View Poll Results: Does Roger need Guatemalan heart surgery?

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  • Yes

    5 35.71%
  • No

    2 14.29%
  • How the fuck would I know?

    9 64.29%
  • I don't like white people

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Thread: Do I need heart surgery?

  1. #1
    Minister of Love Roger Mexico's Avatar
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    Do I need heart surgery?

    Heheh, (hopefully) not a serious question.

    Here's the deal, though.

    [LONG STORY--TLDR section below]

    I missed a day of work last week because I decided to go in for an EKG. Well, before I decided that I decided to skip work because I woke up with a fairly intense sensation of pressure on my chest, it took moderately more effort to breathe than normal, and the muscles a bit lower down in my abdomen cramped up severely every time I tried to stand up straight or walk.

    None of it was crushingly painful, but after walking around the house for fifteen minutes, getting dressed, and otherwise going through my normal morning routine, I walked my son to class (across the street from my house, at the same school where I work), then decided it wasn't going away and went in to my director's office to tell him I was going home. (I just said "I... don't feel well.")

    Then I sat at home for about an hour, variously pacing (cramps, breathing trouble) or sitting in a doubled-over position (easy to breathe, fingers feel a little tingly), feeling myself getting slightly lightheaded and my finger grip on things get slightly weaker (slight enough to have been effectively me imagining things).

    Then I said to myself "shit, I feel like this would be much more painful if I was having a heart attack, but maybe I'd be a dumbass not to go down to town now before it (potentially) gets worse."

    So I did that--of course I am kind of a dumbass about my health, so I figured I'd just try to walk the ~ 1 mile to my usual doctor's office and see how that went instead of asking my landlady next door or the people in the school office to call me a cab. Maybe 1/4 of the way there, a taxi passed me and I flagged it down. I was glad not to be walking, although the ride was, shall we say, unpleasant--the type of vehicle we're talking about here seems to have no official name, but it's essentially a rickshaw hooked up to a motorcycle engine. The roads are very bumpy and the drivers seem to mostly be high on coke all the time, so it wasn't a smooth ride. Every oscillation of the cab sent shooting pain up and down my chest and stomach, but after like 5 minutes of that we'd arrived.

    I kind of limped into the compound where the doctor who passes for my family GP has her office--she's never actually treated me before, but I take my son to her when he gets sick. She saw me coming in and said "oh, are you sick?" (In Spanish--she doesn't speak English, but we usually manage to communicate well enough when I take my son in there.) I repeated the phrase I'd practiced after looking up the relevant terms in my Spanish dictionary at home--"dolor en mi pecho; defacil respirar." She said something I didn't understand apart from the word "gripe" (cough), I said "no, no gripe" and then she had me sit down so she could take my blood pressure.

    Well, apparently my blood pressure was "perfecto" but I'd need to go see another doctor in town because he's the only one with an EKG machine, and even then that seemed to imply a dismaying possibility because "[something, something] Chiquimula" (a town nearby across the border in Guatemala which is somewhat larger and has something more like an actual hospital than what's available here).

    Well, fuck. OK. At least I could get an EKG. That was really what I was after--someone to tell me I was being a hypochondriac about the whole thing, basically.

    So I walked down to the other doctor's office, talked to the guy at the reception desk (who turned out to be my neighbor--LOL small world, hey), and got bumped to the front of the line of waiting patients.

    Of course I did have a long enough wait to peruse the big poster in the front office advertising the available services at this clinic--an interesting mix of legit, I would think fairly high-tech medical practices with stuff on the order of massages and "homeopathic herbal treatments", then things I classified into a third tier of "wait, maybe I'm misinterpreting the Spanish but that sounds a lot like this other thing that is definitely considered New Age hokum bullshit where I come from." (Like "biomagnetismo" next to a photo of a woman lying prone with a bunch of rocks on her back--"no, no, wait, that's definitely the same thing as the New Age hokum bullshit I'm thinking of.")

    Well, anyway, soon enough I head on back and get strapped in for the EKG. Doesn't take long, and the doctor tells me "No infarc--buena gratis de Dios." OK, well, that's good, but it's not like my chest has stopped hurting.

