Tag Archives: Cardiologist

Why the Slow Start?

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Eating is something that obviously over the course of human history, can really easily get screwed up. Nearly everything affects the digestive system–nearly every drug you can take has gastrointestinal side effects on the warning label. Your emotions can both affect the gut and are also greatly affected by it–the majority of one’s serotonin, for example, is produced in the gut. Our obsession with our digestive tracts is obvious to anyone who watches television or wanders the extensive aisles of related products in any store.

I grew up with an iron-clad stomach. I could eat absolutely anything, and I did. There was a period of serious stomach trouble when I was 7, but my mother finally realized that it was due to having been on antibiotics the better part of a year and started me on brewer’s yeast and plain yogurt (appalling, both, but it worked). I considered it a point of pride that I went years and years and years without ever vomiting. There’s a Seinfeld episode on that very subject, where Jerry’s streak is ended by the dreaded nemesis of the black and white cookie.

I felt his pain.

I’ve had two nights this week wherein I didn’t wake up at 3:00 am and lay there, heart pounding, until 4:30 or 5:00 am. I’ve been very careful about not eating dinner too late and for the most part Gnawing Stomach has not been part of the scenario. I suspect I am breaking through the Propanolol, and considered asking the cardiologist if there is an extended release option for night time. But, then, I started having heartburn.

Why yes, Propanolol can cause that. Are any of you familiar with the syndrome whereby you realize something (Propanolol is relaxing my esophagus too much and causing some difficulty swallowing and acid reflux, for example) and yet you choose to deny that this is happening because you’ve checked with all of your internal registers and seen that the problem count is already too high and you just don’t have room for another one right now, thanks very much all the same? I am sure I am not alone.

The complex intersection of that with emotional stress is, I suppose, why I threw up until after midnight last night. I saw the new Shrink yesterday, and a lot of what we talked about had to do with what that person with the personality disorder is doing to continue to try to get my attention. I mentioned that it was my perception that as I ignore all attempts at contact and we get closer to the holidays, this person is going to find themselves in a greater and greater state of agitation and will escalate their behavior. The last attempt was about a week before my birthday in late July, messages on my office phone that I didn’t find until I went back to work. My cellphone already blocks this person and her spouse, as does FB, and my email address is also unknown to her. The new Shrink was very supportive of my position about not letting this person into my life again, and also said, “I keep seeing this image of you on a rickety wooden bridge with alligators below you.”

I will be opening my psychic business soon, if any of you are interested, because I walked into my house from seeing the new Shrink to find that this person is now using Etsy to message me. Turns out you can’t block someone on Etsy. The holidays were referenced, which suggests that I am entirely right about how things will go over the next few months. The new Shrink better put her boots on, as things are going to get pretty deep pretty quick around these parts. Like a fool, I ended my day with chile cheese fries and guacamole salad, and then I went to bed with a glass of wine….

….with what felt like a ticking time bomb in my gut, with fire racing up my throat and a sense that if I lay down correctly it would all just flow out like lava. Or….not. But it was an ugly feeling, kids. Like Jerry Seinfeld, I am not a puker. I know people who are, for whom this is sort of effortless, but I am not at all in that club. But there was no way I was going to survive the night with my ill-considered meal in my belly.

Around 1:00 am, as I lay with the heating pad on my stomach to soothe the turmoil of puking for hours, I realized that because my life is magical and filled with splendid coincidences, my shoulder was very angry about the festivities. Who the fuck hurts their shoulder puking? Me, that’s who. People with EDS, that’s who. So then there was ice for the shoulder and heating pad for the gut and restless sleep wherein I dreamed I was being bitten multiple times by mosquitoes (Oh, Psyche, you borrower of trouble).

The world in all it’s internal and external splendor meets in the gut, with all its alchemical glory. It does not, however, result in gold.

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Getting an A+

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If aging is something one can study for, I am going to totally ace it when I get to being elderly. I am already getting to practice so many aspects of becoming frail, I may not even notice a difference when I’m finally, formally, an old lady. (I promise, though, solemnly, that I will not wear a purple hat–that is some silly bullshit, friends).

It’s not uncommon, for example, to have to regularly monitor one’s blood pressure and heart rate in one’s later years, but that won’t be any kind of stumbling block for me, as I do that at least once a day already. I am acutely aware of my heart’s various flutterings and hiccups, and take a month’s history of it to my cardiologist at each visit.

Likewise, the need to document one’s medical issues is an elderly treat I have already gotten to partake of–I will soon be one of those patients with a clear Ziploc full of pill bottles and scribbled notes and a notebook full of diagnostic letters and test results. Remember the halcyon days of youth when the only medication you were on was maybe birth control or allergy meds? No more, now there are beta blockers and handfuls of supplements. I have arrived, old age, I am already amongst your people.

