Goodbye Wonky Lady Parts!

Well. I did not die in surgery.
I really thought I was going to. And more often than not (as my family can attest!) I often am able to oddly predict things (though John always complains that I'm unable to predict the lottery numbers)

So all those Circus Peanuts, Twizzlers, ice cream, potato chips I ate thinking it was my last time on Earth, are now clinging to my thighs saying, "Haha, don't believe everything your "sick" sense tells you. Sick sense is like "sixth" sense - get it? Unless you are on Oxycodone you probably won't.

Anyway. I not only didn't die, but my surgery allegedly went fantastically. I was asleep, so what do I know? I had no adhesion's, and even my cysts had disappeared. UPDATE: 8/29/2014 - I received a copy of the pathology report, actually, I did, indeed have cysts. I had cysts in both fallopian tubes, in my follicles, and I also had fibroids and mild cystic cervicitis and benign basal endometrium (say that 5 times fast!). Remnants of the hemorrhagic cyst remained.
I am so glad that I asked for the report, because had I not, I would have wondered if the CAT scans had been wrong, if the pain had been in my head, etc... End of Update 8/29/2014

WHAT?

Dr. Ianieri assured me that cysts pop up and go away quickly, so this made me rethink everything. Perhaps all the abdominal pain had been the cysts coming/going. It's just a bit odd since one box of tampons has lasted me 2 years.

I'm praying giving my lady parts the boot will resolve the lower left abdominal pain. If not. I'm done. I'm tired of being poked, prodded, and that getting a second opinion often is so opposite from the first opinion that a third opinion is required.

Anyway, back to surgery:

Doylestown staff is quite awesome. For the most part. I mean, nothing is perfect (other than, of course, my Jewish Apple Cake) , I try to keep that in mind. Nurses/staff prior to surgery, in recovery, and in my room, were awesome.

I came out of anesthesia and I didn't feel that bad! As the night wore on, however, I spiked a fever, started having irregular heartbeats (oddly prior to surgery, my heart was smooth and not spazzing out!)

(I did go into an arrhythmia under anethisa, but they were able to take care of it. I know this only because someone told be while in recovery. I was a bit spaced out, so I'm not sure exactly what happened, but would have loved to have been given paperwork so I could share it with my cardiologist and keep it in my file. They gave me my blood work results when I was discharged (which I thought was great! Didn't even have to ask!) and my red cells and hemoglobin were down - my white cells were all over the place. I expected that, though. I've finally come to understand this is simply how my body reacts to infection/injury.)

I felt so horrible as the night wore on, I considered asking them to put me in a coma until my body adjusted itself. But then my fever went down, my heart stopped being irritable, and I was able to watch the Food Network so all was good.

I felt much better as the morning wore on. I was eating! Eggs! Bacon! Pizza! Then I went home. Slept all of Saturday. Sunday was horrible. My fever came back, the only thing I could eat were popsicles and then I promptly threw them all up.

Thank God for Ambien. I went to sleep that night, woke up Monday, and my fever was gone. I was now walking without pain and by Tuesday, I could lie on my sides in bed. Today - 7 days after surgery, and the pain is hardly noticeable. I'm dying to walk Jack (who has been pouting since last Friday when I skipped his daily walk - the first time since June!) but he weighs like, 80 pounds, and he pulls (bad training - I know this is my fault!). My anemia has set in, however, and this is the frustrating part. After I do anything minimal; dishes, walk (I'm up to 10 houses), shower, I have to take a break. I have shortness of breath (almost feels like a chest cold). But no fever. And so, other than WANTING to do more but not wanting to overdo it and make recovery longer, I'm doing fantastic - if I do say so myself.

This has been a crazy journey. Learned so many things (good and bad) about navigating the medical system - how important communication is (and how lacking it can be which only adds to more grief!).

Most importantly, I think I've FINALLY learned how to spell Dr. Ianieri's last name. Ian. IE (i before e), RI (Rhode Island).  Pronouncing it, however, is still a bit tricky.

Love Dr. Ianieri!!

Neurotic Heart

Listen, because I was told "your palpations are "just a thing" -nothing to worry about...and because I know from being a paramedic that YES, some people do have excitable hearts...I believed the cardiac doc's in 2006 when they said my cardiac problems weren't really problems.
It wasn't until I had to get surgical clearance for my hysterectomy that I started to request reports that had been done. Now, granted, there weren't GLARING red flags - but there always seemed to be something a bit off. And in the EKG report from my visit on 3/13/2014 (there were two, interestingly enough) - one said their might be possible left atrium enlargement.
Dr. Kmetzo and Jennifer Brown didn't take me seriously; and I  had planned to see a cardiac doc affilated with Abington, wondering if perhaps Doylestown docs would stand as a united front in the case that something HAD been overlooked.
But then I realized the cyst on my ovary needed to come out sooner rather than later and I didn't really have time to start all over again with an Abington practice (not to mention my surgery was going to be done in Doylestown).
So I went to see Dr. Renee Sangrigoli with Doylestown Cardiology Associates for "surgery" clearance on the advice of Dr. Dinesen.
Well, she didn't even listen to my heart. LOL. I shouldn't laugh - but it's just so ridiculous that these doctors do NOTHING to alleviate anxiety. I guess she reviewed my medical charts because I handed her the reports from my arrhythmia during surgery and she barely glanced at them. I explained I was worried about my heart during surgery and she said there was nothing to worry about - I simply had a spot in my heart that often misfired but it wasn't anything that couldn't be easily managed. She gave me a form clearing me for surgery.
You hear that heart? You are fine. Stop over-reacting!

Blood Doesn't Affect Your Heart!

