Sunday, March 02, 2008

Saturday in the Hospital with Schizohedron

AFTER FEELING A SECOND TWINGE of pain in my chest in three days, I ended up spending the better part of Saturday's daylight hours in the emergency department of my somewhat local hospital. I have thus far been asymptomatic, and I have been spending no small amount of the time since then contemplating my job, the likely source of these pains. Details follow.

During the past week, I have been struggling to get the March issue of our magazine out the door. I've fortunately had to spend less time dampening the managing editor's (hereinafter ME) expectations of an earlier onpress date than on the February issue. Despite this improvement, this is the first issue I've had to do completely alone since the departure of the other senior editor. All we have is the ME, two designers, and myself.

The ME was in my office two days last week, which saved me some PDF-swapping time via email. After she left, on both Wednesday and Thursday I felt the same shortness of breath and uneasiness I felt when the other senior editor gave notice. I had managed to keep up with daily exercise, but as has been the case recently, my sleep schedule and my dinners have been subpar. I did notice that, once I went home — hell, once I got into the car at 5:00 — the short-breath and spacey feelings disappeared.

It was on Thursday that I got a frightening and different symptom. I'd completed a full workout that morning with no breathing problems or irregular heartbeat/pulse. Sure enough, by the time I sat down at work, my breath became shallow. It wasn't due to exhaustion, or tight clothing, or heavy physical labor. It was starting right at the head of the day. I did my best to handle the various departments of the magazine one at a time, but because the assembly of the features had been so slipshod, I found myself having to break away from forward progress (ever my mantra) and fix problems. And it was amid this juggling act that I felt a twinge of pain in my center-left chest.

I stopped what I was doing and tried not to panic. It had lasted for just two seconds tops. Imagine someone poking you in the sternum, only feeling it a few inches below your skin. Quick, with no lingering pain afterwards. Though I knew them in rough outline, I checked the symptoms of heart attack on WebMD. I had none of them, save the preexisting breathing problems, which I was fairly sure could be ascribed to stress; and feeling warmer than usual, which was due to the heat in the office and my department facing the western sun. Of course, merely looking these symptoms up was enough to make me more panicky.

I did not go home, but finished out the day, keeping most of my attention on the contents of my ribcage. True to recent form, my breathing began to return to normal once I was backing out of my spot and tuning NPR onto the car radio.

Friday brought fewer ridiculous interruptions and reasons to extinguish long-smoldering fires. No chest pain at all. Deeper breathing. Same push to get pages out the door, but I had more time to sit there and do proofreading, which I find calming. I had skipped my gym trip to get a little more sleep. I actually stayed at work an hour later to compensate for the distracted quality of work I'd done Thursday after my weird chest twinge.

I arose early on Saturday and headed through melting slush to the gym for my scheduled cardiovascular session. About 25 minutes through a 30-minute elliptical workout, I felt another twinge in my chest, exactly the same as the one Thursday. Again, no follow-up pain, nor any of the other heart attack markers. Still, chest pain is chest pain, especially for a fat person, and I halted my workout (being somehow with-it enough to note my pulse at the time on the console: 120) and left the gym.

I called my primary-care physician, figuring I'd start there in absence of any other symptoms and let him tell me if he wanted to see me at the office or go straight to the ED. The nurse told me she'd message the doctor (they were on a shorter Saturday staff) and let me know what the verdict was. I then passed one of my tenser half hours, thinking not as much about what medical fate might await me, but how my parents would react to the news. I had no desire to send either of them into a panic, though I know they would surely react far worse if I were found dead rather than merely being hospitalized for observation.

Though I tried to hold off on eating in case they wanted a fasting blood test, at about the 30-minute mark I could hold out no longer, and I mixed a protein shake with some flaxseed just for extra omega-3 oomph. With perfect comic timing, the nurse called just as I was settling into it, to tell me to drive to my local ED for admission.

It was then that I called home to report the news. Mom took it well, but insisted that my father drive me over. Not a bad idea, if the medical advice already had ruled out an ambulance trip. If things suddenly got worse, at least I wouldn't be behind the wheel. (Though the dying act of ramming a cellphone-using driver has appeal.)

He arrived shortly thereafter and ferried me to the hospital where my doc has rights. There was some brief confusion over who might be the patient after I reported chest pains — myself or my dad — but once they realized it was me, I was wheeled right in via wheelchair to give a nurse my history. Still no recurrence of pain, and notably, no shortness of breath — hell, not even while I was stepping along merrily at the gym earlier that day. I do have a tiny bit of fitness, even under the lard. (See what gym attendance and eating whole-grain mulch and mackerel capsules gets you.)

From there, I half-stripped for a technician who festooned me with EKG leads. If your computer monitor has a million Post-Its on it, you know how I felt. After he printed out a nice cardiac seismograph for the record, I was then given the infamous ass-open hospital robe (my second recent chance to model one), wheeled over for a chest X-ray, and then returned to the ED waiting area while my bed was being readied.

