Need Guidance Please

[KimC]

Hi,

I'm confused about a reoccuring and intermittent chest pain I've had since April.

I had a normal stress test in Aug., and an MRI in Oct. to check for blockages, etc. Both tests suggested that I don't have CAD. I also had an endoscopy in Sept., (something I have to have every four years for GI reasons). The results showed no evidence of acid reflux.

It's plausible that the pain is lung-related. My PCP thinks I have chronic bronchitis based on descriptions of my symptoms, but I've never smoked. I'm seeing a pulmonolgist on Dec. 16 for his expert opinion, (even though I hate the thought of further tests). My latest blood work came back with high nuclear antibodies and eosinophils, which means my immune system is in full swing ... something's up.

Now, here's my question, (and thanks for baring with me). The chest pain I've mentioned was very prominent yesterday, on and off all day. I noticed it especially when I was carrying around my three-year-old. I felt the discomfort all evening until I went to bed. I wasn't hungry for dinner, but didn't sweat or feel abnormally weak.

I thought about calling my doctor but was afraid to. I also thought about going to the ER for an EKG after the kids were in bed. The pain was nagging, sometimes burning and smack dab under my left breast and towards the center of my sternum! I'll be damned if I put my hand right on the spot and felt my heart beating strongly.

Today, I didn't feel the pain other than for a minute while walking on the beach, and I've tried to put it out of my mind.

You know, I've had some pretty sophisticated tests and feel like it's either time to let it go or walk into the ER exactly when I'm feeling the pain and say, "Hey, what the hell is this?" I keep telling myself to just deal with it.

Could moderate AI or TI cause that kind of pain?

Thanks,

 

[HFK]

IT's good your seeing a pulmonologist, but when was your last echo? CXR? How do you feel most of the time? I would continue to pursue this matter ,too many things could be playing a factor at this point.HFK

 

[Karlynn]

You can get chest pain from valve issues too. Next time you experience it, I'd go in and get it checked. I think having them run some tests, while you are having the pain, is better than trying to talk yourself out of being concerned about it or making guesses about why it's occuring. I know it's difficult with children, to have to stop everything and take care of yourself, but you are doing it for them too. I've been down that road, having the majority of my bad symptoms when my children were small. You want to talk and rationalize yourself into being O.K for them.

Good luck!
Karlynn

 

[Nancy]

Hi Kim-

Chest pain should always be checked out at the time it happens, particularly since you have a lot of "stuff" going on inside that chest area.

Why would you be afraid to call the doc?? That's what they do for a living, try to sort out what is going on with your health. Call any time you feel the need. If it's nothing, then great, but if it is something that needs attention, the sooner the better.

And call when you are symptomatic. That's the best thing, once the symptoms go away, it might be harder to track down.

Remember, you guys and gals are not mere mortals. Everything means something to you, sometimes small, and sometimes not.

So go, call, bug your doctor. It doesn't matter what tests you had in the past, this is something that's happening NOW. Get an answer for what it is. Then you can have some peace of mind.

Best wishes.

 

[KimC]

Thank you for your replies. You guys are so great.

This is my ego talking and it's deep: I'm afraid to be humiliated if they can't find a reason for the chest pain. I grew up in a med family, and often heard my dad criticize women who complain about aches and pains. It wasn't until my recent pregnancy that I became more assertive about my health care.

I need to work up the courage to get it checked out next time I feel it, even if it means my first trip to the ER. The curiosity is killing me ... ha. (Bad joke).

I'd be happy if they gave me a valium and sent me home!

Warm wishes,

 

[lcwhitney]

GET YOUR CHESTPAIN CHECKED OUT

GET YOUR CHESTPAIN CHECKED OUT

i am sure tha most of you thought i had vanished but, I'm baack..
find out what is causing your pain. after havin two valve surgeries i still have some pain. the pain is caused by scar tissue from my surgeries. if you fcan rule ou cad this could be your problem too an echo will show this
lettitia

 

[bvdr]

Welcome back Letitia!

Kim,

I know the struggle you have experienced while evaluating your own situation and deciding when it is VALID and the proper time to get it checked----especially when deciding when to go to the ER.

