What to Expect When You Go to the Emergency Room with Chest Pain
A Trip to the Emergency Room
You are lying in your bed at night, or in the wee small hours of the morning and you begin to feel what matches heart attack symptoms you've read or heard about. They aren't the classic symptoms most men have -- a painful squeezing sensation near the heart, shortness of breath, sweating, and the rest -- but they are the symptoms some woman have -- pain in the left arm, the back behind the heart, and a strange sensation in the left jaw.
If you're like I was two nights ago, you might be going over a mental checklist. Let's see. I've got the right kinds of pain for some women, but I'm not sweating, no clamminess, no squeezing sensation, no shortness of breath. Perhaps I'll just turn over and try to go back to sleep and I will be better in the morning. You turn over when more thoughts come. I had similar symptoms two nights ago and that worked. Yeah, but that was just behind the heart, not in three separate places. I was having memories of my husband's heart attack symptoms last August. His chest pains were more classic. He had gotten up and measured his blood pressure. It was very high. I had driven him to Twin Cities Hospital, about five minutes from home. His was a heart attack. He had needed an angioplasty and stent. He was gone three days.I chewed on a baby aspirin. The pain remained.
I decided I'd better get up, take a nitroglycerin tablet, and measure my blood pressure. It was higher than I'd ever seen it. My husband woke up and insisted I go. I asked him to help me take the blood pressure measurement one more time, since I wasn't sure I'd done it right. He was more interested in getting me to the ER as soon as possible and went in to get dressed. While he was dressing I printed the form for an income tax extension so he could mail it if necessary. I put a book where it would be easy to find, and I grabbed a book of quotations to take with me. I fully expected they'd do what they did last time. Keep me busy with tests, tell me it wasn't my heart, and send me home. I was only half right. We left for the hospital after I'd taken the last of three nitro tablets.
Heart Attack Symptoms in Women
Hospital Pass for Services
What Happened at the Emergency Room
If you walk in the door instead of arriving in an ambulance (which I would have called if my symptoms were classic) you first have to wait until you are signed in before anything happens. It was about ten minutes before I actually was wheeled into where the doctors are. After all, I had to get my fancy hospital ID bracelet before I could get through those double doors.
As most of you know, you first get to change into a gown. If you came in with chest pain, they hook you up to all kinds of monitors. First they connect the EKG by putting all kinds of sticky tabs to your body and connecting wires to them. They hitch you to a blood pressure cuff that automatically takes your blood pressure periodically. They put one of your index fingers into a clothespin-like gadget that measures your oxygen level. And they give you oxygen through some tubes that connect to your nose . That's pretty routine. A nurse asks you a bunch of questions about symptoms, medications, and the usual medical history.
After that, a doctor will come in and introduce herself. She will ask the same questions the nurse did and then she will explain that you will have some more tests. First they will test your blood to look for enzymes that will indicate if there has been any damage to your heart. Since I was already sick with a respiratory bug before I came in, they also gave me a chest X-ray. What's nice is that now they bring the machines into the ER next to your bed so that you don't have to keep being wheeled around to labs. In my case, they also wanted a side view of the chest after seeing that first X-ray, so I still had to go to the lab for that and then back to my room at the ER.
After that it was a matter of waiting. I had come in about 7:30 AM, and I was beginning to get very hungry. They would not allow me even water, since they still did not know if I would need surgery. If there is any chance they might have to put you out for surgery, you can't have had anything to eat or drink for several hours. That's one reason I didn't grab a banana while my husband was dressing in the morning.
By about 11 AM they hadn't found anything yet, since tests were coming up negative, but they decided I needed to be admitted so that they could keep observing me until I had a final blood test the next morning, and so I would rest. As most of you probably know, the hospital is the last place to go if you want to rest. I was still hoping they would let me go in time to get a hub written for the contest that day. But that didn't happen.
Yep, That's Me in the Emergency Room
How Familiar Are You with Your Nearest Emergency Room?
Have you ever been taken or taken anyone else with chest pain to the emergency room?
What I used to block the hospital noises
Admitted to the Hospital
I guess I should be glad I didn't have to go through the usual hospital admitting procedures, but there is no escaping the paper work. Before I was wheeled to my room, a woman from "records" arrived with a clipboard full of papers and a pen and told me where I should sign and initial after a one sentence summary of what I was signing. By then my mind didn't care because I was so tired and hungry. I signed and initialed. I knew someone else was probably waiting for my room.
I arrived in my real room about an hour before lunch.I sent my husband home to eat something and bring me back some things I really needed. The first was a stack of books. I don't get much out of TV, and was really stressed because my roommate had hers on, and listening to it was driving me nuts. I could picture how high my blood pressure was probably rising just from that. The second was something to block sound. The nurse had said she could get some earplugs, but they did absolutely nothing, which was what I expected. I can't read if I'm hearing words on a media device, so I couldn't do much with the book I'd brought. Finally the nurse said she'd ask my roommate if she'd be willing to listen to her TV with earphones, and she agreed, so that source of stress was gone. It made her steady stream of visitors tolerable, since I could eavesdrop. Also, they finally brought lunch, and I really did join the clean plate club. I had been starved. I could have eaten two of those plates.
The third thing I had my husband bring was nutritious snacks. He brought me some raw almonds and raisins -- low sodium and only the right kind of fat. My lunch had been a chicken breast with brown rice and some fresh broccoli with a pudding for dessert. After lunch Hubby came back with the items I had requested and my newspaper. We talked a bit and then I told him he could go home where he'd be more comfortable.
