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Emergency room woes: An ache, a pain or what?

Posted Jun 28 2011 4:57pm

Last Thursday at 2:30 am I found myself lying on a bed at our local ER with a curtain drawn around my tight quarters, wondering if this nightmare would be one from which I would awaken soon.

The drama actually unfolded the day before when I had an echocardiogram (E.C.H.O.) to check on my mitral valve prolapse . This condition, which I’ve likely had since birth, is a heart dysfunction in which the valve dividing the upper and lower chambers of the left side of the heart does not close properly. The E.C.H.O was done in preparation for my annual checkup next month. A routine test, I was not concerned about it. But when I think back, the technician was a bit rough, probing as she did along my chest wall, bare of all fat, ribs poking out like a Somali refugee.

After the E.C.H.O. I headed to the health club, did my mindless 30-minute cross-trainer routine and drove home. My son and I ate dinner together (hubby was busy getting a lake house ready for renters). The evening saw me lost in a good book as I soaked in a bubble bath surrounded by soy candles. (I figure the soy scent wouldn’t affect my estrogen levels.)

How could anything go wrong after a bubble bath and aromatherapy?

At 2 in the morning I woke up with a sharp pain in my chest at the same spot where the technician had been rubbing her cardiac probe. And fortuitously at the same spot where two malignant tumors had reared their ugly heads in the past. At first I thought, This is just a bruise from the probe, so don’t sweat it (except for your night sweats). But the pain prohibited sleep and when I got up, I changed my thought tune:  Wow, maybe this is a heart attack! Maybe all that adriamycin and Herceptin treatment for cancer finally got to my heart.

Since I’ve had cancer twice and treatments with possibly permanent nasty side-effects, I take any acute symptoms very seriously.

Into my tee and shorts I jumped. I forsook my compression sleeve but grabbed my glasses.  My son John was standing in the kitchen (thank God he is a night owl and still living at home) as I rushed past him saying I was on my way to the ER for chest pain. John moved more quickly than I’ve ever seen him. Despite the trauma of the moment, I smiled to myself and shed a silent tear. His mama must mean something to him.

The two of us charged into the Prius and drove the four-mile dash to our nearest hospital in record time. Because they are building a new ER, we had to walk almost a mile just to get to the entrance. At least it seemed that way to me in my dazed state of mind.

I had never been to the ER for my own emergency except for a sprained ankle many years ago. So this was new to me.  I’d heard many horror stories of long waits and extended tests, and possible admission, so I braced myself for the worst. But when we arrived, the sole person sitting in the waiting room was called in. At the front window when I told the receptionist of my chest pains, a nurse promptly appeared, asked me some questions, and brought me back. Before I could even open a magazine. Wow, was I impressed!

In no time the M.D. on call peaked in behind the curtain and asked me some family medical history and lifestyle questions.  Based on my answers he was quite confident a heart attack was not causing the pain. In the next whirlwind hour and forty-five minutes different technicians subjected me to an electrocardiogram, blood pressure and pulse rate readings, blood draws, and finally some chest x-rays.

I was pleased to discover that my slow pulse rate was that of an athlete. And approached that of Lance Armstrong. It’s oddly comforting to be included in his camp.

As expected, all the tests came back showing no abnormalities. The official diagnosis was chest pain with an unknown cause. But unofficially they agreed with me that the pain was likely from ribs bruised by undue pressure from the E.C.H.O probe. Which is what I originally thought—and hoped for. The other possibility that occurred to me was that since chest pain is a symptom of mitral valve prolapse, maybe the test triggered this symptom where formerly there were none. A good question for my primary physician next month.

The chest x-ray was an added bonus because I haven’t had one in a long time. I’ve heard many stories of people finding lung cancer through a chest x-ray ordered for another reason. I’ve asked for chest x-rays from my oncologist, but apparently insurance won’t pay for routine tests without a proven benefit. Clearly my own diagnosis of breast cancer and my mother’s diagnosis of lung cancer weren’t enough to convince the powers-that-be. So I was thrilled at this opportunity to find out if I had lung cancer or lung mets. I didn’t!

Can you tell I always try to find a silver lining?

When we arrived home at 3:30, I thanked John profusely for taking me and waiting so patiently and cheerfully. A quiet sort, he was very companionable as I lay supine upon my bed of probes and pricks. Back on my own king mattress, I snuggled under the comforter, my bed of roses. Although I had taken a Tylenol and two mini-aspirin before going to the hospital, I didn’t sense the pain to be any lesser. But being assured my heart was okay, I willed myself to sleep.

When I awoke at 7:45 I was not sufficiently refreshed to go to work, but went anyway. Too many things to do. I dragged through my duties that day, with the chest pain still breaking through my consciousness. Sleep came much easier the second night.

When my hubby later returned home, he shared that his bruised ribs from a karate kick took two weeks to heal completely.  So recovery could take some time. But that’s so much better than the alternative. In the back of my mind, as most breast cancer patients well know, I thought this might be a recurrence. After all, this chest wall pain arose in the exact same spot as my two lumps. Aches and pains are not the same in my new-normal post-cancer existence. I’m only glad the E.C.H.O. was done the day before, so I had good reason to believe it was something else.

Life goes on. In the fast lane. And I’ll embrace it with every last breath.

Have you had aches and pains checked out after cancer treatment?  Have you had any emergency room visits for chest pain or other symptoms of a heart attack after treatment for cancer? If so, what were these experiences like?

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