Getting to the Heart of the Matter

Okay, blog buddies - a few things before I launch into the story about this whole ordeal:

1. I'm fine.  I mean, I'm not perfectly healthy yet/again, but right now, I'm at like 80-85% of my normal, and that's not too bad, overall.  Lots of folks have it way worse, particularly right now.

2.  I apologize if you're a close friend/family member of mine, and this is the first you're finding out about this.  It's kinda impersonal - I get that - and I'm sorry.  I have to be honest and say I've been reluctant to mention this to too many folks until things resolved a bit further.  Everyone is worried about so many things right now, and I didn't want to throw yet another pine cone of stress on the proverbial dumpster fire that is the year of our lord 2020 (for those of you who didn't grow up as pyromaniac Girl Scouts, pine cones tend to explode when you throw them in a camp fire - FYI).

Okay, with those important disclaimers out of the way, here's the scoop - in a nutshell (lots of flora-related metaphors this week, dang), I'm currently working my way through a bout of pericarditis.

Thanks, helpful image I found on the Googles!

About eight weeks ago, it was nearing lunchtime on a Friday, and I suddenly started feeling significantly short of breath; I'd gone for a 30-minute, easy run that morning and felt fine, and I had already laid out my gear for my weekend long run, scheduled for the next day.  I remember sitting down in the chair next to Chris' work-from-home station and mentioning how I was having trouble taking a deep breath - almost like I had a band around the bottom of my lungs, restricting me from inhaling fully.  I finished out my workday (I sit at a desk all day - it's not particularly active) and chilled on the couch that evening, and by the time I went to bed, I noticed I was starting to develop a sore throat as well.

The next morning, I woke up without any improvement in my condition.  Since both shortness of breath and sore throat are on the short list of symptoms for you-know-what, I figured a COVID test was in order.  Chris drove me out to an alleged testing site in Maryvale (in the nice part of town) and when that didn't pan out (no one was there except for other people trying to get tested), we waited for an urgent care in our area to open, and I headed in.  By the time I left, 45 minutes later, I'd had the nasal COVID test (not super fun - bring tissues for when your sinuses decide to revolt after it ends), a strep test (negative results right away) and a chest x-ray.  The swab results would take 3-5 business days to process, and although the x-ray would be sent to another radiologist for reading, the urgent care doctor mentioned that it looked like I had peribronchial cuffing.  Cuffing can be caused by all sorts of things, but essentially, your bronchial tubes get all mad and irritated, they swell up, and then you can't breathe as well as normal.

Man, Google really is the best.

That's not me, but that's what my x-ray looked like.

They also call this condition the "doughnut sign,"

because it looks like you have, well, doughnuts, in your lungs.

Noms.

Throughout the next week, I waited for my test results and tried to chill the fork out.  I stopped exercising entirely; even an easy yin yoga session had me gasping for breath (same with standing at the sink for 15 minutes to wash dishes), so cardio was absolutely out of the question.  Just in case I had COVID, Chris and I kept our distance from one another; he took care of the dogs as much as possible, and I wore a mask around the house whenever I was working with clean items (laundry/dishes) or food we'd be eating raw.  Eventually, the next Friday rolled around (the outer edge of the "five business days" prediction), so I called urgent care to follow up.

Turns out my COVID test results were negative, yeah!  Good news, however, that meant I didn't have any clue at all what WAS wrong with me, since I was still feeling like butt.  Although the sore throat had gone away (it was super mild anyway), the shortness of breath was still there, and I'd also developed a band of tightness across my chest.  Super fun.

It was time to call my primary care and see if I could get in for a more comprehensive examination; of course, it was a Friday morning, so the soonest appointment was on Monday.  When I mentioned my symptoms, the office staff found a nurse, who, upon hearing I was having chest tightness, made the very stringent recommendation that I stop f'ing around and go the ER already, stupid.  

Chris once again piled me in the car, and we headed for the ER that's ten seconds away from our house at St. Joseph's Medical Center (which is now called something else, like Dignity Health or whatever, but everyone around here still refers to it as St. Joe's).  He couldn't come in with me, so I waved adieu to him and settled in with my book for what was sure to be an exciting, fun-filled morning of emergency medical care.

