Oh, those wacky bipolar performances!

In a recent article I addressed the challenges of “coming out” in public.  Do you tell people you’re mentally ill and face the resulting backlash?  Or do you pretend that everything is normal while still displaying symptoms?  Neither seem like a good option, and there’s no third choice.  I’ve also mentioned how much I admire Carrie Fisher (as well as many others who speak in public about mental illness).  Her straightforward attitude regarding her struggles gives me a great deal of courage.

carrie fisherMs. Fisher was briefly hospitalized recently after an incident on a cruise ship.  According to reports she appeared drunk, her behavior erratic.  Was she drunk?  Maybe.  Or she might have been on one of any number of mood-altering drugs commonly prescribed to bipolar patients.   Look at these headlines:

Carrie Fisher Heads To The Hospital After Her Wacky Bipolar Performance On A Cruise Ship! (Perez Hilton)

Carrie Fisher briefly hospitalized after bipolar episode during bizarre performance on cruise ship (NY Daily News)

Vs.

Carrie Fisher briefly hospitalized (CBS News)

Carrie Fisher discharged from hospital after bipolar episode on cruise ship (Toronto Sun)

Arg.

I can not speak for Carrie Fisher.  But I have taken a drink more than once. I don’t like alcohol and I hardly ever drink socially.  But when the anxiety of a manic phase becomes too much, when the buzzing gets too bad, I have few options.  Narcotics?  Sure.  I have bottles full of the things, a different color for every occasion.  Problem is, one pill can last for hours, sometimes days, long after the symptoms have worn off.  In almost all cases the side effects from a tranquilizer are much worse than the symptoms of mania.

bacardiberry5 Alternative?  A shot of Bacardi.  I was doing that LONG before I was diagnosed – all through college in fact.  For a while I was worried about becoming an alcoholic.  I used to just grab a fifth and down a few swigs.  Yeah, Janice Joplin lite.  The effect is nearly immediate, it doesn’t last nearly as long as pills, and I can FUNCTION.  The buzzing emotions calm down.  Now that they’ve started flavoring the rums, it almost tastes good.  Sort of.

Of course, there are a few downsides to this.  Empty calories for a start.  During my heavy drinking period I pudged out quite a bit.  Not pretty.  And, of course, alcohol is addictive.  Once you reach the point of addiction any benefit a person may receive from doing a shot is negated.  Now you have two problems – you’re still bipolar and now you’re an alcoholic.  Joy.

There’s also a third downside which only becomes apparent as the cycle progresses.  I only need to drink when I’m manic.  I get the jitters, I start to spaz, I need to calm down  fast.  But when the mania phases into depression… then what?  I start to feel awful, I reach for a shot.  And I immediately feel worse.  What makes the manic phase bearable makes the depressive phase a living hell.  But it’s not always obvious when the phases have switched, except in retrospect.

 
we Carrie Fisher, wherever you are this morning, I salute you.  As always you give me courage.  Courage to write, to get the word out, to continue to champion the cause of those who struggle with mental illness.  It’s not a sexy fight, but hey – someone has to do it.

Advertisements

The night of “The Voice” or Why I Don’t Trust Therapists Anymore

“Even in the wizarding world, hearing voices isn’t a good sign.”  Hermione Granger, speaking to Harry Potter.

HermioneI hear voices.  As in “I’m hearing the voices” type voices.  And no, I do not admit this very often.  Why?  Hermione said it beautifully.   Even people who know I’m mentally ill will give me “The Look” <tm> when I mention hearing voices.  You know, the nod, smile and don’t make any sudden movements look?  That look.

The specific psychiatric term for hearing voices is “auditory hallucinations”.  In other words, you register a physical sensation that isn’t actually there.  There’s two main types.  If you experience physiological hallucinations, sometimes called “sane” hallucinations, you may not suffer from any other mental health issues.  It’s thought that 1 in 25 will “hear voices” at some point in their life.

