Things have certainly gotten interesting around here. I don’t like to think of myself as getting old but my body is reminding me every day that it needs my attention.
Over the past few months I have gone on a rant about the lack of good medical care in my life. I wasn’t feeling listened to and felt some complaints were being disregarded. All of that has come to an end. I had some second thoughts about writing about all this, but it might help someone else once they read about my experiences.
On Tuesday morning of this week I spent three hours with a wonderful naturopathic MD here in Concord. I had waited seven months for this appointment and it was well worth it. She listened and responded to every symptom and concern I had and dug deeper when she sensed I was minimizing or trying to skim over certain issues. By the end of the three hours she had come up with a preliminary plan.
First of all – MODERATO has to be my new motto. I have a tendency to do a lot, then I have to crash. This even includes exercise. My pattern is to go out for a three mile walk and then need to rest for three days because everything hurts. I also work hard, travel a lot and then wonder why I am exhausted by the end of the week. MODERATO!!
She also validated that mindfulness meditation and yoga is excellent and should be a part of my daily routine.
Then we moved into new territory. Here is what I learned about medication for depression and anxiety. I have been taking Celexa for a few years and it helps with anxiety. Without it, I am bouncing off the walls, can’t sleep, and ruminate over everything from the Viet Nam War to oil spills. However, even with the Celexa I have some low grade depression that just never lightens up. Even when I am having a good day I can still feel blue.
The doctor explained to me that the Celexa only regulates Serotonin and Gaba and helps to decrease anxiety, but that it lacks the dopamine and nor-epinephrine which are needed to relieve depression. She said that from what I was telling her she could tell I needed something to increase dopamine. She explained this all in a way that I understood. I know from my research on the effects of trauma that the brain can use up dopamine and have difficulty producing more when a person has been under prolonged stress. She has given me a supplement that will work to increase the dopamine and I hope to feel some improvement by the end of the week. She is also going to help me get a good deal on a light box before winter sets in. I do feel more depressed from November to March so a light would be very helpful.
She also gave me information on some inserts for my shoes to help with plantar fascia.
The most important thing she did, though, was take my complaints about fatigue and general overall exhaustion seriously. She looked at my family’s medical history and asked me about heart disease and when I talked about having times when I felt some pressure in my chest she did not allow me to minimize it. She took it all seriously and had an EKG done. She explained to me that women do not feel chest pain in the same way that men do. She said that women are more likely to feel pressure. I told her that I usually felt it after going up these damn New England stairs (there are ladders in ships that are less steep) and it went away after a minute or so. Very calmly, she explained that is exactly a symptom of a possible blockage in an artery and that she wanted to have an imagining stress test done. She was so calm and yet concerned, that I knew it was necessary but I was not anxious.
I left her office after having an EKG. I had a plan, orders for a lot of blood work, a kit to submit saliva and urine samples, and the promise that the nurse would get back to me with an appointment for the stress test.
Over the next 24 hours my schedule opened up and the diagnostic center was able to get me in to have the test over two days. I stopped drinking caffeine and eating chocolate (yes, Boo is still alive, but it is a damn good thing I live alone and had the Chris Botti concert to attend on Thursday evening) and didn’t eat after midnight before the test. On Thursday morning I was injected with a radioactive dye, swaddled in a blanket and was allowed to take a 20 minute nap under a gamma scanner. It took pictures of my heart while it was in normal mode. The next day I was hooked up to an EKG machine while walking on the treadmill. As soon as my heart rate reached the targeted heart rate of 142 (220-my age X 85%), they injected me with the radioactive dye again, had me walk another minute and then I was allowed to rest and have a few sips of water. After about 20 minutes I was able to take another nap under the gamma camera. For some reason the pictures didn’t download onto their computer, so I was given time for a second nap. Not a problem. Afterward, they unhooked me and let me go. I left , went into the Starbucks on the second floor of the hospital, got a chai latte and went home feeling that all went pretty well. I hadn’t felt any problems during the stress test and I was convinced I had passed with flying colors. My denial was even working so well that I convinced myself that since I hadn’t felt any effects from not eating breakfast that my blood sugar must be stable and that I didn’t need to worry about the glucose tolerance test coming up this Monday.
I had a great Friday. I spent it working on the novel and taking some time off of work. I was just settling down to a plate of scrambled eggs with feta and spinach (there is irony here) when the doctor called.
I don’t have much experience with doctors calling me. In fact, my last PCP’s office told me that the doctors do not make phone calls, the nurses do. So when I heard the doctor on the phone I knew something was up. She said, “How are you?” I said, “You tell me!”
She explained that the tests show that I have signs of Coronary Artery Disease. Fuck NO!!! But she also explained it was good because it had been found and that there were steps to take care of it and I was already doing some things I needed to do. She said she will be conferring with my new PCP and they will be setting me up with a cardiologist ($$$$$$$$$$$$$$$$$$$$$$$) and I will probably need to have a catheterization. Whew!!! – they won’t be cracking my sternum open like a lobster. PLEASE!! - I will do anything – but not that!!! She also said that she was calling in a prescription for nitroglycerin (oh, damn, I have to carry that stuff around with me all the time and I can barely remember my car keys) and that I needed to start taking an aspirin a day – for the rest of my life!
She was wonderful. She asked me how I was, she let me know she was available to talk to me any time and that she really felt that this was a good thing to have found now. She explained what to do when I felt pressure, when to take the nitro, when to call 911, and asked how I was going to spend the weekend. She also reiterated how heart symptoms are different for women and to not take the absence of pain as a sign that everything is okay. She urged me to do my normal activities, take walks and do yoga. No hills or mountains, though.
I spent the evening in a fog and near tears. I called my friend, Barbara, and she gave me a great pep talk. I had thought of canceling out on a yarn shopping trip but decided I was going to have fun. But I also experienced a lot of anger because I have been complaining to various medical professionals about these symptoms for at least three years and have not been taken seriously. Then I let it go. I realize that everything comes at the right time and now I have a doctor who is listening and taking me seriously. She said that this explains my exhaustion and the catheterization should be able to help.
Yesterday evening I remembered that I have an aunt who has been living with heart disease for probably thirty years so I know this doesn’t mean I am going to die any time soon. That was reassuring. However, having my chest cracked open with rib spreaders frightens me even more than death, so I will do everything I can to avoid that.
This morning I talked to my nurse friend, Darcy. She knows me well to know that I could be on the floor and out of breath and still questioning whether or not I should call 911. Darcy made me agree that if I felt like I should take a nitro to give her a call and she will use her nurse voice to convince me of what I should do.
I am definitely blessed in the friends department.
I also have a cat that likes to give me Kitty Reiki. She lies down on my chest and purrs so loud that I can feel the vibration go all the way to my heart center. I know that has to be healing.
I am going to continue to post on this journey. It helps me to process and I also hope it will help someone else down the line. As of right now, I feel pretty good because I think I have good medical, friend and family support and all will be well.
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