Or, an alternate title: What to Expect at the Hospital When You’re Experiencing Chest Pain.
So right off the bat, I’ll let you know: I didn’t have a heart attack. My heart is fine. I’m spoiling the ending, but that seems like the right thing to do. And it also seems like the right thing to do to share what this experience is like, because it’s scary and unnerving and weird, and if you have to go through it sometime in the future, you’ll know what to expect. Onward!
Monday night, around 7 or 7:30ish, I noticed a pain in my chest. A hard to explain pain, but I’d say it was sort of a heaviness, combined with a little bit of pinching, and kind of a dull ache. I didn’t immediately feel too concerned, because the pain was just right of center on my chest. But as time ticked on, the pain (which ebbed and flowed) moved a bit down my right arm, and I was feeling an occasional radiating numb/tingly/chilly feeling that would rush through my body, kind of like a lighter version of what you feel when you’re about to pass out.
I started freaking out a little. I told Scott what I was feeling, then I went to my old friend, the internet. Where I learned that for women, heart attack signs are frequently weird — my favorite is the “feeling of dread or doom.” (Which I totally had, but was probably the anxiety kicking in.) The pain isn’t always on the left side of the chest, or in the left arm. It can occur on the right, or you could have no chest pain at all. Numbness, tingling, chills — all possible signs. Combining those with the fact that one of my Crohn’s medications lists chest pain and numbness as possible serious side effects, and we decided to hit the emergency room.
My last ER trip was for a major Crohn’s flare in early 2009 — incredible joint pain and a fun rash. I think I waited in the outside waiting room for an hour and a half to be seen that time. We chose a different (and far superior) hospital this time around. And know this — if you go to the ER and say the words “chest pain”, you get seen FAST. I was hooked up to an EKG machine within 5 minutes of arrival. After that, I answered a few questions about past surgeries, medications, conditions, and pain level on the 10-scale (I gave it a three), and they moved me back to a bed.
I got gowned up, they put an IV port in the big, juicy vein on my right arm, and they drew some blood. More about the IV port later, with a picture coming up (fair warning if you’re easily grossed out). A couple of nurses came by to get me comfy, then a doctor came to visit. He let me know that the standard procedure was to keep me overnight, then run some tests in the morning, including the stress test (the treadmill — you’ve seen it on House). He’d looked over the initial EKG, and it looked mostly good but there was one “blip”. He thought it might just be nerves making me blip, but they absolutely wanted to make sure.
Then he proceeded to tell me that all week, he’s had a weird streak of thirtysomething women come in with chest pain, and more than one had “the real thing” (read: heart attack), so he wanted to be absolutely sure about me. Way to make me freak out a little more, doc.
They also took a chest x-ray, which I didn’t even have to move for. They brought the portable x-ray equipment to me! Which was much nicer than the other hospital when I had my big Crohn’s flare, where they rolled me down the hall to the x-ray room and made me stand up with my arms over my head for the test. Since my joints were rock-hard and on fire, that was horrifyingly painful. This time, a piece of cake.
They were having a full night at the hospital — we sat and twiddled our thumbs for a couple of hours, while we heard the nurses talking about how there were no rooms and no beds available. But finally, luckily, a single room further back in the ER opened up, and I was moved there. I used my panorama camera feature to show from the monitor over my head to the big glass door (which doesn’t cut much sound from the hallway).
I settled in, and since it was 1:30am by that point, Scott went home to get some sleep. I was told that there would be more blood taken at 5am for testing, and sometime after 8am I’d go for my stress test. Lights out, and I tried to sleep. But the ER is a noisy place, even if you’re in a back corner, and the combination of that, my monitor beeping now and then, and the automatic blood pressure cuff inflating on me every hour or so made sleep hard to get.
Here’s my monitor, by the way. Top line is heart rate (even when I’m calm, it’s in the 70s — I have the heartbeat of a hummingbird, so 90s when I’m moving around isn’t that unusual). Middle line is my breathing, bottom line is blood oxygen percent. The blood oxygen meter was strapped to my finger, but it frequently dropped its connection, and it would beep whenever it went to the “?” reading. Also, you may think that a blood pressure of 110/52 is low, but my record for the night turned out to be 97/45. It’s always low, though, so no worries.
Okay, so the IV. That also kept me from sleeping.
That thing hurt worse than my chest. I couldn’t bend my arm, but I also couldn’t straighten my arm. And I couldn’t really twist my arm. There were only a couple of positions when I didn’t feel the dull throb of a foreign body in my arm, which meant that I had to try and sleep on my back (I’m a total fetal-side type) and keep my arm resting carefully on a wad of blanket.
From the blood around the entry point, I’m going to guess that a fine bruise will be appearing in the crook of my elbow in the next couple of days. The nurse who put it in wasn’t particularly gentle.