I remember that my Grama would often bemoan not being able to eat whatever she wanted anymore, as many things seemed to upset her system. Given that last night and two nights ago I had big meals from carry-out restaurants and each night awoke at 2:00 am with gnawing stomach that lasted until 4:30/5:30 am, it seems I will not have to face that hurdle in my seventies. It will be old hat to say, “Oh, I need to watch my portions and be careful not to overeat because it makes my stomach hurt at night, dearie–you can have the rest of my smoked rib plate/reuben sandwich for me”. And, “I need to eat dinner earlier rather than later, or I won’t be able to sleep.” I should just start working Jeopardy into my life now; I can watch it at 4:00 while I eat a small, bland dinner.

Old people often feel stiff and achy in the morning–gone are the days of springing out of bed and leaping into whatever tasks or adventures were ahead. Each morning as I stagger to the shower with my hand on my lower back, wincing as my ankles and wrists and shoulders speak up with complaints of their own, I’m grateful that I will not have to go through the disappointment of feeling this way when I am old. I will not wake up one morning to find my youthful spring-of-step mysteriously compromised, I will feel the same way I have felt since I was a 46 year old babe with dewy skin and innocent expectations.

Older people spend a lot more time at the doctor’s office, too. Yesterday, waiting to be called for x-rays of my hands, neck and right shoulder, I overheard this conversation:

Sweet old couple waiting nearby, are approached by a receptionist:

Receptionist: Mrs Smith, have you visited Africa in the last 21 days?

Sweet old lady: What? What did you say?

Receptionist (louder, but not slower): HAVE YOU VISITED AFRICA IN THE LAST 21 DAYS?

SOL: WHERE? WHAT?

Receptionist: AFRICA!

SOL: Africa? (looks to husband) No…..I don’t think so. Why?

Receptionist (still not slowing down): It’s because of the EBOLA.

SOL: What?

Receptionist: I’m just checking “no”, thank you!

SOL: What’s your name?

Receptionist: Adawnna.

SOL: What?

Receptionist: Adawnna. (leaves)

SOL (to her husband): WHAT DID SHE WANT? WHY DID SHE CHECK SOMETHING OFF?

Husband (rising painfully slowly to his feet, goes up to receptionist’s desk, the same conversation is had, and he returns): -chuckles- They thought we might have gone to AFRICA.

SOL: Where?

Husband: AFRICA. WHERE YOU CATCH THE EBOLA.

SOL: She said I have the Ebola?

Husband: No, no, she said you haven’t been to AFRICA.

SOL: Well that’s true, who would go there? They have the Ebola.

Then they laughed and laughed.

See? I haven’t been to Africa either, so I’m in the club.

Old people also have trouble getting in and out of the car. I can no longer manage to control the swing of the truck door and get in at the same time, so I go wait in the driveway while my husband backs out, and then I get in. The reverse happens when we get home, and have to sort of let the momentum of the door haul me out in a controlled slithering operation. I have similar struggles with heavy doors, and hover around them waiting for someone to open them for me whenever possible. I also stick my foot out so that if someone crashes through it maybe they won’t break my wrist and knock me down–us old folks know there’s a broken hip lurking around every corner.

On the bright side, I look really good for being 80–I mean, I look half that age, really. I’ll be able to get lots of dates at the retirement home, I’m sure.

Paradoxical Response

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Someone got to leave work and go straight to the cardiologist for an EKG this morning.

The weekend was horrible. I continued having nausea, and started to feel more and more spun up–like I was vibrating really fast and might fly into pieces. My brain was a runaway train loop of paranoia and anxiety. I started wondering, “How come instead of tired (which is typical of beta blockers), I am feeling revved up?” I knew that I was overreacting to things in the extreme. The interface for my workplace went down, and when I tried to log on it flashed that “YOU ARE FORBIDDEN” and I was 100% convinced that I’d been fired. That’s how my weekend went.

I called the Cardiologist’s office promptly at 8:00 am and they put me through to a medical assistant

YES THAT IS A TRUE THING THAT HAPPENED, SOMEONE IN MEDICAL CARE WAS RESPONSIVE. UNICORNS ARE REAL, TOO.

who said that she would get back to me as soon as the doctor came in. At 9:00 they called asked me to come in at 10:00 am.

YES THAT SHIT ACTUALLY HAPPENED, TOO, THEY WANTED TO SEE ME RIGHT THEN TO DETERMINE WHAT WAS WRONG.

I arrived with a blood pressure of 144/110, shaking like a vibrator with new batteries and convinced, utterly convinced, that the doctor would come in and fire me. And that I’d had a heart attack over the weekend. And that they were going to put me in the hospital. And that I would die. My pulse was a casual 115.

