Chest Pain (Yes, I'm still complaining about it.)
by Robison Wells
Last month I blogged about my most recent medical problem, chest pain. (In the four years that this blog has been in operation, I think I've blogged about medical problems about eighty five times. It will continue until I get a casserole.)
The story was this: on the night of the BYU-Utah football game, I got some very sharp, very heavy pains right in the center of my chest. I ignored them for the customary number of hours (defined as: the amount of time in which I would have died if it was a real heart attack), and then I went to the ER.
The ER diagnosed it as pericarditis, which is an inflammation in the lining of the heart. They told me to wait a couple weeks, lay down a lot, take some drugs, and it will all be better. That was two months ago. Diagnosis: doctors are liars.
The medical treatment of this condition has proceeded slowly, due to the fact that I didn't have insurance during the month of December. So, even when I went to see the doctor he took things slow, doing all the cheap stuff first and then ramping up into the more expensive tests. If I had died early in the process, my tombstone would have read "GOOD THING WE STOPPED HEALTHCARE REFORM, GUYS!" But, I didn't die, so long live the Love Revolution and all that.
In the realm of cheap treatments, my doctor tried a predisone regimen, with the philosophy that it would address any inflammation issues, whether they were heart-related or musculo-skeletal. For those of you who are unaware, predisone is a steroid, and it sucks.
Wikipedia listed prednisone's side effects as: insomnia, euphoria, and mania. I'll be honest: I was excited. A drug that gives me euphoria? And it's legal? (My boss was excited about the mania part. "Maybe you'll actually get some work done, crappy employee" was not his direct quote.)
But as it turns out, the only side effects I really noticed were an intense pressure on my chest, and insatiable hunger. I would eat a big dinner, put my plate on the counter, and immediately begin to fantasize about Taco Bell. I am not kidding when I say that in the twelve days of prednisone treatment I did not feel full once--and I really tried.
And, worse still, the pain didn't go away. So, last Friday I went into the hospital for an echocardiogram (basically an ultrasound of the heart). When I got to the echo lab the doctor decided that I ought to have a stress test as well.
This doctor also had a poster prominently hanging on the wall by her desk that declared "Dare to do things worthy of imprisonment if you mean to be of consequence. -- Juvenal" Now, I'm a fan of Thoreau's Civil Disobedience, and I've attended protests, but should a poster like that hang on the wall of a doctor's office? Was she going to do things worthy of imprisonment while I was there?
Turns out the answer was yes, because a cardiac stress test is essentially torture. First, they shave your chest with something that looked like a serrated ice scraper, then scrub you with steel wool (I think) and then wash you down with alcohol. It's painful. And then, plastered with electrodes, you run on a treadmill until you collapse. (Very literally. I believe the point of the test is to make your heart problem become very bad while they're monitoring it.)
(Sidenote: I had to take this test on the same day I had the worst migraine I'd had in a year, and I'd spent all morning puking. So, hooray!)
Anyway, after falling back onto the echo table and writhing in nauseated, crippling agony, I heard the results. The cardiologist declared "I don't know what's wrong with you, but you are not in need of a cardiologist."
This is good news and bad news. The good news, of course, is that the ol' ticker is fine. After a lifetime of absolutely terribly eating, the tests showed that not only is my heart fine, but it's really really great. And, even better, my blood flow is great, and there's no sign of coronary disease (which, you know, is the big worry when you drink bacon fat with every meal, as I do). Obviously, when it comes to nutrition and heart problems, I AM INVINCIBLE.
The bad news, though, is that my chest still hurts.
So, we're going to have a blog contest. The first person to successfully and accurately diagnose and treat my chest pain wins a free thing of minimal value. Any diagnoses that are crazy will be automatically disqualified, and any treatments that have not been clinically tested in independent double-blind studies will be mocked publically. (Exception: I will accept phrenology diagnoses, but only if you can catch me to measure my head!)
You can follow me on Twitter! In fact, most of the jokes in this blog already appeared there. So, follow me there and you'll be aware of how often I rip myself off.
Last month I blogged about my most recent medical problem, chest pain. (In the four years that this blog has been in operation, I think I've blogged about medical problems about eighty five times. It will continue until I get a casserole.)
The story was this: on the night of the BYU-Utah football game, I got some very sharp, very heavy pains right in the center of my chest. I ignored them for the customary number of hours (defined as: the amount of time in which I would have died if it was a real heart attack), and then I went to the ER.
The ER diagnosed it as pericarditis, which is an inflammation in the lining of the heart. They told me to wait a couple weeks, lay down a lot, take some drugs, and it will all be better. That was two months ago. Diagnosis: doctors are liars.
