Wednesday, July 18, 2018

Tired of Visiting E/Rs

I have been having some unexplained shortness of breath problems since at least May when a 1.2 mile walk to the convention center where the NRA Annual Meeting was held left me struggling to keep up with an NRA employee wearing high heels.  Last night, the "overly demanding" exercise was 90 minutes of doing the couch potato.  Many of the symptoms were those from before my aortic valve replacement; I spent several sleepless hours deciding whether the post-operative pain of going through that again was worse than calling it a life, and moving on.  Thinking through the effects on my wife, kids, and gun rights, I decided that it was worth it.  (Or perhaps doing the slightly riskier transarterial valve replacement (TAVR), which does not require cutting you open.)

This morning, the shortness of breath problem woke me up.  Walking to the kitchen to prepare breakfast not only exhausted me but produced upper left chest pain.  Nitroglycerin pills solved the pain, so we set out for the St. Al's E/R.  The very concerned, engaged, communicative (can I think of some more positive adjectives?) doctor found an EKG no worse than my last post-myocardial infarct EKG. 

Dying heart muscle produces a protein called troponin in the blood.  Even three hours later, there was none in my blood, so he ruled out a heart attack as the cause.

What he did notice was anemia.  Many symptoms of anemia mirror a heart attack because insufficient oxygen in your blood causes the same problems as the loss of blood flow to the heart; nitroglycerin essentially explodes the arteries open, improving flow of whatever oxyhemoglobin actually is present.  The E/R doctor also thinks my recent hernia repair surgery might have lowered my hemocrit levels, which can take 60 days to recover.  He pushed a previously scheduled cardiologist appointment up from August 9th to tomorrow. 


  1. Check with your surgeon for estimated blood loss for your hernia surgery. The EBL should provide an index for lowered crit.

  2. Well. Good. I'm a cardiac nurse. Might I suggest downing an aspirin and heading to the ER as soon as you feel unexplained shortness of breath? With your history...

  3. My first thought is a problem that I occasionally deal with: non-wheezing asthma. It's an odd problem. When it hits hardest, walking up a half flight of stairs can leave me wobbly and feeling like I just ran a 4 minute mile. But there is no evident gasping for air. Breathing seems somewaht normal, but there is insufficient gas transfer, apparently. Rescue inhalers have a slight improvement. Mold can trigger it. My mother seems to have suffered from it, but I hear was never diagnosed. But, I can look back at her complaints and think, bingo! Too often, doctors only see what they expect to see. I don't remember dealing with this until my 50's.