P.E. or not P.E., that is the question

Two nights ago I had alot of trouble sleeping.  Whenever I'd begin to drift off, my breath would catch at the depth of the exhale and send me gasping for oxygen.  Or my heart would pound so hard it would wake me.  This happened enough times that I gave up on sleeping altogether and instead volunteered both overnight feedings with the baby.  But by morning I was pretty worried.   I'd been experiencing some pressure, like a finger, pushing at the center of my diaphragm, on and off for the past week.  I didn't know what it was or if it was related to the sleepless night,  but I was concerned enough that when Cecily asked if I wanted to go to the E.R., I agreed.  So we piled in the car, poor sleepy Tori included, and drove off to our local hospital.

Now the best time to arrive at a suburban Emergency Room is definitely Sunday at dawn.  The place was  quiet as a winter beach.  So I was seen immediately, ushered into a bay, and hooked to an array of monitors.  I was given an EKG and intranasal oxygen.  An IV line was established and blood was taken.  Cec and the baby waited with me.  After the EKG, the doc said my history and description of the discomfort, along with my EKG result, was leading him toward a daiganosis of pulmonary embolism. 

I had to roll that one around in my mouth awhile... pulmonary embolism. 

I remembered my father, who'd had his first heart attack at 39, and the fatal one at 46.  I remembered the huge grins Tori had given me just that morning, and how much I want to be there for her, to see her grow up.  And how much I missed my dad.  I asked if maybe we could take some of the big-money chips off the table and talk about things like sleep apnia, reflux disease, or hiatal hernia, all of which are part of my health history.  And yes, he said those were ll potential causes, butthey had to rule out PE. 

There was a blood test, the doc said, that would be definitive.  But it would take time, so they were just going the faster route of a chest x-ray and a contrast CT.  And they were fast.  I was wheeled into the x-ray before 10am and had the CT before noon.  Then the wait for the results.  I asked the doc about treatments (he was a very nice D.O. and took time to answer all our questions).  He said that the first thing to try, if I had a PE, was blood thinners like coumidin or heparin. 

By this time, Sarah had arrived to give Cec a hand with Tori and to be the kind of unconditionally supportive friend few are lucky enough to have.  And we waited.  And waited.  We watched my blood pressure rise and fall...talked about people and TV shows...cooed over Tori...and tried not to think about pulmonary embolisms.

Finally the resuilts came back... all negative for PE.  So, the Attending said, this was the good news.  But what had caused the pressure, the heart poundng, the insomnia?  No clue.  They sent in the Respiratory Therapist, who gave me an albuterol breathing treatment and a prescription for an inhaler, and then sent me home, with advice to see my family doc (which I'd already planned to do).

But yesterday afternoon again, each time I lay down, my breath would catch, my heart would pound, and I'd startle and gasp awake.  Cec suggested I try one of her blood pressure pills (methyldopa, leftover from pregnancy).  I'm not a huge fan of med-swapping, but I took one.  In 20 minutes, I felt relaxed, and in another 10, I was asleep in the easy chair.  I later went up to bed and got a few more gasp-free hours of high-quality REM sleep.  Then fed our beautiful baby girl at 3:30am, promising I'd always be there for her. 

I don't know what the day will bring, but facing it on a few hours of decent sleep can make a world of difference.

Comments

[Jon]

This sounds very similar to something I experience. At first, I thought it was something with my heart, that was quite a few years ago. It happens on and off... and scares the crap out of me every time.

From the research I've done, I'm pretty sure that what it is, is called a "myoclonic (or hypnic) jerk".

It happens as I'm falling asleep, not while completely awake. It feels like my heart forgot to beat, and my lungs forgot to breathe, but then, all of a sudden, they remember and my whole body will jerk.

Whatever it is, I hope that they can figure it out for you. It sounds scary... and with Tori... yeah, I'd be completely flipping out right now.

[Catherine]

Jesus Christ Charlie. That is scary as fuck. It actually sounds a little like a panic attack, too. Lots of stresses on you right now. I am so, so glad it's not a PE (BTW, the other reason you got treated right away in the ER is because it was potentially cardiac-related. They'll let you bleed from a head wound all day long in there, but tell them you have chest pain and you get whisked right in.)

I hope they figure out the problem very soon. It turns out I'm quite fond of you. (((BIG HUG)))

[leslie]

Sounds truly miserable :-( Here's hoping it's one of your better options like reflux or apnea! And I hope you can find out without going through a long drawn out process with lots of nasty tests while you're at it!

[Leslie]

Oh Charlie, it sounds very scary especially with your father's history. Hope everything turns out ok.

[sheilah]

Oh, Charlie, I hope it is something that is simple and treatable.

It is funny how having children makes you want to be around for a long time. Not for yourself but because you want so badly to see them grow up and realize their dreams.

