Update: Medical students, cardiopulmonary specialists, and heart patients, this is an actual post written while I was having what was later diagnosed by a cardiologist as a relatively ‘mild’ heart attack. Bear in mind no heart attack is truly mild in any sense of the word. Read below, learn what NOT to do when having symptoms.
So I’m having the usual holiday AS flare up, it seems to get worse in December like clockwork every year. And yesterday afternoon there’s a new worrisome symptom: chest pain! It was kinda behind the sternum, seemed to be in the base of the throat a little bit. It wasn’t debilitating but given my age, 50, and general risk behaviors, eating crap and smoking, not to mention constant high blood pressure and high blood fats, I’m a prime candidate for an MI and this could be a warning sign. To complicate matters, I also used to suffer from chronic panic attacks, so last night was real fun.
As in laying awake all night terrified to fall asleep and waking myself up every time the sand man knocked. It’s hard to say if it got worse, but it seemed like it might have a little bit. Finally at dawn I figured, what the hey, I have insurance, really good insurance in fact, I’ll just saunter on down to the ER and have this checked out. This is where you readers in civilized countries will need to stop and understand; going to the ER in the states, even with great coverage, is an expensive proposition and a bit of a gamble. For starters my copay is 250 bucks, all kinds of services have a knack for falling through the insurance grid and landing on one’s credit, and if it turns out not to be life threatening the insurance company can actually deny coverage. For an EKG and xray in the ER read by a cardiologist that could easily add up to thousands and thousands of dollars.
It hurt and it hurt in the right places, but it didn’t hurt real bad. There was no cold sweat or vomiting, no pressure sensation, the pain didn’t shoot into the arms or jaw, there was no trouble breathing, I didn’t even feel particularly panicky. It also happens I’ve lost 40 pounds and gotten my sorry ass in decent shape over the last year. Hell, a couple of weeks ago I ran 10 miles. But if you read the intertoobz it’s not hard to find examples of even younger people in way better shape having sudden death massive heart attacks.
What to do?
At 6 AM this morning I got in the car and headed off to the ER. On the way there was a grocery store and I needed some cash. The drug section was on the way to the ATM, so I happened to stop, buy some antacids and prilosec, chowed down some chalky tablets and popped a pill in the car. I was literally pulling into a local hospital ten minutes later when the it became clear the symptoms had noticeably backed off.
What to do? The smart move would have been to go in any way. But the reality here in the US is we are held hostage by rapacious health insurance companies and they would be well within their rights to screw me royally if this turned out to be a false alarm. Over the last hour the symptoms have mostly gone away, there’s still some pain behind the sternum, but not as bad, and now there’s also a dull burn in the pit of my stomach.
I’m going with the scientific method. The suite of initial symptoms better fits heartburn/ulcer, it’s the time of year when richer fattier foods are consumed (And believe me, I have been consuming them all week), the ‘test’ for heartburn or ulcer, i.e. antacics and acid blockers was positive, and on top of that a quick search on the Internet suggests people with rheumatoid disorders are more prone to gastrointestinal issues anyway.
Now it’s just a matter of trying to get into see my PCP today and hoping I won’t be penalized for missing a day of work after being up all night suffering from a possible heart attack, and taking some time today to recover and get some medical advice about it. Because my employer proudly advertises they penalize anyone — as long it’s someone in my low paid powerless position, different rules for others of course — for missing time no matter what the reason. Doesn’t matter if you’re in ICU or hung over in bed.
That’s just another day in the life of a peasant in the US healthcare system and the great American workplace.