The pain in my temples started as a nuisance, became slightly more disconcerting when it traveled to my neck, and had my full attention when it began to radiate throughout my jaw. Now it was in my chest and running down my arms. The pain was so intense I couldn’t think, my breathing was shallow, and my skin was turning pale. Sheila, being an ICU nurse, recognized my symptoms as those of a heart attack and made the call to 911.
[Sheila: The original plan had been to drive to the hospital ourselves, but once Dave started sweating profusely and asking for a trashcan to throw up in, there were just too many cardiac symptoms to risk doing so alone.]
I ran to the bathroom. I vomited with more force and greater volume than I thought humanly possible – repeatedly [Sheila: While under the influence of pain medications Dave would later tell me three separate times that, “it was like it was in The Exorcist!”–highly ironic, since he’s never seen the movie]. By this point my thinking is entirely consumed in the pain that is wracking my body and the nausea that wells up in my stomach. The clock stands still, every moment feels like an eternity.
The EMTs arrive and are asking questions. First time around I can say my name, second time around I’m struggling. They shave my chest in a smiley face pattern (unfortunately, the mouth is slightly off-center – why didn’t the EMT’s take the time to align my smiley face?), attaching electrodes, and firing up an EKG.
[Sheila: Dave was so disoriented that he couldn’t identify the electric razor the paramedic pulled out to shave his chest. He was as pale as the bathroom tiles. His blood pressure was much too low, only in the 80’s systolic. When the first EKG showed peaked T-waves I said to my father, “I think my 30 year old husband is having a heart attack.”]
I’m in and out, now they are hoisting me into some sort of chair and taking me down the steps. I’m no longer intelligible – but still managing to vocalize with load groans [I’d cry three times – once in the bathroom, once upon arriving in the ER, once when my blood pressure tanked. Those who know me know that I don’t generally respond to physical pain with tears.]. In the driveway they load me onto a stretcher and then up into the ambulance. I don’t remember much of the trip to the ER – Sheila tells me they pumped 75 mcg of Fentanyl into me (a heavy-weight pain medication).
In the ER they are jabbing me with needles. I’m hooked up to an IV which is providing me with saline solution and 4 mg of morphine. They kept drawing blood and sending it off for tests and taking my urine and sending it off for tests. [I don’t remember peeing in a bottle – but I must have, since they kept taking it from me and I certainly wasn’t walking anywhere.] They wheeled me over to radiology for chest x-rays and then for a CT scan.
The technician pushed my stretcher against the CAT scan bed and I rolled over onto it. I was too low he said, I needed to move up higher. I thought (but did not verbalize) that this seemed a highly unreasonable request – didn’t he know how much energy I’d just expended flipping from one stretcher to the next and now he wanted me to scoot upwards? [Dave: But my ability to think without vocalizing is in question, see Sheila’s note regarding transport below] Am I an Olympic athlete or the hulk that I can accomplish two such great feats in rapid succession?
There were so many doctors and nurses. They came and went and occasionally I realized that Sheila and Paul (her dad) were sitting near me. They wouldn’t give me water – but I was so thirsty [Sheila: I explained to Dave that this was because we still didn’t know what was going on with him, and if he’d needed surgery or a cardiac catheterization his stomach would need to be completely empty; however, even now he doesn’t remember this conversation, and that answer was entirely dissatisfying to him when all he wanted was some water. When they lifted the empty stomach restriction his nurse brought him a cup of water. He drank about half of it, and was then holding the cup at a precarious angle. I tried to take the cup from him so he wouldn’t spill, and he proceeded to go full Gollum on me, holding the cup out of my reach and saying, “You can’t have it, you won’t give it back!”]. They asked me questions but they waited so long between the questions that I’d fall asleep and then be shaken awake. Why didn’t they just ask their questions in a timely manner? I wouldn’t fall asleep if they didn’t wait so long between questions…
[Sheila: Dave was actually so heavily medicated and sleep deprived at this point (we arrived in the ER just before 2 am) that he would fall asleep again immediately after being woken, and was unable to answer nearly every question posed to him.]
I passed in and out of consciousness – did I dream? I don’t remember. When I was awake I was intensely aware of my pain. The time between the pain medications beginning to wear off and the next dose being administered felt to me as I imagine a castaway might seeing a ship on the horizon but experiencing it’s approach as being so infernally slow.
The ER was full due to flu season. They wanted to admit me but lacked beds. When a bed finally became available they lacked transport. Internally I wondered how this was possible [Sheila: He wondered out loud, too. Repeatedly. 😉 Dave: Every time we talk through this story I learn something new!]. How hard is it to wheel someone from one room to the next? Pahh.