I arrived around 10am and within an hour had an EKG (passed!), another chest x-ray (still some mild cuffing), an O2 test (passed!), and several vials of blood draws.  I was killing time reading my book and texting Chris screen grabs from Patriot (if you don't watch it, you should - it's on Amazon and it's only two seasons), when I realized it was almost noon, and I was hungry.

This was about the state of things at the time.

Not seeing any options for food in the foreseeable future, I cleared it with the nurse on duty (who let it slip that I was due for another set of blood draws around 1:30pm - hmmm, that was interesting - no one had mentioned THAT to me yet) and the security guard, and I was able to meet Chris in the parking lot to eat some lunch he'd brought from home.  After a quick bite, it was back into the ER waiting area for me.

Around 2ish, myself and a few other folks were shuffled to another waiting room, and I got to spend more time with the phlebotomy technician, who came to visit me again and steal more blood.  Spoiler alert - later in the day, we were eventually on such good terms that we spent a few minutes after a third draw showing each other dog pictures on our phones.

Right around 2:30, Dr. Ngo, who I later found out would be my admitting physician, came and introduced herself, breaking the news that I'd be staying the night under the observation of the fine staff at St. Joe's.  I'll frankly admit that this came as a shock.  I think the last time I spent a night in a hospital was when I accidentally speared my finger with a letter opener when I was 3 or 4, and I don't even remember that.  According to Dr. Ngo, all of those blood draws continued to show my troponin levels as highly elevated, and they wanted to keep stealing my blood throughout the night to see if they would ever go down.  While all of this made sense, and I couldn't deny that something was wrong with me, this still dealt me a solid blow.  I think of myself as somewhat invincible - I run marathons! I hike!  I bike (not that well, but whatever, you get my point)!  I'm healthy! - and this really threw me for a loop.  I remember getting choked up and starting to become emotional, but my more sensible side took over, commanding me to focus and listen to Dr. Ngo.

Whew, that was heavy.  More picture time!

Look, it's troponin!

After having all those blood draws,

I had a troponin complex for sure!

(rimshot, thank you, tip your waitress, try the veal)

Troponin is an enzyme your heart releases

when it's stressed out - which mine very much was.

In order to figure out where to place me, I had another nasal COVID test, which was worse than the first one; instead of the collection device being a longer handled Q-tip, this one had a tiny brush at the end.  Also, instead of doing a 10-second count in each nostril, this one required a 15-second count, but only in one (thank goodness for small miracles).  It was pretty gnarly, and my nose started bleeding almost immediately after it was finished.  Thankfully, that test came back negative, just as my earlier one from urgent care did, and that meant I'd be headed to the tower of the hospital for patients who were COVID-negative (there were whole floors/wings/towers for folks who were positive, and I'm glad I didn't find myself there).

While they waited for a room to open up in the Heart and Lung Tower, they moved me from the waiting area into a bed in the ER, behind the "you can't go home now" door.  My ER nurse, Eddie, took good care of me, and he let me know that although no one was allowed to come see me, Chris could drop an overnight bag with security, and they could bring it to me.  Chris hustled to get all of the items I texted to him into a duffel bag, even suggesting a few things I overlooked ("do you need the laptop?" "oh sh*t, yes, I'm teaching a class!" because of course I was); once the drop was complete, Eddie brought the bag to me, and I killed time continuing to read (I finished two full books and a Travel and Leisure magazine during my stay), teach my class, surf on my phone, and of course, take pictures of the space around me:

My view from my ER bed - 

I was right at the end of the hallway,

which kept things quiet.

However, I was also next to the used linen bin,

so whenever someone dropped those off,

it was quite clang-y.

Me with my first set of monitors -

that's an O2 sensor on my finger,

and I've got a portable heart monitor stuck to me.

I was finding little sticky patches of goo

on my skin for DAYS after this.

