The Dentist, Tums and the Widow Maker

Been an interesting few days, oh few and faithful. I know quite well that the best laid plans of mice, men and salamanders oft go astray, but somehow I continually fail to take that into account. Here is a summary of this past weekend.

My six-month regular dental appointment was 8:45am Saturday. I like to get these over with as early in the day as possible, so it doesn’t loom over my entire Saturday experience. I’m no longer the dental phobe I was twenty years ago, but I’m not a big fan of getting my teeth scraped either. Still, I like my teeth, which is enough to make me keep appointments. My medical history makes it necessary that I pre-medicate, so I took my 2000 mg of amoxicillin as soon as I woke up and then prepared my mouth for formal presentation.

While I was brushing my teeth, the not-unexpected heartburn set in. Take 2000 mg of amoxicillin on an empty stomach and that’s what happens. I drank half-a-glass of cold water to tamp it down, finished my morning ablutions and went to get my smile examined.

My dentist has a really nice aquarium in her waiting room, and I watched a bunch of neon blue fish schooling around in there while waiting to be called. It only took about five minutes of wait time and I was firmly seated in the dentist chair, reviewing the usual health details with the tech and bracing myself for a dental sandblasting. Not surprisingly, the amoxicillin decided to make itself known again. Another glass of cold water, some chiseling around the enamel and one dentist-granted gold star later, I was back in my little orange chariot, heading out for weekend adventure. The plan was to hit the farmers’ market, get my car washed and gassed up, pay a few bills (not necessarily in that order), and afterwards head to Founders Day festivities in My Little Town. The freaking amoxicillin made another return visit to my esophagus while I was driving, so I returned home first, thinking I’d wait until my pH level got a little closer to neutral before running my errands. When I got home I took some Tums and settled down to watch the last half of “Stand by Me” (I had started to watch the evening prior). Sure enough, the flames finally subsided.

I was getting my act together to run the errands when Heartburn on Steroids kicked in. I decided I was done fooling around with the obnoxious hydrogen ions trying to tear a hole in my esophageal lining and hit it with more Tums and some simethicone. Take THAT, you worthless protons. I sat around waiting for the indigestion to subside for a final time, and sure enough, adding simethicone did the trick.

I gathered up my empty water glass and assorted trash and took it to the kitchen. I began to fill the glass so I could take my morning pills (which can make me a little nauseous so I had delayed taking them until Operation Fireball was resolved). Before I got the pills out of the case, lightening struck yet again. This time it brought its friends, referred arm and jaw pain. As I imagine most of you readers out there have already figured out, I finally realized that maybe I’d been playing fireman during a nuclear holocaust. It was 11:00 am, and I went upstairs to wake the Professor (he teaches night classes and often doesn’t make it to bed until well after 3:00 am) and ask if he’d consider running me over to Little Local ER.

At that point I still believed that this was just the biggest case of indigestion this side of the Mississippi, but the jaw pain had me spooked (I have disc problems in my neck, so weird arm pains are nothing special). In the ER I apologized to the receptionist, the nurses and the doctor for wasting their time on a probable case of indigestion. Didn’t matter. They still whisked me to a bed (and didn’t that earn me a couple of glares from future patients in the waiting room who were there when I arrived) and set me up on an EKG. They also sent some STAT blood samples to the lab to look for heart attack acute markers. As I predicted, the EKG was normal and so was the blood work. They continued to hold me. At about 1:00 pm a small spike in troponin showed up in the blood work. An hour later and the troponin level had doubled. I was admitted, transferred to Big City Hospital the next day, and the day after that they performed a heart catheterization on me to figure out which artery was misbehaving. Using the same catheter that injected dye into the coronary arteries, my doctors then placed a stent in the left main coronary artery, about halfway down its full length.

Today is the day after that. In reviewing what happened, my cardiologist told me that blockages in this artery are called “widow makers” and are known to cause sudden death, especially if they form a bit higher in the artery than mine was. My blockage was only 90% of the artery, and I came into emergency relatively early, so all is now good. The stent is well placed, more than adequate blood flow has been restored, and I’m supposed to be released sometime in the next few hours (although no one has actually said that officially yet).

Things I have learned in the course of these three days:

1. If indigestion doesn’t respond to your usual ministrations, it is safe to assume that it may not be indigestion.
2. According to one ER admissions clerk, a bunch of nurses and two doctors, nobody is going to think you’re a hypochondriac or suffer from Munchausen’s if you go to ER with persistent heartburn.
3. Heart catheterizations are kinda cool to watch, especially if the performing doctor will do playbacks of the recording for you afterwards and explain everything that happened.
4. Even if your blood pressure and cholesterol are being treated and well within normal limits, genetics is a bitch.
5. That whole thing about pain in your upper left arm? Misleading to inaccurate. Pain can occur anywhere in your arms and hands. Mine was just below the elbow. BOTH elbows. And while jaw pain is also a common go-with to myocardial infarction, mine wasn’t in the hinge of the jaw as I always pictured, but along the base of the jaw, both sides. I now know that everyone is wired a little differently, and referred pain can appear just about anywhere, based on an individual’s hardwiring.
6. It really pays to have a husband who rolls out of a dead sleep and can get his act together quickly.