Tuesday, February 24, 2015

Chest Pain Radiating to the Shoulders & Neck - A False Alarm (part 1)

In the past month or so, I had been experiencing some tightness in my chest, burning sensation in my shoulder and neck muscles, along with dizziness which I can describe as similar to turbulence while flying in an airplane. I’ve always rode it out rationalizing that it was just muscular pain and my inner ear problem which happens from time to time but always suddenly disappears for months at a time. I couldn’t account for the burning sensation though. I finally made a doctor’s appointment and told him about my symptoms. Blood was drawn and the doctor’s office was going to get a preauthorization for a treadmill stress test. My lab tests turned out to be normal except for a slightly elevated creatine kinase (CK), and bilirubin. When I asked the doctor about this, he said those numbers were nothing to be concerned about. In the meantime, they were still waiting for the insurance company to respond to the preauthorization request.

On Sunday morning, February 15th, I felt the symptoms worsen in the morning, then thinking I might be hypoglycemic, I ate 3 pieces of toast and lay down on the couch for a few minutes, which seemed to help, before I started my workout. Because of the way I felt, I only did a low intensity workout on the recumbent stationary bike and kept it to my minimum of 30 minutes. I had lunch afterwards then watched a video. At about 2 p.m., I started feeling the symptoms again and it worried me. Perhaps it was time to call 911 before anything worst happened. I picked up my phone (Majicjack) and there was no dial tone, so I disconnected the USB cord then reattached it. I dialed 911 and was transferred to the paramedics line. After a few rings, I got cut off! I dialed again and this time the paramedic dispatcher answered and verified my address and was told the paramedics were on the way.

Initially, 3 medics came, then at least 7 more showed up. I said, darn, how many units rolled? One of them said “The city of Long Beach considers you a very important person”, which made me chuckle. They said they were going to take me to a hospital. On the way out of my apartment on the second floor, the paramedics asked me if I was able to walk down the stairs towards the gurney. I said yes. I was already attached to an EKG machine with the wires on my chest. The paramedic holding the EKG machine led the way and I said to him, "this must be how a dog feels on a leash". He laughed and said, "oh, still cracking jokes huh?"

As I was being loaded into the fire department ambulance, the medic mentioned that I was going to be taken to Pacific Hospital of Long Beach (now College Medical Center). I asked if I can be taken to Memorial Hospital of Long Beach instead or Community Hospital of Long Beach where I work. He said that the only emergency department that was would be able to take me is PHLB because the others were busy. So off to PHLB we went, the same hospital that laid me off a year and a half ago, with an ER that I did not exactly trust based on my observations when I used to work there. The medic gave me three sprays of nitroglycerin 5 minutes apart and had me chew and swallow 2 baby aspirins. Time of arrival in PHLB: 3:15 p.m.

The thing with chest pain is that you get seen by the nurse or doctor right away, or so you would think, but since I was still conscious, did not appear to be in distress, with a heart that was still beating, I wasn’t seen as quickly as I had been in my previous hospital visits. I was transferred from the paramedic gurney to another gurney right next to the holding room where the psych patients were waiting to be medically cleared before being transferred to the psych unit. I was hooked up to an EKG/blood pressure/pulse oximeter machine which emitted beeps every few minutes signaling something amiss with my heart. Either that or the machine was not detecting accurately. Blood was drawn, a chest x-ray was done, then a CT scan of the head. I had sent a text message to my cousin Maryann informing her that I listed her as my emergency contact. Shortly, she and her husband Mike showed up at the emergency department and I updated them on what was going on. They were surprised to observe what appeared to be homeless people in the waiting room and the behaviors of the psych patients a few feet away from my bed. Believe me, I experience that every day I’m at work because that’s the population we mostly treat.
Before Mike and Maryann showed up, I heard a policeman mention a 5150 to any designated LPS facility and asked one of the nurses what LPS meant. The nurse didn't know, so being the show off that I am, I proceeded to explain that LPS stood for the Lanterman-Petris-Short Act which basically says that no one can be involuntarily committed to a psych hospital indefinitely unlike before. For more detail, you can read about it here: http://en.wikipedia.org/wiki/Lanterman%E2%80%93Petris%E2%80%93Short_Act . 
In the meantime, the admissions staff was trying to get authorization from the insurance company to admit me for observation or transfer me to another hospital within their network which have prearranged contracts with the insurance company. That took hours probably because it was a Sunday and the following day was a federal holiday (President’s Day). I was offered morphine for the chest pain which I declined because I felt it was too strong a medication for me, so I was given a couple of baby aspirin. I was told that my troponin level was normal but the CT scan showed a possible mini stroke very recently, however it was inconclusive.

When the insurance company finally gave authorization to transfer me, I thought I would be sent to Memorial Hospital which was only about a mile away and because it was part of their network. Instead I was being sent to Presbyterian Intercommunity Hospital, and I was thinking the one in Downey, but then I was mistaken again and was told it was the one in Whittier which was much farther away from home. Maryann and Mike stayed until 10:30 and when I learned of my transfer, I sent them a text message update. Thank you so much Mike and Maryann for staying with me for a few hours. The ambulance arrived at midnight and shortly after, I was being whisked from Long Beach to Whittier. I learned later why none of the other Long Beach hospitals couldn’t take me.

To be continued in Part 2, as this entry is quite long already.

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