I suffer from experience pathological hallucinations.  In the past, conventional wisdom associated pathological hallucinations with a severe mental illness – usually schizophrenia.   With time the diagnosis has gradually extended to include such disorders as bipolar.

Auditory hallucinations usually mainfest in one of three ways.  The first is very dangerous.  Called a “command hallucination“, this is a very clear, distinct voice that offers a specific direction.  The command can be very simple, such as “stand up” or “sit down”.  However, they can also be threatening, such as “kill your boss” or “burn the house”.  Sometimes the threat becomes personal.  “Stab that guy, or I’ll stab you.”

Then there is “Exploding Head Syndrome“.  For example, I’ll hear a gunshot, or a rocket taking off, or sometimes impacting. It’s not distinct.  Let’s say there’s a tv on in the next room.  There’s a cartoon on and it features rockets and a gun.  That’s pretty much what it sounds like.  I can hear it, but it’s not alarming.

Generally, I hear crowd noise – the sound of a large crowd at a distance.  Imagine that you’re approaching a large room full of people, but you’re not quite there yet.  You’ll have a subconscious awareness of the sound of many voices, but none are distinct.

In addition to the “crowd noise” I can hear people speaking.  They don’t talk to me, or about me.  They’re just having a conversation, and none of them are in English.  There are two women who speak Japanese.  Maybe they’re out shopping.  I have no idea – I don’t speak Japanese.  I also hear two men talking.  These are older gentlemen, and they speak Russian.  My mental image is of two guys in a park playing chess, but again as I don’t speak Russian I couldn’t tell you what (if anything) they’re really saying.  They seem friendly, and they’ve been with me as long as I’ve been aware of “me”.

The study of voices has come a long way since I was diagnosed.  In 2001 there was only one reason to hear voices – severe mental illness.  A very dangerous kind.  But recently, the “Hearing Voices Movement” has taken off.  They reflect the new understanding of mental illness – while illness of this kind can be dangerous and harmful, there may also be aspects that are beneficial.

This is a very welcome trend!  No illness should be treated in absolute terms.  Here’s why.

It was a normal night, I was in bed, asleep.  Then, around 1 am or so, I was startled awake by a voice.  At first I thought someone had turned on the television, or the radio, or an alarm had gone off.  But then I heard it again.  This was the only time I ever heard a Command voice.  It was male, but strangely flat and devoid of emotion.  It said one single phrase.

“Children are a nuisance, and you should be rid of them.”

Um, what?

My therapist had just started a 24 hour “hotline”, which he encouraged his patients to use.  I talked it over with my current partner.  We reasoned that I might need to increase one of my medications, and I should ask sooner rather than later.  So I called.  We spoke for a while, then she asked me to call my current partner to the phone.  That was weird, but I handed it over.  They spoke for a time, then she frowned and covered the handset.  “Hey,” she whispered, “I think she called the police!”

I couldn’t believe it.  Not even 10 minutes later, two cops walked in.  They asked what was going on, and if any children were in the house.  I said no, there were no kids anywhere around us – the community was mostly of retirees.

“But you’re planning to get rid of them?” the cop insisted.  I had to admit, that was what the voice said, but I had no plans to act on it.   At all.  None.  No children lived with us.  None of my friends had kids.  None of my relatives had kids.  See?  NO kids.

handsAfter 45 minutes they explained that I needed to come with them to the hospital.  We’d sort it all out there.  Which was how, at 3 am, in front of a few curious neighbors, I was led out of my home in handcuffs and placed in the back of a police car.

They took me to the hospital ER.  They took my purse and my clothes.  It was around 4 when we arrived.  I didn’t see a doctor until 8am.  I was not given any food, I was only allowed to drink water in the presence of a guard.  I was not allowed to move even when I explained I had ruptured disks in my back and I needed to walk every so often.

When the staff psychologist arrived I told her what had happened, and I was sure that finally, with a qualified professional present, someone would see reason.  After I told her my story I waited for another 2 hours.  When she returned she informed me that I would be taken from the ER and transported to a secure facility.  I was being placed on a 72-hour involuntary hold.

