Visit to the Emergency.

Yesterday September 24th, 2011, I woke up feeling out of sorts.

Mind you, that in itself is not overly unusual, I tend to wake up feeling out of sorts most mornings, it's all part of the joys of having FM and CFS, so I didn't think this day would be much different than many other days.  

I'd say the extra pain and tiredness could even be somewhat expected as I was during my monthlies, something that tends to multiply all my symptoms tenfold, and the weather had this high humidity and coolness that doesn't do anyone with chronic illnesses any favours.  So all in all the day did not start that unusual. 

I got up around 8 as I was hoping that I would be able to diminish the pain as early as possible so I could get some of the things I wanted to do, done, like doing the laundry and purging clothes and linens.  Often when I wake up in pain, it eases during the day as I start moving, so the earlier and start getting around the earlier it has a chance of easing and I can get on with my life.  \the pain that I had yesterday morning were the same that I have been having for the last little while, my legs felt weak and burning, my arms felt like I had overdone weight lifting and over stretched them, my lower back felt like the slightest wrong move would make it seize, and my upper back / neck area felt like I had fallen on them from about the third story a few days prior.  I woke up tired, but them again I always do.  If it wasn't for caffeine, I would not manage most days.

Another reason that I wanted to get up and moving is that one of my favorite store was having a "Sidewalk / Tent sale"  I expected such a sale to be on the sidewalk or in a tent on the property, however, the sale was within the confines of the store, with little papers indicating the stuff on sale.  I was hoping that some of the things I needed from that store would be on sale at a better price.  No such luck, but I still did manage to get a thing or two that were worth it.

When we came back from the store, I was hit with this utter exhaustion and the pain seemed to have gotten worst, so I decided to go lie down for a bit.  I had pretty much figured by this time that I was not going to have any laundry or purging done on this day.  There was still hope that I would get something done on the next day.  I napped for about 1:30 hours, and got up at about 4:00.  I needed to figure out what to make for supper, plus I also needed to take some medication as the pain had gotten worst still and I had developed a severe headache.  I can safely say that the headache was actually a migraine.  

I try to take as little medication as I can get away with, putting up with most of the pain.  I don't have a family doctor, so I don't have many of the treatment options or pain relief available by prescription.  Back when I had a family physician she was not very helpful, tending to fluff me off as much as possible.  In order to find a better doctor I had to drop her.  Finding a new doctor is very hard as we have a shortage. So I have to rely on over the counter medications as well as some I did get by prescription a while back that I saved for the worst of pains.

This day definitely qualified as a day requiring a cocktail of meds for pain management. I ate a bit to line my stomach then took:

- 2 Advil gel caps Extra strength

- 3 Naproxen (over the counter)

- 1 Tylenol with Codeine.

Before taking the Tylenol Arthritis and the Celebrex, I decided to wait and see how this would affect the pain.  I needed to deal with supper and decided to go to the store to get some supplies for supper.

While at the store, my chest started hurting.  The migraine went away, and my legs were feeling woogly, but mostly painless.  My arms and upper back had gotten better as well, but in all honesty there was still enough pain that I was considering taking the Tylenol Arthritis after having eaten supper.  While shopping the pain in my chest started getting worst and worst. I started trying to hurry my daughter so we could get home before the pain got really bad.  I sort of wanted to try and hide from her the extent of the pain.

By the time we got to the cash, there was no hiding the pain any longer as I could barely stand or breathe.  When the girl at the cash asked how we were doing (as they tend to), I believe I responded "oh dandy" as I usually do, but to be quite honest, I don't exactly remember because the pain was quite overwhelming.  I know at a certain point she asked me if I was OK because I was hunched over the cart breathing shallowly and my daughter mentioned that I had fibro, it would be fine.  I told her I did not think this particular pain was just my fibro.

Pain, what kind of pain am I talking about...

The pain kinda felt like a stabbing in the middle of my chest, maybe like a lance that pierced right through from the front to the back.  The pain was slightly more concentrated in the front of my chest, but in my back it radiated to my neck and my waist, from armpit to armpit.  It even radiated down my arms.  I had trouble breathing, like my lungs had no room to take in air.  At times, trying to breathe in felt like trying to breathe underwater.  My chest felt tight, really tight, like my organs were too big to fit.  It felt like something was squeezing my heart.

I felt nauseous, I was sweating profusely.  I had trouble standing.  My skin was cold and clammy.  The pain was slightly relieved by leaning forward or sitting leaning back.  The pain came in waves, similar to contractions when giving birth.  The longest wave was probably not more than 15 minutes with a few minutes relief in between.  I have given birth twice and I can tell you with absolute certainty that giving birth hurt a lot less than this pain.

My daughter and I brought our stuff to the car, my using the cart as a crutch.  She loaded the car and I went and sat behind the driver's seat hoping to be able to drive home.  My daughter is not able to drive yet, but I have every confidence that if I had become unconscious she would have discovered abilities within herself to avoid us being gravely harmed.  On the way home, one of the cars in front of us (a city truck as it turns out) stopped in the lane to access a light.  It stopped without any warning and contouring this vehicle cause uncomfortable delays.  I did not want to let on to my daughter that I was very worried that I would not be able to make it home.  Tough at this point she might have been just as worried, if not more worried that I was anyway.  In the car, I explained to my daughter that when we got home, we would ask our neighbour to drive us to the emergency at the hospital.  I did not trust myself to drive.

