Saturday, September 06, 2008

How Not To Spend Your Last Day At Work

(Other possible title: How To Not Spend Your Last Day At Work)

I went to work yesterday like it was any other day. I drove by myself instead of carpooling because I was planning on going down to Dallas for the First Saturday Sale with a friend after work.

On my way in I started feeling, let's call it intestinal pressure, and pulled off at a gas station at about 7:30am. I was feeling a bit lightheaded as I sometimes will when that occurs but even though not much happened, the pressure and drowsiness subsided.

By the time I got to work 30 minutes later, the pressure was back so that was my first order of business. Again, not much happened but the lightheadedness did not completely subside. I returned to my desk, logged in to my workstation, launched my applications and started to work. I felt a little short of breath but proceeded to send an email to one of my customers. I started to get a feeling at the bottom of my throat that I still wouldn't describe as chest pain but more like a lump in my throat. By the time I finished the email, I knew I just didn't feel right and told my team lead I was heading to see the nurse (the company has an on-site occupational health nurse). The nurse wasn't there. It was just before 9am and she doesn't come in until 10am on Fridays.

The sign on the door said to call security if necessary so I just headed for the security station at the front door. I explained how I was feeling and the guard asked if I wanted her to call an ambulance. Well, NO, I didn't want an ambulance. I was just a little short of breath. I didn't think I was quite at the stage of needing an ambulance. She ended up notifying the emergency response team (employees throughout the building with first-aid or first-responder training are encouraged to volunteer for the ERT). I hoped they might take my pulse, check my blood pressure, and get an assessment of whether I really needed an ambulance. Nope. Apparently it doesn't work that way.

I told the two ERT members who responded what was going on. They asked me a few questions like did I have asthma, has this ever happened before, etc. Then one of them suggested calling an ambulance so they could do the assesment I was trying to get in the first place. I agreed.

As I waited, I gave the ERT some more information for their report and the pressure eased off quite a bit. I almost felt normal when a group of what I assume was fire/rescue personnel arrived. They weren't part of the ambulance crew but they were all dressed in navy blue T-shirts with their names and ranks on them (EMTs don't have ranks, do they?). The first one through the door took a look at me and immediately said, "Hey guy, you look kinda pale. Do you usually look like that?"

The rational part of my brain said, "I'm Italian. Pale is not a word I would use to describe my normal complexion." The irrational part of my mind said, "Crap. This isn't going to end well." My voice said nothing.

The F/R crew proceeded to ask some of the same general questions as the ERT: What's your name, describe how you're feeling, etc. Before it got too deep, I saw a gurney rolling in surrounded by three individuals in crisp, white security uniform style shirts. Seeing the gurney, the irrational part of my brain again said, "Crap. This isn't going to end well."

The EMTs immediately asked what hospital I wanted to be transported to. "I don't know, but I'm not quite ready to say let's go yet," was my response. After a few basic questions regarding the situation, I was asked to lie down on the gurney so they could hook me up to a portable ECG hanging on the side of it and make it easier to get my vitals and assess the situation. I'm all about making things easier on people who are trying to help me so I acquiessed. Before they even finished hooking me up, they buckled a belt around my waist. The irrational part of my brain observed this and said, "Yep. I'm on the right track."

I wasn't on the gurney very long before I started feeling lightheaded again and felt short of breath. The EMTs gave me a couple of chewable baby aspirin then suggested a shot of nitro. "Oh please don't. I've taken that before* and it gave me an instant migraine. I would rather not if we don't have to." One of the EMTs spewed his disclaimer about refusing this particular treatment and we went on.

A few blinks of the ECG, a few more questions and a few vital signs later, they asked about hospital preference again. The rational part of my brain said, "If they're asking that again after making a basic assessment, it's probably a good idea to go." The irrational part of my brain said, "I don't feel so good." I had no idea what to tell them since I don't live in Oklahoma City but our facility happens to be less than 10 minutes away from one of the bigger hospitals that also happens to have a heart hospital and chest pain diagnosis center as part of it. Off we went.

As we waited in the ambulance (for what, I don't know) I started feeling more and more out of touch. They asked me some more questions, like my date of birth, that I really had to think about to answer and I answered them slowly as if I weren't entirely sure I was giving them the correct information. Finally, we were off. No sirens, no rush, just on our way. The ride wasn't so bad for about 30 seconds when we hit the first speed bump. We took it slowly but it made me superfluously uncomfortable. It was for this reason that when they again suggested the nitro, I agreed. I would try anything for relief. At the very least, I figured the migraine would take my mind off the other discomforts. As it turns out, the nitro did provide relief but not a headache. Before we got to the hospital, I got a second shot of nitro, a little more relief and still no headache. The rational part of my mind told the irrational part of my mind, "What do you know, it appears you were on the right track."

I spent about an hour (maybe two, I'm not entirely sure) in the ER getting my blood drawn and getting a chest X-Ray while hooked up to an ECG/respiration/Oxygen/BP monitor. By this time, my mother-in-law, wife and a family friend were there. I was extremely appreciative of their company.

When the initial blood work came back okay, I relaxed a little bit. The doctor came in and told me he wanted to take another blood sample in an hour or two then would schedule a nuclear stress test (where they inject you with a radioactive agent, take pictures of the heart, torture you on a treadmill for about 10 minutes, shoot you up with some more radioactive goo, then take another picture of the heart). Luckily, I was in one of about two or three hospitals in the state where I could have that done the same day. If everything turned out okay, he felt they could have me home that evening to sleep in my own bed.

At that point, they moved me into the Medical Decision Unit. This is a unit attached to the ER where they can put patients that are stable and do not yet indicate admission to await test results while clearing the true emergency rooms for incoming patients. Pretty cool idea, I thought.

Jumping ahead, the second set of blood work came back normal and we learned just before 6pm that the stress test indicated normal heart function. By this time, I was back to myself and feeling pretty good. It had been a long day but I was leaving with answers. Not complete answers, but answers.

So, what happened? That remains to be determined. I will be following up with my family physician to see where he wants to take it. The strong money, however, is on an anxiety attack possibly complicated by gastro-intestinal issues.

So my last day at work had a pretty dark cloud hanging over it but it actually produced several silver linings:
  • I know my heart is functioning normally
  • The nuclear scan did not indicate blockage significant enough for concern (I have no idea if it indicated no blockage at all, I just got told it was normal)
  • I learned that I have a LOT of people who care about me
  • I was working with one of the best teams and for one of the best companies I have ever worked with. No, make that THE best.
  • I was good at what I was doing
  • I am and was well respected
  • I will be missed
  • I have a job if I ever need one - all I have to do is call one of about half a dozen people (or more)
  • I move forward with more confidence and a greater appreciation for things I often take for granted
Just for the record, I opted not to go to Dallas.


*A couple of years ago, I has having some bad problems with reflux. The doc prescribed some nitro pills because they can relax the esophagus. I tried it once and it took less than a minute to give me a migraine like I have never experienced.

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