I went ballistic.   I was so mad I’m pretty sure I was turning colors.  I demanded to see my own doctor, who was on staff at the hospital.  But he wasn’t scheduled to be there until the following day.  And that was that.

GROUP-THERAPY-SMALLAt the facility, in a group therapy sessions of 30 patients, the doctor asked me why I was there.  I told him “I don’t know”.  He looked at his clip board and said, in front of everyone, “It says here you attacked a child.”

From that point forward it didn’t matter what I said or did.  Every patient heard I had attacked a kid, and I was given a wide berth.  If I lost my temper again it would get even worse.  So I gritted my teeth and just stopped talking.   I stopped moving.  I sat still and waited.

My doctor arrived the next day, 36 hours after I heard The Voice.  I told him what had happened and demanded to be released or explain why not to a judge.  This is not something a patient on a 3 day hold can say.   I was released within 2 hours.

My bewildered parents came to pick me up.   I had no idea how to explain any of it.  I’m still at a loss.

The mentally ill are the most stigmatized members of our society.  Within this group, those who hear voices are even more isolated, as it’s one of the least understood symptoms.  But I’m pleased to discover that through the efforts of groups such as the Hearing Voices Movement, attitudes are slowly changing.

Today is my anniversary

A “Jubilarian” is someone who is celebrating something special, especially the anniversary of something special.  Today is one of those special celebration days.

One year ago today, at this very hour, I was starving.  I hadn’t eaten anything since 7pm the night before.  I was standing in a carport, it was snowing, my head was pounding and I was having a full-blown panic attack.  They’d predicted snow, yes.  But only flurries.  This?  This was not flurries.  Flurries are not measured in inches.  Several inches, by the look of it.

I was waiting for my father, because I couldn’t drive myself.  No one drives themselves to surgery, much less something this big.  But if he couldn’t make it through the increasing snow, the rush hour, if there was just one accident, I wouldn’t make it.  They’d cancel the surgery, I just knew it.  I’d have to somehow live with this pain longer.  Maybe I could call an ambulance… could they do pre-op on the road?

As each minute passed my anxiety increased, my blood pressure rose and the pain reached new levels of “Kill Me Now”.  This was to be my second spinal surgery.  The first was on my lower spine to repair a ruptured disk (the other, still inoperable, remains to this day – probably the subject of surgery #3).  This one was to repair a rupture between C5-C6-C7.  Without the procedure I felt as though I’d been shot through the shoulder, close range, but somehow the shoulder was still attached.  My left arm was on fire and my migraine had a migraine.  I smelled pain, I chewed pain, my entire world was pain.

Suddenly, there he was.  Late, yes, but not by very much.  I was shaking with relief, nearly babbling gratitude.  Now all we had to do was make it across town, in an unexpected snowstorm, at rush hour.  I don’t know how we did it.  No one else was expecting heavy snow either – the normal procedure of “set your clock an hour early to get to work on time” hadn’t been factored in.  And yet, somehow, promising to hire a team of huskies if he had to, my dad got us through.  I checked in exactly on time, headed for my bed in OR… and waited.

And waited.  And waited.  And waited.  And oh my heavens waited some more.  The nurses continued to update me as best they could.  The previous surgery was taking longer than expected.  No, the doctor started on time, she was just being thorough.  She was thorough to the tune of an additional six and a half hours past when I was scheduled to go in.

The nurses were so grateful I was taking the delay so well, they bought my family lunch.  I wasn’t taking it well.  What they didn’t know is that I’d handcuff myself to that bed if I had to.  I’d wait until midnight if I had to, just don’t cancel the surgery.

