Monday, November 21, 2005

Where I've Been

I know some people have been waiting to see what I would write about recent happenings in my life. I have held back because I didn't know quite how to address this. Should I be light and humorous? Should I be deeply reflective and profound? I also held back because I wanted some time to think about it all. What follows is merely prose.

Be careful what you pray for.

I was sitting in church on the Lord's Day a couple of weeks ago, mulling over various situations of friends and family and my own failings that were having me bummed out. As I sat there, I thought to myself "Lord, it would be so wonderful to be free from the power and presence of sin." An hour later a group of us were discussing various issues, and I began to have some chest pain. I thought perhaps it was a bad gas attack or something because it felt like I had swallowed some pills the wrong way, so I gathered the kids up and got them out into the van. As I drove the 20 minute drive home, the pain continued to grow and radiated out from my sternum towards my armpits and my back. By the time I drove into my driveway, it had gone down my left arm and I had a feeling of pins and needles in it. I had checked my heart rate as I was driving, and it was plodding along in its customary way. However, the pain in my arm had me a bit worried, so I stuck my pinky finger in my mouth and bit down and held it. The heart meridian happens to run into that finger.

I got out of the van and walked into the house and could barely make it down my hallway because now the pain was so intense that I couldn't breathe well and I felt slightly nauseated. My son Ben came and put his arms around me and asked me if I was ok. I said I didn't know and stumbled upstairs to my room. Bethany, my 10 year old came in and with a worried look asked me if she could make me some tea or something. I told her to go and get her father.

I was gasping and crying with the pain when Marc came down and found me. He took one look at me and asked me what was wrong. I told him about the pains I was having. He asked me what I wanted to do. I said, "Take me to Cal's!" (Cal is my health care provider.) "Don't be crazy!" he replied. "I'm taking you to the emergency room!"

In short order he hussled me out into the car and drove me to the hospital. The pain was still pretty intense, but it began to ease off. We arrived at the hospital and Marc ran in and grabbed a wheel chair and wheeled me up to the triage nurse. In a short period of time she had me hooked up to a blood pressure cuff, was taking my temperature, checking my oxygen saturation and firing questions at me. Next trip was down the hall to a small room with a bed to strip off and put on a hospital gown and await an ECG.My blood pressure was only slightly elevated. By the time the lab tech hooked me up to the portable ECG machine, it was considerably eased. She did one strip and then came back and did another in about a half hour. Another lab tech came and took some blood samples.

Sunday night is typically a busy night in the emergency ward of our local hospital, and this night was no exception. My bed was needed for other people being taken in, so I was asked to dress and go and sit in the waiting room until the doctor was available to see me. When Marc and I went out to the waiting room, Mike, one of the fellows from church came in. In his humorous way he said he was in the neighborhood and recognized our car so he stopped in to see what was going on. The truth was that either he called our house or my son Trahern called him and told We sat and chatted for a bit and in a little while they called me to come in to the actual emergency ward for an assessment. Being able to sit and chat with Mike and joke around helped to add some normalcy to the situation.

The doctor was very nice. He explained that it looked like I might possibly have had a very slight heart attack, but they would know for sure when the blood work came back. He was extremely doubtful that it could be that because I don't have any of the risk factors for it: no family history, no smoking, no drinking, and I was relatively young. Plus the number of children I have had is actually a protection against heart disease. He was thinking it might have been more along the lines of an esophageal spasm. At this point I am ready to get up and leave because I am thinking about Sweet Baby James at home without his mama and his nursies for several hours. Plus I wasn't in pain and just wanted out. It was not to be.

My blood work came back and showed slightly elevated enzymes. Gone was the warm reassurance that everything would be ok; now I am being informed solemnly by the doctor that I must not have any more children. And drugs are being ordered. Lots of drugs.

At this point I said, "I'm a nursing mother and I need my baby!" Well, ok, but baby will have to be brought to me and would someone be available to help look after him? Marc left with instructions to bring back James, his portable crib, clothing, and various things necessary for a short hospital stay. I lay back in my bed with a sense of unreality about all this.

