How I Spent My Wednesday Evening

On Monday and Wednesday afternoons, I have been attending a pulmonary rehabilitation class, learning how to exercise with reduced oxygen capacity. I have been quite successful in increasing my endurance and learning how to go longer by going slower.

On Wednesday afternoon this week, I had a progress six minute walk, and I walked 1705 feet, or 519 meters, which is about 100 meters further than I had walked earlier in the spring. I went pretty hard at it, since it was a one-shot deal and not trying to sustain anything. I got my heart rate up to 140 at one point, which is higher than I normally go, but not a lot higher. My oxygen got down to 90 percent, and I was breathing a supplemental 3 liters per minute of oxygen, so for you normal people, this would have been pretty exhausting. My body is actually used to it, so it didn't feel all that bad.

When I exercise hard, I have a small sore spot in the upper left quadrant of my chest. I was told some time ago that it was probably my pulmonary artery, since it was already under some high pressure stress, that the additional stress or exercise, or coughing, would make it further stressed. On Wednesday afternoon, it was a bit sore as usual.

When I got home, I picked up the mail, sat down on the couch and flipped open a laptop to look at some afternoon e-mail traffic, when I felt a TWINGE. In the upper left quadrant of my chest, in the same place it hurts when I exercise. It was sharp, it was short, it was instant, it was basically unremarkable except it made me cringe a little.

I wouldn't have paid any attention to it, except that in about 15 minutes, it TWINGEd again. And about every 15-20 minutes, it would do it. Not related to anything like breathing or pulse. Just TWINGE.

My husband came home in about 45 minutes, and we discussed what we needed to do for the evening, and I had another TWINGE. I mentioned it to him, and he immediately thought I should call the Cavalry. I said "It's only a TWINGE."

So, I agreed to call the on-call nurse at the PH clinic and see what she thought. She said to call the local EMTs and have them do an EKG and see if anything popped up, then to go from there. So I called the local EMTs. And they came screaming over the two blocks from the firehouse in the FIRE TRUCK, with all the lights and sirens and all that. All my neighbors came out. I waved at them. I waved at the EMTs. They asked if I was the patient. I said I was. They made me sit down. They did an EKG, and it wasn't remarkable. They were very impressed that I took nine Viagras a day. And I had no TWINGEs while they were there. Not a one.

So, I called the on-call nurse back and told her that we had decided we were going to go get some dinner and if I was still TWINGEing after that, we'd go out to the hospital.

We went out and got into my (wonderful) car. My husband promptly flooded the engine, which he does because he does not know how to treat a piece of machinery as marvelous as Miss Kitty, so I yelled at him to stop stop stop what he was doing. And I had a TWINGE. And another. And I said, "Screw this, let's go to the hospital."

So we drove out to the hospital uneventfully. I went inside and registered at the desk, and they promptly took me into the triage area and did a real big 12-lead EKG, not like the pesky 4-lead that the EMTs had. I chatted with the nurse, who had gout and had to sit down, and he told me to get dressed again and go into the waiting area until they had a proper examination room available in the emergency department. So I did.

When I went into the waiting area, I could not find my husband. I walked all around, looking at every face, but there was no one familiar to be found. Then, I heard a sound. A buzzing, flapping, whining sound, coming from outside. As I craned my neck to see the source of the racket, I saw whirling rotors attached to a Bell 412 descending upon the helipad next to the emergency room. And across the parking lot, I saw my husband, intently observing.

He had heard the discreet "code blue arriving by air, ETA 2 minutes" and gone out to observe this arrival. Since he is the head boy in charge of EMS helicopter voodoo at his job, he felt obligated. And he likes noisy things. And flying things.

It does not matter to him that his poor wife is inside busy dying of a TWINGE.

I told him so when he came in.

They came out and fetched us promptly, and I was moved into room 16, my new home-away-from-home. A nice lady came in and said she was Sue, a registered nurse. I told her I was Ellen, a registered patient. She and another nurse came in and started asking me questions and I answered them in way, way, way more detail than they were accustomed to, so they agreed to leave it to the doctors.

So Young Dr. Jesse came in. Young Dr. Jesse was about 12, I estimate. He claims to have been in the Navy, but I just don't see how that could have happened by age 12 if he also went to med school.

After I explained everything to him, he is leaning in the direction of pulmonary embolism. It is not the direction I would have leaned, but it is nonetheless a legitimate one. PH patients have a tendency toward blood clots and many of them are on blood thinners. I am not one, and I didn't have many of the other symptoms associated with clots in the lungs. However, this was the direction he decided to go, and I was along for the ride.

I told my husband to go home, because when I heard the list of tests they wanted to do, I'd done 'em all before and I knew how long they'd take. He can sleep at the drop of a hat, so I knew if he went home he could get a few hours rest anyway.

Under ordinary circumstances, they do a CT scan with contrast to look for emboli. But, as usual, nothing is ordinary in my world. I'm allergic to the contrast dye (which I found out when I had one once before and the tech said "Did you have that rash when you came in?" and I said "What rash?" and he said "Uh oh."). So instead, they did a doppler ultrasound on my legs to look for clots, a chest x-ray and a V/Q scan, which you breath radioactive stuff, then are injected with other radioactive stuff while they take portraits of your lungs.

The X-ray was uneventful, and the V/Q scan was uneventful.

The ultrasound was not.

The ultrasound tech was a little Filipino man named Gerry, about 60 I'd guess, chatty and grey haired. When the do the sonogram for clots, they take a picture of your vein, then they mash on it and get a compressed view of the vein. As Gerry pressed on my leg, I winced, because, well, it hurts. He apologized.

I was going to say "Oh, I read a book once by a man who was tortured and he told his torturers 'I can stand the torture if you can stand the screaming.'"

What I said was "Oh, I read a book..." and he cut me off and said "By Bill O'Reilly?"

No, I don't think I've ever read anything written by Bill O'Reilly. And I don't know exactly what this had to do with anything. Except maybe it would be torture to read a book by Bill O'Reilly?

Anyway, I don't have any blood clots but it took them until 3 am to figure that out. I called my snoozing husband and he fetched me home and I had a bowl of soup at 3 am because I still hadn't had dinner.

And I'm still TWINGEing. But less often.