The medical treatment of this condition has proceeded slowly, due to the fact that I didn't have insurance during the month of December. So, even when I went to see the doctor he took things slow, doing all the cheap stuff first and then ramping up into the more expensive tests. If I had died early in the process, my tombstone would have read "GOOD THING WE STOPPED HEALTHCARE REFORM, GUYS!" But, I didn't die, so long live the Love Revolution and all that.
In the realm of cheap treatments, my doctor tried a predisone regimen, with the philosophy that it would address any inflammation issues, whether they were heart-related or musculo-skeletal. For those of you who are unaware, predisone is a steroid, and it sucks.
Wikipedia listed prednisone's side effects as: insomnia, euphoria, and mania. I'll be honest: I was excited. A drug that gives me euphoria? And it's legal? (My boss was excited about the mania part. "Maybe you'll actually get some work done, crappy employee" was not his direct quote.)
But as it turns out, the only side effects I really noticed were an intense pressure on my chest, and insatiable hunger. I would eat a big dinner, put my plate on the counter, and immediately begin to fantasize about Taco Bell. I am not kidding when I say that in the twelve days of prednisone treatment I did not feel full once--and I really tried.
And, worse still, the pain didn't go away. So, last Friday I went into the hospital for an echocardiogram (basically an ultrasound of the heart). When I got to the echo lab the doctor decided that I ought to have a stress test as well.
This doctor also had a poster prominently hanging on the wall by her desk that declared "Dare to do things worthy of imprisonment if you mean to be of consequence. -- Juvenal" Now, I'm a fan of Thoreau's Civil Disobedience, and I've attended protests, but should a poster like that hang on the wall of a doctor's office? Was she going to do things worthy of imprisonment while I was there?
Turns out the answer was yes, because a cardiac stress test is essentially torture. First, they shave your chest with something that looked like a serrated ice scraper, then scrub you with steel wool (I think) and then wash you down with alcohol. It's painful. And then, plastered with electrodes, you run on a treadmill until you collapse. (Very literally. I believe the point of the test is to make your heart problem become very bad while they're monitoring it.)
(Sidenote: I had to take this test on the same day I had the worst migraine I'd had in a year, and I'd spent all morning puking. So, hooray!)
Anyway, after falling back onto the echo table and writhing in nauseated, crippling agony, I heard the results. The cardiologist declared "I don't know what's wrong with you, but you are not in need of a cardiologist."
This is good news and bad news. The good news, of course, is that the ol' ticker is fine. After a lifetime of absolutely terribly eating, the tests showed that not only is my heart fine, but it's really really great. And, even better, my blood flow is great, and there's no sign of coronary disease (which, you know, is the big worry when you drink bacon fat with every meal, as I do). Obviously, when it comes to nutrition and heart problems, I AM INVINCIBLE.
The bad news, though, is that my chest still hurts.
So, we're going to have a blog contest. The first person to successfully and accurately diagnose and treat my chest pain wins a free thing of minimal value. Any diagnoses that are crazy will be automatically disqualified, and any treatments that have not been clinically tested in independent double-blind studies will be mocked publically. (Exception: I will accept phrenology diagnoses, but only if you can catch me to measure my head!)
You can follow me on Twitter! In fact, most of the jokes in this blog already appeared there. So, follow me there and you'll be aware of how often I rip myself off.
RobisonWells — 1/27/2010 11:23:00 AM
29 comments
29 Comments:
Did they check your esophagus? Pain from a hiatal hernial can feel a bit like a heart attack too. The tests for that are lots of fun too.
Hmm... Interesting thought, Janice. They checked for acid reflux, but not for the hiatal hernia. I'll have to ask the doctor.
Taco Bell...hmmm...how about plain ole' horrific-sized heart burn?
And really funny post! I have to admit I laughed out loud, though I am sorry for your pain! Really I am.
Have they checked your gallbladder? Gallstones or gallbladder inflammation can sometimes cause pain right up the middle of your chest. It can also be exacerbated by high fat intake.
You should also have your pancreas checked. It's right in that general area and can cause tremendous pain.
Stress? Stress can have a strong physical effect on the body. I had a stress echo a year or so ago and nothing turned up--I'm guessing stress caused my symptoms, though they weren't nearly as severe as yours.
Rob:
Dr. Anonymous here. I take it that you're not a tea party guy? But really, do you want people who are forced to pay taxes to cover your medical bills or do you want your family, your friends, and your church to help you out? I think option number two brings communities together. Federal government taxation and redistribution tends to destroy communities and replaces "Am I my brother's keeper" with "I already paid at the office."