[Amy]

Hoping further testing rules out the potentially nasty stuff. Scary stuff. Perhaps (hopefully) it was anxiety related, your life has been rather stressful lately.
Regardless, be HEALTHY, you have two great gals who need you.

[Abigail]

Oh Charlie that sucks. If it is any comfort, medicine is a lot further along then when your dad had his heart attacks. I'll be holding good thoughts for you - keep us updated if you can.

[Jaimie O.]

One word: C-PAP. I'm guessing you don't use one. My guy suffered from what you're describing EXACTLY and then broke down and did what's necessary to remedy the gasping awake bullshit. After learning to sleep with the magical breathing machine, he now sleeps like a baby. No more gasping awake, heart racing, panic from feeling of suffocating/heart-attacking.

You need a sleep study and prescription to get a C-PAP. Please, for your sake, your little girl's, and Cecily's, agree to have complete strangers watch you sleep while you are connected to machines.

Hoping relief finds you soon.

[Stephanie]

I suggest a sleep study if you can get one. It's important that someone be there monitoring when it happens. If they can see what is actually happening, not just a description it may allow them to diagnose it.

Don't forget to keep us posted what the Family Doc says. And don't forget to mention blood thinners helped! That's important.

You're in my thoughts.

[Coral]

Thinking of you.

hugs

[friend]

Charlie,
Sorry to hear about your medical issue. I'm glad it is not a pulmonary embolism & hope it is not anything as serious.
Peace & love,
A friend

[Haylie]

Definetely sounds like panic attack. I only get them at night when I am trying to sleep and even though I think I am relaxed my brain things otherwise. Look into anti-anxiety meds...they work wonders. You don't have to feel stressed on the outside to have your body react in this way. Feel better!

[SandyC]

Oy. This is so scary! Good luck and good speed in Dr land.

[Julie]

Charlie - what you are describing sounds very much like what a friend of mine had. His diaphram is partially paralized due to a diving accident. He jumped into the water and tweeked his neck - turns out he damaged the nerve that controls his diaphram. It took almost a year for them to figure it out.

If you have had a neck or back injury - please make sure you mention it to your doctor. If you need a pulmonologist - let me know - my Dad sees the best one in town :)

[Linda B]

Just reading this freaked me out but I'm so glad it's not PE. My good friend had one a few years ago and survived. It's so scary. Thank goodness it is not that.

Take care. You have a beautiful family.

[jennifer]

Scary stuff. I hope you get some better answers soon.

[bad penguin]

Wow, that sounds very scary. I hope your doctor can help sort it out.

[Cindi]

Here's hoping for a quick diagnosis and a quicker fix. Medical excitement is not required every weekend. I swear it isn't necessary. =-))

Cindi

[terri c]

raced over here from Cecily's -- oy, sounds very scary, and am glad it was not a PE. It could be many things and I hope the family doc is getting to the bottom of it even as I am writing. Lots of people pulling for the three of you...

[Julie O]

Hey Charlie-

Hope you guys get to the bottom of this and you can (literally and figuratively) sleep easily soon!

Julie

[Gabby]

Hi Charlie, I came over from Cecily's.

Since everyone is throwing in their two cents...

I noticed sometimes when I was falling asleep my heart would trip, like it was skipping a beat, and it would always jolt me back awake like you experienced. Now, I didn't have any chest pain to speak of, it was mostly just the irregular beats, but it was always at night.

I got an echocardiogram because it scared me. Everything came back fine. Since I was fine, the doctors made no effort to find out what was going wrong. I thought maybe it was caffeine, so I stopped drinking it completely. No more heart palpitations.

Do you drink a lot of caffeine? Just a thought!

[Lisa O]

I have no diagnosis but am so glad it didn't turn out to be PE. I will be praying for you and your docs in the upcoming days/weeks. Please keep us posted.

[Charlie]

Thank you all for your kind wishes and concern. As some have pointed out, caffeine may have played a role in this weekend's scare. Tho I didn't drink any Saturday, I am VERY attached to my afternoon mega-mug of java and half-dozen cookies.

I am now off coffee 4 days (ARGH!)

I also have since had the idea that spending alot of time in the hot sun Saturday afternoon may not have been the best idea.

As for the heart "trips"... that is the feeling I was experiencing; funny thing is that I had a couple while I was in the hospital and hooked up to an EKG. Each time, I looked at the monitor to see if my heart actually did skip a beat, or if there were any differences in the rhythm at all. To my surprise, there were not. So I'm back to the esophageal spasm theory.

As for those who suggested I look into CPAP, I did a li'l web surfing on the topic. I s'pose after getting over the sheer bulk of the headgear, I'd adjust. Only problem is that according to Cecily (who frequently stays up later than I do, and thus sees me sleep) my sleep-time breathing is ordinarily just fine.

So the puzzle continues. I'm supposed to have a treadmill test that my doc is setting up for me. Perhaps more will be revealed.

Thanks again for all your well-wishes.