Thanks, Rob is a miracle, isn't he.  He even puts up with my blondness.
 Which is a good thing, as I'm about as mentally blonde as they come.

Pam S.

Thank you.  I know you are right - or at least my head does.  It's just that
my heart hasn't quite caught up yet.

Tweed

I am sorry to hear about Christina's mom.   My mother died of
congestive heart failure, but lab results, which the doctor didn't
get back until the day after she died, showed that she had had a
heart attack about one week prior to her death.

Incidentally, when I had my heart attack in 1999, the pain was a
diffuse aching in my left arm, the _right_ side of my chest, and in
the right side of my jaw.  So, heart attacks in men don't always have
the classic symptoms either.

Cardiac events, in general, can manifest differently than many people
expect. Now, while it's been a while, I have been through advanced
cardiac life support training (wasn't eligible for certification since I
wasn't in an emergency services unit), and have quite a bit of
experience with cardiology and internal medicine.

One evening, while having dinner with friends, I found I couldn't seem
to get comfortable in my chair at the restaurant. At first, it felt as
if I had twisted my upper back.  Somewhat later, it felt like an upset
stomach, and then again an achy back.  

I was home by this point, and got into a hot tub trying to work out the
kinks.  After some minutes, I realized the pain, which was under my left
shoulderblade, was now radiating into my arm, and I was sweating far
more than I should be. There also began to be some actual chest pain.
So, it was a good two hours after the first twinge when the picture
suddenly came together for me, I cursed, rolled out of the tun, got on a
bathrobe, and headed for the phone to call 911. By the time I got to it,
the pain was severe and I was gasping. I don't think I was in denial, so
this is an example of even where a trained person doesn't recognize
atypical symptoms.  

It happened that this was unstable angina rather than a true heart
attack.  While I do now have some scarring in my heart, I always acted
quickly enough to get intervention to prevent further damage -- and,
indeed, a good deal of the damage has reversed.

The lesson is that a mysterious pain that won't go away really needs to
be evaluated.  Even once I was in the emergency room, the basic tests
were all negative. The symptoms, and that they were relieved by
nitroglycerin, made a clinical diagnosis.  Only after I had heart stress
imaging were the details apparent.

Let me also purr, because I have a case of a what-if in my family,
something that hits me emotionally although I know objectively I
couldn't have made a difference. My father-in-law [1] called us one
night to say he was in the hospital, hurting, and they weren't sure what
was wrong with him.

He told us he had complained of a backache for about two weeks, and had
been going for repeated chiropractic sessions. Now, I know chiropractors
that are responsible and work well with other healthcare practitioners,
but this jerk was one of those that believed chiropractic cured
everything.

I asked a few questions about the nature of the pain, and promptly got
scared. What he was describing, and apparently had been going on for a
couple of weeks, was absolutely classic for a problem with an internal
organ -- it wasn't remotely like a back problem. Any nurse, paramedic,
or physician should have recognized this and gotten him to an ER --
except the chiropractor didn't recognize it.

By the next morning, a ruptured aortic aneurysm had been diagnosed. He
was in Corpus Christi, TX, which, at the time, had no open-heart
surgical capability.  They were considering if they could stabilize him
enough to get to Houston, but he died soon after.

Even if he had been in the hands of a competent heart surgeon when the
pain first hit, his chances of survival, at the time, would have been no
better than 50-50.  But, Christina, I always ask myself the same sort of
what-ifs: what if I had just happened to call earlier? We typically
spoke on the phone a couple of times a month. I really believe that I
could have gotten enough information to convince him something was
seriously wrong and to get to an ER -- if I had spoken to him in time.

Yes

Lower back and what she described as her "back passage."

I must find the mail that my German friend sent me (she is a doctor who
practises only homeopathy now) describing how different the symptoms of a
heart attack can be in women.  When I find it, I'll post it so everyone can
have a look at it.  Yoiu never know, it might save a life.

[..}

Thanks.

Tweed