    Back to the waiting room. Then after a while he calls me into his office and does a little interview:

    -He smelled tobacco on me before, and I wouldn't have lied about that anyway.

    -Had I been sick? (Well, a minor stomach infection a week ago.)

    -Appetite? (Normal)

    -Sleeping well? ("Normal", meaning 'no, not sleeping well at all, but whatareyagonnado')

    -Heart disease in your family? (Yes, a fuckton of it; my grandfather died in his 40's and my brother needed his aorta completely rerouted when he was 3 years old)
    -"And you smoke?" [Good-natured facial gesture that clearly means "fucking idiot"]


    He looks at the EKG printout again, and says (he speaks a little English) "oh, nothing really, just a block but..." [handwaving, smiling and shrugging while he punches stuff into his computer]


    OK, time for a basic physical, I guess, so we head into the room for that.

    - Knee hammer taps (OK)

    - Throat check (OK)

    - Ear check (OK)

    - "Does it hurt when I [press on your abdomen like this]?" (Fucking ey, yes it hurts--mostly it makes my chest hurt, though)

    - Blood oxygen test (93--"oh, this is very low; you need to get more exercise")

    Then he pulls out this thing that looks like a glue gun, and says what sounds like "A coo-puncher--without needle; eh?"

    - (I don't really know what you just said, but OK, whatever)

    - He consults a little booklet then presses the thing into the joint between my hand and thumb--"do you feel it?" (Feel what? No, I guess.)

    - Now? (It starts vibrating or pulsing or something, and hurts a little--"uh, oh yeah, now I feel that")

    **[Ooooh, he said "acupuncture without needle"; not sure what for, but... OK? I know nothing about acupuncture, so maybe you can diagnose heart problems with it? Maybe?]

    - He does this on a few more pressure points or whatever they're called, then tells me I can "come back every day for more, to quit smoking" (um, OK, I'll keep that in mind)


    I guess that's it for the physical, so back to his desk.

    Conclusions and instructions are:

    - Quit smoking, dumbass.

    - How much coffee do you drink? [about 5 cups a day] Oh, well, knock that off. Try one a day.

    - Get more exercise; you need to deal with the low blood-oxygen thing

    -[I tell him I walk like six miles in average week, and play basketball every Friday]

    - Oh, OK, well then you need to quit smoking, dumbass.

    - "I'm going to give you some medication ... for sleep. And something for your intestines."

    - [OK]

    - "Pharmacy's over here; have a nice day."

    [OK, thanks.]


    Well, I pick up the pills:

    -one is "bromuro de clidinio", which I'm supposed to take with meals.

    -One is piracetam, which comes in a box with a brochure that has an English section; "Indications: psychosis, anxiety, apathy." [doc's instructions are one of these every 8 hours--there are like 30 of them in the box]

    - The third one is alprazolam. No documentation besides the blister pack, but the pharmacy guy (my neighbor) says "that one's for sleep"; half a tiny tablet every 12 hours, and there are about 12 of them in the bag [I looked it up online later--it's a benzo]

    Aaaand, I get the EKG printout to take home.


    LOL, TLDR:

    So here's what I'm thinking. I slept the rest of the day, and for the next two days my chest was kind of sore, but nothing like how it felt that one morning (this was last Tuesday).

    He basically put me on two different tranquilizers and told me to deal with my lifestyle issues. (Fair enough--I completely agree about the cigarettes and the coffee, and I do need to sleep better.)

    My stress levels have indeed been fairly high lately. I went from 5 "preps", or different subjects, last year to 8 this year. Four of those are with a group that has 22 kids in it; last year my biggest group was 15 kids until two of them left at the semester break. That's a lot of extra grading to do on top of extra planning on top of a workload that I was frankly not always completely on top of last year despite my best efforts. (Single parent, bla bla bla.) I've spent every weekend putting in 12-hour days of grading and planning, I usually sleep about 4 hours a night, and I still missed the deadline for having all of my grades updated for midterm progress reports. I hate failing at shit like this, but I'm honestly not sure what the solution to the problem is ("stop slacking off" doesn't exactly seem applicable). Oh, and I really goddamn cannot fucking stand the feeling of being unable to come up with a solution to a problem. ("Ask the administration what I should do, or if they can reduce my workload" is also unpalatable, because I'm a big ball of those kind of neuroses.)