This took very little time, which was possibly as much a factor of my hitting the joint early in the day as the report of chest pains. Soon I was in bed, with an RN taking more history and attaching a few more leads so they could get an extended read on my ticker. During this, I happened to receive the compliment that I have very nice, long eyelashes. I guess she wanted to calm me down. Honestly, I don't see it when I look at them, but other women have made this observation. As all of them have either been involved or otherwise out of reach, including our RN in question, it can only go so far. Still, nice to hear while being wired up like string art. I look forward to an exciting career as an eyelash model.

I then got a visit from an ED doctor. I told her the whole story from Thursday on. As I was otherwise asymptomatic, was showing a normal EKG and blood pressure, and had no other concurrent health risks (smoking, drinking, previous cardiac ailments) other than being obese, they didn't put in an IV. They did take a blood sample, which would reveal any enzymes or clotting irregularities that would indicate heart muscle or coronary artery damage. The results would take about 45 minutes, which I spent mostly resting my eyes. With noon having passed, I urged my dad to get something for himself at the cafeteria and to call my mother with an update to quell her nerves.

While lying there amid the usual hospital din, I thought back to a friend of mine who had been doubly stented about 4 years ago. His case was much different; in addition to being obese, he was an indiscriminate eater, a heavy smoker, and a past abuser of alcohol and drugs, plus he had been sustaining a load of stress far higher than mine. I also thought about a hugely obese person I'd seen at a restaurant while out with my parents last Wednesday. Easily 150 pounds more than me. And surely not alone in today's America. If I had gotten this far, while trying at this late date to amend my own dietary and activity deficiencies, before having what my instinct suggested was only a stress-related episode, how much time would that guy have?

I didn't consider my presence in the bed an injustice, as though someone of his weight ought to be there instead of me. At 5' 8'' and 227 lbs., I'm not exactly at my ideal weight either. This was a helpful warning sign, to let me know something was wrong. I knew there would be some next step based on the blood test and any other follow-up tests. And fit, slim people (or those striving for better fitness) are not immune to cardiac problems if they are genetically skewed to high cholesterol or heart irregularities. Both my father and his mother got pacemakers, for instance, so I assume at some point I'll get one too. Better to know this now, than be surprised and have to be wheeled into a hospital past the point when you can speak for yourself.

My dad returned shortly before the doctor did with the news that my blood test was normal. No sign of any heart damage. What they did find was an area of congestion and impairment at the very bottom of my left lung — though no thromboses, which was a huge relief. At the beginning of the year, I suffered for 2 weeks with a bad, productive cough that I only slowly shook off. To clear the lung out and forestall walking pneumonia, she prescribed a 5-day course of Zithromax. She also directed me to follow up ASAP with my own doctor, who might want to order a stress test or refer me to a cardiologist. She also left the go-ahead to resume strenuous exercise up to my doctor's judgment.

Shortly after this, I was given my release papers, along with a written diagnosis (Chest Pain—Unclear Etiology), and I walked out of the hospital under my own power, itself a victory. I spent the rest of the day reading at home, itching the welts where I'd lacerated and depilated myself while removing the EKG leads, and hitting the hay relatively early. I was worn out from all the excitement. Before doing so, I did call home to let my mom know that I was still feeling well, and that I'd be absenting myself from the plan to get Chinese food on Sunday. Mass consumption of animal grease didn't seem like the smartest course of action after visiting a hospital for a suspected cardiac event. (We compromised on meatloaf.)

So that is how things stand. Being locked up here was driving me nuts, so I just walked two blocks under glorious blue skies to get a bottle of Diet Coke. I forced myself down to a normal person's pace and not the double-time march my instinct, and my exercise-craving muscles, desired. I inhaled the cold air as deeply as I could, to stretch that afflicted section of lung, and made both the out and back journeys with no impairment or pain.

I suppose I'll also be forcing myself not to keep thinking about my heart these next few days, except when I'm actually at the doctor's office being checked again. A call over there is tomorrow's first order of business. The next: to inform my immediate coworkers, in language as temperate yet direct as I can muster, that I will be tending the needs of my own sweet ass first and foremost, ahead of all other work concerns. Already we've had one other person black out from stress due to the current staffing crunch. No more. The March issue will get out when it gets out. Writing my performance review is also not something I'm going to rush into, and I think I can safely say that any fantasies about taking my former boss's position can be safely cast aside. I do get a break from the madness this coming Thursday, when I have the privilege to volunteer during the WFMU 50th Anniversary Fundraising Marathon. Once again, this is assuming my health is sound. I am taking the next week on a hassle-optional basis. (Though dying on the hallowed grounds of FMU would be a stone groove, I'd like for it not to happen during my 30s.)

Until tomorrow, I will take it quite slowly, and look forward to returning to my regular exercise, and possibly a saner workplace, as the green fingers of spring enfold in comfort the sad brown bosom of the earth.


India said...

Whoa—glad to hear that you're (mostly) okay. Take care of yourself.

Schizohedron said...

Thanks very much, India. I think I got my point across to the folks at work about how I intend to proceed, so that should hopefully make the next few days a bit easier to manage. Getting what I hope to be a clean bill of health from the doc tomorrow or later in the week will also help.