Clutch My Chest and Writhe in Pain

It was Saturday night.

Alarm bells rang. Horns blasted. Lights flashed. I clutched my chest and fell to the floor screaming, carpet burn instantly burst into flame on my right forearm and cheek. My eyes closed and there it was – a time-lapsed video that was my life. It played out longer than I expected for a mere 42 years. (I guess no one ever said I was boring.) So this was it. This was how it was all going to end. I was a total cliché – death by heart attack from 32 years of type 1 diabetes.

Actually, that’s not how it happened at all.

You see, I am a curious human specimen, the word “typical” impossible to apply to my diseased body. (Okay and maybe my whole quirky self. Never mind that.)

Yes, I did end up in the emergency department of the largest hospital in the area due to symptoms of a possible heart attack. It just didn’t happen how one would expect.

It all began mid-evening with an indescribable localized headache. (Wait. I’m a writer. Challenge accepted. Let me try and paint you a picture. It’ll be fun.)

Puke. Sob. Lie down. Try to breathe. Sob. Breathe some more.

I suffer from stress headaches, eye strain headaches, hypoglycemic headaches, hyperglycemic headaches and puking migraines. This was not any of those. Picture in your mind, a glass ramekin. (Ooo! Creme Brulee! Yes please!)  Now, eat that crème brulee. (Or feed a friend. Just please don’t throw it away!) Now fill the ramekin with tnt, pack it in tight, place it under your skull northwest of your left eyeball facedown with the open end resting against your brain, and then watch it explode. I’ll tell you what happens next. With nowhere to go, the wreckage swells and smokes. Tears and nausea join the attack as if somehow this will relieve the pressure.

25 minutes and two cold compresses later the headache settles into acceptable proportions and I get up.

Okay, so what the heck was that?

Puttering around the kitchen in my dressing gown, I am thankful the worst is over.

Suddenly my hand flies to the front of my neck as a shallow knife slices upwards. There it is again. And again. I’ll be honest…this does not feel quite right.

I sit.

Okay. So my neck is calming down. I’m fine.

Wait.

Why is my left shoulder aching? Oh wow. It is really aching. And there goes my whole left arm. As tears flow, I scoff at the word “agony.” It is but a weak child cowering under the torturous monster that has consummed my left side. Why is there a sharp tingle shooting up my back?

Wait.

Okay. That’s gone.

But breathing just got difficult. Did I run up a three mile, 10% grade hill in the last two minutes? No. I just stood up and walked a few steps.

And…

There it is.

My chest is tight. And is that a strange twinge of pain rippling across? It’s not terrible though. My arm hurts worse than my chest. And my head is much better. The knife at my neck is gone. As I silently try to process what might be happening, Don’s voice breaks through my thoughts.

 “So, you know you are having all the symptoms of a heart attack, right?”

“How do you know?”

“I just looked it up on the internet.”

“Oh. Okay. But heart attacks don’t usually start with a headache, do they?”

“It didn’t mention a headache, but you do know you are not normal, right?”

Good point.

You may be questioning why the next words I type aren’t, so we went to the hospital. Judge if you must, but if I went to the hospital every time I had a new or weird and whacky symptom, they would probably charge me rent. And you have no idea how exhausting it is to try to explain me, to a doctor who knows nothing of my situation or history, only to be sent home 10 or 14 hours later with no diagnosis. Plus, my symptoms were happening in a sequence rather than all at once, so this was not a simple case of, so we went to the hospital.

Some time goes by while I play ping pong in my head, the opponents being Stay or Go.

Soon though, everything but my arm and shoulder (okay and my chest a little and maybe my back so mostly everything) are feeling much better. Crisis averted, right?

As I sit in my bed, now approximately 2:45 a.m. doubt sets in. Am I okay? Should I have gone in? But it must be too late now, right? Then Google explained there is a blood test that can determine whether a cardiac incident has occurred or not. Hmm…Should I be going to get this test? The episode was over (?) but maybe I should find out if any damage had been done to my heart?

Cue FB messenger.

My dear cousin and friend is an emergency room nurse back in the largest hospital in Winnipeg.

You there?

She was. After a lengthy discussion (and her giving me heck for not going sooner) she convinced me it probably wise to still go in and get the test, despite my symptoms now almost totally gone.

People with diabetes don’t always present heart attacks like other people. They can even have silent (painless) heart attacks, so this could definitely have been one. Do whatever you have to do. Clutch your chest and throw yourself on the ground if you have to.

Fine.

“Honey, I think we better go in after all.”

Part 2:

Pulling into the drop off loop in front of the A and E doors, Don parks off to the side and out of the way. Before the driver’s side door is even closed, a security guard is sure to tell Don to move the car asap. (Now, I get that the loop needs be kept clear for emergencies, but, umm, I am the emergency at this point, yes? Back off dude. I could die at any second.)

I check in only to wait a short five minutes while the hoodlum in triage gets his arm wrapped, his saggy-panted (trousered) friends loitering in the door, enjoying the show.

My name is then called and I go in alone, since my dearly beloved is still outside properly parking the bloody car. (Sorry car. It’s not your fault.)

Mr. Triage asks a few questions, types a few notes and immediately does an ECG. (Which comes back normal.)

“Are you always this pale?” Mr. Triage asks. Umm…I can’t see my face {when I’m with you.} (Actually, that would’ve made such a better lyric, yes? At least it makes more sense even if lacking in poetics.) So that’s a tricky one. Am I more pale than my usual pale self? Where is Don when you need him. Oh right…the car.

