Once More Unto The Breach
Tales of my second go-round with breast cancer before the age of 40, and everything since.

And a Third

I hesitate to post this, since I fear that it will cause undue worry and possibly result in perfectly well intentioned yet amateur diagnoses (not to mention prescriptions), but here goes:

I spent all of last Monday in the emergency room, for the first time in my life as the patient.

I started having a weird breathing thing (yes, that’s the technical term) after my spinning class the previous Friday. I felt fine during the class—it was strenuous, but no more than usual. Afterward, however, I felt some kind of tightness or at least unusual awareness whenever I took a deep breath. Kind of how it feels when you breathe deeply in very cold weather, but minus the cold.

Anyway, I felt fine the next day and went off to ballet class, which was relatively intense as ballet classes go—we spent 30 of the 90 minutes away from the barre, doing a beginner’s version of Agnes DeMille’s Rodeo—but I was no more winded than any of my classmates. After class, the weird breathing thing (WBT) returned, then abated.

I took Sunday off from exercise, but the WBT came back. Then it went away. Then it came back.

When I woke up Monday morning, I had not only the WBT but the distinct feeling of a hand pressing on the center of my chest, as if holding me back from a fistfight. It did not feel like an elephant sitting on my chest, and the pain did not radiate anywhere, but it was a palpable sensation.

I couldn’t get through to—or in to see—my internist, and after waiting a while for him to call me back, I told Zach that I thought we ought to go the emergency room. Even as I said it I felt ridiculous, but I also didn’t want to mess around. My family history is not great in the realm of the heart (heart attack, quadruple-bypass surgery, valve-replacement surgery, angina, high blood pressure, high cholesterol, atrial fibrillation, need I go on?), and I know that heart trouble is underdiagnosed in women and that, unlike men, women can have heart attacks with few, if any, symptoms.

So off we went.

The ER was quiet when we arrived. I was triaged and taken inside right away. I provided a urine sample using the most over-engineered sample cup I’ve ever seen—tragically, one that did not prevent me from peeing all over my hand. A nurse started an IV (painfully, unfortunately) and took a bunch of blood along with my vitals. In short order I had a chest X-ray, an electrocardiogram, and a bunch of labs. The X-ray was negative. The cardiac-enzyme test was negative. My blood count was normal.

The ECG was abnormal. I predicted this, because my last two routine ECGs were abnormal, and both times specialized follow-up tests were normal. The last one, an echocardiogram, was done in May of this year.

The ER doc consulted with my internist (funny how ER docs can get people on the phone) and proposed that I have a stress test.

I hadn’t had any exercise in a couple of days, so I figured the stress test would kill two birds with one stone, and off I went.

(The urine sample was never used, by the way, but it did follow me the whole day, sometimes sitting on a counter near my bed, sometimes traveling with me on the bottom of my gurney along with my stylish Patient Belongings bag. I did not find this reassuring. Or pleasant.)

A couple of hours, some radiation, a few pictures, and some quality time on an increasingly fast and steep treadmill later, I was told that my heart was absolutely fine, and I was sent home.

The only problem was that my symptoms hadn’t changed a bit. The new ER doc (the first one had already left for the day) told me that some gastrointestinal problems can present as heart problems. And I have a history of GI problems, although none that felt like this. Plus I had been belching a lot on Monday (although not on Friday, Saturday, or Sunday).

The nurse-practitioner who supervised my stress test gave me the name of a cardiologist who specializes in women and in micro-vascular disease (the stress test only looks at big arteries). She said that if I didn’t get an answer in the ER, I might want to see this woman for a more extensive work-up.

Three days later I had a follow-up visit with a different doctor in my internist’s office. (I could have seen my own doctor if I’d been willing to wait an extra week. I wasn’t.) Another chest X-ray (different view this time) and a breathing test both came back normal. I told him about the cardiologist I’d been referred to, and he agreed that she would be a good person to see. Until then, he said, no exercise except walking.

Unfortunately, the cardiologist can’t see me for more than a month—and actually, my appointment is with her associate. So while I am waiting, and calling twice a week in the hopes of a cancellation, I am also going to see my gastroenterologist (although not for another week, which is the earliest appointment I could get). I’m more and more convinced that this is a GI issue, but that’s not making me feel any better physically. I’ve still got the WBT, and the chest pressure, and the intermittent belching. And I miss exercising, which would likely help relieve some of the stress of worrying about what’s going on.

But, everyone keeps telling me, I should be relieved that it’s not a heart attack or one of the other scary things that have been ruled out.

And I am relieved.

But I’m also uncomfortable and distracted and stressed.


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