St. Joe's is very much a religiously affiliated hospital.

They've got the Jesus everywhere,

and throughout the waking hours,

you'd hear announcements for prayer come over the intercom system.

My IV - it never actually got used,

but I guess it's better to have one already installed

than try to find a good vein during an emergency.

The installation itself was kind of cool - 

Eddie busted out an ultrasound machine to find the proper placement.

Since I've never had my own ultrasound,

it was neat being like, "ooh, what's that?"

"Is that a bone?"  "Is that fat?"

Eddie was very patient.

Also, dang, I'm freckly.

 

Around 7pm or so, a bed opened for me in the cardiac ward, so a hospital volunteer plunked me and my crap into a wheelchair and whisked me through an eerily deserted set of corridors and elevators before depositing me in a new room under the care of cardiac nurse Sandi.  She got me all tucked into my new space (I had a room all to myself!  Thanks, COVID!) with a pocket-sized heart monitor (I no longer had to unplug myself and set off all the alarms when I needed to visit the loo) and an O2 sensor taped to my left index finger.

Using the panoramic option on my phone for only

the most interesting purposes.

I don't remember *exactly* how many people I texted

this picture to, while making an "ET/phone home" joke,

but it was more than one.

Hooray, Oreo snack packs!

Small things like this were a comfort during this whole ordeal.

For his part, Chris was at home, taking care of the kiddos and trying to convince August that he hadn't sent me away forever.

Time for walkies!

"MAN, WHAT DID YOU DO WITH HER?!?!?!"

As the night drew on, I alternated reading with logging onto class and surfing my phone, enduring another few rounds of blood draws.  

They'd poked me so many times in the arms

that I was starting to look like the owner of a SERIOUS drug problem.

It was around this time that they switched to taking

blood from the veins in the backs of my hands.

This sounds horrifying, but it actually wasn't as bad

as I'd thought it would be.

Around midnight, I finally sacked out, my room softly lit by the glowing orb on the end of my left index finger.

My own portable night light!

I was awaken a few times in the middle of the night by various and sundry medical personnel popping by - to check my vitals, to steal more blood, and to do another EKG.  Around 5am, I was finally awake for good, and soon after that, my day nurse, Cyndi, stopped by to introduce herself.  She let the right folks know, and before too long, the ultrasound technician stopped by for an echocardiogram.  The results of that were good, so in another hour or so, Dr. Moe, my new cardiologist, stopped by to chat with me, telling me that I'd be discharged within the next few hours.

Sunrise from my window.
That's Thomas Road running right in front of the hospital

with the Central Ave corridor and downtown in the background.

That's South Mountain waaaay in the back of the shot,

so my window faced - you guessed it - south.

We originally thought I might need a stress test,

hence, the "no food/drink" notes.

I texted my brother Jim with this picture

and told him they'd diagnosed me with

"gremlin-itis."

It was during this time with Dr. Moe that I was officially diagnosed with pericarditis; she told me that the EKGs all looked good and with the exception of my troponin levels (which remained elevated through all of the blood draws), my levels were all great.  They'd officially ruled out the possibility of a heart attack (whew!), and the echo ultrasound clearly showed the pericarditis.  

What they didn't know was what caused the pericardium (the sack around my heart) to start holding onto fluid like crazy; pericarditis can be caused by many things (bacterial infections, viral infections, etc), but I really wasn't manifesting with any of them.  The most likely culprit was a freak virus of some sort, particularly since I don't have a history of any sort of thing like this.  My plan of action at this point was to cut my sodium intake (since sodium encourages your body to retain water) and take a 600mg ibuprofen (essentially, three normal Advil) every six hours, both to lessen the pain and reduce the inflammation (ibuprofen is an anti-inflammatory, after all).

I'd been texting Chris updates since he woke up at home, and he let me know he was putting a hold on his previously scheduled task of installing our new kitchen faucet.  Using Murphy's Law as my guiding principle, I strongly encouraged him to go ahead and start right now, as him being involved in a household renovation was the best way for the hospital to decide that someone needed to pick me up, STAT.

