So. There I am, in the back of The Big White Taxi, my blood pressure is 116/68, pulse is 72, mood is grouchy.
The paramedic, bless his heart, has agreed with me that I am not -- as a matter-of-fact -- having a heart attack. He has run another 12-lead using his EKG and has shown me a strip which shows mild ST elevation on just about every lead, and is busily trying to find a vein.
As he is rooting around, he asks, "Don't like hospitals?"
"I had this exact same pain last year. I thought I was having a heart attack, so I had my lady drive me to the ER -- did you know that the ER doctor association at Big City Hospital doesn't accept County insurance? -- spent four hours in the ER, to find out that it was pleurisy, given steroids, anti-biotic, Aleve and a bill that I finally got paid off this past month."
"Ah," he grunts.
"I've got a really good vein in the back of my right hand. Everyone hits it. Pop that cast right off, and you'll be able to see it from orbit."
He gives me Ye Olde Hairy Eyeball and keeps checking my left arm.
"Since then I've had about six or seven flare-ups. Same type of pain, same location, just not nearly as bad. The first time I hied meself over to Big City Urgent Care, waited for four hours and was told I was having esophaegeal spasms, told to take Aleve, and if I had further episodes, that I might need anti-anxiety meds."
I wave my cast at the paramedic, who still seems to have not found a vein to his liking. He starts eyeing it speculatively.
"The second time, I went back to Urgent, got the same answer. And did you know that the labs that Urgent uses don't take County insurance? Yeah, me neither. I also got the distinct impression that even though I don't like pain meds and frequently refuse to take prescribed pain meds, that the folks at Urgent were suspecting me for fishing for an opiate scrip."
My bad luck, the paramedic hits the vein above the cast first try.
"So the next two times, I went over to Bugscuffle Clinic and Tyre. The doc over there diagnosed it -- both times -- as 'chest wall spasms', suggested Ativan the first time, and Xanax the second, along with a gentle noodge to make an appointment to see the travelling psych doc. So. I double-dose on OTC Aleve for three to five days, it gets better, no muss, no fuss."
And we pull up to Big City ER, the first person I see is the charge nurse.
"'Dog," sayeth that worthy, "What the hell?"
"Not a heart attack," I snip, for the umpteenth time, as the paramedic says, "Called to Bugscuffle Clinic and Tyre for AMI." We go through the Standard Report, and next thing I know I'm in an ER cubicle with Charge Nurse and a padawan. Introductions are made, and then Charge Nurse says, "Remember what I said about 'Special Needs' patients?"
Padawan nods her head enthusiastically, "They're iron-assed, bull-headed, and mule-stubborn; too [deleted]ing ornery for their own good, and too [deleted]ing stupid to go to a hospital instead of dying."
"Yes. And this is their king."
"Given the history, and the presentation, what do you think we have here?"
Padawan frowns at me, "Umm ... pericarditis?"
"Very good. Here's the ECG strip, see the ST ..." The two of them wander off, leaving me to my ownsome until Chris shows up, followed shortly by my lieutenant, AEPilotJim and my lady love.
Long story short, some time later a doctor wanders in, announces that there have "Been changes" to my EKG since the Great Pleurisy Incident of 2011; that a heart attack "Cannot be ruled out" and I'm chucked into a bed in the brand-new Cardiac Care Unit.
Several hours later everyone has gone home, I'm working my way up to "Irritated" from "Peevish" and I open my eyes to find a stranger sitting beside my bed. At midnight. In a hospital. Figuring someone had wandered into the wrong room, I cock an eyebrow at him.
"Oh. Hello," sez he, "I'm your cardiologist."
"I don't have a cardiologist." I reply, somewhat snippily, I admit.
He grins, "You do now."
We size each other up for a moment, and I announce, "I am not having a heart attack."
"Nope," he replies, with a great deal of relish, and more than a touch of confidence, "You are not."
"Great! So I can go home?"
"Charge Nurse called me. We had a long talk, and I'll make a deal with you: You let me do one quick check to verify the pericarditis, and if you feel up to it when I'm done, you can walk out of here with my blessing. Deal?"
I figure, what the heck, nod in assent and my new cardiologist puts the flat of his hand against the left side of my sternum and pushes towards my right shoulder-blade.
The world goes grey, shot through with red flashes. I really, really want to scream, but it hurts too bad to breathe. It feels for all the world that I've just been kicked in the chest by a bus, and the damned thing has parked a tyre on my shoulder blade and is spinning out.
When everything comes back into focus the doc says, "I don't think you've ever had pleurisy. I think you've been fighting pericarditis for the last year. I don't like hospitals either, but you're 45, diabetic, and your heart is pissed-off at you. Spend a night or two here, we'll get you started on colchicine, echo your ticker to see if there's any damage, and send you home. Deal?"
You know, I really couldn't argue with that.