In retrospect, I should have sought treatment much sooner than I did. I had intermittant atrial fib for at least a year and a half prior to having it "documented". When I went into the ER for the first time with very rapid atrial fib, I didn't present myself with a so-called "complaint" but just told the nurse on triage that I needed to get a rhythm "documented". You see, this was the very ER that I worked in for many years, often as charge nurse. I didn't want to go in with "nothing". The monitor showed rapid atrial fib with a rate of over 170. Even then, when I was asked how I was doing, I said "fine". Why I didn't use the opportunity to unload all my symptoms I just don't know. I think I had been conditioned to not make a big deal over things. I was wrong. I should have done things differently. I hope you don't make the same mistake. Don't worry about what others think. If you feel something is wrong....you deserve to find out if there is.

 

[Nan]

Hi KIm, I agree with the others, you really need to get it checked out....especially when it is happening! Hopefully you won't run into those docs who treat women differently...I think there is enough info out there now that it doesn't happen any more. The pain is coming from something, and you need to find out what....could be something as simple as a pulled muscle, but it also could be a sign of something more serious. Get thee to the ER next time ASAP.

Let us know.

Nan

 

[Nancy]

I grew up in a family of very assertive women and my daughters are the same way. I don't think any of us would even pay any attention to a doctor who would treat a female complaint any differently than a male complaint. Forget those "old hat" ideas. Go get it checked out.

If the doctor wants to think of you as a complainer, that's his problem. Just tell him to do his job and find out what's wrong.

Heart problems are not female "hysteria"!

People who are going to talk about you when your back is turned, will do it no matter what, so just go and take care of Number One and let the clackers just clack away.

 

[ccrawford]

Hi Kim - the experts have spoken - so go get it checked out and let us all know what they find. If for no other reason, you need to get it diagnosed cause we'd really miss you if you weren't around ( and so would your little one) Got the message ? Chris

 

[Kim]

Hi Kim,

I posted a month or so ago about intermittent chest pain that I had been having. Of course my great friends here advised me as they did you....get it checked out! I too, have an ego and didn't want to be humiliated and embarrassed if nothing showed up. I had a heart cath in August of 2000 that showed no significant blockage in my arteries. So I figured that the chances of the pain being from CAD were slim. So I did nothing. Then, the day before Thanksgiving, I ran down the stairs to my basement to get a can of pumpkin off my pantry shelf. I was running back up the stairs, when halfway up, it felt like someone had taken a sledge hammer and slammed it into my chest. I also felt like the wind had been knocked out of me. I couldn't get my breath. The pain felt like one big labor contraction across my entire chest. I was scared to death! Then the pain radiated through to my back. I really felt like I was having a heart attack. I kept thinking that I need to get up the stairs and through the garage and into my kitchen so I could yell for my youngest daughter to call 911. The pain lasted probably 2 minutes even though it felt longer!! It subsided as fast as it started. I never told any of my family until the day after Thanksgiving. I just couldn't decide what to do afterwards because I was no longer having pain. Well.....my husband insisted that I call my cardiologist.....I am having a nuclear stress test. But since that episode I haven't had any pain, except some slight chest discomfort like I had been having all along. I know I will be embarassed if the test shows no reason for the chest pain, but I can't forget how very scared I was that day on the stairs. That incidence was very real and something caused that pain!
So.... go get it checked out!! If my stress test comes back showing blockage, I will kick myself for not taking the advise of everyone here. Let us know what you find out!

 

[medtronic of borg]

what to do

what to do

trust your pulmonary Dr!!

Med

 

[derekzmom]

In reference to the chronic bronchitis that they think you have.....Have you ever been tested for Alpha-1 Antitrypsen?? It is a heriditary condition that can cause either premature emphysima or cirrosis of the liver. Its just at though but if you are having chronic lung problems it may be worth mentioning.

Derek also has this but if affects his liver. His AST and ALT were skyrocketing for no apparent reason and this is what his GI doc tested him for and he tested positive. There is no treatment for it and it is not affecting him at all at the moment.