Here are some of the possible sources of your chest pain other than cardio-related causes. If you want more I can send more possible suggestions:
Spontaneous pneumothorax (collapsed lung) occurs when the pressure balance between the sac that contains the lung and the outside atmosphere is disrupted. Its usually caused by the following:
•Injury to the chest that pierces through to the lung sac is the most common cause of this condition.
•This can be caused by trauma, as in a car wreck, bad fall, gunshot wound or stabbing, or in surgery.
•Some very thin and tall people may suffer a spontaneous pneumothorax due to stretched lung tissues and abnormal air sacs in the upper portions of their lungs.
It is possible for these abnormal air sacs to rupture with even a sneeze or excessive coughing.
•Other risk factors for pneumothorax include AIDS-related pneumonia, emphysema, severe asthma, cystic fibrosis, cancer, and marijuana and crack cocaine use
Perforated Viscus Causes
Perforated viscus may be caused by direct or indirect injury. Irritation to the diaphragm in this case comes from below the chest. The diaphragm is the muscle that allows us to breathe. It is located up under the ribs and separates the chest and abdominal cavity. Any irritation to the diaphragm, even from below it, can cause pain to be felt in the chest.
Risk factors not related to trauma are:
•untreated ulcers,
•prolonged or forceful vomiting,
•swallowing a foreign body,
•cancer,
•appendicitis,
•long-term steroid use,
•infection of the gallbladder,
•gallstones, and
•AIDS.
Esophagus Related Causes
Chest pain originating from the esophagus may have several causes.
•Acid reflux (GERD) may be caused by any factors that decrease the pressure on the lower part of the esophagus, decreased movement of the esophagus, or prolonged emptying of the stomach. This condition may be brought on by:
◦consumption of high-fat foods,
◦nicotine use,
◦alcohol use,
◦caffeine, pregnancy,
◦certain medications (for example, nitrates, calcium channel blockers, anticholinergics, estrogen, progesterone),
◦diabetes, or
◦scleroderma.
•Esophagitis may be caused by yeast, fungi, viruses, bacteria, or irritation from medications.
•Esophageal spasm is caused by excessive, intensified, or uncoordinated contractions of the smooth muscle of the esophagus. Spasm may be triggered by emotional upset or swallowing very hot or cold liquids.
As a follow-up to my last post about your symptoms, I would be willing to bet that, if you've been eating a diet high in sugars and processed foods (snack foods, chips, that sort of thing) that you may want to explore the possibility that you are experiencing pain related to Esophagisits or some other esophagial related issue. Many esophagistis symptoms, if not all, are related to the over abundance of one of five thousand strains of a bacteria commonly referred to as an overgrowth. Where those bacteria should be present in a ratio of about 15 percent as compared to the asidopholos family strains that should be maintained at about an 85 percent level, north americans, due to their high consumption of sugars and processed foods, often test at 50 percent or higher for those bacteria that can caused Esophagus Related pains and hence your chest pains.
If I were experiencing your pain, I would see if a change in diet over a period of about 4-6 weeks didn't clear up your symptoms, by essentially restoring the proper ratio of bacteria strains in your upper digestive areas and organs. I would:
1. Avoid sugars, deserts, sugar drinks, etc including, for this two week period, fruit juices that tend to feed the overgrowth of these unhealthy bacterias. Your are, essentially, limiting the food these bacteria thirve on.
2. Avoid Processed foods for the same reason as in #1 above.
3. Eat lots of veggies and only limited fruits like berries and melons while avoiding the higher sugar fruits like bananas, oranges and apples.
Once you're well, you can include some sugars and processed foods back into your diet, but on a much more restricted schedule.
Your body may be reacting to a poor diet, not through your cadiovascular system, but through your digestive system and the overgrowth of unhealthy bacterias.
Good luck figuring out what is causing your symptoms. I'll say a prayer that you'll be guided to know how to heal yourself.
Sincerely,
Doctor Anonymous
(I really am a doctor)
Well, disqualify me right now. I'd just look stupid after the Dr.s comments. ;)
Have you considered that it may be the sheer level of your awesomeness? You're in the red. Maybe you should tone it down a notch or two.
Anon,
Well, you're a doctor but you're not a medical doctor (as evidenced both by the fact that I know you, and by the fact that your medical advice is cut-and-paste from emedicinehealth.com.)
