Heart, Who Needs A Heart

Right now I am supposed to be filling my little Nonni heart with Sidney snuggles.....but that is not what I am doing....darn it.

This is so that everyone knows exactly what happened and so that I am not explaining it over and over. I am a lazy person like that. And if I have told you the whole gory story before, just skip this one.

For a long time it had been on the calendar that I would go out to DC to watch the grand baby for two weeks when TMO went back to work after her maternity leave. SQUEE!! Two weeks of rocking and snuggling and general baby overload. I anticipated. I cleared my calendar. I packed my bag. I planned the knitting to take. Just as an aside, I had more trouble planning what knitting I should take than actually packing my suitcase. I can always do laundry but the thought of not having enough knitting gave me heart palpitations.

HHBL and I packed up the Prius of Death and headed out on May 27th for relaxing Washington, DC. There might have been a bit of sarcasm there because DC is anything but relaxing if you are driving. I didn't need a car so HHBL was just going to stay an extra day and then go back to the Frozen NE Ohio before making the return trek in two weeks to pick me up. On the drive we came as close as I ever remember coming to hitting a deer head on at 75 miles an hour. That will make your heart go pitter patter (ominously as we shall see). We arrived safe and sound despite the suicidal quadruped and settled in to snuggle...and here comes her blog name.....Sweet Short Stack.

I mean, how could you NOT want to just kiss those cheeks!!

We spent part of Memorial Day at Mount Vernon getting our history lesson along with all the other people who thought it would be a good idea to go to a National Historical Monument on a national holiday. Between us we have many higher education degrees but sometimes we don't think smart. Thank goodness we got there early. Tuesday was uneventful. HHBL went home, TMO went back to work, TSiL was still home but I fed and snuggled and rocked Short Stack for most of the day. All was well.

And then came Wednesday. Cue ominous music. This next part is going to be long and I am sorry for it but we all know that I like to excessively use my words.

I woke up with a start around midnight on Wednesday with intense shoulder pain. I couldn't find a comfortable position. Finally I got up and took a Tylenol and went back to bed. I was able to doze off for a bit but at 3:45a I woke with intense chest pain. Oh for the love of Pete!! I needed my rest as this was the first day that SSS and I would be snuggling alone and I wanted to be wide awake for that. I lay there for a while and tried to just ignore it. It would not be ignored. So, I did what any self-respecting nurse would do, I got up and took another Tylenol and said it must just be because I was caring around a 13 pound baby for most of the day before. Surely that is it. 

By now you must have guessed that was not it.

Finally I just got up at 5:30a, crept into the bathroom and took a shower, hoping that the warm water would soothe whatever this was. I was also ignoring the shortness of breath that I was having but if I was trying to ignore the very intense chest pain I might as well ignore this too. Things seemed to get a bit better (I can certainly lie to myself!!) and the day started for everyone. TMO went off to work, TSiL was getting ready to go, I was rocking Short Stack to sleep for the first of her naps........

And I just could not ignore the fact that my chest pain and shortness of breath was back with a vengeance. So, in the most apologetic tone I could muster I had to ask my son-in-law to take me to the emergency room. The last thing that I wanted to happen was to be home alone with Short Stack and have to call an ambulance. And that is what I would have had to do. TSiL is the most amazing and calm person in a burgeoning crisis. He stood there for just a second and then stepped into the breach, packed up the baby bag and the ergonomic baby carrier that has a name that I cannot remember and ushered all of us down stairs where Short Stack and I waited while he went and got the car and plugged in the directions for the large medical center 1.5 miles away. It was a long drive. TSiL dropped me at the ER door and went to park. I made my way in and explained to the nice person that I had chest pains and could they please do something about it? She told me to take a seat. When you are in pain time seems to move at a glacial pace. I am sure that it wasn't any longer than 5 minutes before I was called back to see the nurse but it seemed longer. 

Emergency Departments all pretty much work the same. You tell them you are here. They invite you into the first part of the inner sanctum where they determine if you have earned the right to be admitted to the good place. If they determine that you have not earned the right they tell you so and send you home. The nurse did an initial history and I had the first of two ECG's (electro cardiograms for those who do not know or care). Then they sent me to wait in the "we aren't quite sure that you are that special yet" place for my test results. Again, I am sure it wasn't that long that I was waiting there but is seemed that way for sure. I was in a fair amount of distress. I was treated to watching someone being revived with Narcan and to someone else being told by the social worker that, yes they were in fact well enough to continue working and no the social work department was not going to give them a "note" saying that they could stay away from work and still get their welfare benefits. The little every day dramas.

Finally another nurse appeared in front of me, verified I was who I was and walked me into the inner and VERY busy part of the ED. And when I say very busy I mean that every cubicle was filled and the hallways and every available space was filled with people in beds and on gurneys. Oh man. The only reason I was put in an actual cubicle and not on a gurney in the hallway was because I needed to be on a heart monitor. As I entered took off the clothes requested and settled myself on the more than uncomfortable gurney I was treated to my cubiclemate ripping the ER resident a new one because no one was listening to her and she was in pain and it was just like the last time and no one was doing anything about it. Yikes. She did the same thing a couple of hours later and then checked herself out of the ED.