Hugs

Allison

 

[Ross]

Hi Kim,

I posted a month or so ago about intermittent chest pain that I had been having. Of course my great friends here advised me as they did you....get it checked out! I too, have an ego and didn't want to be humiliated and embarrassed if nothing showed up. I had a heart cath in August of 2000 that showed no significant blockage in my arteries. So I figured that the chances of the pain being from CAD were slim. So I did nothing. Then, the day before Thanksgiving, I ran down the stairs to my basement to get a can of pumpkin off my pantry shelf. I was running back up the stairs, when halfway up, it felt like someone had taken a sledge hammer and slammed it into my chest. I also felt like the wind had been knocked out of me. I couldn't get my breath. The pain felt like one big labor contraction across my entire chest. I was scared to death! Then the pain radiated through to my back. I really felt like I was having a heart attack. I kept thinking that I need to get up the stairs and through the garage and into my kitchen so I could yell for my youngest daughter to call 911. The pain lasted probably 2 minutes even though it felt longer!! It subsided as fast as it started. I never told any of my family until the day after Thanksgiving. I just couldn't decide what to do afterwards because I was no longer having pain. Well.....my husband insisted that I call my cardiologist.....I am having a nuclear stress test. But since that episode I haven't had any pain, except some slight chest discomfort like I had been having all along. I know I will be embarassed if the test shows no reason for the chest pain, but I can't forget how very scared I was that day on the stairs. That incidence was very real and something caused that pain!
So.... go get it checked out!! If my stress test comes back showing blockage, I will kick myself for not taking the advise of everyone here. Let us know what you find out!

This sounds so much like an aortic dissection beginning that I'd say ask for a CATSCAN or TEE.

 

[dwfreck]

KimC and Kim,

Which would be more humiliating: going to the doctor to find out nothing is wrong, or leaving your child(ren) without a mother because you ignored chest pain?

KimC,

I realize that your relationship with your father is involved in this, but I'm definitely in the crowd that says, "see your doctors, that's what you're paying them for." We pay a lot for health care, both in terms of actual fees and in insurance premiums; get your money's worth! Keep in mind that your father may have just been blowing off steam from a job that is very challenging and frustrating. If you really want to know what he thinks, call him and say "Dad I've been having chest pains..." I would expect that as your father AND a doctor, he would give you the same advice you're getting here.

With respect to the visiting the ER, you might want to call your family doctor first, and see if they want to see you first. My family doc has been very accomodating about working me in the same day (even the same hour!) for chest pain; he knows I have a bad aortic valve and doesn't mess around. Your doc should have the same attitude. Depending on your description of the pain (and someone at your doc's office will definitely ask you to describe it), your doc may even recommend you go straight to the ER, possibly via a 911 call.

Pardon me for being blunt, but I feel very strongly about this issue. I'm constantly trying to get various family members and in-laws to see their doctors about one thing or another.

 

[Kim]

Ross,

What is an aortic dissection?


And yes,.....I would rather be slightly humiliated than leave three daughters without a mother! I just want to be sure I have a true problem before whining to my doctor. I always want him to take my complaints seriously and if I have a complaint without having a true cause, he may think I am a hypochondriac or something!

 

[Ross]

A dissection is a weakening in the wall of vein that actually separates and allows the blood to flow in between layers. Aneurysm is where this goes. Pretty soon, all the pressure built up between layers just blows. This is what happened to John Ritter, Robthatsme, and myself. The way you described your pain reminded me so much of what I felt about 3 months before mine blew.

http://www.heartcenteronline.com/myheartdr/common/articles.cfm?ARTID=279

 

[Nancy]

Hi Kim-

Whether your doctor thinks you're a hypochondriac or not, a big "B" or not is totally irrelevant. That shouldn't even enter into your decision to call him. What he thinks is his problem. What he does about your health is your problem.

Your life is precious and if you want to be safe with your heart conditions, then you are going to have to make calls to the doc when you aren't feeling quite right. It's not your job to figure it all out, that's for the professionals.

I've said it about a hundred million times, but people with heart and pulmonary problems have to be especially careful. Everything means something.

Please be self-protective. There is only one YOU.

 

[Kim]

Thanks Nancy and Ross. You are both valuable members of this forum! I must remember I am paying my cardiologist! He doesn't pay me.

Ross, I am having an echo at my regular 6 month check-up which is the end of December. Would that show an aortic dissection? I am not sure what the nuclear stress test shows. I assume not valves because he wants me to keep the scheduled appointment for the echo.

 

[Ross]

Kim if they do a TEE or CATSCAN they should be able to see it. When mine was dissecting, they didn't see it with a regular echo and they didn't see it when they did a Catheterization either. I nearly died before my Cardiologist showed up and ordered the CATSCAN and was immediately Life Flighted to the Cleveland Clinic and handed over to Dr. Patrick McCarthy, their High Risk Professional.