Faithful Readers, I have again been away--partially for the happy reason that I am on the second draft of my romantic comedy (more of a "dramady"). I am proud of this book, even if it never sees the light of day. by being published.
The other reason is that on August 28th, I went to the emergency room at the local hospital, thinking I was having an asthma attack. I have had asthma for many years, not very well controlled despite a daily steroid inhaler. During the CZU fire a couple of years back, my lungs took a hit from smoke inhalation, from which they have never really recovered. Smoke and artificial fragrances set asthma off now almost immediately. On August 28th, while at an appointment, I was exposed to the most vile, oily, toxic air freshener (the plug-in-the-wall kind) in a revolting vanilla fragrance. It could be smelled strongly even down the street. I apologized and left the appointment immediately, very stressed, though I did not indicate that to her.
The ensuing asthma attack (or so I thought) was quite intense--shortness of breath, pain in my lungs (or so I thought), and gasping for breath. Because my symptoms were so acute, I was brought into our local hospital's urgent care section, which is staffed by physician's assistants. The physician's assistant came in and listened to my lungs, said they were clear-sounding (not unusual for me), and ordered a breathing treatment based on my symptoms. A breathing treatment consists of a bronchodilator, delivered in a fine mist and inhaled over a period of time in the ER.
The physician's assistant listened to my lungs again before the respiratory therapist came in with the set-up for the breathing treatment. She paused and said, "I'm going to listen to your heart for a minute." She listened and listened, and when the nurse came in with the breathing treatment, she said, "Don't give her that."
Everything happened quite quickly (and calmly) then. She sent me for a blood draw, then an EKG. Usually when I have had an EKG, they declare it normal, and that's that. The guy who did the EKG left quickly with it, and soon after, I found myself in a wheelchair, being taken into the "Emergency" side of the ER.
And then, Faithful Readers, so many medical folks started working on me that it was nearly like the iconic A Night at the Opera scene where people start crowding into Groucho's stateroom. One person set up an IV port in the crook of my right arm (unfortunately they messed it up at first and blood shot across the room). Someone put a blood pressure cuff on my left arm, I was put on oxygen, and hooked up to a heart monitor with more electrodes than I have ever seen--they felt like they were everywhere. I began to sweat like I'd been running a marathon. My thoughts ran to "This is one hell of an asthma attack." The medical personnel were quite calm, talking to each other, drawing blood yet again, and trussing me up like a Thanksgiving turkey with tubes and wires.
I had literally no idea what was going on until a nurse gave me aspirin and administered the "clotbuster" medication. I did not feel fear, exactly, just reflected that I really, really did not want to be having a stroke, that I did not want to die like my sister did, of a massive stroke that instantly killed her. I did not want my loved ones to be traumatized by another, sudden death.
Then one fellow, who had been scrutinizing my heart monitor, turned to me and said, "So you came in thinking you were having an asthma attack?" I nodded and he said, "Your cardiac enzymes are elevated."
I had no idea what he meant. I figured enzymes were some benign thing, like the type they put in laundry detergent. I did not have time to inquire about that because the fellow said, "We need to do a CAT scan to see if you have a blood clot in your heart."
Somehow, I was not panicking. The calm atmosphere of the room helped. It was explained that cardiac enzymes are usually undetectable in bloodwork. It is only when the heart muscle is becoming injured or dying that these enzymes are released, in particular one called troponin. And what was causing my heart to release cardiac enzymes?
I was in the middle of an evolving heart attack. The fellow further told me that he was glad I did not have a breathing treatment because (drum roll), there was a real possibility I would have gone into cardiac arrest.
Yes, Faithful Readers, I would have, in sum, more than likely dropped dead, my stressed heart unable to withstand the medication in the breathing treatment.
They admitted me and I was taken to the CAT scan room (loads of fun getting unhooked from everything, having the test, and then getting hooked back up). There was no blood clot in my heart, for which I was extraordinarily grateful.