I had a book and my headphones (Silencio Magnum), so I was all set. I put them on and they made most of the noises fade into insignificance by making them seem miles away. Even the vacuum machine being driven past my door repeatedly seemed distant.
Be Aware of Differences in Heart Attack Symptoms in Women
If You've Got Classic Symptoms, Take an Ambulance Ride
The only reason I didn't was because we live so close to the hospital and my symptoms weren't classic. If I had been more sure, I would have called the ambulance. Why? Because the paramedics that come with the ambulance can immediately get to work on you. The ambulance driver who took my husband to French Hospital (See last module), which is noted for its cardiology department, said that they have to take patients to the nearest emergency room, but if the paramedics have determined by arrival that it really is a heart attack, they get an immediate transfer order for French Hospital before moving the patient from the ambulance and take the patient directly to French hospital where the doctors will be waiting for him.
It took my husband 15 minutes to dress and since we had had frost that night, another five minutes to scrape the ice off the windshield. If every second had made a difference, that 20 minutes could have made a big difference, since it would take another five minutes to get to the emergency room and another ten minutes to actually get to the medical personnel once we got there.
What I read to pass the time.
A Chance to Read
After lunch I started reading Low Country by Anne Rivers Siddons, a book I'd picked from the library giveaway stack months ago. I would rather have had a mystery, but this was a book my husband could find easily, and it was better than nothing.
In my tired condition, it took me more than the usual 25 pages to get interested, but once I got to the part about the death of of Caroline's child I could identify, since I also lost my child to the water for some of the same reasons. Both our children had ignored warnings. The plot continued as Siddons told us more about the characters we had met and brought us to Caro's building conflict with her husband over the land she loved. The book was worth my time and certainly filled my need for distraction.
My Walking Papers
What's inside the Exit Package
Night in the Hospital
Just before or after dinner, I can't remember which, another vampire (phlebotomist) came to draw blood. Evidently I was supposed to have these tests every few hours until morning to check the enzyme levels. Finally dinner arrived. I had sneaked a few of my almonds to tide me over. They fit conveniently into the little drawer that pulled out from under my rolling table top. Dinner was beef tips over mashed potatoes, green beans, and a peach and some shortbread cookies for dessert. I ate every bite and would have liked more. Guess they aren't used to people cleaning up their plates at the hospital.
After dinner I settled with my book again. I knew I would finish it around midnight. Around 10:30 PM I asked my nurse about when I would get my sleeping pill I had discussed with the doctor before I left the ER. I also mentioned I wanted a Vicodin for my cough. I said I wouldn't be able to sleep without them. She said the doctor hadn't ordered them. I asked her to try, since my doctor on call was not aware that my regular doctor had prescribed them for times when I could not sleep in my own bed and there would be noises to keep me from sleeping. I could tell the nurse was reluctant to call the doctor, but I figured that since I hadn't had more than two hours sleep in 48 hours, I needed it more than the doctor on call, who probably would still be up anyway. I won.
Another vampire came at midnight, but since I hadn't yet gotten my pills for sleep, I was still reading. He explained he'd be back at 4 AM for more. I argued they had said the reason I was staying over was so that I would get another sample after 24 hours and I needed my sleep. He went away to talk to someone and told me he'd take enough for two samples right then so he wouldn't need to come in at 4 AM again. It didn't make sense to me, since timing was the thing that was important, but by then I didn't care. He took my blood and went away.
I got hungry and knew I needed to have something in my stomach before I took the Vicodin. The nurse was able to get hold of some soda crackers, a little tub of peanut butter and a carton of milk. I put the peanut butter on the soda crackers and popped a raisin in my mouth with each bite. That made it taste like peanut butter and jelly. Together, the almonds I munched afterward and the milk I drank combined to supply some of the calcium and magnesium my evening supplements usually supplied before bed. I did miss my banana.
Finally about 1:30 I got my pills and was asleep by around 2:00 AM. I got to sleep until the vampire came around 6 AM and then went back to sleep until the nurse came to give me my thyroid medicine at 7AM. I got back to sleep for another hour until breakfast was served. The nurse then gave me the good news I could go home before lunch. The tests were negative but my cardiologist wanted to see me in the next two weeks and my regular doctor this week. I was given my walking papers, a packet of instructions and my rights. My husband took me home.
My Favorite Medical Reference Book
This is the book I most often refer to for medical information and reference. It describes diagnostic procedures your doctor might recommend, common treatments for medical problems, and information on how your body works, nutrition, and prescription medications. I recommend every home have a copy of this.
You Don't Always Get to Go Home
I have shared my experience here. I was fortunate to get to go home so soon. When I took my husband to the same emergency room in August he had more classic symptoms. Even though his tests turned out negative, as mine did yesterday, he was advised to have cardiac catheterization and coronary angiography. It turned out he did have a blocked artery. He was transferred to French Hospital that night by ambulance and the next night had an angioplasty, and a stent was put in place. He was also lucky. Some people who go to the emergency room may not leave the hospital for days if it turns out they need open heart surgery.
If you are in your fifties or older, you should probably make sure you understand heart disease and it's symptoms. Be sure to watch the videos I have included here. It also pays to have a good medical reference at home such as the most recent edition of The Merck Manual of Medical Information. This should be handy enough for the one who goes with you to the hospital to grab on the way out the door. Doctors and nurses will throw a lot of terms around you may not understand. Someone with you should be able to understand, and this will help them. It's also good to have around the house in case you want to understand some test or procedure your doctor recommends at anytime. I consult mine many times a year. It may even help you understand if your symptoms merit a trip to the emergency room at all.