Thursday, February 14, 2013

When Your Heart Hurts

It's Valentine's Day, so I guess it's the right time to talk about my recent heart scare.  More frustrating than scary, but there's always an element of fear when you know you need to go to the emergency room.

It's safe to say that I've been in a period of high stress these last too weeks, primarily driven by a PTSD episode triggered by a book club discussion I shouldn't have attended.  Two weeks of fear, sobbing, pain, a desire to hide, a desire to hurt myself, an inability to care about or even notice obligations and people around me.  Walking through life like an automaton.  Going through the motions but often not being fully present.  Desperately waiting for my appointment with my therapist.

About a week into this, my chest started hurting.  Not terribly.  Not sharply.  But it hurt.  Being the pain foolish person I can sometimes be, I ignored it as best I could.  It didn't seem bad.  I didn't have time for this.  I was sure it was nothing.  But it was kind of always there.  Sometimes worse, sometimes better.

Until last Saturday.  The day started out well.  No big plans.  It was a relaxing day and my stress levels were pretty good.  I knew I would be seeing my therapist Monday; that was a relief.  My annual physical was also scheduled for Monday so I'd talk to the doctor about the chest pains then.

But no.  My body decided otherwise.  By the afternoon my chest was hurting so badly I could hardly do anything.  My hands were shaking so badly I couldn't write.  I looked up the symptoms of a heart attack and found several that kind of fit.  Plus, there's that whole scare factor of knowing my cousin had a major heart attack a couple years ago at age 55.  I'm 43 and not in the best of health.

So after getting several things prepped for my kids for the next few days in case I was in the hospital, I went to my husband and told him I needed to go to the ER.  I didn't think it was anything serious, but felt like it needed to be checked out.  He blinked a couple times, he'd been napping, and tried to process what I was telling him.  A few minutes later we headed out, telling the kids (ages 14-22) that we were running errands (yeah, we got in trouble with them for that later).

The ER was slow that day so I felt a bit too well attended.  (One of the reasons I didn't want to go to the ER is because I hate being the center of attention.)  As they questioned me and took my vitals, my husband checked me in.  My heart rate was 115 (usually in the 70s) and my blood pressure was 158/80 (usually about 110/60).  The blood pressure number scared me.  It's never even been close to that.

They get me back to a room.  Lots of people in and out asking questions.  Me feeling stupid, knowing it's going to turn out to be nothing.

They draw blood and start an IV (in my hand because they couldn't get the vein in my arm).  They put on a blood pressure cuff that runs automatically every so often.  They do an EKG.  They take a chest x-ray.  They think it's an anxiety attack (especially after noticing that I'm on anti-anxiety meds and seeing the scars on my arms).  They ask if I've been diagnosed with anxiety.  I haven't, but I have been diagnosed with PTSD, which I tell them.

But just in case, they give me four baby aspirin to chew and some nitroglycerin under my tongue.  Shortly thereafter I feel like my head is going to explode (a side effect of the nitro) and I'm going to throw up (possibly also a side effect of the nitro).  They give me something in my IV for the nausea.  By this point my heart rate had calmed down to a nice 76ish range and my blood pressure was back down to the 110/60 range.  The labs and x-ray are back and they look good.  They are getting ready to send me home.

And then I get cold and start shaking.  Bad.  One blanket.  Then my coat over me.  Then another blanket.  Then my husband's coat.  I'm still shaking uncontrollably.  Soon I'm roasting but still shaking.  We start peeling the coats and blankets off.  The shaking won't stop.  The nurse checks in.  My husband points out that I'm shaking.  I tell the nurse I'm not cold but can't stop shaking.  My heart rate has gone back up to the 112 range and my blood pressure is back up.  He says, "Hm" and goes to talk to the doctor.  I've now been shaking uncontrollably for about twenty minutes for no discernible reason (my muscles are hurting from all the shaking).  The nurse comes in and gives me a shot of Ativan through my IV (it's like Valium).  He waits a minute.  Still shaking.  He gives me another.  Still shaking.  He goes to talk to the doctor again.  About ten minutes later they come back, find me still shaking, and give me two more shots of Ativan (4 mgs. total now).  Boy, am I getting sleepy at this point.  Finally the shaking stops. 

All the test results are good. My heart rate and blood pressure are back down.  So it's time to send me home (although it's tough to walk now after all that Ativan).  The doctor still thinks it's anxiety.  Just in case, he sends me home with a prescription for Prilosec (in case it's acid reflux), an order for a stress test, and instructions to take an aspirin every day.

The PTSD got better after my extra-long therapy session.  Everything went well at my physical.  I did the stress test yesterday (the EKG looked good, but a cardiologist has to look at it and the images they took of the blood flow in my heart before we really know anything).

And my chest still hurts.  I should be relieved that they didn't find anything wrong with my heart.  I guess I am a bit.  But mostly I am frustrated and depressed.  I see all these expensive tests and still no answers or relief.  One more thing that hurts with no explanation.  Like I needed another one of those.