Still, six empty hours is a long, long time to contemplate your mortality.  Oddly, this is the first surgery I’ve ever done that.  I’ve had my tonsils out, my knee operated on, I’ve had windows put into my sinuses and of course the first surgery on my back.  Sad to say, I’m no stranger to the OR.  But I’ve never thought I’d die, until this one.  In fact, I was so convinced I might die that I set up my will and signed a DNR.  I asked the staff to offer a prayer for me (it’s a religious hospital).  I even set up a “If I Die” app on my Facebook page.  I don’t know why it hit so hard this time.  Maybe just the words “spinal fusion” were enough.  Or just thinking about it.  She was going to slit my throat, push my vocal cords over, and fuse my spine from the front.  Really?  How?  I didn’t want to know.  I still don’t

I didn’t die.  In fact, the surgery was a blazing, almost startling success.  But 1 year ago right now I didn’t know that.  1 year ago right now I was in so much pain I couldn’t see.  1 year ago right now I had zero quality of life and very little hope.

At this moment I am looking out over a gentle bed of new snow.  My fingers are a little cold and I really should have worked out last night.  I’m training for my first 5K.  Apart from the fingers I’m in great shape.  My head doesn’t hurt, my shoulder is fine, I can feel my arm and the shot gun feeling is a distant memory.

Without going through that, I would not appreciate sitting here.  Sitting still, without the pain.  I’m grateful for the perspective.  I’m even more grateful I don’t feel like that anymore.  I’m grateful for modern science.  I’m grateful I had the opportunity to have this surgery that even a decade ago would have been much more complicated.

My attitude is one of gratitude this morning.  This is wonderful, and I can handle whatever comes next.

The life changing diagnosis, part 1

Where were you when Kennedy was shot?  The death of Elvis?  John Lennon?  Princess Diana? How about Michael Jackson?  Whitney Houston?

Events like this shake a society by bringing it face-face with its own mortality.  It doesn’t always happen on a personal level.  When it does it’s usually good material for an After School Special, a Movie of the Week, or a “very special episode of…”.  Lucky me, I’ve never won the lottery, but I’ve had the life changing  conversation with my doctor twice.  For those of you who have never had that conversation, I’ll try to describe what the first one was like.

I had just turned 30 when I moved to New Orleans.  I got a job as a tour guide.  I used to walk miles every day.   I lost weight, I was in great shape. Then my back started to twinge.  Just a little at first, now and again.  And my left leg kind of hurt.  No big deal, just walk it off, right?

I walked and I walked and I walked and it got steadily worse.  After a few months I couldn’t sit, stand or lay without pain. Nothing I did made it better, and nearly everything I did made it worse. I had no health insurance, no access to a doctor, and no Web MD.  I carried on until I collapsed.

I vaguely remember standing in line at the ER of Charity Hospital, but I don’t remember how I got there.  By then the pain was so bad I was having trouble seeing, or even breathing. The flaming pain started somewhere at my hip and radiated down until it defined every second of every day.  Eventually, I fainted.  I don’t remember hitting the floor, but I do remember two bands of steel suddenly wrapping around me.  I was told later that one of New Orleans’ Finest saw me go down and got me to a wheelchair.  I don’t know who you are, kind stranger, but from the bottom of my heart I thank you.

I worked my way through the Charity system, which could best be described as “hurry up and wait”.  I was immediately scheduled for an MRI, but the first available was over a month away.  I waited.  I didn’t have a car, or a cell phone.  The MRI department was in the hospital basement, and I remember nearly dragging myself down a long, very cold hallway, only to be told they had tried to call me – my appointment was cancelled.

I burst into tears.  They gave me the MRI anyway.

That’s when things got surreal.

I believe it was the next day – I got a call from a neurosurgeon.  He’d seen the results and we needed to talk.  NOW.  Could I come in that day?  No?  How about tomorrow morning?

When I had answered his call I had picked up a normal phone.  When I put it down it seemed to weigh as much as a bowling ball.

The next morning I wasn’t directed to the hospital clinics, but to a floor of private offices. The surgeon walked in with a colleague, and the two of them were very serious.  I was immediately put through a series of simple tests.  Push, pull, stand, sit, can I stand on my toes?  I could do all that.  But when they asked me if I could stand on my heels… I could not.  I didn’t know that – how often do you stand on your heels?  I couldn’t do it.

Then my world changed.