The nurses were very efficient and in no time at all had me hooked up to all kinds of monitors, stuck full of needles, and on an IV. I'm not the typical patient. Before I would let them give me anything at all, I had to know what it was for, and whether it was safe for nursing mothers to use. I had them bring me the Compendium of Pharmaceuticals and Specialties which is the Canadian equivalent of the Physician's Desk Reference on drugs and another book specifically on the use of drugs in pregnant and lactating women and I looked up each and every drug and its contraindications, side effects, and if it was studied for safety in breastfeeding. The internist who looked after me was of the opinion that I needed the drugs regardless because it was important to save me, but I was of the opinion that I didn't want my baby being treated.

Marc returned with my son Ben and a baby who was very happy to see his mom. James charmed all the nurses, of course, being the cheerful sweet thing he is. It also doesn't hurt that he is as cute as a button. After much trial and tribulation, and finally some assistance from a helpful nurse the crib was set up in my cubicle, and the 40 tons of baby and mother paraphanalia were unloaded into it. James was placed beside me and by carefully manuevering around all the wires and iv lines, he was able to settle down to sleep.

I eventually ended up in the pediatric room in the emergency ward for the night since there wasn't space for me upstairs on the internal medicine unit. It had the virtue of being a separate room with walls and a door which would have afforded me the ability to sleep if it were not for the fact that I had nurses popping in and out all night long checking on me and taking yet more blood for more tests.

One of the things I came to detest was the automatic blood pressure cuffs they put on you. They have no brain and just keep pumping the air in until your fingers turn blue and your arm feels like it is going to fall off. I was hooked up to one and left on it for that first night. Every fifteen minutes it would blow up and cause me excruciating pain because they went and put it on the arm with the saline locks and iv in it. It felt like the iv and saline lock ought to be shooting across the room from the pressure of it. I finally protested to one of the nurses, and when she took it off, my arm looked thoroughly mangled and had long red streaks of broken blood vessels around it. The age of automation has rendered many nurses nearly incapable of taking a blood pressure manually it seems.

The following morning they brought me breakfast: a boiled egg, two pieces of cold toast, black coffee, and margarine. I ate the egg. I didn't sleep much and poor little James was a bit disturbed with it all, but it was a comfort to have him there to snuggle with.

The internist who would look after me came in that morning. His name is Dr. Hamour, and he is a tall, distinguished looking Muslim from Sudan. He has only been in Canada for two months but he speaks English beautifully due to some time he spent in the UK. He had a very calm and dignified demeanor. In the course of our conversation he learned that I had 12 children and that I was homeschooling them. "That is very noble of you," he said in his quaint way. He himself is from a family of 15.

He told me that he thought I had suffered a slight heart attack and that I would likely have to be on a statin drug to lower my cholesterol, a baby aspirin, and some other drugs for some time. I am severely allergic to even the thought of taking drugs so that prospect didn't do much for me. Then a very sweet nurse, who it turns out is a Christian, came in and in her quiet way read me the riot act about lowering my stress levels, taking naps in the morning and afternoon, easing back into life, etc. She went on to say that my heart was very unstable and another heart attack could be much more serious and do more damage if it didn't outright kill me. What a regular ray of sunshine she was.

Later that morning I got moved up to the IMU unit and I was placed on a mobile telemetry unit so they could monitor my heart rate, breathing, etc., from the nursing station and yet allow me up to shower and use the washroom. I was taken off the heparin, which was there to thin out my blood and instead they gave me injections of another similar drug which did the same thing, with the added benefit of leaving huge bruises on me about the size of a silver dollar all over my belly.

"It burns us!" I would hiss at the nurses in my best imitation of Gollum while they injected me.

They also brought me little cups of pills to swallow. I would not swallow them until I had quizzed them as to what each one of them was. Turns out this was a good thing to do. One morning a nurse rushed in at 6 am and woke me out of a sound slumber and shoved some drugs at me and commanded me to take it for the fever I had. Being slow of wit upon first waking in a strange place with strangers shoving cups at me, I did as I was told. Turns out the tylenol was not for me, but was for the gal in the bed beside me! IF I had been feeling somewhat nasty, I could have caused a lot of problems for that girl. As it was, since it was only Tylenol and I wasn't suffering ill effects from it, I let it go but shook my finger at her and told her, "Now you know why I have been such a pain about taking my meds!"

