Don’t you wish all trips to Emergency were like this?

Let’s see if I can get this down before the Vicodin kicks in.  I feel like Hunter Thompson racing across the desert, hoping to make it to his Vegas hotel before the acid kicks in.  It will be very close.

I have a diagnosis so long I routinely forget half of it. One of the parts of my diagnosis is anxiety attacks.  The common symptoms of which are elevated heart beat, shallow breathing, feeling of impending doom, headache, sudden onset fatigue, sweating and a general inclination to scream without warning.  Anything can trigger one.  No rhyme no reason – not like flashbacks.

Last night I was watching a trailer for Titanic 3D and I saw the ship go down.  And suddenly I was in hysterics and I couldn’t breathe.  Full on panic attack.  Only this one was weirder than normal because my left arm was on fire.

Panic attacks mimic heart attacks almost exactly, with one exception.  No arm pain.  And what do I hear going through my head but a half dozen PSA’s saying “don’t wait, if you think it’s a heart attack better to look silly in the ER than dead in a funeral parlor”.

I hedged my bet and called Ask A Nurse, one of the world’s most useful functions for Medicaid.  I love them, and they seem to love me.  Though I hadn’t called in over a year the lady on the phone remembered me from my last call (which, as it happens, was similar to this one).  I stressed that not only do I have a history of panic attacks, it’s actually a primary diagnosis.  But we both pulled up short at the arm pain.   After due consideration she advised calling 911.  Not so much because she thought I was having a heart attack, but it was just weird enough that it should be ruled out.

I thought this was reasonable, but again hedged my bet.  There’s an urgent care clinic not far from my house.  If I could get there on my own I’d save myself an ambulance ride and paramedics wouldn’t have to see the inside of my less than tidy house.  Besides, says I, I’m not really having a heart attack.  I’m just being overly cautious.  So I head out into the night.

When I arrived I explain the panic attack thing, the arm pain thing, what the nurse said, and I asked if they could just run a few tests to rule out an actual cardiac event.  The guy behind the desk nodded, smiled, and went to fetch the doctor.  NOW.  Hum, says I.  Even though the waiting room is full of patients I’m hustled back without delay, typical for a cardiac event.  And then… I’m asked to leave.  They think it so likely I’m having a heart attack they want me in an ER.  Now.  They’re not qualified to handle something that big.

So I found myself in the odd position of trying to calm the staff.  I told them that normally I’d agree.  But I’ve had panic attacks before.  Normally I wouldn’t have come in at all, it’s just this weird arm pain.  It goes blazing hot, ice cold, searing pain, then fine again.  Repeat.  So if they could just rule out the heart attack I’d be on my way.  No biggy.

In short order I was talking to the doctor.  Who immediately ruled out a heart attack.  The heart sounded good, they’d run an EKG to be sure, but no, it’s not the heart.  However (she said as gently as she could) it’s more than likely I’m having a stroke.


The one thing that didn’t cross my mind.  And bloody damn hell.

She gently started running tests, got a few results, found out I’m on birth control I’d had a migraine with aura for over a week, and stepped out of the room.  I found out later she was on the phone to 911 the moment the door closed.  Meanwhile I’m on the table, leads attached everywhere, an 02 mask on my face, answering questions, doing tests and things are suddenly moving very, very quickly.  And of course, the more people that come in, the more needles and cords and tubes and things, the more my anxiety goes up, and the cardiac symptoms present again.  So I’m more or less presenting simultaneous symptoms of heart attack and stroke.

Fun way to spend a Friday night, eh?

And THEN… they walked in.  Two cops.  Cute, and cuter.  Two firefighters.  Damn, MedicalEmergencyand Wow.  And three paramedics.  Two of them were ok.  The third was a dead ringer for Chris Pine.  And I decided that yes, this was really a very cool way to spend a Friday night.  No, seriously.  Come here, Chris… let’s chat.  Heh heh.

In the ambulance Paramedic Pine is trying to eliminate things.  He knows he can’t confirm anything, but he’s at least trying to rule them out.  My heart is going nuts, but not in a heart attacky kind of way.  It’s anxiety.  But the arm is giving him fits.  Not only is it starting to change colors, but he can’t get in IV in.  (just call me pin cusion).  He checks my chart, does a double take, and says “… your fifty two??”  Err… no. I can’t often remember my age, or my birthday.  But I’m seriously sure I’m not fifiy two.  So we dig out my ID that says I’m 45.  He still looks skeptical.  “I would have guessed 35.  40 tops.”  It wasn’t one of those BS compliments, just a simple assessment.  It made my heart go pitter pat.

I started describing what the cold flashes feel like, and then he said something I hope I never forget.  With complete sincerity he told me that women are his heroes.  Not only do they have to go through all the routine crap men do, but they seem to be constantly at war with a body that wakes up totally different every day.  He said it took amazing courage to be a woman.  I decided whoever this guy married would be a lucky, lucky girl.  Sooooooo lucky.

Once in the ER Paramedic Pine recited every single thing I told him verbatim, translated into the strange medical Latin that only doctors speak.  Wow.  Looks, compassion and brains?  Here’s me wishing I was 20 years younger.  And then he left and an entire army of white coats got down to business.  Like Paramedic Pine they eliminated a heart attack pretty quickly, though I have an irregular heartbeat.  I also display many symptoms of a stroke, but none of them indicate it’s happening now, just that it happened at some point.  Which leaves anxiety attack and flaming pain, which while happening at the same time, may actually have nothing to do with each other.

So they shoot me full of valium and settle down to wait.  That was cool.  The anxiety leveled off, the O2 was making me loopy too, and everything seemed happy.  Except that my arm was turning into fire knives, ice knives or ceased to exist at random intervals.

Then came Dr. Hunt.  No, not Megan, but still cute.  He kept holding my hand and the least likely thing in the world happened.  The symptoms happened while a doctor was in the room, in a way he could see for himself.  As he stood there I could watch my arm/hand turn white, then blue, then back to pink as it got hot, cold, numb, and fine again.  For one time in my life I didn’t have to try to convince anyone.  Just… wow.

We started talking about the last stroke, and the disks in my spine, until we finally narrowed it down to this new theory.  Whatever it was that triggered the anxiety attack torqued my spine.  It’s *possible* one of the bulging disks in my neck herniated, causing the symptoms.  He offered to admit me and run more tests on my heart, but we both agreed it wasn’t necessary.  (how cool was it that he made me part of the decision making process?)

In the end I was sent home with a stern warning to follow up with my doctor the moment the doors open on Monday.  When I sadly explained I didn’t have one he found me one that was accepting new patients, accepted Medicare, and got me an appointment for OMG Monday.  With stern instructions to follow up immediately after that with a neurologist.

So I’m kind of back to where I was this time last year, only this time the folks in the ER actually paid very close attention to what I said.  This was the same ER I went to last year that totally blew me off with a “sprained shoulder”.

It was an interesting way to spend an evening, I’ll give them that.  And I woke up this morning still covered in patches and leads from the EKG.  At least I know my heart is still in good working order and my brain isn’t making an above average attempt to kill itself.  Spine is important to be sure, but just a little less than brain and heart.  So we’ll see what happens next, but I’m feeling that gunshot feeling that indicates that something is seriously not right.  So we’ll see.