The Shingle Man’s Guide to Pain

“How are you tonight?” The Nursing Assistant tried to calm me as he rolled my squeaking gurney down to the angiogram area. Pedestrian traffic dodged us as we barreled through the busy halls.

“Worried.” I said. Worried I wouldn’t make it through the night. I’d been belted in the ribs with a baseball bat and set on fire. Felt like it, anyway. Imagine my confusion – roused awake in the middle of the night with no recollection of being beaten or burned alive, feeling like Iron Man when Obadiah Stane snatches his electromagnetic pulse generator, leaving him dying on the concrete floor of his luxuriant workshop-garage.

Obviously not me

Ascending Aortic Aneurysm – obviously not mine

Someone had my heart in a vice, squeezing the life out of me while drizzling my back with lighter fluid and striking a match to it. A heart attack can be like that, so they say. But these signs and symptoms don’t always indicate a heart attack.

“Maybe it’s a heart attack,” part of me thought before I ever got to the ER. I had my doubts. “Nah. It’ll pass,” another part of me thought.

I don’t like doctors because they tell me to slow down, and I guess I don’t like to slow down. Pain? I don’t feel pain like most people feel pain, so I ultimately can’t rank pain on a 1 to 10 scale. For me, pain is pressure, so I shouldn’t have ignored it when those bolts hit me. Did I go to the hospital immediately? Of course not.

“Hospitals are for weaklings,” I told myself. “I’ll wait it out like a man.” (I’m smart like that.) When the nausea hit, I couldn’t get comfortable – sitting, standing, laying down, walking around – nothing worked. “Enough with the macho act,” I thought. “If I’m gonna die, it’s not gonna be because I tried to outmaneuver a heart attack. Talk about an embarrassing obituary.” Stumbling to the garage, I eased into my little Fiat 500 and buzzed over to the ER.


One of my many BP readings

“Have you ever had high blood pressure?” The young blonde nurse – taking my temperature and looking at my file – asked me. NOTE: They don’t let you actually see your readings. You have to crane your neck to get the details. And they maintain a decent poker face in the ER.

“No. Why.” I wasn’t really asking her why.
“Because,” she glanced at her colleague. Her plain blue scrubs wrinkled when she pointed at my reading without looking me in the eye. “You’ve got high blood pressure.”

What she didn’t tell me was that I had stroke-level out-of-control high blood pressure (183/134). Now, I’ve always had borderline HBP, but never out-of-control HBP, and certainly not life-threatening HBP. Never has any doctor advised that I go on hypertension meds.

Their goals for me as a newly admitted patient?
(a) Lower the BP and prevent a stroke,
(b) Rule out a heart issue.

What did they find after the angiogram? An Ascending Aortic Aneurysm – a bulge that weakens the aorta – not large enough to warrant immediate surgical action, and a condition that typically produces no symptoms.

“Aneurysms can be genetic,” one doctor would later explain, “and they can also be caused by extreme overexertion.” Out-of-control HBP can weaken an aneurysm and cause it to fray or burst. Death comes in minutes (think John Ritter or Robert Palmer). As a frequent weightlifter, I’d overexerted plenty in the past. Just not the recent past.

What did this mean to me? I would be making new friends in the forms of a thoracic cardio surgeon and a gastroenterologist, not to mention a new primary care doctor (our being new to the area). Of course I didn’t need surgery, but I did need to be monitored. My new team of experts would have questions, and so would I. “If the aneurysm and HBP don’t produce symptoms,” I asked while still in the hospital, “why do continue to I feel like this?”

“Your existing acid reflux can cause those symptoms,” the doctor said as he left through the sliding glass door of my tiny hospital room. Didn’t make sense to me – I know what acid reflux feels like because I’ve experienced it for the better part of 30 years.

“I don’t want this diagnosis to be life-limiting in any way,” the cardio surgeon later told me, explaining that we “caught the disease” – his word – “early.” Tugging at his sleeve to indicate the type of material of which a stent is constructed, he said “we shouldn’t replace one disease with another” (i.e., a mesh stent). “It’s like painting brick,” he said. “You’d be going from zero maintenance to a situation where you’ve got to repaint. Any questions?”
“So, limitations,” I asked, “if it’s not life-limiting, I can lift weights?”
“No. No weights. I’ve got a buddy who’s heavy into power lifting and he’s in horrible shape, what with his blood pressure and his aneurysm. But you can’t tell him anything, so….”
“You can run. Just slow it down.”

Slow down? One of the main reasons I used to run is that it’s fun to run fast. Slow running is shit. But it’s not life-limiting? Who does he think he’s kidding?

The confusing bit: HBP and Ascending Aortic Aneurysms typically do NOT cause chest and back pain. Actually, they typically have NO symptoms. You don’t feel it, and by the time an aneurysm tears or dissects, the mortality rate is 90% IF you’re already in the hospital when it occurs.

WebMD makes it clear: “Without immediate treatment, death occurs.” Beautiful. My blood pressure stayed highly elevated at the ER and later that night in my hospital room because the aneurysm did NOT tear. If it had torn, my BP would have plummeted.

When I left the hospital, my BP had returned to normal (thank you, Lopressor). Then came the rash – the day after my discharge I went to my new primary care doc. Now I had a rash on my back, which I attributed to my new cocktail of meds: “Side-effects include rash.” Seemed logical.

At the end of our short session I told her about the side-effects of the meds and said, “Here, I’ll show you.” As I lifted my shirt, she took a quick gander and asked me if I’d ever had chicken pox.

“Yup. Third grade.”
“Mystery solved –  you’ve got Shingles,” she said, like that old AOL guy telling us we’ve got mail.
“What the actual hell is shingles?” I thought. I mean, I’d seen the commercials, but I tend to mute 95% of TV commercials.
She saw my confusion. “That rash is a band, and it’s not from the meds. It’s from chicken pox,” she said. “We’ve got a mirror in the bathroom – go take a look while I write your prescription and get you on your way.”

So, good news and bad news: I’ve got a mountain of new meds to keep me from blowing a gasket and get rid of the chicken pox virus, and not a dang one of them is mind-altering. What’s wrong with this picture?


1 thought on “The Shingle Man’s Guide to Pain

  1. Pingback: The Shingle Man’s Guide to Pain | Back Bay Diaries

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