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.

SAY WHAT??

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.

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I must be better. I didn’t kill anyone.

I wish I had a better memory for dates.  I’m pretty sure this has been going on since Halloween.  But certainly before Thanksgiving.  So what happened is, I dislocated my right kneecap.  That hurt so bad that I finally decided to go to the doctor, and while I was there I’d have her deal with this pain in my shoulder, which I suspected was a symptom of degenerative disc disease.

She takes a look at my knee, now the general size, shape and appearance of a sausage, and tells me to make an appointment with some orthopedic specialist, if I can find one.  I clearly need an MRI, for the knee and my neck both.  If I can’t find a specialist who will take me soon, go to Emergency.

I call specialists.  None will take me without a referral from my primary care physician, or they don’t take Medicare, or they don’t take new patients.  Hum, says I.  Ok, I’ll go to Emergency.  3 days later I’m in Emergency.  Where they diagnose me with a “sprained shoulder, sprained knee” and tell me I’d only get an MRI if my brains were dripping out my ears.  Maybe not even then.

Grr.  says I.  It’s now mid-December, and I’m having a heck of a time dealing with holiday schedules, pain and what not.  So I decide to wait until the beginning of January.  If the magic elves of health didn’t waive their wand and fix me by then, I’ll go to another emergency room and ask them, point blank, what the hell to do.

January 3rd arrives, and I spend 4 hours on a gurney in a hallway.  3 doctors came to look at me, all with puzzled sympathy.  All agreed I need an MRI, and each one, plus a nurse, asked me why my doctor didn’t write a referral.  Um… I still don’t know.  But the only thing they could do for me was to write official follow up care for me to see… who?  My primary care physician.

Pain makes me bold – I make an appointment for her from the ER for 1 hour hence.  If I can get across town in an hour, she can get me in.  Oh good.  i’m sure that will solve ALL my problems.  I’m discharged and head for my primary care physician.  Who tells me there’s nothing she can do for me, but writes me a huge prescription for vicadin.  Gee, thanks.

Ok, I’ve had it.  Let me see if I can explain why.  Imagine being shot in your left shoulder, close range, from behind.  The pain radiates down my left arm, stopping at the elbow.  The pain from the elbow to the fingers mutates into wild tingling – imagine having a firm grip on an electric fence.  I can’t make a fist.  I can barely use my entire left side.  My last two fingers are numb, though I can still type.  The pain is 24/7.  Oh, and the headache.  I haven’t mentioned that yet.  See, with discs, the pain is never specific to the area.  Sciatica radiates to unrelated places.  When my back ruptured, I felt it down my left leg, not the back.  So this projects to the left shoulder and arm, and to a headache that, again, never stops.  Now, it’s no where NEAR as bad as a migraine.  But it doesn’t stop either.

Anyway, to put it briefly, quality of life has ceased to exist.  And this bimbo has me running in circles for months.

So I called the hospital directly, and I spoke to a very puzzled receptionist.  What do you know?  My doctor writes referrals for them all the time.  Why didn’t she just write one for me?  Hell if I know.  She DID write me a nice presription for an MRI, but not for any specific place.  Could I give that to them?  Receptionist is now deeply puzzled.  Um, no, they don’t take that.  But if her office could just fax the order, I could be scheduled for an MRI in a day or two.

Say what?  Yeah.  A day or two.  That’s all she needed to do.  Or she could play this horse shit game with me and have me feeling as though I’ve just been shot for a few months.  They say pain builds character.  OMFG.

I had the MRI last Thursday morning.  The experience was utterly surreal.  Soft music, soft lighting.  The MRI itself was warm, and inviting, with soft music, and a scented eye pillow.  No, really.  And get this.  When I left, they had… wait for it… fresh baked Mrs. Fields cookies for us.  Fresh. Baked. Cookies.  Yeah.

The first MRI I had was in New Orleans.  It was in the basement, at the end of a hallway, dimly lit.  They yelled at me for showing up, because they cancelled the appointment without telling me.  Finally, after I tried to kill a few of them, they decided to do the test.  It was cold, extremely painful, and there was this guy with a metal bowl and a jackhammer…

I’m pretty sure I just imagined the MRI last Thursday.  Probably the pain pills.

Anyway… I called my doctor last Friday.  Do you have the results?  No.  They’d call me the moment they arrive.

I call again today.  Results?  Um, no.

I call the hosptial.  Do you know when the results might be ready?  Oh!  Says the nice lady at radiology.  They knew how important it was, so they sent it to my doctor last Thursday.  Morning.  9am.  2 hours after the test was performed, my doctor had the results.

Oh fuck me.

I call my doctor again.  Um… results?  By now the receptionist is in apology mode.  She knew they were here, and has been leaving messages for the doctor.  That’s all she can do.

Ooook.

So I call the hospital and explain, in detail, what the hell is going on.  The nice lady helped me find another doctor, and put me in contact with radiology again, who bundled the results up for me to pick up personally.  My appointment with my new doctor is next Thursday.  Oh yay, no information until then.  But at least it was progress.   I called back my now former doctor and – very politely I must say – explained to the nice receptionist that I have a new doctor, and she doesn’t need to pester her boss any more.

I hung up.  Five minutes later the phone rings.  What do you know!  It’s my former doctor.  There’s a long awkward pause.  “I hear you’re getting a new doctor.”  I explained that I was under the impression she didn’t really have time to deal with me, so perhaps it’s for the best.  She explained that it could take up to 48 hours for her to call with test results.  Since it was now 4:30 on Monday and she’s had the results since Thursday morning, even that didn’t make sense.  So finally I just asked if she could tell me if the disc was ruptured.

Instead she reads me a few pages of jargon.  From what I can tell I’ve been re-confirmed as having advanced degenerative disc disease.  Thanks, but I knew that.  The problem may actually be one disc down from what I thought, C6 instead of C5.  And it looks as though it’s inoperable.  The degeneration is causing damage to the nerves.  I think.  Like I said, it was a ton of jargon and it was less than helpful.  But I thanked her anyway and hung up.

So, after this utter circus, it *seems* the problem isn’t a figment of my imagination.  However, that makes no difference.  According to the great font of knowledge, the internets, if it’s not a ruptured disc my only two options are narcotics or traction.  I’ve already tried everything else.

Christ on a pony.  I think I’ll have a little lay down now.  I’ll see what those in the know say on Thursday.  Maybe I can get a straight answer then.