missed a call from the clinic and the phone rang before I could check my messages. It was the doctor I had seen earlier. One of the tests showed an enzyme value that might mean there was an ongoing problem and I needed to go to the ER right away. A short time later my daughter brought me back to the ER.
They got me right in to triage. A short time later they drew blood and ran an ekg. Some time later a room opened up and they brought me in for more tests. Apparently the blood enzyme test confirmed the earlier result and they told me I would be spending the night. The following day the cardiac team came to see me during rounds. They wanted to schedule an angiogram but the lab had been down for a few days and they were significantly backed up as a result. So I could stay in the hospital for a few days until they caught up or go home and come back as an outpatient. Home I went and they called to schedule the procedure a couple days later. I just had to survive until February 27th.
During the time I waited for my test I rode an emotional roller coaster; rising and falling along with familiar symptoms that came and went on a daily basis. Had I not already had an appointment scheduled I might have gone back to the ER. My fear was that would just lead to more hours of sitting in the horrid waiting area only to be sent home to wait for the already scheduled procedure. That fear was worse for me than there being any actual harm done by not going. I dealt with other fear as the days passed. I somehow began to believe I would not actually make it through the procedure or that I would end up needing more extreme repairs such as a bypass or even transplant. I don’t recall having such strong feelings prior to my other 3 stent procedures. As the day grew closer my concern grew larger.
When the nurse called to schedule the appointment she asked me to get some blood drawn for a test they had overlooked while I was in the hospital. I was to do this any time before the day of the appointment. I said I would but I did not. It was getting more and more difficult for me to walk without stopping to rest. Every time I walked more than 100 feet I would feel pain in my chest.
The appointment time said 7:30 AM. I arrived at the admitting office at 7:05 AM. They checked me in and walked me to the elevator and then a short walk to the waiting area for the Cath Lab. The lab opens at 8 AM and an hour later a nurse found me and handed me a lab slip for the blood draw I had neglected to get done. The lab was in another building and for me would be extremely difficult to walk to. I told her I was having a lot of trouble walking and she offered to hold on to my bag for me. I declined and started off. By the time I got to the lab I was experiencing a lot of pain in my chest and numbness down my arm. I knew I should have done a better job of letting the nurse know what shape I was in. I pulled a number from the dispenser and as I sat down I could see there were 20 people ahead of me. The entire time I sat waiting I fought the urge to leave and go home. My fear of the procedure wanted to use my feeling of being treated poorly and callously to get me to submit and run. Honestly, I don’t know how I kept myself there.
In all, it is fairly embarrassing to look back at my thoughts and somewhat irrational fear and recount them here. I’m not intending to troll for sympathy or some kind of vendetta against the Health Care Industry. I’m just trying to tell the complete story here because it takes too long and is too hard to tell it every time someone new wants to know what happened.
My turn finally came. It took longer for them to figure out where to send the results from the blood draw than it did to draw the blood but I soon soon started the long walk back to the cath lab. Once again I felt the now familiar pain in my chest flaring up and stopped a couple times along the way. At last I was being prepped for the procedure. I don’t remember much of anything about the angioplasti. I woke up a few times which I guess was unexpected. I remember the doctor seemed annoyed the third or fourth time he told the nurse to give me more or whatever it was. When it was done the nurse told me she had to give a lot of versed and I might feel noxious but I was fine. The recovery overnight was uneventful and I went home the next day.
I was feeling ok for most of the day but by the evening I was gasping for air at the slightest activity. I was in some kind of extreme denial about my condition because it was 2 days later when my daughter asked if I had taken my temperature which I had not done. When I did, I found I was 101.6 and so she asked if I wanted some ibuprofen. I called my PCP and she set up an appointment for me at 10 the next morning. The ibuprofen had knocked down the fever and I thought I was well enough to drive myself to the appointment. I really wasn’t. I had to stop several times on my way up to the office from the parking lot. I checked in early and they checked my vitals by 10. It was almost 11AM before I was taken to a room and 15 minutes later the Doctor finally came. After his exam he ordered a chest x-ray and a blood test and said to go home and they would call if something showed up on the tests.
After the X-ray I slowly made my way back tot he first floor and decided to get something to drink before the blood draw. On my way to the lab the nurse intercepted me and told me the Doctor wanted to see me. I asked if I should get the blood draw first and she asked me if I wanted to. I laughed(first time in days) and asked her what she wanted me to do so she said to go back upstairs. I had to stop and sit before I could get on the elevator so she went up ahead and I said I’d get there as soon as I could. I finally made it back and they brought me to a room where the Doctor came in shortly thereafter. He said there was something on the X-ray and he wanted me to go back to the hospital. They would arrange a room to be waiting. I said I needed to drive my dog home and get a ride back. They tried to talk me out of it but I insisted. I asked about the blood draw, should I get it done on my way out and the Doctor had the nurse do it in the room before I left.
My daughter drove me back to the hospital and they were having trouble finding a room for me until I told them I was having trouble breathing which got someone’s attention and I was brought upstairs. Everything proceeded normally from there. The nursing staff were great and they got me started on IV antibiotics and breathing treatments. They gave me 150mg of trazedone at 11:30 PM which I normally take to help sleep.
At ~2AM the night nurse came in and said she need to draw some blood. I was pretty fuzzy but used to this sort of thing and let her take my hand and look for a vein. I felt the initial sting of the needle and then another and then a deeper pain and then another and another. I told her that was enough and she withdrew the needle having never found the vein. She put her gloved fingertip over the sight for a minute to stop any bleeding. It seemed strange she did not have gauze or cotton swab for that. She apologized and asked if I wanted her to call the charge nurse to do the blood draw. I told here I didn’t care so long as they were able to get it done without the kind of unsuccessful probing she had done. A few minutes later she showed up with another nurse. I’m thinking this is the charge nurse but after watching this person nervously fail to find a vein I refused to let them do the draw. A bit later another nurse had the same trouble and after a visit by one more Iwas able to get back to sleep without interruption or a poke.
The next morning a nurse showed up from the lab and had no trouble finding a vein and drawing the blood. I was now more motivated than ever to avoid another night in that room and succeeded in passing sufficient tests to allow them to discharge me with some oral antibiotics. Since that time I have been slowly getting better and today (march 9) was able to walk around without gasping for air or feeling exhausted. I look forward to getting myself out for longer walks and better days. Thanks for letting me share and in the immortal words of Don Kent from WBZ in Boston, Go out and make it a good day!