Thursday, April 8, 2010

Asthma ER Tales Part III: What We All Missed & In Which I Overdose on Pickles

Part I is here and Part II is here.

Last year, my blood pressure went high. I thought it was doctor induced anxiety because I had won the asshole doctor lottery and was dealing with a real piece of work in a new-to-me HMO system. An allergist who declared I did not have asthma and wanted to discontinue all my meds tout de suite.

In fact, it was the same allergist that had replaced my first pulmonologist and sent me running for 7 years. In the time since I had last seen her, she had progressed from being a bit nutty to full bore passive aggressive sociopath. (I later learned she'd gotten a divorce and it seemed to have sent her over the edge. Not that that's an excuse.) Whereas, she had been professional before, now she was just psycho, raging on a power trip.

And I was fresh meat. She went out of her way to dominate and disempower me. It was pathological. I half expected her to hump my leg and pee on my shoes. It was bizarre, especially coming from a woman. Male doctors (and men just in general) are more likely to be leg humpers in my experience.

I had to file complaints. I had to involve my employer's benefits department. I spent 6 months arguing with this asshole and the HMO network (of which my current pulmonologist was not a part). It was incredibly stressful. I ended up cobbling together my own asthma regimen from left over medications. Skipping doses. Splitting doses. Winging it on a prayer. Looking at overseas pharmacies. Trying to decide if I should just pay out of pocket to go back to my regular doc. Wondering where the money for that would come from and fuming about the thousands and thousands we paid for a completely useless HMO plan.

By the time the HMO agreed that a) they had botched the methacholine challenge that supported the asshole allergist's tenuous (at best) position that I did not have asthma (she had all my medical records showing otherwise) and offered to redo it and b) assigned me to another doctor, I was unwilling to subject myself to their version of medical care. I was beyond disgusted and could not face that HMO without frothing at the mouth. It was August, I had 3 months to go until we switched our insurance and I could go back to my regular pulmonologist.

So I waited it out and figured/hoped that perhaps the blood pressure was high because the asshole factor was high too.

Not so.

I had hypertension and I had to face it this year now that my insurance had changed allowing me to escape the asshole allergist. So I started two blood pressure medications about 8 weeks ago.

My gut feeling was the hypertension was hormonal in origin. Nobody agreed with me. (That is pretty common). However, I did get an endocrinologist to order to some testing (unfortunately, he was an ass and I refuse to go back to him so I didn't do the test and now I've been on prednisone for a month and can't do the test anyway).

So when this latest asthma episode started, what I didn't realize was my blood pressure tanked once I started taking prednisone. It dropped like a boulder in free fall. I had ordered a home bp unit, but it hadn't arrived yet so I had no idea what was going on. I thought I was dizzy and almost passing out from the asthma. I thought I had chest pain from the asthma.

I didn't. It was low blood pressure.

The ER didn't see this because I was so stressed, my BP was moderately elevated when they saw me. The albuterol helped mask it as well.

What clued me in was staying up all night sucking nebulizer in the hospital and just staring at the monitors (I didn't have the attention span to watch television). When I saw my diastolic go down to 65 and stay there, my gut clenched.

"Uh-oh. Too low," I thought to myself.

When I got out of the hospital,I called my primary care doc. I knew that 116/65 was not hugely low but I also knew it was low for me. It wasn't urgent so the doctor's office didn't get back to me until Saturday.

Friday my BP monitor came and I started checking my blood pressure. I had intense chest pain that was much worse with the nebulizer. To the point where I was delaying the nebulizer as long as I could. I was pretty sure I wasn't having a heart attack as I'd had the full heart work up at the hospital, but I couldn't figure out what was going.

Thank God for that BP unit.

What were my BP numbers?



Too low.

I started eating olives by the handful. Pickles. Drinking olive and pickle brine--just trying to get salt in my system to get my BP up. I got up to 100/60 but still felt really woozy. I googled my BP meds and the damage low blood pressure could do. I panicked a bit as I realized I would have to go back to the ER if things didn't turn around. To cope, I drank more brine. A lot more brine. Buckets of brine. I'm pretty sure I pickled myself that night.

The doc covering for my doc called me on Saturday. I shared my BP readings with them. They told me to reduce my BP meds, that eating salt had been the right move, but if my BP stayed that low to go the ER asap.

To which, after I hung up, I thought, "Fuck that." The last thing I needed was to go back to the ER. I needed rest not ER trauma-drama. Besides, I had heartburn from all the brine. I couldn't stomach any more. I discontinued all the BP meds and decided I would rather be high than low for a while. I had an appointment with my PCP on Monday--just a day and a half away, the risk was acceptable to me.

Miraculously, I turned the corner at this point. I suddenly had energy. I no longer felt like I was going to pass out all the time. The chest pain stopped. I was now just dealing with asthma alone and nothing else, which was soooooooo much easier.

And I did not have to go back to the ER, which was the best news of all. Go pickles!

Postscript 1: So when I switched insurance to get away from the asshole allergist and got back in with my beloved pulmonologist, I told her about the whole experience. The asshole allergist and my pulmonologist had been co-workers. She told me that they also experienced the asshole allergist as passive aggressive. Just so you know I'm not totally off base.

I would say this asshole doctor has been independently verified by a third party. And if I ever see that bitch again... well she's lucky I can't run and breathe at the same time so she'll probably get away just fine. You have no idea what she put me through. She is the only doctor I've ever run across, ever, that I would be willing to sue, that I wouldn't let touch me for fear she would kill me. And that's saying something because I've had some pretty strange doctors. I will have to tell you about the proselytizing Jesus freak doctor next just to prove the point.

Postscript 2: I checked my blood pressure while writing this post. First high spike I've seen in 2 weeks. Last year was absolute hell.

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