Meantime, the pain on the left side of my chest was worsening. I felt like someone had leveled a blunt, ice-cold pole and popped it into my left-side chest, hard. They asked me to describe the pain--I said it felt like there was a large circle of pain on the left side of my chest, surrounded by coldness (that was the weirdest sensation of all). There was pressure on the left side, also. A doctor who works with my primary care physician came in and began to watch my heart monitor. She told me to tell her when my chest pain increased. When it happened, she gave me a nitroglycerin tablet under my tongue, and the pain and pressure went away.
This process went on and on: I would feel a rise in the pressure and pain, she would watch the monitor, then give me a nitroglycerin pill. Sometimes the pain would not stop with one nitroglycerin; I ended up needing three tablets a couple of times. Once, when she stepped out of the room, I felt the pain and pressure start, but wondered if it was enough to call her back in the room. She walked in, looked at the heart monitor, then as if reading my mind, said "Please don't wait to see if it's bad enough."
I wonder if they had, at some point, given something to relax me because the next thing I remember was being taken to the Cardiac Care Unit (comparable to an ICU, but with specialized equipment for cardiac patients). The nurse was a courteous young man who helped me get comfortable, as much as I could, and I fell asleep. I was beyond exhausted. I was sweating, still mostly in my street clothes except for a hospital gown, and famished (they gave me a turkey sandwich and an apple juice).
A cardiologist came in the next morning and discussed my condition. He said he would do a cardiac catheterization (where a catheter is threaded through a major artery into the heart, and dye is injected into the heart so the coronary arteries can be visualized). I suddenly remembered that I'd had this procedure years ago, when my chronic illness (lupus) was first diagnosed, and I was put on heart medication for a long period of time. Somehow that condition stabilized, but I do not remember what happened. I don't even remember what the condition was (it was thirty+ years ago, for one thing).
The cardiologist explained that the procedure was different from many years ago. Instead of putting the catheter into the femoral artery (a really creepy procedure), they thread a thin catheter into the radial artery of the wrist and into the heart. The cardiologist further explained the risks of the procedure, that he could do things like a coronary bypass through the catheter, etc. He was a kind and courteous man.
I was wheeled into the catheterization lab--and talk about state of the art! Stainless steel everywhere, and very disorienting, with reflections like a funhouse mirror. I was not allowed to watch the procedure; they put up a kind of shield.
Turns out my coronary arteries were free of plaque that would indicate clogged arteries. It was discovered that I have a slightly enlarged heart, that a small section of one coronary artery is inside the heart muscle, not on top of it. The other condition is spasms of my coronary arteries, which causes the chest pain. It can be a dangerous condition: if the spasm goes on too long, or compresses the buried section of artery too much or too long, I can have a heart attack.
I'm now, once again, wandering in the strange, almost afterlife-like, world of the chronically ill. I now have a cardiologist, who has put me on time-release nitroglycerin, so that I do not have to use the "rescue" nitroglycerin tablets. This dilates the coronary arteries and reduces the amount of work my heart has to do. I am also on statins (cholesterol medication). My cholesterol was a bit high, and my cardiologist wants it below 100, all to support my heart and keep it working so hard.
Lupus (which I have had now for 30 years) could very well be the culprit, but I will not know until a few more tests are run.
In sum, I am profoundly ill, even though I do feel much better after a few months of recovery, mild exercise, eating a heart-healthy diet (as much as I can), and taking all my medications properly. I am not afraid to die. I AM afraid of leaving people I love behind, and hurting them by my going. I have no desire to plunge people into those year+ grieving periods that seem to happen more and more these days.
Every day now is precious, even though I must confess that I am not always using my days well, and would like to change that. I could live for many, many years and hope I do. But I am mortal and at some point, my story and my journey must end. Every day of my life since 1993 has been bought with more tremendous effort than I have ever let on. It has been a worthy price to remain on this planet.
I often say that the death of my precious daughter broke my heart, and turns out it did. I believe in an afterlife, and I hope that I will be reunited with my loved ones.
But not now, and hopefully not for many years.
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