I did have some concern for Mr. Triage as his breath is more laboured than mine had been at the peak of the whole fiasco. Out of shape? Asthma attack? Heart attack?? This line of thinking might border on oversensitivity or even paranoia, but I feel for the guy. With a quick phone call a wheelchair is ordered (for me, in case you too are concerned for him) and Mr. Triage opens the door so we will know when it arrives to whisk me away for the test.

Here’s where it gets a little weird. Piecing together what Don witnessed in the waiting room, (Yes, he was back from the oh-so-important car parking.) and my perspective from inside the room, we still can’t conclude the why as to what happened next. A mother, father and a four or five year old son had checked in and were told to wait for triage. The second the door opens, with me sitting inside waiting for my wheelchair, the three of them move into the doorway totally blocking it and just stand there, staring at me for the next four or five minutes. They do not glare. They stare. I stare back. Umm…I just had a heart attack people. BACK OFF. (Okay, it’s four a.m. Give me a break.) Even Mr. Triage is shocked to see them there as he peeks around his desk to see what is going on. A teensy bit of satisfaction may cross my face as my wheelchair arrives and this little family of three have to move out of the way. As I am whisked away I can’t help myself. I meet Mom’s eyes, silently gloating that my case is serious.

After the driver wheels me backwards to my curtained-off room (insert motion sickness here), we arrive to see two chairs and a bed. We sit in the chairs. Why did you not get on the bed, you ask? A nurse walking by asks that same question until I simply lift my arm and point to the bare, unmade bed. To her credit, she promptly gets the disinfectant spray, wipes it down and makes it up with (hopefully?) fresh linens. (This is where I point out that hospitals can be one of the most dangerous places for sick people with all the viruses floating about – yet another reason not to rush in unless absolutely necessary.)

I climb up onto the bed. (The word bed is a little deceiving, as that would imply some level of comfort.) But I have to admit, so far the staff have done everything right. (Minus the backward wheeling.) I got in immediately. Triage took me seriously. An ECG was done. And the bed was quickly made. After many an emergency room visit, this one impressed, so far.

A nurse or lab tech arrived within half an hour, inserted a line in my arm and took four vials of blood. Then she said, “This could get messy. I have to take a vial of blood.” Umm…you just took four already. Did you think I didn’t notice? And why would number five be messy? Regardless, the last vial, a different shape being longer and narrower than the others, did not cause a mess and she assured me it would all be sent to the lab immediately. Results would return within an hour or two and then the doctor would see me and decide what came next.

Absent of working wifi, I decide to try and get some shuteye while we wait. Always in some level of pain in the night, this just wasn’t happening – not with the lights, noise and the non bed-like bed.

Still I try. I close my eyes. My thoughts turn to pancakes. Yes, my pillow is but a flat pancake, void of maple syrup or Nutella. Now I can’t stop thinking about Nutella.

My blood test results are returned and hung on the wall to taunt. Is my heart okay? What will the test have shown?

Two hours later a doctor appears to discuss my case.

“Describe the headache to me. How long did it last? What were you doing when it started?”

I answer, adding the list of other symptoms that occured.

“You may have burst a blot clot in your head. We call this venous thrombosis. We may need to do a CT scan. I will discuss this with the consultant on duty. First though, let’s do some neurological testing.”

Umm, okay.

I follow her finger with my eyes. I keep both arms raised in the air. I push against her palms. I pass all the neurological tests.

“Okay, so I will just go and speak with the consultant and he will decide if you need further testing.”

“Sure, but wait,” I say. “What about the heart blood test? Is it normal?”

“Oh, we didn’t do that test. It doesn’t look like it was ordered.”

I turn my head and meet Don’s eyes. She did not just say they didn’t do the test.

“Umm, I have had type 1 diabetes for 32 years and came in with symptoms of a heart attack and you didn’t do the test?”

“Well, I’ll check again but I don’ think it was ordered.” She walks away to talk with the consultant.

A silent and invisible question mark stands tall like a statue between Don and I as we wait for the doctor to return.

The curtain pulls back and she reappears with their conclusion. No CT is necessary and no need for the test to be ordered.

For the sake of rationing words, I will just tell you this. For the next 10 minutes or so a debate came to life as to whether the test should have been done, based on symptoms and my risk of a cardiac incident due to the diabetes. Apparently, I am too young and too healthy to have a heart attack? This conclusion was drawn after no questions as to my history of high blood pressure, high cholesterol, and after giving the list of multiple serious complications from the diabetes. Hey, I love the idea of being at low risk for heart disease, but seriously?! AND YOU TOOK FIVE VIALS OF MY BLOOD.

We left the hospital with mixed emotions. Was I probably fine? Yes. Could they have ruled out anything serious? Yes. Did they? No.

Knowing we had an appointment with an amazing specialist the very next day (for other reasons), we knew we could get an honest opinion as to whether we were we right in going in and should they have done the test and could it still be done.

His answers went like this: Yes we did the right thing. Yes, they absolutely should have done the test, (when in fact, almost everyone who walks through the door gets the test) and sadly, yes, I am at a higher risk than the average person for heart attack. (An atypical one, thanks to the Betes.) And without a baseline from the time of the incident, a test at this point would not give us a comparison, thus telling us nothing.

We missed the window.

At the close of this discussion, the advice we received was this: If you get these symptoms again, go in and present your symptoms.

“As in, clutch my chest and throw myself on the ground, writhing in pain?”

“Correct.”

Message received.

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