5am came, and they drew more blood. The nurse told me that they check for a certain cardiac enzyme that the heart releases during a heart attack. They were also running a lipid panel. Off she went, and I tried for a couple more hours of sleep. By 7am, I gave up, sat up, and turned on my TV. Fortunately, USA was running some Bond movies, so I was able to enjoy the awfulness of the ending of Dr. No and the first half of Moonraker. And really, was there ever a point where Roger Moore’s Bond didn’t seem like a dirty old man?
Scott and I texted back and forth for the morning. He got his morning in order then headed over, and showed up around 9-ish. We got a visit from one of the cardiac folks, and she told me about the tests in store for the morning. And also that I wasn’t allowed to eat until I’d done them. Before Scott arrived, a nurse also came by with toothbrush, toothpaste, and some lovely warm, wet towels to swab my face with. I changed into a fresh gown, and she gave me a pair of fuzzy socks. Very nice.
10am or so, and it was off for the tests. First, the stress test (which Scott wasn’t allowed to watch). I met the cardiologist, a nice guy who was shocked at my cholesterol levels. “Why are you even here?” He asked. “Your cholesterol is 140, and half of that is HDL!” (For the record, this morning’s cholesterol levels: total 144, HDL 61, Triglycerides 49, LDL 77.)
They strapped me up with a dozen electrodes and had me hop on a treadmill. They amped the speed up until my heart rate was over 155 beats per minute. (I was hovering right around 179 for the bulk of the testing. I really didn’t know that my heart even goes that fast.) I didn’t actually run on the treadmill; the top speed was just a very brisk walk with the belt on an incline. When it ended, I felt like I was going to pass out (which is apparently completely normal and expected). I plopped back down on a gurney, and they checked my blood pressure for a few minutes. Everything slowed back down, the electrodes came of, and I was stuffed back in my wheelchair (which was enormous) to head out for the next test.
Next was the Echocardiogram — an ultrasound peek at my heart’s shape and size, and the workings of all of the flaps and valves and doohickeys. They also look for clots, strictures, blockages, and anything else that might be amiss.
The easiest way for the technician to ultrasound me was for me to lie on my side, which was doubly great because I could see the screen clearly. Scott was allowed to come in for this one, and snapped a shot of the fun. The tech took all sorts of still pictures, some video with cool color, and sound files of the various lub-lub and whoosh-ka-whoosh noises for the cardiologist to look at. Some of the sounds of the heart actually sound like a DJ scratching a record. The technician said that she sometimes thinks her job is “a cross between DJ and video gamer.” Very cool!
We headed back down to my room in the ER (a regular room still hadn’t opened up yet) to wait for all of the results. We were told that the stress test and echo results should come back pretty fast, because the cardiologist was going to leave at noon. I was cleared to eat without restrictions, and one of the nurses brought me lunch, which I ate while The Price is Right was on. Double win!
This was possibly the best industrial meal I’d ever been served, you guys. A grilled cheese sandwich (although they probably used margarine), tomato soup, peas (not bad at all with some salt & pepper), iced tea with lemon slices, some slimy pears (which I skipped), and a sugar cookie. Damn the gluten, full speed ahead — I dipped the sandwich in the soup, was pleasantly surprised by the peas, and the cookie was shockingly good. I did not, however, eat the decorative slice of beet on the big-ass leaf. We all have our limits.
We were warned that I might not get results (and/or released) until 5pm or so, or even possibly the next morning, but fortunately everything came through earlier than that. I didn’t have to spend a second sleepless night, hooray! The stress test and echo came through great — no blockages, no murmurs, no weirdness. My heart is totally good to go.
I didn’t get an answer on what’s actually wrong with me, but we were able to check the most important and deadly thing off the list. Now begins more investigation with my regular doctors, to try and find out what it could be. I’m still feeling the pain a little bit tonight (even though it’s less than it was yesterday), so I don’t think it’s indigestion or sudden-onset GERD or anything. But it could be something as simple as pulled muscles, or some weird inflammatory thing, or any one of a huge list of other things. I’ll visit both my gastroenterologist and my regular clinic in the next week or so, and we’ll take it from here.
So, there’s what to expect in the ER when you have chest pain. Don’t be afraid, and don’t be afraid to go there. Even if it turns out to be nothing serious, even if your heart turns out to be fine, it’s SO worth it to get checked out. Even if (especially if) you’re a big guilt-riddled worrywart like me, who’s sure it’s nothing but freaks out at the thought that it might be something. The woman in the next room over, when I was in the first bed, said she’d had her chest pain for over two weeks. Which almost made me feel even more like some sort of weird whiner, because my pain had only started that night. But it also shocked me, because who waits for two whole weeks before being seen with chest pain?
So go! Get it checked! Don’t wait, and don’t be afraid. They’re all there to help you, and want to make sure you’re OK.