[Please note that this is a practice I think every person should employ if they find themselves in the hospital. If you can't do it, or you have a loved one who is out of it and unable to do it for themselves, then do it for them. If mistakes are made, you are the one who has to live with the results.
Medical mistakes kill 100 000 people a year. Is there something you can do, even from your sickbed, to protect yourself? Become an expert. First, know what ails you. Ask your doctor all about it. Research it on the Internet, for instance or look it up in medical books like Merck Manual. Patients should feel entitled to inquire about their care no matter how sick they are. Second, know about your drugs. The study shows more than 7,000 die each year because of medication errors. ]

On my second morning in the hospital, a cardiac nurse came to visit me. Up to this point in time, I was being a bit cagey about what I thought about all of what was happening. Some doctors can get really snitty if they know you use alternative forms of healthcare. Marvin was there to talk to me about lifestyle, eating plans and all that sort of thing. The first thing he told me was that he usually does this sort of thing in a group setting, but in reading over my chart, he found I was so atypical that he wanted to talk to me one on one.

He started out by noting that I didn't have any of the things that would normally raise red flags for doctors concerning heart problems. My blood pressure, even while still in the midst of the "attack" was only slightly elevated -- the sort of elevation you might see in a person who has "white coat syndrome" which is stress-induced by being in medical places. I am slightly overweight, but other than that, nothing in my history would suggest cardiac problems. My blood work for cholesterol had come back and it was nearly perfect. My HDL levels were very high, my triglycerides were in the basement, and I had only a slight elevation in my LDL levels. Instead of using statin drugs, which I know to have many bad side effects, I could use niacin to lower it to normal. I related to him how I had checked my pulse during the episode and it was beating at its normal rate. Other than the initial blood pressure reading which was barely high, it had remained in the normal range once I stopped taking the bp meds. ( I figure that no blood pressure is just as bad as too high, and they had it down to 95/55 on only half the medication they had prescribed for me!)In the course of the conversation, he looked at me thoughtfully for a moment and then asked me if I had a medical background.

"Why?" I inquired warily.

"Because most people don't know the medical terms you are using to answer my questions. Nor do they look up drug interactions and contraindications or quiz people about their vitals."

"Oh, well I read a lot. "

He raised his eyebrows.

"You know. Medical studies, and um, things like that."

"Why do you do that?"

I sized him up for a few moments and then... "I um.... I intend to be a naturopathic doctor some day." I blurted out and then waited for the explosions to start.

He grew quite animated, but in a pleasant way. Turns out this guy is into complementary medicine as well and we ended up having quite an enjoyable time together discussing alternatives to the drug therapy route. My diet was already pretty good. I just had to knock off the sugar which I was wanting to do any how and get more exercise to drop my weight back to what it should be. (This last one could be a feat in itself since I find it harder to lose weight when I am nursing a wee one.)

Later that evening, Cal stopped by to see me and check up on how I was doing. In between the nurse coming in and doing my vitals, he managed to give me a quick check over. In his opinion, it wasn't my heart that was the problem -- it was the pericardium, or the membrane around the heart. From what he could tell, it looked like I might have a bacterial infection in it. Now, I had quizzed the nurse about this very thing. Could a cardiac arterial spasm cause an elevation in enzymes? It is quite possible. Before you all think this was a bunch of malarky, I had been to see Cal six weeks earlier, and he told me at that time that something was going on in my heart region, but it wasn't at a level of severity that would cause concern. In the intervening weeks I had been under considerable stress with all that I was doing with homeschooling, lessons outside the home, business meetings and my clinic. The straw that broke the camel's back and likely caused the spasm was the stress I felt in church. (Incidentally, my sister, who is a nurse who worked in the emergency ward told me that they always had what they termed "the church crowd" on Sunday afternoons. People seem to find church stressful and the ER would get busy with all the people who had chest pains, fainting spells, and similar maladies.) In any event, when I went to see Cal a few days after I was out of hospital and he was able to do a more thorough examination, he told me that my heart was sound -- something that I had found in my own testing, but that my pericardium and the heart-end of the portal vein were both considerably weakened by the bacterial infection. And you know, that makes a whole lot more sense to me than what the doctors and nurses were telling me.

