I had a scare this week. Monday evening after dinner, I was starting to sew down the binding on a UFO [it was my last day as UFO Queen on the Stashbusters Yahoo group, so needed to git 'er done] when the chest pain that had been nagging me on and off all day suddenly got worse. A LOT worse.
When I asked TMOTH to convince me I wasn't having a heart attack, he called the ambulance. In the driveway in the ambulance, they did an EKG which was basically 100% normal, so MI was unlikely. Did I still want to go to the hospital? Um, yeah. I've had a lot of experience with both muscle and joint pain, and this didn't seem to be either. And I was having a LOT of pain. So off we go - the two "trauma" hospitals were on "Code yellow" and I was OK with going to the not-trauma hospital with my normal EKG, so I was taken to MedStar Montgomery Medical Center (a.k.a. Montgomery General Hospital). Sadly, no lights or siren.
Once in the ER, they did another EKG (still normal) and drew blood. At that point, since my pain was worse with breathing, the ER doc ordered a D-dimer test that would basically rule out a clot and pulmonary embolism - but no, it was elevated. So off for a lung CAT scan. The CAT scan was "sub-optimal" so they could only rule out a major PE (not in the large vessels) and see some "indications" of lower left lobe embolus. At that point, I get put on anticoagulant therapy and moved out of the ER to "observation."
Meanwhile, despite all of my normal EKGs, normal heart scans, and normal cardiac bloodwork, I'm not allowed caffeine.
Tuesday morning, I go off to Nuclear Medicine for a SPECT ventilation/perfusion scan. That showed a definitive v/q abnormality in the left lower lobe. They keep me for the rest of the day for a couple more tests - Echocardiography of my heart (a little overkill, perhaps, considering that everything else cardiac was normal, but they wanted to make sure there were no emboli hiding in the heart) and a deep vein Echo-Doppler of my leg veins to rule out additional clots that might be hiding there. Both were negative, so they leg me go Wednesday morning with a prescription for Xerelto and a recommendation to follow up with my PCP and a hematologist.
If the Lovely Daughter hadn't locked herself out of the house, Starbucks would've been the first stop. As it was, we let her in the house and then headed over to the local Safeway to get my caffeine fix and the prescription filled. Starbucks came through, the pharmacy, not so much. They didn't have it, so called the Germantown Safeway, and they did. So off to Germantown.
First, they can't figure out the hospital doc's signature - how's that for cliche? They finally find him and that's where insurance rears its ugly head. The 2x day dose - which is standard of care for initiating treatment for pulmonary embolism - isn't on the insurance drug list, only 1x day. The pharmacist, to her credit, tells me straight up that the hospital docs will not deal with insurance issues and to go to my PCP to get the script re-issued. (By now, it's after 1 pm.)
I call my PCP's office and they tell me to come in at 3, but be prepared to wait. I'm OK with that. So off I go. The front desk can't find my appointment (this is fairly normal, but they're never unpleasant about it so I deal) but agree they should work me in. I wait no more than about 10 minutes to go in to see someone. My CRNP is totally awesome and erupts in righteous indignation that the insurance company wants them to jump through hoops to have the appropriate therapy covered. She goes off muttering to herself and comes back triumphantly with a bag saying "You are a blessed woman today!" And I am - she's rounded up enough sample boxes of Xerelto to cover the 3-week initial dosing schedule. She also recommends a hematologist, and I have a follow-up appointment with him on Thursday.
SO - today I'm almost pain-free (yesterday as well). I still have odd twinge-y pains in my shoulder and chest from time to time, but it no longer hurts to breathe.
I am a lucky girl, and I know it.