And then for the next 10 hours I was in the ED. I am not going to give you a blow by blow but here are some hightlights

• medical history by a very earnest resident (we all have to start somewhere)
• they wouldn't let me walk to the bathroom the first time so I had to use the bedside commode. Now THAT is a humbling experience.
• chest pains that would not subside despite 3 nitroglycerin tablets and a nitro paste patch (I did refuse the morphine as that seemed a bit excessive)
• feeling so shitty that I didn't even want to read or knit. THAT tells you how bad I felt.
• being alone for 10 hours in the ED. I sent TMO, TSiL and Short Stack home. No need for the little one to be there and she is sort of tied to TMO.
• finally talking to the cardiac resident, Dr. Khan, about what was going on. He told me that they were admitting me to the cardiac observation unit but they didn't have a bed for me yet (this was a hour marker 8 in the ED saga)
• finally FINALLY talking to the cardiologist, Dr. Ertel, who said, "Well, I think we are going to escalate your case a bit and get you into the cardiac step down. You may get a bed faster that way."
• Just at ED hour 10 they wheel me up to 4NE room 4

The rest of Wednesday was sort of like the first part of Wednesday except with a MUCH more comfortable bed and some food. They did put me on a nitro drip for a number of hours but that dropped my blood pressure so low that they stopped it in the middle of the night. By morning my chest pain was a 2-3 on that subjective "tell me how your pain is" scale so it seemed like that was some progress but there were still no answers. I did not sleep well but I slept a bit. Oh the noise!!!! And the damn phlebotomist who shows up at 4:30a, knocks once and flips on all the lights. Really!!

Thursday, or as I would also call it The Day of All the Tests and Blood Draws. I couldn't have anything to eat after midnight because I was scheduled for a heart catheterization but because I was an "add on" they couldn't tell me when they would actually do it (4pm it turns out). We started the day with an echo cardiogram, otherwise known as "let me smear all this gel all over your chest and try not to get it on the clean sheets". Fun times. BUT, the echo was the first test that gave the doc an indication that this might not be a heart attack.

Dr. Ertel and team (Senior resident Dr. Khan, residents, hangers on) arrived on rounds to tell me that the echo indicated that what I was dealing with wasn't a heart attack but something called Takotsubo Cardiomyopathy. It wasn't a heart attack (which was good), it was treatable and reversible, but it had to diagnosed through the process of elimination so I had to have the heart cath. Say WHAT! Follow the linky thing for a very good article on what Takotsubo is. We would be here for another week if I had to explain it. The thing that is interesting is that the onset of my Takotsubo might be tied to the very short and very stressful incident of not actually hitting the deer on the highway. Dr. Ertel also said that I could have small sips of water (praise the LORD!) and my nurse, Jill, brought me an orange Popsicle.

Ambrosia on a stick. I ate it with undo haste.

We don't need to discuss the heart cath other than to say good drugs make for good procedures. The only problem I had was with the 4 strict hours of complete bed rest afterwards. I mean, what if I have to go to the bathroom before 9pm I asked. Bedpan was the answer. I can hold it was my reply. Dr. Ertel appeared again (is he ALWAYS at the hospital?) to tell me that my arteries were lovely (well thank you!) so this wasn't coronary artery disease but they wanted to do one more test, a cardiac MRI. Have I ever mentioned to you that I get claustrophobic? Hmmmmmmm. Have you ever had a closed MRI? It is a claustrophobic's worst nightmare. 45 minutes in a magnetic tunnel of death where the noise is horrendous and the panic is always just below the surface. I had the tech put on MercyMe, I kept my eyes closed and I imagined Jesus right beside me. If you think I am saying that flippantly I am most assuredly not. That was how I got through it. And also not thinking about the fact that I really had to PEE!! Finally I was back in my room just about 10p and I elected to go to sleep (after peeing) rather than watch the second half of the Cavs-Warriors game. Oh JR!!!

By the way, I should mention that HHBL had arrived back at my side on Wednesday evening and stayed with me all day Thursday til he went home to bed and then back on Friday for doc talk and discharge. The man is the BESTEST of husbands and the rock that I couldn't do without.

Friday dawned. I actually got a bit of sleep but again Oh the noise! Oh the damn 4:30a phlebotomist with the touch of a gorilla! Finally Dr. Ertel and entourage arrived with the good news that it was Takotsubo and that I could go home with a lovely array of new drugs that I needed to take carefully albeit temporarily (bloodthinner, baby asprin and a Beta blocker). I was to see my primary physician and a cardiologist in the next couple of weeks and I was to REST and do nothing for the next week. We were out of the hospital by 1p and on the road home by 2:30p. I was amazed, and not in a good way, how little energy I had on Friday. Just taking a shower and packing up my stuff totally did me in. But each day is getting a bit better. One of the medications makes me a bit dizzy at times and the cost of the other medication about gave me a heart attack for real, but other than that I am on the road to recover.

I do want to take a minute at the end of this to say a big and heartfelt thank you to everyone at Medstar Washington Hospital Center. I know that you will never see this but your care of my poor little overly fat padded self was wonderful. To my nurses, Sheenali, Jill, Jennifer, and George, you were all kind and compassionate and knowledgeable, just as a nurse should be. To Dr. Khan and Dr. Ertel, thank you for answering questions and really for having the knowledge to know, right off the bat almost, that this wasn't a run of the mill heart attack but was Taketsubo which is something that isn't seen all that often (trust me to have something obscure). Washington Hospital Center is known for their cardiology care. The Lord put me in just the right place for this latest little adventure. Thank you again to all who were a part of my treatment, I cannot say enough good things about you!

Takotsubo Cardiomyopathy you are not the boss of me! (for long that is).