When they said “degenerative disc disease” I didn’t know what it meant, though it sounded dreadful.  “Ruptured disc” got the idea across with more clarity.  There were two of them in my lower spine.  One was inoperable.  The other needed immediate surgery.  In addition, I suffered from a rare birth defect.  Normally it wouldn’t matter – unless I needed spinal surgery.  In this case if the surgery went wrong I had a good chance of ending up a paraplegic.  It could even kill me.  Without the surgery the pain would only get worse, and I was already crippled from it.

How did next week work for me?  They left the room to let me think it over.

Most people, when talking to strangers, try to be friendly.  I was smiling and nodding throughout the conversation.  After they left I realized I was still smiling, as though they had been talking to someone else, saying something else.  Subconsciously I was waiting for someone to pop out from a hidden door and say “just kidding”.  When I stopped smiling everything just seemed to… freeze.

It was as though I could hear the air, or the colors in the carpet.  I remember the fabric of the chair was burgundy, and slightly rough.  The carpet was made of tight little wine colored loops.  The frame of the window was black and the glass had tiny bubbles in it.  The people on the street below were walking in the sunlight, the cars were driving by like everything was normal, and fine.  Oddly, it was as though I was seeing a chair, a window, a carpet, even sunlight for the first time.

In retrospect I’m sure they’d seen a similar reaction before.  The surgeons left me enough time to get a grip, but not enough time to panic.  The surgery was scheduled for the following week.  I thanked them, and left.

I don’t remember getting home.  As I didn’t own a car then I took the streetcar everywhere.  Not easy with ruptured discs.  But I don’t remember it, or calling my parents, or telling my housemates what was going on.  My memories are all strangely specific, like the light and shadows forming cracks on the sidewalks, or the sound of people talking, but not their words.

My emotions were locked in a crazed merry-go-round loop.  I could be dead in a week, or paralyzed.  There was no getting out of this, it would never get better.  My choices were stop where I was or go through this nightmare of hospitals, surgeons and recovery, knowing that it was the first surgery, not the last.  My traitor back had become a dangerous hurtful thing I could not escape.

I had no choice, which was confusing.  Surely there had to be options.  Where was the guy who would pop up and say “just kidding!  Here’s a prescription – pop this pill for a week and you’ll be fine”?  I kept waiting for that guy.  In truth, a little part of me is still waiting for him.

Of course, I lived through it.  Or, more accurately, I survived.  I didn’t know it at the time, but the person I had been, the one who took things like good health and long life without pain, died that day.

The second time I had that conversation, it was even worse.  But that’s for another post.

Of stress tests and alien DNA – or how I spent my spine operation

Even in the fabled words of Inigo Montoya… there is too much.  I can neither ‘splain,dm
nor sum up.   As usual, I’m certainly not normal, and the fictional character I now have the most in common with is Dr. Manhattan.

It started with “chance of flurries” predicted for the morning of surgery.  Which manifested into, well, not exactly a blizzard, but one hell of a lot more than “flurries”.  Several inches certainly of the nasty white stuff with traffic at a stand still and me in a dead panic.   Somehow by the grace of God the surgery had been scheduled when there was no other conflict with anything.  And with the pain quickly growing from “bad” to “unbearable” to “kill me now” to “no, seriously, now” the only thing I could think of was calling for an ambulance and somehow doing pre-op in the back of the truck.

clock Fortunately that wasn’t necessary.  Not only did my father deliver me across town in a snow storm in rush hour ON TIME, but the surgery was delayed.  First by one hour, then by two, then by several.  I was scheduled to check in at 9am and be in OR by 11.   I’m not sure what led to the delay, but I was actually wheeled back into the room at 4:30 pm.

