Update on 85-year-old man

• by BillRussell
• 2014-01-19 11:01:11
• Complications
• 2012 views
• 10 comments

I have posted a few times about my dear husband's pacemaker insertion on January 3, 2014. I will not repeat all the previous details, but it has been a very scary and bumpy road thus far. The most frightening one occurred about 2:30 a.m. on Saturday morning when he awakened me with pain in his chest plus a squeezing sensation. I had been watching him closely for signs of a rise in blood pressure above 180/80 to 90 with rise in temperature and signs that his DVT in the PM side arm had gone to his lungs. His blood pressure had risen and his pain was increasing with shortness of breath. I called 911, an ambulance arrived in less than 5 minutes (excellent work), and they began to examine him and whisked him away very quickly. I could not go in the ambulance but drove the 10-mile trip by myself--I have nighttime blindness but I drove without even a close call, not much traffic at 2:45 a.m. They immediately began EKG, lab tests, and all the usual. At that time, the ER doctor asked us all the questions, etc., and my husband was having just squeezing chest pain. Just very quickly the pain turned into excruciating pain with pain extending into the neck and jaws. Fortunately my son and his wife had arrived from across town and were there to comfort me. I actually thought he was dying. The veins in his head were distended very much. They administered morphine intravaneously but it did not help the pain. They gave him a "cocktail" of some type thinking that perhaps it was gastric reflux that was causing the pain in the neck and chest. It numbed his mouth and throat but did not stop the pain. A second dose of morphine was given, more lab tests were made, a CAT scan was done, a chest x-ray, and nothing revealed that it was a heart attack. Nothing showed that it was a pulmonary embolism from the arm that has the blood clot. All the cardiac enzymes were clear, no increase in the troponin level from two sets of results taken 4 hours apart. After the second dose of morphine his pain subsided some but did not go away.

The ER doctor returned and said he had talked with the electrophysiologist on call from the Heart Clinic where the surgery was done (adjacent to the hospital), and because he had all of my husband's medical background, surgery, office visit last week and every detail about him, he knew all about this (I guess electronic records are wonderful when a doctor can pull this up on his computer in his home). He agreed that my husband had not had a heart attack.

Results: The ER doctor said that they did not know what had happened, did not know the cause, but that he did not have a heart attack and did not have a pulmonary embolism. Our choices were that we could come home and be on rest, liquids, 10 mg of predisone and Dilaudid for pain control. (They gave me a prescription for 12 pain pills to take every 4-6 hours and three 10-mg prednisone pills to take one daily.) The other solution was that they could admit him to the hospital for observation (no diagnosis) but that would be very dangerous because, "There are so many things going on in this hospital with several deaths from the flu and all kinds of bugs that it would really be dangerous for him to be in the hospital." He gave my husband a choice and he chose to go home.

I just about panicked because I honestly did not think that I could take care of him. I am 78 and have diabetes, polymyalgia rheumatic, two total knee replacements (one failure), and am a bundle of nerves. Of my 4 children, only one lives in town and he and his wife are helping to take care of her father who has advanced Alzheimers, so they are really tied down. One of my sons came up from Atlanta and that saved my life. He helped me Saturday night and until 2:30 today.

Up until 2:30 today, my husband would still have a squeezing pain right where his heart is and a shocking type of sensation that seems to be a pacer lead wire. Since then and after taking the first dose of prednisone, he has done much better. He still has shortness of breath when he gets up to walk to the bathroom but has had only one twinge of pain. He still has an occasional temperature increase but not as high as it was yesterday. He is sleeping now and seems to be comfortable. He worries about not getting up and walking, but I told him we would work on strength building after we see the surgeon hopefully tomorrow. The thought of the doctor in the ER as a result of all the tests is that he has inflammation in the heart that is causing the pain. I asked about pericarditis and he said no. No infection in the lung. No heart attack. No pulmonary embolism.

I am just looking for answers. I don't know if I will find them. Sorry to be so long-winded, but I just wanted to give the details and ask if anybody has ever heard of this kind of pain with a pacemaker implantation. I have searched the internet every spare moment I have had (which has not been much) and I can find no answers.

Please help me if you have heard of this. I'll anxiously await any information.

Thanks so much.
Anna R.