Thursday, April 2, 2009
Joining the E.R. Club
I got my own personal E.R. visit this morning. The end result is that I'm fine, but the last few days have SUCKED.
I've been feeling periodic dizziness and shortness of breath since last year, a few months before Simon was born. I have been chalking it up to anxiety, since I have a history of panic attacks and sometimes just generalized anxiety. I went to see a doctor about it then b/c I wanted to rule out anything scary. Got a clean bill of health and just worked on managing the symptoms. Then, a few months ago a started to feel some pressure in my upper chest that would spread up to the top of my neck. A little concerning, but probably anxiety. Then this past Sunday I started to feel heart palpitations. Not like 1 or 2 fleeting ones, but like 20 throughout the day. Then I would have a combination of shortness of breath, dizziness and/or shortness of breath. Not fun and definitely more intense than usual.
I went to see my primary care doctor (love her!) on Monday and she took my complaints seriously given my symptoms and terrible family history re: heart disease. She began a cardiac workup including an EKG and bloodwork. The EKG in the office showed a variable heart rate but nothing super clear, so she decided to have me wear a 24 hour Holter monitor (device that tracks all heart activity for 24 hours). I planned to pick it up the next morning.
That night I felt a bunch of palpitations and since we have handy dandy stethoscopes all over the house, had Laura listen. She could definitely hear the hiccup. I called my Dr. and she said that basically unless I was having severe symptoms (extreme breathlessness/passing out), there wasn't much to do. If I went to the ER. they would just send me home and tell me to see her the next day. That made me feel a little better that she wasn't super concerned but I still felt like crap and pretty symptomatic.
Tuesday morning I picked up the Holter and the diary to record symptoms. I was supposed to write down every time I had a symptom and the time and they would check it against the monitor printout. I hadn't realized it until I had to write it down, but I was having some type of symptom averaging every 10 minutes. Sometimes it was every 3 minutes, sometimes I'd only have 3-4 in an hour. It sort of freaked me out to realize how frequent they were.
I turned in the Holter yesterday morning and then learned that they wouldn't have any results for 3-7 days. I called for blood work results- totally normal, so it wasn't my thyroid. However my symptoms just kept increasing to the point that last night, at my Mom and Stepdad's 20th wedding anniversary dinner, I really couldn't eat and felt breathless and horrible most of the time.
I had a rough night's sleep last night and then called the on-call doctor at my primary care office at 6 am this morning. I told him what had been going on and that my symptoms were getting worse and asked if I should go to the E.R. or just hang tight. He suggested I go to the ER to see if they could pick up something that they Holter might miss and because we'd get results sooner. I felt so relieved. The idea of waiting 7 days to find out what the hell was going on, when I felt so badly, made me just want to pass out.
Laura and I tried to figure out if we could get someone to watch Simon, but realized it just wasn't really possible at 7 am so I went by myself. They got me in right away and took a preliminary pulse, bp and blood oxygenation. Everything looked good. They put me in a room and started hooking me up to a heart monitor and a pulse oximeter (measures oxygen saturation in the blood). Heart looked pretty good but my pulse ox was 88. It should normally be 97 or higher. They thought maybe it was because my hands were cold, but they put me on a nasal cannula and it picked right up. That's usually a sign that something is up. If the Oxygen brings it up, then it's not the sensor, it's the person. The monitor above me kept dinging and the 2 nurses kept looking at it, a little worried. I was starting to feel a little nervous that there actually might be something kind of big wrong.
The doctor came in (the same one who saw Laura when we had to go to the ER for her back pain when Simon was still in the hospital) and he asked me a bunch of questions and then felt behind my knees and in my calfs. I realized he was checking for a blood clot in my leg, called Deep Vein Thrombosis. They're dangerous b/c little pieces can break off and go to your lungs. My old boss had this happen (called a Pulmonary Embolism) a few years ago and it took her out of work for months.
He ordered a blood draw that included atest that would check to see if I had a Pulmonary Embolism and a chest x-ray. Depending on what that showed, I could expect a chest CT scan to find the clots if they were there. The doctor left and I asked the nurses if they could tell me anything. They said it didn't look like it was a cardiac issue but that the doctor thought I might have a pulmonary embolism given the shortness of breath and poor oxygenation. I felt a really weird sense of relief. Pulmonary felt a lot less scary than heart. Call me crazy for preferring a blood clot in my lungs to a cardia arrythmia, but I felt a little better.
They started an IV, drew blood and then I was taken to have a chest x-ray. They said it would take 45 minutes to get the results of the bloodwork to confirm if there was an embolism, so I called Laura in the interim. Poor thing. She was not as comforted by the news of a possible Pulmonary Embolism. I joked that Simon and I could take Coumidin (blood thinning medication) together. Again, she did not think that was very funny. I can kinda understand...
About 20 minutes later, the doctor popped in. "We're sending you home", he said with a smile. "You are the picture of health. Whatever you are doing it, keep doing it. Do follow up with your primary care and get the results of your Holter, but you look great. By the way, did anyone ever tell you that you look like Frances McDormand? In a good way. She's more blond and you're more redheaded but you totally look like her". And he was gone.
So, evidently, I can climb Mt. Everest AND I need to get crackin on getting my anxiety under control. Guess that will be my new project.