June 9, 2019
Feeling or showing an appreciation of kindness; thankful
I learned a few things this week…
- Cardiac symptoms are horrifying and the feeling of helplessness and fear that accompanies them is something I never want to feel again.
- I suck as a patient.
- I don’t ever want to be in the hospital again, unless I am working.
- I have an amazing boyfriend…although I already knew this, my health crisis made me see that I can truly lean on him when I need to. He helped to keep me calm, held me and reminded me that he was there for me and that I was going to be ok.
- My family was more supportive and positive than they have been in years. Relationships were mended.
- I need to make some changes. This will absolutely never happen again.
Sometimes it takes a crisis to truly appreciate what you have. I thought I was having a heart attack. I am a nurse and am very familiar with the signs and symptoms of a heart attack. I have triaged many people with these symptoms and have sent them to the ED to be evaluated. Everyone says that they don’t want to waste their time in the ED if it’s nothing. Don’t be a fool…get checked out. Better to be alive and in the hospital than dead at home, right? The problem is that when it is you, it is really hard to determine if it is for real or symptoms of something else that are non-emergent. We are really good at rationalizing all the reasons that the symptoms we are having are probably nothing…there is no way this is happening to you. Why? Probably because some heart attacks are sudden and intense…but most start slowly, with mild pain or discomfort. The symptoms are easily blamed on other things that are less serious.
- Chest Discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes – or it may go away and then return. It can feel like uncomfortable pressure, squeezing, fullness or pain. It can feel like heartburn we blame on whatever we recently ate…there is no way this is a heart attack…right? Wrong…it definitely could be.
- Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. Nausea, vomiting, diarrhea, numbness and tingling in one or both arms, tightness in the neck, pain in the jaw or back. Yeah, I had most of those…but I just ate a big breakfast…I probably shouldn’t have had that last bite. How many of us blame these symptoms on everything except what it really is?
- Shortness of breath. This can occur with or without chest discomfort. If you are having all the symptoms again…maybe you are having anxiety now and feel short of breath? Yep…that was my rationalization…because it can’t be my heart…no way am I doing this. Not today.
- Other signs. Other possible signs include breaking out in a cold sweat, nausea or lightheadedness. Fuuuck…sweating…my hair is now wet, my face, arms and legs are sweaty…I can barely sit up straight and I’m so lightheaded that I am afraid I am going to fall right off the chair. This is it…the last straw…I can’t blame this on my breakfast anymore.
I was sitting in a restaurant last weekend with my Love, having a late breakfast. I had just started on some new medication the day before, a water pill to remove all the water that is collecting in my legs. I have no idea why I have bilateral lower extremity edema but when I am on my feet and/or its hot outside, it is 3+ pitting edema and it makes me short of breath with activity. How do you exercise if your body won’t let you? Walk more, they say…I can’t. It’s not because I am out of shape…although I am now…its mainly because I have so much retained water. I can’t breathe. It has become a vicious cycle. I sought out help from my PCP and she started me on these low dose water pills. I lost 7 pounds on the first day and I felt amazing. I was optimistic at the change that had begun and what I had in store for myself. At breakfast, it was about 3 hours after taking my second dose of medicine. I was happy and we were talking about how we wanted to spend the day together. I was calm and relaxed, then I abruptly felt nauseous followed by abdominal cramping and pain. Within about a minute, I started sweating. I was drenched from head to toe. My boyfriend said that I lost all color in my face and then I became lightheaded and came dangerously close to passing out. I was so scared and I could hear the concern and fear in his voice as he asked me if I was ok…did I want him to call 911? Oh hell no…there is no way this is 911 worthy…or is it? Fuck…am I going to die in a restaurant? Not today. The episode lasted about 4-5 minutes before I started to feel like I could stand up safely. I walked to the bathroom, got my face wet and found myself in a recovery period. The waitress came in to make sure I was ok. That meant he was worried about me being in there alone where he couldn’t see me. I shakily came out, he had already paid the bill, and as we got in the car, I asked him to take me to the hospital. If it was a heart attack, I was petrified that another one would be coming and it would be worse than the last.
The next 4 hours are a blur to me. It didn’t feel like 4 hours because I was still dizzy and was having trouble focusing on what was happening. Lots of labs were drawn. I had a chest xray…a CT of the brain…ultrasounds of the legs. I looked at my nurse and said…ok…these are not cardiac tests…does he think I have a PE? OMG…that is actually worse! Yes…she told me that he is ruling it out because of my symptoms and the normal cardiac tests. No heart attack, sinus rhythm, normal troponin…of course we are looking for blood clots. I know the routine. Then the tests started coming back…normal CT, no shift, no hemorrhage. Normal D-dimer and ultrasound…no blood clots. Chest x-ray is clear and heart is not shifted. No PE. No stroke. That’s all great news…but what is wrong then? This couldn’t be anxiety…I was calm, happy and optimistic when it happened. It was a vaso-vagal response according to the doctors. A sudden drop in my blood pressure and pulse that caused all the symptoms. All was normal now though. I could go home. I needed to follow up with my PCP. No more water pills until I talk to her and follow up with a cardiologist. I was shook up but relieved. We went to my parents house where I was going to spend the night and let my mom keep an eye on me for the following day…no work for me.