    The pain tends to come back a little every time I sit down to work, or even think about work, so it may well be a valid point that stress is a factor here.

    I also know I have a minor heart defect (a bradychardia, which is a sticky valve that slows down blood circulation a little bit); this was diagnosed when I was 13. If I'm basically smacking my slightly defective heart around with a combination of too much stress, too much caffeine, too many cigarettes, and not enough sleep, it wouldn't be that surprising that I'd start to feel the wear and tear on it. I mean, I'm thirty-one years old, but I'm not twenty-one years old anymore, you know? I never expected to get away with that shit forever.

    Here's the thing, though. I was telling the whole story to a coworker the next day, and he pretty much said the same thing has happened to him. As in "so your blood pressure was normal? Did they check your blood oxygen?" [Yes,...] "Was it 92?" [Um, 93--good guess, or now I'm a little freaked out about this data point being a specific indicator of a problem we've both had.]

    Oh, and the EKG printout, combined with that little exchange, has me wondering if I should get a second opinion. (I guess I could go back to the doctor I went to the first time--she seems to practice regular medicine, not "regular medicine plus hippie rainstick hoodoo", so maybe I should ask what she thinks.)

    The printout says:


    Spoiler: DATA (are any of you doctors or anything?) LOL


    SYS/ DIA 110/70 (90? It might say 90. I mean, 70 would be ridiculously low, right?)

    HR [bpm] 64
    PR interval [ms] 140
    P duration [ms] 107
    QRS duration [ms] 127
    T duration [ms] 240
    QT/QTc [ms] 427/443
    P/QRS/T Axis [deg] 53.8/24.8/44.4
    R(V5)/S(V1) [mV] 1.44/1.06
    R(V5) + S (V1) [mV] 2.49



    CONCLUSION:

    Leve desviacion izquierda del eje

    Bloque completo de rama derecha
    So, OK, I'm not exactly well-versed in medical Spanish, and neither Google nor my dictionary is of much help here.

    But I know enough to interpret phrases like "bloque completo" and know that it sounds like something that isn't exactly a trivial problem. "Rama" means "branch" or, according to Google, "bundle branch"--gee, thanks.

    My right bundle branch is completely blocked. I don't know what that is, but I'm fairly certain I don't want anything in that general region of my anatomy to be "completely blocked" at any time.

    (Google says the first bit is "mild left axis deviation"; eh, OK.)

    Well, OK, I'm not a doctor, and the doctor who did the damn thing waved it off and told me chill out. Maybe I should chill out. He's the one with the medical school degree--uh, the medical degree and the Biomagnetic Jedi powers--after all. Surely he knows what he's talking about? (He's not just putting me on benzos and blowing smoke up my ass because I have a problem he's not equipped to treat? No one would do that, right?)

    EXCEPT:

    Then fucking yesterday I'm talking to coworker guy's wife (the guy who said he'd had this happen to him) and she says "Do you have a blocked artery?

    And I'm all like "well, I don't know exactly, but the EKG thing says something is blocked. Maybe?"

    And she says "So, then, you're gonna need a stent put in?"

    And I'm all like "Uhhhhh, what? Wait, wait, maybe that's not what I have. I do have this bradychardia thing, and the doctor said I'm too stressed, and really I am very stressed, and I do drink too much coffee, like he said--that must be it. I just overstrained my sticky heart valve and I just need to keep taking these benzos and everything will be groovy."

    SHIT.

    Mommy, I don't want to go to Chiquimula.




    (I mean, it sounds like a nice town and everything--they have a McDonald's!--but "have heart surgery in Guatemala" wasn't really on the list of adventures I intended to have when I decided to do this. I guess the upshot is that if I have heart surgery in Guatemala it might not bankrupt three generations of my family. Hell, I even have health insurance. I forget about that. You know, Honduran health insurance, but still...)
    Quote Originally Posted by Ptah View Post
    No history, no exposition, no anecdote or argument changes the invariant: we are all human beings, and some humans are idiots.

