My Lost Weekend



British military hospital in France, WWI,
from National Library of Scotland
(via Flickr Commons)

I'm home from the hospital, after spending most of Saturday and Sunday there.

Things actually started Friday evening at work.  I began having some fairly intense pain across the upper shoulder area of my back while at work.  This was unusual, because while I have occasional back pain, it's almost always in my lower back, not the upper.  Early in the AM on Saturday, the back pain lessened, but I began having pains in my upper chest area instead.  I started thinking it might be a good idea to go to Urgent Care or the ER after work to get checked out.

The chest pains continued to get worse, and I started thinking I might have to get off my shift early to go to the ER.   About 3:00 AM, when the pain was still continuing to get worse, I finally radioed Sam, the other security guard on duty that night, and filled her in on what was going on.  She called the security head and let him know what was going on.  By this point, I was starting to think that it would not be a good idea to try and drive myself to the ER, so paramedics got called and I ended up going to the closest hospital, John C. Lincoln, by ambulance.

Initial tests in the ER (ECG, etc.) came back negative for a heart attack.  I got admitted for further observation and testing.  The first set of enzyme tests also came back negative.  I was seen by both a cardiologist and an internist.  The internist thought my problems were probably coming from GIRD, Gastro-Intestinal Reflux Disease.

I don't think so, or at least I think there was more going on than GIRD.  For several days previous, I'd had a feeling deep down in my throat when I swallowed something, like my esophagus might be scratched or irritated.  But that only happened when I swallowed, and when I've had reflux attacks in the past, it's always felt like a constant heartburn down in the mid or lower abdomen.  Plus I'd already taken my daily omezaprole (Prilosec) just before work, and took a cimetidine (Tagamet) about an hour after starting work, when I was still getting that scratchy feeling in my throat.  Ever since I got diagnosed with reflux some years ago, the omezaprole has almost always kept any symptoms from developing, and on the few occasions when it didn't, adding a Tagamet on top always cleared up the problem.  The pain in the upper shoulders was something that had never been connected with GIRD before.

(Also, it's my body, and after sixty years I'm pretty well acquainted with it.  And, several times in the past, when my doctors have given me a diagnosis and I've thought "Not that simple", I've generally tended to be right.  A good example is my shoulder pain following a fall back in 2010; I kept saying "rotator cuff tear" and the doctors said "No, it's just a sprain; you only need physical therapy."  Finally, an MRI showed I did have a rotator cuff tear, just in an uncommon place, and I ended up having reparative surgery.)

The pain across the upper chest continued thru Saturday, sometimes backing off (but never completely), sometimes going back up to its higher level.  Saturday evening I finally agreed to a light shot of morphine, and was able to get to sleep, though I tended to wake up for a while every few hours.  (If you're awake at 4:00 Sunday morning and don't have a book to read, you'd better hope you like watching TV infomercials.)

When I woke up for the last time at about 8:00 AM Sunday morning, the upper chest pain had finally gone mostly away.  Yay.

A second enzyme test, for which blood had been drawn the previous evening. also came back negative.  But I still had a nuclear stress test scheduled for Sunday morning.

The stress tests I've had before have been treadmill tests, where they take ECG readings at rest, then have you run on a treadmill until your heart rate is elevated and do a second set of readings.  The nuclear stress test differs in two ways: 1) rather than an ECG, they inject a radioactive tracer and run you thru a big scanner, and 2) instead of a treadmill, they inject a drug that increases your heart rate ands simulates having exercised, then run you thru the scanner a second time.  I think I'd actually prefer the treadmill; when they inject that drug and just a few seconds later your heart is pounding and you're gasping for breath, it's alarming, even though you've been told what to expect.  (I gather that some of the street drugs available give a similar rush.  Some people apparently find that a positive experience.  Those people are insane.) In my case, while I never actually threw up, I also felt nauseous.

The stress test also came back negative for any signs of heart damage or my having had a heart attack.  By this time, the upper chest pain seemed to have faded away.  So I was told to follow up with my regular doctors and discharged.

(My regular doctors, for the most part, are with the Arizona branch of the Mayo Clinic.  With hindsight, I'm a little regretful that I didn't feel like insisting on going to the Mayo Hospital here, about 12 miles further away, instead of John C. Lincoln.  John C. Lincoln is an older hospital, I think first built in the late 1950's, and the general feeling while being there was that the hospital and staff were... "tired", I think is the best word.  There didn't seem to be much enthusiasm or energy.  My Mayo experiences have generally felt like the staff is actually happy to be working there.  I also know, from my own and others' past experiences with Lincoln, that their collections department was apparently trained by Michael Vick, so I expect to start getting phone calls and demand letters from them in about a week.)

I expect the doctors at Mayo will probably send me for an endoscopy to check out my esophagus and stomach re the possible GIRD problems.  At this point, I'm not sure what to guess about the upper chest and shoulders pain I was having, but I'll see if the Mayo doctors have any ideas of where to go from here.

A few miscellaneous things from my hospital stay:

One of the nurses on Saturday told me it was okay to get out of bed and use the room's bathroom "if you need to pee-pee."  Yes, she actually said "pee-pee".  I wouldn't have objected if she'd simply said "pee", but "pee-pee"?  That's a little kids' word.  "You can go ahead and say 'urinate'," I told her. "I'm an adult."

My roommate on Saturday didn't have as much luck with his test results as I did.  He'd had a quadruple bypass some years ago, and was now in for a quintuple bypass.  This was apparently going to be a fairly high-risk surgery, and there was a fairly constant stream of relatives and friends coming in to visit, some of them travelling from out-of-state to be there.  Then one of his doctors came in to tell him that a brain MRI had shown several mini-strokes within the previous few weeks, and that his surgery should be delayed about six weeks to give his brain a chance to heal.  This news upset the roommate's wife, who wasn't sure he'd still be around to have the surgery in six weeks.  But wait, there's more!  About an hour after that, another doctor came in to tell him "Your chest MRI showed a lump on your heart.  We think it's probably cancer."  That's not a trifecta you want to win.  (He was moved to a private room shortly afterward, both to deal with the news more privately and to deal with the congestion from his visitors.)

I was really glad to get home to Hilde and our Sleep Number bed.  The Sleep Number beds really are as good as their commercials say.  After spending a day and a half in that hospital bed, my chest pains might have gone away, but my butt hurt.