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Yosemite morning

Friday, December 2, 2016

Reeling and rocking

I had been feeling funky and lethargic for much of the week. Noticed a bit of swelling in my legs but nothing else really significant. Cognitively a bit blurry, not able to find familiar words at the normal speed but have also been a bit hammered by current events.

The weirdness got a bit weirder towards the afternoon. I felt a big aching under my left pectoral muscle, that rose from a focalized pierce to a full blown elephant sitting on my chest by nine o'clock that night.

I had a heart attack several years ago and the pain was similar if not more intense, although that pain radiated from my back and the backs of my arms while this was front and center.

It got so bad that I couldn't breathe and told Leslie she had to take me to the hospital around 10:30. Fallbrook no longer has a hospital and I thought about my options and chose Palomar, about a thirty minute drive at that hour of the night.

She hightailed it down there, I called en route to warn them. Still had to go through the triage slough in the waiting room, even after I mentioned that I thought I could be experiencing a cardiac event. Finally they found me a room.

I am not going to go through a full rundown but I was administered a battery of tests, ekg, xray, cat scan with contrast, ultrasound, enzyme, the whole gamut. They were worried about a clot from my legs lodging somewhere it wasn't supposed to be, perhaps a little blowback from my airplane flight to Dallas and back.

All the tests came back negative, except they did see some lingual pneumonia at the bottom of the left lung, near the pain source. A fast google check on the phone showed that this type of pleurisy can mimic cardiac symptoms.  The on call doctor had twins to deliver  and we were left in limbo until the next morning when we met the hospitalist. The nitro patch they administered the night before had left me an intense headache throughout the night and I was largely left adrift without food or medical attention. Leslie squirmed on the uncomfortable seat and we tried to deal with the hand I had been dealt.

They wanted to admit me but couldn't find a room, the place being full up. I had some more tests, a full workup and another enzyme draw. Threw up some blood and bile. Feel like an over-taped human pincushion. Finally I got a tylenol and a room upstairs but was having second thoughts and feeling the distinct urge to get off the hamster wheel and amscray.

I saw a silver haired gentleman and some other folks that radiated authority on the fifth floor near my door and asked if I could have a word for a second. Hot damn, I had hit pay dirt, managing to find the man known in those parts as the Grand Poobah, the chief medical person at the entire hospital, Dr. Roger Acheatal. We sat down and I pled my case. Heavy bargaining phase.

I went over my cardiac and other medical history and pointed out that the emergency doctor's inclination was probably correct. It pointed towards pneumonia. The Grand Vizier was also a cardiologist and he knew my retired cardiologist and he agreed that the the testing probably ruled out a cardiac cause although an angiogram might still be necessary down the road as I don't really know about the amount of obstruction and plaque my arteries currently bear.

I explained that I had a repaired mitral valve and murmur, recounted my voluminous cancer and medical history. My family has a disposition towards angina and my past Prinz metals heart attack was anginary in nature. I agreed to do whatever tests they felt prudent and necessary but voiced my strong urge to vacate the premises as fast as possible, before the cash register wheels really started spinning. The nurse giggled when I gave my pleurisy hypothesis and made a funny comment about "google doctoring" and self diagnosis.

It has been a bad year for me, having switched to Blue Shield from my Health Net PPO and later discovering that none of my providers would work with them. Even my forty year gp. Basically stopped seeing doctors. Which in a way is a good thing, since mostly I didn't need to see doctors. Anyway I told them that having been through the medical circus so many times with my extensive history I believed that I had to be my own best and strongest medical advocate and they surprisingly totally agreed with me. They agreed to release me if they could get a clearance and approval from the on call doctor, who I had not yet met.

I went down and took the stress test, per her orders. Blew them away, they were amazed at my cardiac function and health, although my a fib sort of went crazy at full exertion. But I gritted my teeth and passed with flying colors, without a moment of slowdown, through sheer will and a strong desire to get out of the hospital.


I met with the Indian born Doctor Sanpath, educated at UCSD. She was very bright and personable and cautiously went over every test before granting me my pardon. She did not think the pneumonia was severe enough to have caused my grief and tended to think that it was an angina attack. I told her that I was not ruling out sudden Trump onset.

The rapport I developed with these people was fantastic and I come away from my experience being very bullish about the healthcare at Palomar, which is affiliated with Kaiser. I could nitpick some little things but I will not. Place was clean and professional and the doctors listened, a real rarity. Nurses were extremely warm and caring.

Left last evening, in the midst of a gorgeous sunset. Have to thank Leslie, my wife. 27 hours without sleep, she rose and met every challenge like the loving warrior she is. Thanks to all of you for your good wishes. Still not sure exactly what happened but I think I am cool and okay. Got a nitro prescription if this sort of thing should happen again. Going to find a cardiologist soon and get back on track. I have things to do but will chill as much as possible this week. Chest still hurting but not as bad.

Had a strange dream last night.  I was lying on a beach. My friend Gary was nearby on his own towel. I saw a huge typhoon like wave coming. I decided to do nothing, wondered if my friend would save me but had lost the inclination to do anything to save myself for some reason. Didn't care. I was caught up in a leviathan set, would surely die. Lo and behold, my friend did not save me. I started to fly and saved myself. I flew to an unidentified city and past a highrise with an old woman inside one room. I opened the window and made her acquaintance. The furnishings were sparse but modern, a guitar was sitting in a spot in the middle of the room. She was listening to Eddy Arnold. We talked for a while and then I woke up.


9 comments:

Sanoguy said...

Glad things are Ok, BH!

A suggestion to you and others: having your sort of symptoms, you should call the paramedics. They function as an mobile emergency room. They provide immediate intervention and when you get to the ER, you move to the front of the line.

What would Leslie have done had you had the big one along the way? Not a pretty thought! A lot can happen in 30 minutes. Don't take that chance!

Ken Seals said...

I'm glad you are still among the alive and kicking. Did you also mention to them that you can do 8 miles at 6,000 feet elevation in the Sierras? Carrying lots of camera gear?
We are truly grateful that you condition was not more serious.
Ken and Lauren

Helen Killeen Bauch McHargue said...

So happy to hear you're OK!!

Blue Heron said...

Thanks all. Mike, my last AMR ambulance trip, from Fallbrook Hospital to Scripps, cost 8k. Fought them for years, finally paid the bastards. Insurance co. said it was unconscionable and usury but wouldn't help me. Left a very bad taste in my mouth.

Sanoguy said...

Death would leave no taste, I guess!!!

An emergency ride is different than an inter-facility transfer. I don't think an emergency ride with FD medics would be a problem with insurance paying. I suggest you talk to the fire department pro-actively and find out the details ahead of time.

Jon Harwood said...

Good luck with the follow up!

island guy said...

Happy you made it out once again. Had a thought after reading this that most people don't have the knowledge or experience to negotiate their way through the maze of medical mysteries. So great that you had and connected with some of the really good people on the other side of the white coat.

Anonymous said...

Robert,
Shocked to hear you had a cardio scare. Ambulance service is a big $cam nowadays. Leslie-what a good loving wife you have. You need to take care of yourself-quit eating all those big gourmet meals and take a good break from stressing about double-cross Donald. Your blog has been great reading lately, and I for one would miss it, but not at an expense of your heath.

Hope you are feeling and doing better, SLOW DOWN!
KJ

Anonymous said...

Wow Robert, glad your ok. Better be nice to Les, she is one in a million!
XO Melissa