"Water off, under-sink area cleared!

Time to go get Amy!"

While I waited for my official discharge, I ate some breakfast (I think the least beige thing I ate my entire time in the hospital was that pack of Oreos) and continued taking pictures out my window.

Noms.  That was one hard English muffin.

Downtown, a bit closer up and later in the morning.

Around noon, I got the all clear, worked through my discharge instructions with Cyndi, and was able to have Chris come get me.  I spent the rest of the day moving between the couch and bed, trying to rest as much as possible.

The kids tried to rest up, too

My poor arms a few days after all of those blood draws

As I publish this blog, I'm about eight weeks out from the very beginning of this whole process (my visit to urgent care), and I'm still not back to 100%.  I still have some pain/discomfort in my chest many mornings, and unfortunately, extreme heat seems to be a trigger for my worst days - if only Phoenix didn't just have its hottest July in the history of EVER (even with the elevation difference, I felt so much better when we visited Flagstaff a few weeks ago).  Just this week, I had yet another blood draw to see how my levels are doing, and Dr. Moe's office is working with insurance to schedule another echo ultrasound.  According to Dr. Moe, some cases of pericarditis can be "stickier" than others, so to really get mine gone, we may need to find another course of action, perhaps through different meds or something?  I guess we'll find out, hopefully soon.

Honestly, I'm trying to keep this whole thing in perspective and be thankful my situation isn't worse, but it's really frustrating.  I haven't been able to work out almost at all for two full months now, and since that's normally my main way of dealing with stress, some days see me climbing the walls at home.  The acquisition and use of Arlene the trailer has been a massive help with that (it gives me something to plan and organize!), and of course, Chris has been amazing throughout - when I made it home from the hospital, I told him about needing to watch sodium, and within 30 minutes, he'd ordered three different "heart healthy" cookbooks and a bottle of avocado oil on Amazon.  I am thankful that I didn't have this happen in the middle of Phoenix winter, because it's honestly not that hard avoiding running when it's 118 outside; if it were 65 or so, though, that would be a different story.  

So, that's the story, or at least, the story of where I am now.  More updates to come as things progress, hopefully, in a better direction!

Later!

Amy

P.S. - I don't like to get all political/topical on this blog, but in case anyone doubts that COVID is real or that its impact is as widespread as the news outlets are making it out to be, I cordially invite you to spend the 28 hours I did in the ER/heart and lung wing of a major metropolitan hospital.  It was equal parts horrifying and heartbreaking; people were crying (some quietly, some not) in corners, including one scared elderly gentleman who asked everyone who walked by if they knew how to reach his son.  Doctors and nurses were hustling between treating patients with COVID symptoms and those with non-COVID issues (like me) and trying to keep everyone separated and safe, while still attempting to find a quiet spot for necessary breaks for their own health and well-being.  Patients were being tested and re-tested to ensure that if they were moved to the COVID-negative section of the hospital, they didn't suddenly present positive, which would contaminate everyone on that floor.  While it was quieter in the heart and lung tower, the nurses were taking on extra shifts and their patient loads were higher than their stated maximum; one of my nurses also mentioned that due to the extra load, they were handling patient issues they normally didn't, so it was taking them longer to treat each person as they moved from their specialist set of knowledge to a more generalist view.  It's important to keep in mind that during all of this, except when they were being treated by staff, every patient in the place - from folks just heading into the ER to heart patients to those clinging to life on ventilators - was completely, 100% alone.  No family, no friends, no one.  Had I needed to stay longer than I did, or had my condition been worse, I would have been terrified.  

P.P.S. - As noted above, I was at St. Joe's for around 28 hours, and I was in a mask the.entire.time (per my request, Chris put a few extra in my overnight bag, so I did change them out every now and then).  If I can wear a mask for 28 hours - while not breathing well and having chest tightness, as well as being poked and prodded from every angle, multiple times - you can wear one for 30 minutes while you're shopping in an air-conditioned Costco, cool?  Stay home, wash your hands, and wear a mask.  Don't be a fucking idiot.