I've had growing concerns over my bradycardia, which is simply a slow heart rate. It can produce fainting, and I've never fainted, but I don't want to.
A few months ago, I asked my family physician to get a little more aggressive in helping me deal with bradycardia. He made a referral to a heart doc which fit into my medical insurance plan.
And so, I got to wear a heart monitor for 24 hours. It showed.... pretty much nothing, other than the usual mix of benign contractions common to many people. For instance, google "Premature Ventricular Contractions". My heart averaged 49 BPM for the 24 hour period. Low, but not a problem, according to the heart doc.
He also scheduled me for a treadmill stress test. I did it, and I thought I was pretty spectacular. No problems from my side.
After I'd returned home, I got a call from the nurse. She advised me that the Doc had seen something suspicious -- he wanted me to take the more detailed version of the same treadmill test, this time with nuclear dye in my blood and pre/post cardiac imaging. OK, I was concerned now. We scheduled and took the test.
A day later -- the Doc informs me that there is no significant blockage. My anxiety fades away.
Four days later -- my elbow, close to the catheter injection site for the dye, gets very tender and starts to swell to magnificent proportions. It hurts. It is tender. It is warm. Later, I take a pic of the elbow area:
Two days after that -- with an unchanged elbow problem, I head to Urgent Care. It's Sunday around lunchtime, and the place is very unbusy. weird.... The receptionist takes my quick info and schedules me for an appointment. That's why no one is there. Patients come in to urgent care, get assigned an appointment time, and leave to return at the appointed time. Kathy and I do the same: we leave, eat lunch, and return.
When we return, the receptionist has us take a seat for a few minutes, and then advises me that I have an outstanding bill with the hospital. I'm not sure what to do with the information that the institution that is giving me care first reminds me of financial obligations towards them. That is so TREMENDOUSLY helpful in making me feel calm and collected.
I get into a room, then a PA comes and takes a quick look at the elbow. Without a great deal of consideration of the history of how I got this Big Bulging Elbow, she prescribes an antibiotic and sends me on my way. My pleas to get alternative theories as to what is happening in my elbow fall on her very tired and deaf ears.
Within two days, the swelling subsides, so I'm comfortable that the diagnosis was correct.
A week later, I'm still having symptoms. Weirdly, some of my veins now feel hard and tender as they march up from my elbow towards my wrist.
Three weeks later, I'm still having symptoms. The area of tenderness has rotated around the area below my wrist.
Five weeks later, I'm still having symptoms. I take a picture of my arm, marking off the progression of swelling and tenderness. You can see areas one, two and three here:
Six weeks later, I'm still having symptoms. In fact, one of the veins crossing my wrist into my hand is now swollen and tender. That would be Area Four of this growing problem. My body starts to have general aches, like a cold.
One morning, I wake up and look at my left hand. It is very swollen. My frustration of this situation has met a snapping point of sorts. I take a photo of my two hands, showing the difference, and I write up a brief history and send it to my primary doc along with the photo. (I do this using the online patient portal.)
The picture that (maybe) saved my life
Expecting nothing more than an appointment with the doc, instead, my phone rings. It is the nurse. She tells me: "Go to the ER. We're sending the same instruction to you via your patient portal." I'm stunned. I ask for some reasoning, but don't get a lot. I read the email from her in my patient portal, and it also says to go get emergency services. ??? It mentions a possible blood infection.
I walk around the corner to Kathy's home office, and tell her that we are heading to the ER. She is as puzzled as I am; she can hardly believe it.
The experience at the ER takes five hours.
So I'll cut to the chase: you already know that Emergency Rooms can be a hell hole of frustration, right?
They triage me in and assign me to an ultrasound of the arm.
That turns out to be a spot-on idea: the ultrasound reveals that I have a blood clot in a vein in my left arm. The NP discusses the chronology of events with me. I am once again struggling to understand how I have a blood clot. What was the sequence of events? How did it start in my elbow and move towards my wrist? More questions and assumptions than answers. The diagnosis is a Deep Vein Thrombosis in the Upper Extremity (DVT-UE), which is exceedingly rare. It also has a very high mortality rate. (Since I'm alive, diagnosed, and on appropriate medication, I assume I've dodged that bullet.)
Good news: It's not occluded, or my hand would be the size of an orange.
Even better news: a $500 per month drug will solve the problem if taken for a minimum of 3 months.
Even better better news: the first month is free. The second month has a discount coupon.
I am advised to make a follow up appointment with my primary care physician on my ER discharge instructions. It says to see the doc within "1-2 days". I call my doc's office the next morning: first available date is 2 weeks away. I indicate that I'm happy with that, but what about seeing them within 2 days, per the discharge instructions? The scheduler replies: "that's just a suggestion."
Bottom line: I was trying to solve the bradycardia slow heart rate issues, and I ended up with a blood clot in my arm. It's kind of like planning to go to the party, and you somehow end up in the sewer, floating downstream.
I'll try and be a little less bitter in my next post. I'm currently on day six of Xarelto. I will be taking blood thinners for 3 months.
If you enjoyed reading this post, you should also read my prior post on FAA medical issues relating mostly to depression and anxiety. The link is here:
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