We did make it home without incident.  With luck my son was at the house that we didn't have to look for him to tell him where I would be going.  My neighbour was also home and agreed to drive me to the hospital.  My son brought some of our groceries in while my daughter went and asked the neighbour to help, explaining her mom was not well.

The car ride to the hospital was probably one of the worst experiences of my life.  I have to say my neighbour drove very well; he did not drive in a dangerous way at all.  My daughter in the back seat was worried by trying to hold her panic in. I on the other hand, was probably in full blown panic attack, along with the chest pain.  I was trying to calm down, pacing my breathing, trying to take long deep breaths, and to some extent, I guess my efforts did help because the pain lessened enough to be able to talk to my neighbour and my daughter.  We cracked a joke or two on the way to the hospital during my hiatus.

 When we got to the hospital, as I was in a "remission", I thought I would be able to walk in and registered myself, No Problem.  That was until I stepped out of the car.  The act of leaning forward and standing brought the pain back quite vividly.  I had to lean forward, my head close to my knees to be able to breathe.  I tried to walk but couldn't.  My neighbour sent my daughter to get a wheelchair to wheel me in.

Now registration at the hospital is confusing every time.  My daughter wheeled me to registration, they told us to go to the nurse first.  We were seen by the nurse right away.  (I think the wheel chair made it look urgent).  She asked me some questions.  When she asked me to describe my pain and its location I unknowingly did the "Levine sign".  This is a gesture that hospital personnel look for in a patient with chest pain. This sign is seen in patients with Acute Coronary Syndrome (myocardial infraction and angina pectoris). In other words, a heart attack.

I was sent to registration right away, and from there I was sent immediately to emergency care.  From there I was called right away for an ECG.

Now in the past I have had costochondritis and an attack of GERD (gastro esophageal reflex disease), both conditions that can cause worrisome chest pains.  In GERD, the esophagus can have some very painful spasms, and since it occurs right behind the heart, it can have almost the same symptoms as a heart attack.  I suspected that I might have the GERD chest pain because of the medication that I had taken a few hours earlier.  I mentioned this to the lady who did the ECG, but I said since this pain was so much more intense than anything I had ever experienced before in my life, I thought I would better be safe than sorry by having doctors take a look.  

I have to mention that when I got to the cubby where they were going to examine me, they made me take off the clothes covering my torso.  This meant taking off my bra.  My daughter helped me (even though mommy's nudity made her very uncomfortable and she desperately wanted to go wait outside).  Taking off the bra, even though it was not tight, I believe did help with the pain.  The pressure went down.  If you see someone with chest pains, try removing any clothing that may be tight; you never know what could help.)

Back to the ECG.  The results looked OK.  So not a full blown heart attack.  YEAH!  I had to wait for the doctor.

While my daughter and I waited for the doctor, she played games on her IPod, did homework, and we listened in on the patient next to us.  This guy was not a nice patient and the resident attending him had an amazing amount of patience. He had unrealistic expectations of the medical system (probably watched too much "House" or other such medical shows).  Most importantly the waves of pain became less intense and further apart.  This convinced me that I had probably been dealing with GERD after all.  I felt foolish for wasting so much valuable health care dollars.  I wanted to go home.

When the doctor showed up, the first thing out of my mouth was that I was ready to go home, I now felt fine.  Told him it must have been GERD after all.  He made a face, movement that obviously meant, "Can you let me diagnose you?"  So since I was there anyway, I let him ask all his questions and check me out.  The questions.  Oh boy I really did not mean to be a difficult patient!  Seriously, I did not know the answer to many of his questions.  I have FM and CFS.  As such I get many symptoms and discomforts that I discount and blame on CFS and FM.  I don't notice a lot of stuff because I am just so used to having discomforts and pains all the time.  It's a way that I manage my pain, my life.  If I were to stop on every little thing I could not do anything.  It would be overwhelming.  So without wanting to, I made it hard for the poor doctor.  We tried having a sense of humour about it though.  One question he asked that I didn't know was if I got chest pains after exertion.  I said I didn't think so.  Today I noticed the answer might actually be yes.  ANYWAYS

He told me he didn't think I'd had a heart attack, that I may be right that it was GERD.  The chances of it having been an attack were maybe around 5%, but he wanted to do a blood test to make absolutely sure.  For the blood test I would have had to wait another 3-4 hours for a certain enzyme to show up in my blood.  I refused the blood test, saying I wanted to go home.  I was very tired and just wanted to go home.  The pain had depleted me.  The doctor seemed clearly uncomfortable with letting me go without a blood test and made me promise that if the pain came back, that I would take a Zantax then head right back to the hospital for further checkup.

Even though our neighbour was MORE than willing to come and pick us up, my daughter and I took the bus home.

Today, I tried taking it easy.  My chest is still a little sore.  I am taking Zantax, taking it easy...  Not doing my chores.  This is not helping me with being ready for work on Monday though.

I regret not sticking around for the blood test.  I would have liked to know for sure, but staying at the hospital while I was so tired just did not look appealing.  Just like the doctor, I have that little doubt, and not having a family physician, I can't just go discuss it with him/her.

I'll just have to hope for the best.