On February 17th this year, I went to the emergency room. If you know me, I don't go to the ER. Having worked there for twelve years, I've seen far too many people use the ER for primary care taking resources away from people experiencing true emergencies like heart attacks and trauma. I understand that an emergency is how the individual perceives their situation and that an emergency to me is not necessarily an emergency to others. That said, I'm either bleeding to death or dying before I consent to the ER and even then, I drive myself. Ambulance? Over my dead or unconscious body.
In this case, I couldn't breathe. My chest had clamped down in stabbing excruciating pain and breathing was getting more and more difficult. I tried Advil. Yeah, didn't help. When I arrived at the ER, many of the folks I used to work with took one look at me and brought me straight back. My numbers were good and I was a little embarrassed that I didn't have a documentable problem but that didn't negate the fact that the pain in my chest was significant and I was a poster child for pulmonary embolism. Don't die at home being stubborn and stupid. It's a balance.
At this point, I'm not thinking embolism or deep vein thrombosis although my medical team started down that road and all the symptoms made sense. Stabbing, pinpoint chest pain, difficulty breathing, history of travel.... It all fits. This buys me a helical chest CT and a chest X-Ray which is really what I was after anyway. Do I have a mass in my lungs? Has my cancer returned? Every medical emergency sends me to this place. Six months of chemo and frying my thorax with gamma radiation doesn't necessarily leave behind a picture of supple, healthy tissue. I'm at risk for all sorts of messed up stuff and at the five year mark, things are just getting interesting.
Thankfully, my chest X-Ray was clear. This means no pneumonia or infectious type stuff and no obvious mass, and at this point, the drugs are kicking in and life is good because I don't have cancer and I'm finally able to breathe. I got time.
CT showed some funk. Nobody can figure it out, but the good news is no embolism. Yay me. This little work up, while perceptually yielding nothing, means that I'm not going to die of anything spectacular in the next 48 hours, managing pain means I can manage at home and I got time to figure it out.
So I followed up with a pulmonologist. He's stumped. It's some sort of inflammatory thing because both ibuprofen and prednisone seem to keep it manageable but now I've developed a hacking cough that really sucks. It's deep, it's non-productive which points toward asthma but my inhaler doesn't provide any relief. On top of this, there is a "cloud" on my CT. It looks like a solar flare. It's some sort of infectious something but none of my blood tests point to infection. If it were pneumonia, I'd have a fever, chills, body aches, elevated white cell counts and neutrophils and none of that is showing up.
We didn't figure it out before our vacation so now I'm just managing symptoms. The cough remains and I've been through three units of "barf in a bottle" as Zoe so eloquently describes it. She's not far off. It tastes terrible and it is a mix of cough medicine, expectorant, and other stuff to keep me from hacking up a lung. I'm hoping it will resolve as I rally my way through a tropical paradise and enjoy the beauty of the South Pacific. Dying here wouldn't be a bad thing.