Several cool points of interest here.  They let me get onto the table by myself.  None of this “I am the walrus” heaving of flesh which does terrible things to the dignity at a time when it’s least needed.  Also, each member of the team introduced themselves while I was still awake enough to be gracious about it – again a very nice touch.  If they’re mucking in my spine these are people I want to be polite to.  My surgeon gives rise to phrases such as “liquid pools of obsidian” – she has lovely eyes with absolutely no pupils.  She’s a tiny little Puerto Rican 10 years younger than myself whom I have a serious intellectual crush on.

ab Then I pass out.  When I faint it’s usually one of two ways, either the world goes away in tunnel vision, or there’s the sound of a billion bees before I hit the ground.  Usually it’s the bee feeling I feel when the anesthesiologist is finished with me.  And that’s as sick as a human can feel and live through it.  It’s not pain, its a sick that attacks to the point of making one regret the very idea of life.  When they’re calling you out from the drugs, all you want to do is crawl back in.  This time?  When I woke up it was like waking from a nap on a May morning.  I couldn’t believe it.  It was about 7:30 or so and I felt FANTASTIC!  It was so… weird.  I hardly knew what to do with myself!  I was talking and things and stuff.  All good.  And I got wheeled into a private room.  Oh folks, I hit the home run of health care.  Which is why the next part is so weird.

Whatever happened at 2:30 in the morning no one can figure out.  Not me, my MedicalEmergencysurgeon or an entire hospital full of doctors.   What I know is that I suddenly couldn’t breathe.  I was being compressed between a vice and there was a hot rock in the center of my rib cage.  Cardiac?  Anxiety?  Who knows?  I still hadn’t eaten anything, so for all I knew it was acid.  But suddenly I had EVERYONE’S attention and they were moving fast.  My private room melted behind me to a fast trip to cardiac and that’s where the fun began.

Last week I had 3 chest X-rays, 4 spine X-rays, a mammogram, and a CAT scan.  Suddenly I’m back in radiology for 2 more CAT scans, 2 ultra sounds and a stress test with radioactive isotopes.  Really?  From an acid reflux something or other?  Oh, but it gets better.

See, I had to fast before the surgery, which had been delayed for hours.  So the last time I ate was at 10 pm on Monday night.  We’re heading into Wednesday afternoon and I still haven’t had so much as a saltine.  And what do we do before a stress test?  We FAST!  Which triggers what?  Acid reflux.  Talk about a set up!

cpr

I’m so freaked out by this point that I’m nearly gibbering.  And I’ve been hearing all day how sick a chemical stress test makes you feel, which I figure is my karmic payment for how good I felt waking up from the anesthesiologist.  It’s going to open all my valves and give me the world’s worst headache, which was just what I had surgery to avoid.  It’s going to be the world’s worst hot flash.  It’s… who knows?

doctor chemical The stress test is in three parts.  They take pictures of your heart “normal”, then introduce the chemicals, then more pictures.  So after the first set the nurse wheeled me back to where they’d give me the IV for the chemicals.  Except normally she’s not in transport.  She just felt sorry for me.  So she’s managing my charts, my IV, and my wheelchair, and she suddenly drops my charts onto my head.  Which I think is funny as hell.  Now, all she did is say sorry for bonking me and vanished.  It wasn’t until later that someone said “Where did that blood come from?” that I realized that she actually cut my head open!  Now that was bad enough, but this was even better.

So there I was, laying on the table about to be injected with chemicals guaranteed to alien-chest-burstermanifest Sigorney Weaver’s Alien straight out of my chest, I’m pretty sure, blood pooling in my hair, totally freaked out, when suddenly (no, seriously) the fire alarms go off.  We’re talking Awoogas, with the blinking lights and the official response over the intercom and WHOOSH go the chemicals into my veins and I’m laughing so hard that I’m pretty sure I shot alien DNA all over the wall from my nose.

So that’s how I spent my Wednesday.  I finally got dinner around 6:30, they never did find out what was wrong and because I got transferred from neurosurgery to cardio it took them about 9 hours to figure out how to discharge me today.  But that’s another story, I’m home now, and I’m very very glad to report that on top of a temporarily repaired spine, I also can confirm I have an incredibly healthy heart.  And I may be possessed with Alien DNA.  We’re still not sure.

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.