I woke up on Monday night at 11 PM with what I thought felt like heartburn, something I’ve experienced regularly throughout this pregnancy. I took two Tums, as has been my treatment. However, things continued to worsen and by 2:30, I knew something was wrong as I was still in pain and was also sweating. It had to be really wrong because what ensued was waking my husband, waking our son, packing a bag, and heading to the hospital in the wee hours of the morning.
We got to L&D at around 3:30 and after an EKG, and some blood work to rule out a heart problem, it was determined that it was reflux. Because I was in so much pain, they treated it with a “lidocaine cocktail” which was liquid lidocaine mixed with milk of magnesia. By around 6:45 I was feeling better enough to go home.
I went straight to sleep when we got home and slept in fits and starts for a couple of hours. My husband came home for an early lunch and by the time he did, the lidocaine had worn off and I was in worse pain than the night before. It was a radiant pain, emanating from the center of my chest out toward my breasts and up to my clavicles. It wrapped around my back and was so painful it made my breathing shallow. And, it crept up my neck to my jaw, behind my ears and up the nape of my neck.
Rosie O’Donnell was on my mind. I watched and read reports of her heart attack, saw her interviewed, and watched segments of shows dedicated to the symptoms of heart attack in women. I emailed my OB and included all of the above symptoms and got a call from her nurse. She was at the hospital and I was to go back, immediately. I would learn later that the jaw pain was what caught her eye.
My son was in school so my husband drove me in. We arrived at around lunchtime. They ordered another EKG, and a more inclusive cardiac blood work-up. Something in the EKG caught my OBs eye and she ordered a cardiology consult. In an effort to manage my pain and because it seemed to have worked before, I had another lidocaine cocktail only this time it didn’t work nearly as well. The cardiologist came by and reviewed my history, focusing on the fact that I had had a prolonged chest cold that only recently resolved itself. We were still waiting for the results of the blood work, and he decided to do a cardiac ultrasound (using a handheld ultrasound machine, almost no bigger than an iPhone, that I fully believe should be offered to all pregnant women) looking for fluid around my heart. He asked me a lot of questions, the answer to one of which would become the key to my diagnosis, which was, ‘do you feel better or relief from the pain if you are standing up or sitting upright?’ to which my answer was yes. By this point, lying down was excruciatingly painful, taking a deep breath, coughing, or even clearing my throat were out of the question and I was tachycardic, with a resting heart rate around 130bpm.
Let me break here to say that baby was monitored fully and during my first trip to L&D they did an ultrasound before I went home. Because he is breech, that added to the initial diagnosis of reflux, that his head was pushing the stomach acids more easily and fully up my esophagus. It all sounded reasonable to me, except for the pain factor. I rated my pain as a 5 during the first trip and it was an 8-10 by the time I returned.
We were there, in L&D triage, all afternoon. When the test results had all come in, the resident quite calmly explained that it was possible I had had a mild heart attack. Cue the freak the fuck out music because it scared the shit out of me to think I was 46, in otherwise reasonably good health, pregnant and had had a heart attack. It was also probable that I had pericarditis (an inflammation of the sac around the heart, usually brought on by a viral infection). Of primary concern was my continued tachycardia that did not improve as the afternoon wore on and the elevated ST segments from the 2nd EKG I had. We would not know for sure if it was a heart attack until a series of 3 sequential triponin tests came back (the third of which was this morning). I would not be going home, they were going to admit me and determine a treatment plan.
We had a friend pick our son up from school and she kept him through dinner. It was around this time that it was decided I was going to be admitted. I worried about our son and how the night would unfold, so as scared as I was, I told my husband to go home and pick him up. We tried to come up with a Plan B that would allow my husband to stay with me, but there wasn’t one. I cried as my husband walked out the door.
Just the mere thought of something being wrong with my heart scared me in a way that I can’t adequately describe. It is hard to not think the worst and the worse was dying before this baby was born or before I saw my son again. I was alone, in the hospital, in pain, and scared. I would later post to Facebook that I was too scared to sleep and I didn’t. They started me on meds to treat the pericarditis which thankfully began to alleviate the pain. The MFM on call had to research the best way to treat me as I was pregnant and the prescribed treatment was Ibuprofen which is not safe for babies past 34 weeks as it can close one of the vessels of the heart.
She came by on rounds early this morning (by then, I’d had two doses of two meds she’d prescribed). She had 3 residents in tow. The first thing out of her mouth was, “You are an unusual case. I’ve only seen one case similar to yours in 30 years of practice.” Really. Where have I heard that before?!
Cutting to the chase, I did not have a heart attack (Amen! Alleluia! Thanks be to the universe!). The diagnosis is acute pericarditis brought on by a viral chest cold (they are still trying to determine which). I have to take medication for the next 3 months to treat it but the pain as abated significantly already. My discharge was contingent upon a significant lowering of my heart rate (which was in the 90s by the time I was last monitored) and the results of a favorable echocardiogram (I got to look at my heart beating from various angles for the 45 minutes it took to do the test) which I got. I was discharged and on my way home with my husband and son by 3:30 this afternoon.
I have become used to being an ‘unusual’ case but it is sometimes hard for me to understand why these dramatic health issues happen to me. It is a lot for one person to bear and a lot for those who love me to go through. If it weren’t happening to me, I wouldn’t believe it (and believe me, I have lost friends over my dramatic health issues). It has been quite validating to have been with my husband long enough for him to witness these diagnoses first hand.
I am home.
“When you arise in the morning, think of what a precious privilege it is to be alive – to breathe, to think, to enjoy, to love.”