The doctor came in and asked for the run-down and I described it all to her, so jittery it was hard to sit still, and she said, “I’ve never had that happen before. I’ve never had anyone have a response to taking this medication like that.” I said I was sorry. She said, “You don’t have to apologize, why would you apologize?”

YES SHE DID SAY THAT, IF I HADN’T BEEN DYING ALREADY I WOULD HAVE DIED MORE.

I said that I was worried that I was too difficult. She said that she didn’t mind that I’m difficult, and she wants me to feel better.

YES. CAN I GET AN AMEN?

She said, “You are having a paradoxical response, where the medication is acting the opposite on you from what it’s intended.” I told her I had a very similar response to Cymbalta last year, two times. She said it would take a week for it to clear my system, and since I had already tapered it for two days to just stop altogether. She decided that we would try Propanolol again, and see if it worked at a higher dose. She felt that my insomnia and such with it was my condition breaking through the drug, not the opposite, and that since I did not feel at all paranoid/crazy/jittery on it that we should give it another chance. I agreed.

She asked me if I had a nice long weekend. I said no, no I didn’t, I’ve felt like this all weekend. She said, “I’m really sorry about that. Stay in touch and come back in if you need to.”

YES. I CAN’T BELIEVE IT EITHER.

Of Beta Blockers, Side Effects and Unreturned Calls

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The cardiologist kind of wowed me with this, “Of course I know about EDS, a cardiologist has to.” Also, where she said, “This is not in your head, you have a collagen based disorder and this is how your disorder affects your body.” She first said I needed to see an Electrophysiologist. Then she said that well, we’d try a beta blocker first. She asked me to stay on it for one week, even if I thought it made me really tired–which is the expected result when adjusting to beta blockers. The other weird thing was that she noted my blood pressure was pretty high, and even as I showed her the last month’s worth of daily readings, it was never particularly low–something it has always been in the past. She checked my ankles for swelling and found none.

The next day I hid from work and stayed home, ostensibly to rest. Instead the busy, busy monkey that is my brain started wondering, was she checking for heart failure? Oh, and, OH OH OH (my brain gets really excited about freaking me out), what about that ten pounds you’ve gained so mysteriously in your belly? You’ve never put weight on your belly. Let’s ask Dr Google if mysterious belly weight gain is a sign of heart failure! So we did……and it is……and my brain celebrated this exciting possibility all damn day long. “Remember how you’ve felt really tired? Yeah, yeah, fatigue is a symptom.So’s high blood pressure!” All day long.

The cardiologist had put me on Metoprolol ER, the lowest possible dose, which is 25 milligrams once a day, taken in the morning. Day one, I noticed that I was nauseated pretty much all day, and found it curious that my urine seemed dark (urine, I said, did you have a multivitamin when I wasn’t looking?). The next day I got on the scale and was five pounds lighter than I had been the day before (my brain scribbles this down, “see? it’s water weight, you’re in heart failure.”). I was, also, completely uninterested in food and noticed that the wave of nausea seemed kind of regular, like they were happening each time the drug released throughout the day.  Day three I was still the same weight as day two, meaning I apparently didn’t imagine that new number. Also, I was nauseated all day long, but I could find windows where it ebbed after a release.

Now, if you’re saying to yourself that obviously I should have called the doctor rather than googling side effects and such, allow me to politely suggest you shut the front door, because I did. I called yesterday around 10:30 am. I reported that I had a question about a medication and that I was experiencing nausea. You know as well as I do there’s no reason to give the receptionist a list of things, they are there to send the message. She said that the doctor was in surgery all day but the message would go to the medical assistants. (Then I got a shitty email from work and my blood pressure went up to 145/110, which I think if I had a fancier monitor it might have called 911 for me. But I don’t so I closed the work email and avoided it the rest of the day and the numbers went back to the new normal of not low).

Of course no one called me back, right?

Right.

We went out to dinner and I was hella nauseated all the way there, then it cleared for a second and I ate, but about a third less than normal. On the way home I started to have intense stomach and chest pain. This lasted about an hour, then resolved around the time I was thinking okay, if you have to ask yourself if you are willing to sit in the ER with all the people who think they’re at the daycare for their neglected children, then you do not need to go to the ER. Got it? Oh look, my stomach stopped hurting as much, cool.

I suspect there is zero chance I will hear from the doctor’s office before Tuesday, and one cannot just go off beta blockers. You can have a heart attack if you don’t taper down very slowly, so I’d kind of like some direction from the expert before I do anything differently. But, how good does another few days of nausea sound? Not so good. No me gusta, honestly.