Jaci Dawn

Physical heart issues, I should clarify: Issues *of* the heart can be harder to recognize and I’m still learning.

The past week has been a bit of a roller coaster ride for me emotionally. I noticed I had some swelling in my left leg on (or around) the 8th of February. It raised a little red flag, but the swelling wasn’t severe, so I filed it under “check that out daily”. I knew it could be the sign of a blood clot, but I also knew I hadn’t injured my leg in any way. My brother had a clot in his leg around ten years ago, but he had an injury to his leg that precipitated the clot.

Friday morning, the 11th, my leg was taut and obviously swollen. I showed my husband and he noticed the difference between my legs. We had plans for the afternoon, but I came upstairs to my studio and called my primary caregiver’s office anyway. They could get me in at the same time we had plans for: oops. So we changed plans slightly: doctor first, skip the shopping trip to Home Depot, but go out for an early Valentine’s dinner anyway.

My primary caregiver is a Nurse Practitioner and I truly adore this woman. She examined my leg, tossed out a few scary terms like “blood clot” and “heart failure”. Blood clot was the foremost theory. But you know how your mind runs away with things? Yeah, my mind did exactly that.

I did put my leg up the next few days and the swelling all but disappeared. I called and scheduled a sonogram for as soon as I could get one, which was yesterday. I also let close family members know what was going on (this is important because my parents never let us kids in on any major medical issues whey were having, or they would tell my brother but not me, or me but not my brother: I won’t do that).

Well, I had the sonogram done. I arrived early and was called back to the lab early: no waiting! This just never happens, so I should have taken a hint: “the day is not over yet”. The sonogram itself was interesting: the technician sometimes punched my leg where the vein was to get a stop and flow of the valve (I could hear the “whoosh” of blood on the ultrasound machine). I remember thinking I should have checked to see if there was any arnica in my purse because I was (for sure) going to bruise from all that punching and pressing (I didn’t bruise, I discovered I did have arnica in my purse 24 hours later).

The tech escorted me back to the waiting room while she attempted to call my primary care give and discuss the results with her (which automatically reads: “there are results to discuss”). I had a 2:30 lunch date with an old friend that was looming on the clock in the waiting room. When the tech reappeared, I still had 30 minutes before I had to head north to the restaurant we were meeting at – except…

Except the tech was agitated. She had not been able to reach my primary caregiver. She left two voice mails and was “dropped” by the system once. She was making an executive decision (and if you know me, you know I LOVE people who are capable of making executive decisions that are above their pay grade and they make them anyway. I really hate wishy-washy people who hem and haw about making that decision when it is clearly the only decision to be made.

She broke protocol to tell me mt test results without my doctor being present, and she made the decision that I should go to the ER to be seen (and after reading the MyChart notes this morning, it was the decision my NP would have made. I was, after all, in the same building as the ER). I was escorted by the tech to the other side of the hospital to the ER waiting room where she explained to the receiving clerk what was going on. And left me.

I texted my friend first: cancel lunch. Called my husband next: I don’t know what’s up, but I do have an acute blood clot in my left leg and I am in the ER waiting room and I have no idea what to expect. Texted the people closest to me, including two precious prayer groups. Turned my phone onto airplane mode because I didn’t have a charger with me and I didn’t know when I would have a chance to charge it again.

LET THE WAITING BEGIN. It’s a small hospital with a small ER waiting room. And I digress here from knowing the symptoms (which I pretty much covered in the first paragraph) to people watching. I had no idea how much people watching I would get in. I *felt* fine. No pain, no chest tightness or pain, no struggling to breathe: just a pesky swollen leg (but not too badly swollen) and a Dx of an “acute blood clot). (My brother texted back: “Why can’t it be an ugly clot?” Me: “Because I *like* cute!”)