Just as transport arrived, I crashed. I was due for another round of pain medications, the nurse was standing with the morphine ready to inject into my IV when my blood pressure began dropping…I wasn’t going anywhere. [Sheila: It took a full liter of IV fluid to bring his pressure back up]. When all was said and done I’d spent twelve hours in the ER.
Eventually I was transported to a transitional unit (kind of like purgatory). They were full – were could they place me? There was a private room used for something or other, they stuck me in there [Sheila: We were placed in the airborne isolation room, which was actually a huge blessing–in a unit otherwise comprised of nothing more than curtains between beds, we had a door, a private bathroom and the ability to turn off the light]. The nurse isn’t coming around. Its been so long and she hasn’t come around. Why doesn’t the nurse come?
Sheila is a strong woman and she used that strength this day (for it was Friday daytime now). I don’t remember much of what happened – other than that I eventually received the care I required and was awed by the fire and steel in Sheila’s feminine frame [Sheila: This is Dave’s way of politely saying that I repeatedly bullied the nursing staff into giving him appropriate treatment. That’s another story altogether…but lets just say that there is great value to having a nurse in your corner!].
At some point I was moved to an actual room. I shared it with Joe, an elderly man, who had just had a fourth stent placed in his heart. Sheila was completely exhausted and I told her to go home and get some sleep – by this time it was late Friday evening.
Sheila suggested I use the small urine bottle that was next to my bed rather than traveling to the bathroom. I insisted that I could make it to the bathroom and back…and I did, twice [Dave: Sheila and I are both known for our very unstubborn personalities]. The second time Joe called over to me, “Are you okay?” Apparently the fifteen minutes of me grunting and groaning getting out of bed and walking to the bathroom and then another fifteen minutes in reverse had him concerned. Yes, I was fine – it just took me a little while to traverse the miles between bed and toilet.
I gave up on the bathroom at that point – urine bottle it was. Eventually my nurse came in to give me medication. Now that I was out of the ER the doctors always insisted on giving me a regular painkiller (Motrin, Tylenol) before giving me the stronger one. I took the proffered Motrin, and after suffering for an hour received the necessary morphine. I’d sleep fitfully through the night.
I was feeling better in the morning. Still nauseous, still breathing shallow – but I was able to walk around.
The doctor’s conclusion: pericarditis. Pericarditis is inflammation of the pericardium which encloses the heart and its symptoms can mimic those of a heart attack. Ironically, I’d been diagnosed Wednesday by my primary physician with costochrondritis – that is, inflammation of the cartilage between the ribs of the chest. My PCP had given me a prescription for an NSAID (non-steroidal anti-inflammatory drug) and perhaps if I had begun it a few days earlier I would never have known I had pericarditis – as the treatment for both is the same (a heavy dose of NSAIDs).
The hospital couldn’t do anything else for me. We tried a weaker pain medication which was available in tablet form (morphine and Toradol being IV) and I seemed okay [Dave: I actually haven’t ended up taking any pain medication, nausea and weakness being the greater challenges]. Not great, but alive and stable. Why stay in the hospital when they couldn’t help me further? The doctor agreed and allowed me to leave. By late afternoon on Saturday I was back at Paul and Cindi’s (Sheila’s mom) house.
[Sheila: We are very grateful to my parents for all of their support during this scary and difficult adventure; they allowed me to fight for Dave while maintaining a shred or two of sanity. G.K. Chesterton wrote, “There are no words to express the abyss between isolation and having one ally. It may be conceded to the mathematician that four is twice two. But two is not twice one; two is two thousand times one.” Having them as my allies made all the difference in the world!]
The rest of Saturday and Sunday I felt like crap. Bouts of nausea washed over me, my chest hurt when I breathed deeply, and now I was constipated to high heaven (a side effect of opioid medications). Still, I slept through the night both days and by Monday morning I was up and about in a more agile manner.
I’ve continued to do well. That is, if we take into account that “well” at this point is relative – aka, I’m not dying and I’m stable. I’m still weak and I have to take things easy – but the nausea is infrequent, my stomach is beginning to cooperate, and it no longer hurts to breathe.
Before this occurred Sheila and I had decided that we were going to push our departure time for traveling out further. It was taking longer than expected for me to wrap up some responsibilities and it seemed wise to address a few of my health problems that were flaring up before setting out to foreign lands…the trip to the ER confirmed this decision.
We will be moving to a nice apartment in a nice community in New Jersey (with an awesome library!) that is near Sheila’s work. We will continue to make strides towards setting out on our venture – but we are planning on at least another six months in the area and potentially up to a year.
We will continue to update this blog with what we are learning about becoming full-time wanderers as we progress (e.g., the results of the copious research Dave likes to do before making decisions). We also will be using our apartment as “base headquarters” for exploring the general area (New Jersey, southern New York, Maryland, Delaware, and eastern Pennsylvania).
Thanks for taking the time to keep abreast of our journey!