As for the tea party issue, I'm more than happy to discuss it, but offline. You can email me (sans anonymity) at robisonwells@gmail.com, if you really want to discuss it.
Just some anecdotal comments. My mom and a couple of others I've talked to, have complained of severe chest pains, bad enough to go to the ER. It may be the hiatal hernia that was mentioned earlier. For my mom, there was basically a pinch in the upper part of the stomach that was producing rather intense heartburn-like symptoms. The other two people I talked to said that their problem went undiagnosed, but that it hasn't happened again.
When in doubt, you should probably try the House diagnosis method and just blurt out stuff like:
"Lupus!"
"Amyloidosis"
"Intubate!"
(And then you take a drink.)
I think one of the "best" diagnoses I ever heard was something about a friends chakra's being out of alignment and causing the chest pain.
The solution?
Dr. Q: Rub a ruby on it! 10 times a day.
Friend: I don't have a ruby.
Dr. Q: That's OK, I have one I can sell you.
So our current self-health solution is Rub a Ruby on it. And I haven't had any chest pains since last summer when I got rid of that extra gallblader stone I had.
You have small children, right? Are they crawling into bed with you and sleeping on top of your chest?
Is one of these children sleeping sideways between you and your wife so that you are clinging to two inches of mattress space? This can also cause pain.
Clearly, I am not a doctor, but since the "doctor's" suggestion included that it might be caused by pregnancy, I suggest you take his diagnosis with a grain of salt. Unless, of course, there is something you're not telling us.gat
Did they test for gall stones? Hernia? Pancreatic cancer?
I know the cancer sounds awfully scary, but you never know.
I noticed an article in the D-News today about the BYU basketball coach and his battle with pancreatic cancer last summer. You may want to check that article and see if the symptoms he discusses have any similarity to your symptoms. Again, scary.
I don't think I know you, Rob. But if you know me, great, you are one very amazing clairvoyant. Which brings up a funny thing. Did you see all over the news yesterday the HS basketball coach in, I think it was Missouri, who was blindfolded by the student body officers during a school assembly and promised two tickets to the NCAA b-ball final if he could sink a half court shot. The student body was coached to cheer wildly when, as they assumed would be the case, he missed the shot. They didn't really have any NCAA tickets for him. Turns out he made the shot. Blindfolded. And they captured all of it on video. I think you can see it at KSL.com. Amazing accuracy. I also noticed that he made a few shots afterwards (or before, I don't know which) without the blindfold. The guy can shoot.
I don't think I'd enjoy talking politics with you. You're far more versed in the political world than I.
Actually, the chest pain analysis comes from a medical physiology guide that's in print. I think the website you mentioned acutally got their overview of chest pain from that printed guide. If you want the guide information I can get that to you, or you can use the online version. I don't know if the online version is exhaustive, but it looks like it has a number of pages, so it may have all the same information. I'm sure the online guide will actually site their information at the end of their postings.
Good luck with your illness. Praying that you'll find something that cures your symptoms. Fast.
I got my degree in medical physiology. Which actually means I know just enough to be dangerous. And I'm not a medical doctor trained or licensed to treat patients, so do take what I say with a grain of salt.
All the best
I have absolutely nothing of value to add to this conversation except for to say, I'm sorry and I hope you get fixed soon. You mentioned a casserole. Would a casserole fix you soon? 'cause that I can do.
Costochondritis.
Joss,
Costochondritis is a big suspect, but it's not supposed to hang around for two months. (The reason I took the predisone was because it would have addressed both costochondritis or pericarditis.)
Tristi,
Casseroles cure everything.
David West,
I am totally going to try rubbing a ruby on my chest. I think more bling is just the thing I need.
Jon (and others),
I'm taking Omeprazole just in case there is something esophogeal going on. No results yet.
Anon,
There you go again with your misleading credentials. You may very well have a degree in medical physiology, but it's not your doctorate. Why not just post with your real name?
Evil HR Lady,
Perhaps I am pregnant. You never know. Is "Robison" really a boy's name?
Rob, I hate to tell you but it took my husband about two years to get rid of his preicarditis. And I had costochondritis that took a very long time to get rid of also. At least you know it isn't your heart. Good luck
Rob, for what it is worth, you might want to listen to anon and the bit about diet.
This is just my experience- a few years ago I was having some of the same symptoms- execpt I didn't wait the customary hours to go to the dr. Turns out it wasn't my heart and then started the long months of testing and different meds and doctors.
It was finally determined that it was a form of arthritis called Ankalosing Spondalitis (took me about a year to learn to say it and then another to spell it)
After a couple years on Predisone and 5 other meds I had gained weight and still felt awful. It wasn't until I cut out the sugar and processed food that I began to feel better.
