Chest Pains? Don’t hesitate. Get to an Emergency Room.

12 lead electrocardiogram of a ventricular tac...

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A few days ago, I sent a text message to my fiancee while at work, and just happened to mention that I was experiencing "chest pain". That choice of words is very important. I didn't say indigestion, or heartburn, because, well, I simply don't get them all that often. What followed was a blinding panic, of which the details have now become incredibly hazy, and to most of which I was completely oblivious. I simply walked over to the first aid cabinet, took myself an antacid, sat down, and continued to work. I proceeded to make my scheduled phone call and carried on as if nothing untoward was happening. I sent what I thought was a reassuring text message to say that I was OK, it was nothing, and it would pass. Yes, I agreed, this probably was the worst case of heartburn I'd ever experienced, and yes, I was a little surprised that it had pretty much been with me all day, actually, now I think about it, maybe it started last night, and nothing had shifted it. But I was OK, absolutely, and with that supposedly-reassuring message, I continued with my work day.

I've only recently joined the ranks of millions of people "my age" who have to take medications to manage their health. For far too long, I've been of the opinion that, if I don't feel good, I should simply take a tylenol and just "get on with it". Anything more serious than that, well, that's what sick days are for. Up until this year, I can't even remember the last time I went for a routine doctor visit, or a check-up. It was quite possibly back when I was under the protection of Britain's National Health Service, and I haven't lived there for fifteen years. Doctor visits have been something only "sick" people do. Perhaps then, I was overdue for an awakening. Of course, I have far too many risk factors. I'm overweight, I was a heavy smoker since being a teenager, I have a family history of high blood pressure. It turned out, in fact, that wasn't the whole picture. My triglycerides were astronomically high; so high, in fact, that my cholesterol readings wouldn't even show up through them, and no lifestyle changes could possibly bring them down rapidly enough. My doctor promptly put me on medication for the trigs, and pointed out that just because my blood pressure was the same as I'd ever seen it, that didn't mean it was "normal". Even considering all these risk factors and my new medication regime, I still didn't find any reason to be perturbed that afternoon.

My work day certainly was not going to continue as normal. As I continued with my scheduled phone call, other calls were incoming. I must admit, I have probably had about three incoming calls in the past three months. Three within a few minutes seemed, well, a little unusual. Never mind; they could leave a voice mail – I'll pick it up later. Next, instant messages. One from a contact in the process department. "Are you there?" – what's this? Did I not fill out my forms correctly? "Please, answer me." Yes, I'm here, I'm fine. What is all this fuss about? Another IM, this time from HR. "Do you need us to call you an ambulance?" Of course not. I'm just a little uncomfortable, that's all. The facilities coordinator walked into my cube to "check" on me. Yes, I'm here. Oh yes, I'm fine. Nothing to worry about. Erm, what's going on? "Your fiancee called the front desk, distraught that she couldn't get a hold of you." I looked at the blinking light on my phone handset. "She's left work and she's on her way here. Since you won't take an ambulance, she's going to take you to the ER herself."

I sighed in complete disbelief. I'm fine, this is nothing. The phone rings, one more time, and this time I answer it. It's C, driving up the interstate, absolutely frantic with worry, crying. Once again, I'm trying to explain. I'm OK. This is nothing. It can't be anything serious…

Can it?

Or is it?

I must point out, I've been in "emergency" rooms a lot, lately, and it's always seemed like something of an oxymoron. You go in there and register, which involves sitting in the waiting room and filling out paperwork, which you duly hand in, to be told to sit back down. Perhaps what seems like an hour might pass, before you go into the little entrance room, get your vitals taken and an initial assessment, and if it's apparent you're not in any immediate danger, then it's back to the waiting room again. Eventually they take you back to an exam room, where you may eventually get seen, and, more than likely, depending on what other poor souls are in that night, it may be a couple more hours before you might get some pretty ordinary pain medications, perhaps some cursory first aid, and then you're sent home.