  2. #2
    Persona Oblongata OrionzRevenge's Avatar
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    I doubt we could get rid of you that easy.


    Cramps and stabs of pain caused by moving a certain way don't sound at all like Cardio events.

    You a relatively young, skinny as fuck,

    You have insurance, a career, and a son --- I seriously doubt any doctor anywhere in this world would deem arterial blockage anything but a 4 alarm emergency in said situation.

    Hmmm, so the doctor thinks you might be prone to anxiety attacks???
    ^^^ I would have never guessed.

    Chill and cut back on the smokes, I'm sure we'll be reading your TL;DRs for years to come.
    Last edited by OrionzRevenge; 10-02-2014 at 01:06 PM. Reason: spelling
    Creativity is the residue of time wasted. ~ Albert Einstein

  3. #3
    (╯□)╯︵ ┻━┻ Deckard's Avatar
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    Here's my totally competent diagnosis:

    Gastrointestinal bloating / distress caused the discomfort, breathing difficulty, chest pain & anxiety. Pain localisation is often inaccurate around the abdominal region.

    Not sure about the cramping lower down -- are you sure it was cramps? Have you had cramps around there before? Which muscle felt like it might have been cramping?

    What did you eat the night before? Did you get any other gastro symptoms?

    It's bizarre that you were prescribed piracetam. It's used as a nootropic ("smart drug"), and it's not going to provide sedative or anxiolytic effects, probably the opposite.

    Prescription:
    If you get similar symptoms again, try an elimination diet to see if you can isolate a food that you don't react well to. Test for Helicobacter pylori infection. Throw the benzos away and find a better solution for sleep. Chill the fuck out. Take a proper look into anxiety and look into treatments, preferably of the lifestyle modification kind. And stop smoking, dumbass.

  4. #4
    a cantori Perdix's Avatar
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    Go to a doctor, no one here is qualified to diagnose a heart condition, even if they are a doctor, an accurate diagnoses requires physical testing and imaging.

  5. #5
    singularity precursor Limey's Avatar
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    You should get a proper diagnosis, at least in Guatemala city, if not the US. Stop smoking completely and stop the caffeine, I would think you will need a baseline that stimulants are going to fuck with.
    Sounds like xanax gets handed out like candy all over the world now. I got given that and ambien for insomnia, when all I needed was a routine and more exercise.

    You need to know if it's stress or a blocked artery. I worked with a guy that ignored the tingling in his arm for a while and he's lucky we finally got him to get it looked at because he needed a stent pretty urgently and apparently only survived because he had some weird 1/14 natural bypass vein (I took his word for this part). He gets to see his daughter grow up now.

  6. #6
    Senior Member Senseye's Avatar
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    Like you, I am an idiot when it comes to seeing doctors and monitoring my health. BUT - this seems much more potentially serious. You need to go to a better doctor - and probably one who speaks English so you can ask pertinent questions.

    It's way too premature to be self proscribing yourself heart surgery - but I would head off to this Chiquimula place immediately for further diagnosis.

    I've never heard of anything like straining your heart valve, sometimes weird things can cause chest pains that are not heart related, but if your chest pains ARE heart related, you probably need some sort of treatment. I don't think hearts are big on self healing.

  7. #7
    libertine librarian sandwitch's Avatar
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    The rickshaw with a motorcycle motor is called a tuk tuk. I don't know anything about health, but "acupuncture without a needle" sounds like bullshit.

  8. #8
    fhtagn Rhu's Avatar
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    You have two options: make further use of the local doctors until eventually they turn to leechcraft. Or seeing a specialized cardiologist for further diagnosis.

    The latter case can be fun, especially if they let you watch the echocardiogram imaging of your own heart. But not as fun as playing baseball with bloated leeches.

  9. #9
    凸(ಠ_ರೃ )凸 stuck's Avatar
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    Don't agree to anything unless they magnetize the leeches!

  10. #10
    Senior Member
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    I hear Chetumal has pretty good hospitals. I'd go to Mexico over Guatemala for healthcare, mostly because my 1 experience with Guatemala wasn't great. It's much further though.

    It could also be cramps due to dehydration. Hot weather + coffee + beer means you're probably not drinking a whole lot of water.

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