Now, 1 year after changing my diet I have only one medication and have lost a lot of the weight and feel pretty good- unless I eat something with sugar, asparteme, or white flour.
But of course you already know this about me because of my posts over on the other blog:
http://www.pushingpastthepounds.blogspot.com/
Who says migraines have to be in the head? Maybe you are having migraines of the chest.
Sandra,
I don't have any problem with recommendations about eating a healthy diet. I completely and totally accept that eating a healthy diet will solve numerous issues. I am somewhat hesitant about such things as "cutting out sugars and processed foods", in part because "cutting out" something is the opposite of a balanced diet (because you're no longer balancing, you're cutting), but more because blanket statements about "processed" foods are neither specific enough to be helpful, nor supported by any kind of research (and, like I said, I like science). Processing food is not inherently bad. Pasteurizing milk, for example, is processing food, but it's a good thing. Cheerios are a processed food, but they're recommended by the American Heart Association. Cooking food is processing it; putting food in the blender is processing it. Heck, breaking down wheat into flour is processing it, or squeezing oranges into juice is processing them.
This is why no mainstream health organization makes blanket statements about processed foods: because "processed foods" encompasses so much as to render the term useless. (Take a look at the USDA's Processed Foods Research Unit, whose mission is: "to enhance marketability and healthfulness of agricultural commodities through processing and biotechnology." In other words, the USDA feels that processing can add healthfulness to foods.
Anyway. I don't doubt that your diet helped you. I'm just saying (as I implied in the final paragraph of the blog) that I'm not going to make radical changes to my lifestyle based on anecdotal evidence. (I mean, there's plenty of real well-researched, extensively-tested nutrition advice that I'm not following. If I'm going to change my diet, my first priority would be to just eat less and maybe try to incorporate the food pyramid a little better. It makes much more sense, to me, to start there instead of going the untested, anecdotal route of cutting out all sugar and "processed" food.)
(Incidentally, my complaints with Anon had nothing to do with the quality of his advice. It was with his false claim of authority.)
Fair enough, Rob. Point taken. I will think of another word to use instead of processed- though I know you know what I meant.
And Heather, my sister and my daughter have both been diagnosed with migrains, but they manifest in their arms.
(And I am going to add an anecdotal statement here- the change in diet I stated earlier co-incided with the cessation of my debilitating migrains as well as those of my son and the afore mentioned daughter. I'm just sayin')
Oh, and Rob, my real point that got lost in my lifestyle plug, was the rare form of arthritis that first manifested itself with the pain in the chest. The rest was just the way I choose to treat it.
Hey Sandra,
I really do appreciate your concern--and the concern of everyone who has posted ideas. I realize that my skeptical views about nutrition and alternative medicines are not shared by everyone. And even though, if we're speaking honestly, I chalk up most alternative solutions to either placebo effect or confirmation bias, there's no debating the fact that you're feeling better. In other words, if you want to do it, and you feel that it's working, I'm happy for you.
And I'll look into the arthritis issue. I'm going to see a orthopedic guy next week. (From what I hear, they want to try a cortisone shot. That sounds worse than my current problem!)
Oh, I hate corisone shots!!
A word of advice- remember all those Lamaze breathing exercises your wife learned? Practice them.
Here we go
Breath in through your nose, hold for a count of three, slooowwwlly breath out through your mouth. Repeat until the sadistic doctor finally takes that stupid needle out and try really hard not to take a swing at him.
To get Ultrasound degrees, you will need to get your associate's or bachelor's degree from a trade school, community college, or university. Ultrasound degrees usually take about two years, but there are accelerated study programs available. Classes will include biology, anatomy, and other medical topics as well as hands-on experience with ultrasound machines. Many sonographers take the voluntary certification exam with the American Registry of Diagnostic Medical Sonographers as an extra mark of confidence for their patients and medical coworkers. In fact, some employers require their sonography techs to have ARDMS certification.
Chest pain does not necessarily mean that there is something wrong in the heart. It is generally some sort of pain in the chest. Chest pain is very common of chest pain like anxiety, heartburn, angina, asthma, bronchitis, etc. It is very necessary to find the causes and symptoms of chest pain and finally get the treatment done.
This article regarding Chest Pain is very interesting and useful, the chest pain issue can affect your sexual activity, and this not only happen to older people as I used to believed, young people can also be affected so you may need to use generic viagra to help yourself on those situations. Thanks for sharing and have a nice day.
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