So what caused the chest pain? Likely a spasm in the pericardium or portal vein -- enough to cause an elevation in the enzymes. One of the enzymes is that which has to do with muscle damage, so I am not certain that it was actually caused by the spasm or from the fact that I had been working out at the gym the day before. What is certain is that I am taking it a bit easier these days and my family is assisting for the most part.

I left the hospital with a list of about five drugs that they want me on. I only filled the prescription for one: nitroglycerin. (Mom don't freak. I know what I am doing.) Instead I am watching my diet, exercising more, taking niacin for the LDL, herbs for the infection, and resting when I am tired. I am trying to lower my expectations with regard to household neatness standards. I think one of the banes of society is the Beautiful Homes and Gardens or House Beautiful types of magazines. The ideal homes never seem to have anyone living in them. That being the case, I guess I should stop trying to pretend that 11 people don't live in my home and work on keeping things clean, but not pristine. I never achieve pristine, but it doesn't seem to keep me from trying.

Thankfully, the last time I got seriously ill I gave up the notion that I was somehow invincible because of the supplements and herbs I use. If you have an excellent diet and are getting all the right nutrients but are under constant and sustained stress, the stress will "eat up" the nutrition and leave you vulnerable to whatever is gonna get you. Not only that, even youth grow tired and weary, and young men stumble and fall. But those who wait upon the Lord will renew their strength. Diet, exercise, supplements, herbs, and prayer are only the usual means to good health. If the Lord doesn't want to use those means and would rather you endure a physical trial, He is free to withhold His blessing from them and allow you to become ill or even die.

I know the reaction of a lot of people when this happened was "Cheryl!?!" At one time this would have caused me shame and embarrassment. I mean here I am an enthusiastic promoter of good health and nutrition and this sort of thing happens? However, I got over that sort of thinking and now look on these sorts of things as invitations to learn something new. Last time I was ill I learned a lot about how to manage inflammation, systemic yeast conditions, and treating allergies. Now I will be learning a lot about cardiac issues and intensifying my knowledge and practice of stress reduction and management. This information won't be kept to myself, but it will become a tool for helping others.

For those who are worrying about me bucking the medical establishment in my treatment, I am going to get the echocardiogram and do a stress test as well as follow up blood work. This is to prove to myself, my family, and the doctors that I am really ok.

I can't close this post off without thanking all those who knew for their prayers on my behalf. Mike G. told me that before he came up to the hospital to see me that fateful night that he prayed that God would show mercy to my children, husband, and church by not taking me right now. I think my mother and father had me on half the world's prayer chains. Thanks Mom and Dad! I appreciated the visits from friends while I was in hospital, the beautiful flowers, Joyce sending me a care package, the phone calls, cards, meals for the family, and Teresa and her girls taking James a few mornings so I could rest in the hospital for a bit without worrying about him. God promises rewards to all of you; for in doing this unto this least of your sisters in the Lord, you did it unto Him.


Carol said...

Wow. I don't know what to say. I learned a lot from your post and I thank God you are okay.

Susan said...

Hi Cheryl... if it's any consolation, far from givng you hassle about your approach, I applaud you. I would have done the same thing. In fact, when I had some chest pain earlier this year I decided it was time to do a long-term fast just in case there was gunk clogging my arteries. Since water fasting for 3 weeks I haven't had any chest pain at all and my fertility has returned (we're 17 weeks now). Good for you questioning the docs and the meds! Too many just blindly follow and pay a big price. I'm glad you're on the mend!

katrina said...

Hi dearest Cheryl;

Thanks for sharing your thoughts.
A big hug to you dear sister.

Doralynne said...

Yahoo, you're back! Thanks for giving us the low down. Glad to see you're in the clear for now. I was worried about ya. It musta been scary but I think you acted very level-headed and showed good presence of mind with the ordeal.

Remember to take it easy, Cheryl. We don't want a repeat!

Anonymous said...

Thanks for sharing your experiences with us Cheryl. It means alot to me and I have learned alot.
Love in Christ, Kathryn Hautsch

TulipGirl said...

Oh, Cheryl!


Rejoicing with you, that you are home and resting.