2 Event PMR

[nancyannehanson]

December 3rd twenty 16 I woke up and it seemed to be a rough day it was 8 a.m. in the morning and I felt the sickness around my chest or I could just barely breathe. I laid back down and try to sleep it away wasn't successful. The pain then began clean tighter around my chest Tighter and Tighter with a weight right in the center. I called nine-one-one the ambulance came based on an EKG they were prepping me for a stemi. I immediately went to the cath lab only to find that I was perfectly clear. They now have me taking two additional drugs to keep down Big Bird my wrist is bruised from hand to Elbow the tops of my hands are bruised from all the needles. Now here I am back in the same place and what's going to happen if once again it presents as a heart attack I'm so scared. Try to get a consult for Rheumatology while in the hospital logo so I'm alone again until I see her January 26th any advice any support would greatly be appreciated.

[PMRpro Ambassador]

I'm sorry to hear that - scary start to the day! And really impressive bruises!

If it happens again - you do the same again and call 911. But the cath lab presumably did a full angiogram and it was clear? Did they come to any conclusions? It may have been what is called a cardiac spasm - the artery wall contracts and prevents the blood flow rather than it being a clot that blocks a normal width artery. The effect is the same - but the spasm is temporary and brief so it eases off. It is sometimes called Prinzmetal's angina. It can be treated with medication which should reduce the likelihood of a repeat a lot.

Hope you feel a lot better very soon - and that your bruises go away! Arnica is brilliant for bruises.

[nancyannehanson in reply to PMRpro]

I was told we know your heart is strong. No signs of plaque. They put me on protonic for reflux I still feel minimal tightness in the chest around the back.

[SheffieldJane]

Poor you nancyannehanson, those bruises look truly dramatic and the whole experience has left you in a heap of fear. I would take comfort from all the tests they have done on you. You are probably safer than any of us right now. Arnica is a good idea for the bruises and the shock you've had and it is entirely harmless in homeopathic form and surprisingly effective, perhaps three times a day, you can't go wrong and there are no interactions with other remedies.

[Admiral06]

Hello nancyannehanson, I too am now getting large bruises each time I get stuck. I went in for a routine colonscopy and each time the tech tried to insert the catheter (4 times) into the back of my hand, she would exclaim that the vein "blew". When a vein blows (ruptures from the stick) the blood leaks into the surrounding area making it useless for drawing blood, injecting medication or using as an IV. When I went in for the next blood test, the phlebotomist explained I should drink lots of water before coming in and ask that a butterfly (which has a thinner needle) be used. This has kept the bruises to the size of a golf ball.

[PMRpro Ambassador in reply to Admiral06]

No tech would have got to a 3rd attempt on me - never mind a 4th! One blown vein is bad luck, 2 is careless. More is not on! Anyone who knows what they are doing would have immediately got a smaller needle.

My husband had similar experiences after he had chemo - they got to foot veins to draw blood in the end and it was always a struggle. He had a really bad experience when having some procedure when a doctor made a mess twice, catching a nerve each time, which is excruciatingly painful. He told him to get someone who knew what they were doing! (He was a member of staff!) When we moved here and he started going for monthly bloods he was amazed at the phlebotomy clinic: they haven't failed yet after some 7 years!

[Admiral06 in reply to PMRpro]

PMRpro, I'm afraid that part of what is missing, especially in a high volume arena, is a sense of compassion and accountability. I have been to the same lab frequently enough to know who the good plebotomists are, but am not permitted to make requests. I now inform each of the unfamiliar ones that I bruise easily and that others have blown veins. I can only hope this puts them on their toes.

[PMRpro Ambassador in reply to Admiral06]

Every system is different of course - and I was (I hope) a good and kind phlebotomist in my day! However - now as a patient I would make a complaint about anyone who tried 4 times on the same patient and made a mess. It is more difficult for the person who comes along afterwards to sort it out. And one day it may matter when life-saving access to a vein is impossible because of them.

[Admiral06 in reply to PMRpro]

PMRpro, I certainly complained to the gastroenterologist during my follow-up visit and showed him my bruises, but while it was happening, I had never heard the term "the vein blew" and thought it was my veins that were somehow causing the problem. I also had a very nice chat with him on my use of depo medrol for PMR; which he supported. Though not a rheumatologist, be certainly deals with many nasty inflammatory diseases of the colon which are treated with steroids. He informed that he gets a faster and greater drop in CRP and ESR with depo-medrol (while using less steroids), but few patients continue with the injections which they find painful. I also plan to send him my tapering algorithm which should be finished today.

My initial 80 mg weekly injection had a median daily dose of 10.3 mg which I stepped down to 70 mg (9.0 mg median) three weeks ago. This lower dose requires 1 mg "spikes" with oral medrol on the 6th and 7th nights to maintain daily serum levels above the 5.3 mg withdrawal level determined by Upjohn Pharmaceuticals. On Tuesday I will begin a 60 mg dose which has a mean of 7.7 mg and needs a bit more spiking. After one month at this dose, I will go to 50 mg (median 6.4) for one additional month. Below this level, I plan to drop the injectable dose by 8 mg per month and flatten the pulse with spiking. These will represent .5 mg per month reductions.

I will keep you informed of my progress.

[nancyannehanson]

Thank you....good feedback.