Not this time. My feet didn't touch the ground.

My vitals were taken the moment I walked in the door. Before I knew it, I was swept into an examining room where a huge number of sticky electrodes were waiting for me. I needed to use the restroom, desperately. "I have to go", I pleaded, only to be told, no, let us do this first. The electrodes were stuck on me, in places I'd expect, and other places I never thought. My ankles? Why are they putting electrodes on my ankles? Suddenly, I felt considerably less confident than I did earlier that this was nothing serious. Can I go to the restroom now? Please? Paperwork swept under my nose, quickly and efficiently. "Do you have a religious preference?". Oh my God. Suddenly, it seems perhaps I do. Not tonight God, please, not tonight. Restroom, now, quickly. I believe it might have been a few seconds too late, but any embarrassment for that seemed irrelevant now. More staff awaiting for me, seemingly right outside the restroom door. Shirt off, arms above head, two chest x-rays, one from the front, one from the side, don't even bother getting dressed. Slip on this very fetching hospital gown, and straight to an exam room, covered in sticky monitor pads. Oh no, not a needle. A blood sample drawn. I must have encountered fifteen different members of hospital staff in the space of a few minutes. Results, back already. EKG appears normal; chest x-ray is clear. Troponin levels OK. Troponin. A substance measured in nanograms, that's capable of determining whether there has been any cardiac muscle damage. Not just to show whether you're having a heart attack, but maybe even if you've already had one. For the first time, that possibility struck me. The damage could have already been done; and, of course, I broke down and cried.

The emotions of the experience were thoroughly draining; finding out that I was indeed OK had an effect on me I didn't expect. I became indignant, upset, even angry at all the fuss. Over "nothing, nothing at all". It all gushed out of me later that evening, in a fit of unexpected and unjustified rage, one that, for the second time in a day, brought C to tears. Once spent, once exhausted, I finally took the time to sit up and listen, to see what had just happened from her perspective. Then, and only then, did it completely sink in just what had happened; more importantly, what could have happened. After waiting too long to find each other, one of us could simply have disappeared; the two of us could very easily have become just the one of us, just the one, in a blink of an eye. Every second mattered; every moment; that's why there was no delay, no hesitation from the wonderful staff at El Camino Hospital. And yet, for several thousand seconds before that, I had dismissed it all as nothing important, nothing significant – yet, very easily, there could have been nothing left at all.

What have I learned from this experience? Two things – first of all, if ever your partner is getting frantic, and desperately telling you what you need to do, listen. Listen very carefully. Think exactly why they're saying these things. Don't be selfish, because if you don't take notice, that's exactly what you're being. They know exactly what they're talking about, whether they happen to be a nurse or not. But, more importantly, if you feel a pain in your chest, then don't hesitate. Don't brush it off as "just indigestion". It could so easily be something far more serious. It took my emergency room experience to appreciate that.

This has been a public service announcement.

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About darlingman1970

Born in the UK and a graduate in mathematics from Cambridge University, Chris Nash has followed a career in software engineering which he continued after moving the United States in 1996 and now brings him to California in 2010. However, Chris does not want to be considered as merely a code monkey, and has always been interested in writing; in areas as diverse as factual technical manuals all the way through to fiction. An avid reader, Chris is a fan particularly of mystery novels and enjoys above all the works of Agatha Christie and David Hewson. Chris has recently gone through some significant life changes which, at the moment, he is considering as the basis for a forthcoming novel and as food for thought on his blog. He manages to couple his loves of writing and technology and is particularly interested in how internet innovations have an impact on the writing and promotional process. Chris is a firm supporter of Creative Commons and other 'open' initiatives and believes strongly that such distribution mechanisms are the "right" way to handle intellectual property in an evolving digital world. Chris is a keen Nintendo DS and Wii player in his spare time, and is currently happily attached, living in the Central Coast area of California. Find him on Twitter as @darlingman1970. Don't ask him how old he is.
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