The next day went well. I was feeling better, a little weak but closer to my normal self. Toward the end of the day, I received a call from my PCP office telling me that she wants me to restart the medication and see her in 2 days. Well…ok…but I don’t like the sound of this. Now I’m afraid it will happen again. I think it is the medication that is doing this. I will try to be the patient though and follow the direction of my doctor. I was lightheaded and couldn’t concentrate the next day at work for a few hours after taking the new first dose. Then it passed and I started feeling better. OK…I just needed to get used to it I guess. All is good. The next day, I took it again. No dizziness. I got a lot of work done…I drank lots of water. Then left work a little early to go to my follow up appointment. I was listening to music, had the windows open and felt pretty good. Then it happened again. My arms we heavy and tingly…I had a heaviness in my chest and throat…I was a little lightheaded and there was nowhere to pull over. I was stuck in construction traffic 4 minutes away from the office. I cranked the air conditioning and put my arms up over my head. Deep breaths…its ok…its not a heart attack…its your blood pressure again…these damn pills. Fuck. I really hate this. The next 5 minutes felt like an eternity as I fought the lightheadedness and made my way to the office. I looked at my apple watch and saw that it recorded a heartbeat of 46…lovely…now it isn’t just my blood pressure…its bradycardia too. Excellent.
The appointment went well. Nothing seems to be wrong other than the medication creating side effects. She agrees that it is time to stop them and see a cardiologist. We need to know why I am retaining the fluid…she isn’t saying what she thinks is the cause but I know what she is thinking. She wants me to see a cardiologist because she thinks it could be heart failure or a valve issue. Great. I went home and still didn’t have any answers. This could easily happen again. I drank water…a lot of water. I wanted my fluid volume to come back up so the blood pressure would level out. I improved through the evening but still had a few low blood pressure and pulse issues in the morning. I thought it would have been better by now. I made my commute to work and had a decent day. My pulse was low and I was monitoring it pretty close because I worried that it wasn’t going back to normal yet. Then in the afternoon, I felt pretty good. I got a lot of work done. Crisis averted!
Then it happened again. I was driving home and I started having tightness in my chest, numbness and tingling in my arms, fullness in my throat…fuck. It’s nothing, right? I don’t want to go back to the ED and be told its nothing…again. No…I’m going home. It’s fine. It will pass…I’ll keep hydrated and drink water. It didn’t pass. By the time I finally got home I was stressed because I knew that the weakness I now had was the last straw and that there was no way I could ignore it. I asked my daughter to drive me to the local ED. They didn’t play any games. Another chest xray and lots more blood taken and then a doctor calmly telling me that I was being admitted to the tele unit because I had come in for the same thing twice in a week. They needed to figure out what was going on with me. I bought a sleepover party at the hospital this time. That is scary…I spend a lot of time in the hospital for work…I have not had to go through this process of being a patient though. It sucks and I just wanted to go home.
That first evening in the hospital was uneventful. I was scared of what was going to happen and what they were going to find, but two of my daughters were there and my boyfriend left work early to be there with me. I felt safe. So far my tests looked good. Labs were still normal. Chest xray was still normal. Then a hospitalist came in and asked me if I had ever had an echo or was previously told that I had heart failure. What? No….I’ve never been told that before. So this is what’s happening then…we are going to work me up to determine if I am in heart failure…I know what they are going to do before he even has the chance to tell me. I will be having a stress test and an echo before I go home. I am on a continuous heart monitor, have an IV and need to wear the compression device on my legs to prevent a DVT. It was getting late so my visitors went home to get some sleep now that the crisis was over.
More blood tests with normal results overnight, a stress test with imaging before and after the test, and an echocardiogram. Yep…all normal. My new favorite person, my cardiologist, tells me that I have a healthy heart. No coronary artery disease. No valve prolapse. No heart failure. I am ok. The water is probably from too much salt in my diet. I need to start exercising more and make improvements to my diet. I can take the water pills when I notice the water building up but don’t need to take it every day. I can go home. I just got my do-over. I am one of the lucky ones…this was a wake-up call to tell me that I needed to find a way to manage my stress, get more active again and to be grateful for what I have instead of worrying about everything that isn’t going smoothly.
Today, I am grateful. I am grateful for my amazing my Love. He takes wonderful care of me. He respects me and he loves me. I am a lucky girl to have him in my life. I am grateful to my amazing family. My kids dropped everything and stepped up to take care of things at home when I wasn’t there and spent the evening and next day at the hospital with me, never complaining about being stuck there…not even once. They are amazing kids and I am grateful to them for being them every day. My parents and sister and brother were an amazing support system in making sure that everyone was taken care of, offering to help in any way that I needed. I know they were worried but they never increased my stress…they were truly supportive and wonderful. My friends…I’m so grateful to my besties. They checked on me and made me feel loved and supported. I was scared and they helped me to keep my head on straight. Finally, I am grateful for my co-workers…my manager and director and others in the organization were amazing throughout this week. They told me to take care of myself and didn’t make me feel like it was a problem to be away. They were generally concerned about my well-being. Not everyone has that and I am truly grateful for my work family.
I am a lucky girl and I am going to appreciate my life and when I get stressed and feel overwhelmed…I am going to try harder to remember all the good things that happened this week and everything that I have to be grateful for. Now…I’m going to have some oatmeal for breakfast and go for a walk.