There were some pitifully skinny teenagers in Emo clothes who came in. One was with her mother. The other was with a girlfriend of friend who wore funny slippers on her feet and outweighed him by threefold. She had a tiny orange plastic purse just large enough for her ID and debit/credit cards which he held onto for her. There was a drama queen, an older guy who complained about the wait and who took to groaning and coughing loudly to get attention (I don’t know, maybe he really hurt that much? How could I know, not being in his shoes? Still, I labeled him a drama queen). A girl who looked five shades too pale, who moped and tried to nap, but still had the nerve to joke with the National Guard guy who was looking for someone. A Hispanic guy who must have been injured on the job, information I picked up from his coworker who kept leaving the waiting room to talk to someone who was calling to check in on the status (a foreman, I would guess, by the snippets of conversation). An elderly man in his late 80’s or early 90’s who fell onto his side and injured (or broke) his shoulder and hip. He was with his daughter who was on the phone whispering and cancelling dinner plans and letting her adult children know that Grandpa was in pain at the hospital. They took him back twice for x-rays.

I waited four and a half hours. I played a few games on my phone. Rued that I didn’t bring my Kindle. Wondered if any of the others in the room had as wonderful a support system as I have. Thanked my support system (mentally) a dozen times. Prayed for everyone else. Concentrated on NOT thinking about myself, but about putting all of these before me (and, indeed, most of them were taken care of before me, except the poor girl who was five shades too pale). She did arrive after me, but nearly everyone else was after me. I guess she & I just didn’t make it up the triage notch. I do hope she got hep for whatever was wrong and that she feels better today.

Around 4:15, I was finally called back to a private room. Until that time, honestly, all I heard coming out of the actual ER was that there ‘were no rooms available, do you mind being in the hall on a gurney while we see to you?” I was kind of embarrassed to get a private room. But, there I was, with no idea as to whether or not I was spending the night or having surgery (not usually how they tackle blood clots) and how much of this was Medicare going to cover (a question I will not have the answer until I get the bill). The nurse drew more blood and ran the same panels my doctor had just run five days earlier, but I guess they needed to see if anything had changed since then).

My husband showed up about that time. He had waited until he thought I would probably be in a room (good guess!) and until the dog was settled enough to corral him in a kennel (you’d have to know the dog). He could at least take my mind off of myself for the last hour of waiting. I really didn’t want to be focused on myself: my imagination can do the greatest damage. I was already living one of my “worst case scenarios” from the night before: being in the ER for the clot!

The denouement: The ER doctor came in (finally). Did I know anything about blood clot treatment? I told him I had enough knowledge to be scared: my brother injured his leg and had a blood clot and they prescribed Warfarin or coumadin. I didn’t want to give up leafy greens or any of my Vitamin K foods.

Fortunately, they prescribe one of those TV commercial medications for dissolving blood clots now: Eliquis. The only side effect is that I could, possibly, worst case scenario, bleed to death. No, really. Thin blood, less clotting ability. Oh, and I would bruise easily.. As in, more easily than I already bruise. As my husband joked, “She already bruises if you just look sideways at her.” As is, I better have that arnica ALWAYS in my purse going forward.

The point of this entire tale is this: if I had not known that the swelling in just one of my legs was not natural, I may not have called my primary care giver in the first place. Then I probably wouldn’t have had an untrasound that eventually led to me waiting for hours in the ER waiting room only to be told, “Take two of these and go home”.

No, the blood clot would have just loosened in the vein in my ankle and made its way into the lining of my lungs, shutting down my ability to draw a full breath and resulting in an ambulance ride to the hospital and God-knows-what-else. Or it would have made its way to me heart and stopped it altogether (only after it depleted my ability to breathe).

Know the symptoms. If one leg swells more than the other and it’s never done that before… Call your doctor. My brother’s was caused by an injury and he called his doctor. Mine is called a “predatory” clot: no injury precipitated it. But I knew the symptoms because of my brother’s experience. And if you have to sit in the ER waiting your turn, remember this: other people are hurting more than you right now.

Be patient. Be kind. Know the symptoms.

I love you.