On the morning of April 11th (Friday) - my palpations were in full swing and now I also had this odd warming sensation around my heart. My calves were cramping, and I'd been using two pillows to prop myself up at night to make it easier to breathe.
I called Dr. Kmetzo's office and they said they could fit me in at the Chalfont office with CRNP Jennifer Brown.
I went in for an appointment and while Brown was nice - I found it interesting that she didn't take my blood pressure, didn't take my pulse ox when I had told her my history of anemia. She told me blood counts don't matter (really? because I was pretty sure that an infected/injured heart could affect blood cells and be the cause of anemia) She didn't put me on a heart monitor but she did listen to my heart with a stethoscope and said she did hear PVC's. She sent me home with a halter monitor but because we didn't have a home phone, I'd have to drop off the monitor to download it after I had recorded 5 episodes of PVC's. WHAT? FIVE episodes? My heart was beating irregularly constantly! I'd be back in a freaking hour! She gave me a prescription for Lopressor even though I explained I had LOW BLOOD pressure and they tried to put me on that back in 2006 and it only made me dizzy. Sigh.
I put it on, left, went home. Had a few episodes of fluttering on my way home, recorded it, and when I got home, took it off, walked Jack, (and while walking, the fluttering seems to calm down) and then put it on. Well, in less than half an hour, I had used up all "Five" slots and now had to go download the halter monitor to free up room. God, this was ridiculous. Would I be running back and forth all day? All weekend?
I sat outside and tried to wait out the fluttering. I hated to go back to the office. It wasn't getting better, however, it was getting worse.
I decided to drop off the monitor and while driving over (a short 10 minute drive) - my arm was tingling, I was having heaviness in my chest. When I went in to turn in the monitor, I asked if they could put me on a monitor - I explained the symptoms I was having.  They hooked me up to take a 12 second strip and I wasn't surprised when it didn't show my PVC's (as those quick strips never do). I asked if they could hook me up to a regular monitor and they said they don't have one. What? Isn't that kind of like going to an ice cream shop and finding out they don't have any ice cream dippers? They didn't take my blood pressure, they didn't check a pulse ox. I was complaining of trouble breathing and they didn't even offer me any oxygen. I knew they probably thought I was having an anxiety attack (hmmm, would anxiety cause me to go into bigmeny and trigemeny while under anesthesia?) - but even if I was having an anxiety attack - I knew from my work as a paramedic, be calm with the patient, be reassuring, and put an oxygen mask on their face but don't give them oxygen...often that will call them down.
I got none of that. I got this:
"Have a seat in the waiting room and wait for Brown."
Ok.
Twenty minutes later, the anger I was feeling at the way I'd been dismissed and not taken seriously did not help my heart which was now bounding out of my chest. I asked for a copy of my halter monitor report and said that I was leaving. They gave me the report (it showed I had multiple PVC's) and off I went. I considered going to the ER - but after the visit on March 31st - I worried I would be taken as seriously as the staff at Central Bucks Cardiology treated me. My had lost most of my faith in Doylestown doctors. With the exception of Dr. Jennifer White and Dr. Dinesen. I had one last doctor to see, Dr. Ianieri. She would be the last ob/gyn and be the tie breaker on if I should have a complete hysterectomy. I'd made the appointment over a month ago - I was tempted to just cancel it and give up on everything Doylestown, but my sister in law had loved her so I was willing to give it a chance.

Nuclear Cardiac Stress Test

The morning of April 9th, I had a cardiac stress test at the Womens Health Center in Warrington. I love the place. It's got a gym, a cafe, a pond. It's gorgeous. This test went something like this: inject stuff into my veins, take pictures of my heart, then run on a treadmill. The report said that there were rare PAC's throughout.
I realized I should have made the appointment for the end of the day - that's when I was experiencing most of my palpations. And the funny thing, when I exercised or walked, I was usually able to stop the palpations. The staff was very friendly and they had great magazines to read that were up to date (really, this is important when you have to wait).

March 31st - MRI and ER Visit - Mean Jean (worst mean nurse EVER!) Doylestown ER

On March 31st - I reported to Doylestown hospital early in the morning for an MRI. I was feeling good (I usually did in the mornings). The guy doing the MRI asked me what kind of music I wanted to listen to. I picked Country. Turns out, he LOVED Country music and so we started talking about what concerts he'd been to, who he liked the best. He was very cool and made me feel totally at ease. Funny thing was, he mentioned also why I would be getting an MRI if I'd already had a CAT scan. I, who generally felt I was "in the know" when it came to my health (getting copies of reports/labs/etc) started to question if I was really as proactive as I thought. Two medical people questioned why I was getting an MRI when a CAT scan had already shown what was wrong. But here's the thing - I'd liked Dr. Minissale, so when he said, "Get an MRI" - I just said, "Okay!" Perhaps I should have asked why, and what information would it provide that wasn't provided by the CAT scan...

Anyway. After the MRI, they gave me a copy of the MRI on CD so I could give it to any doctor who may ask for it in the future. I thought that was awesome. I think we should automatically receive copies of our labs/EKG/reports - we shouldn't have to request them.

I'm in a great mood. I'm feeling positive! I feel I'm NOT dying! I get home and go on line and start to work and I'm working for about an hour when suddenly - I feel 3 strong very forceful palpitations from my heart.  BOOM! BOOM! BOOM!

What. The. Fuck.
I had to fast the night before the MRI and had been given injection dye. After the MRI, I had a Diet Coke...I wonder if perhaps it's the caffeine on an empty stomach? I wait for it to pass but those three original palpitations seemed to set off a constant parade of palpitations. Fuck! I don't have time for this! I just WANT TO GET BACK ON TRACK WITH LIFE AND FEEL HEALTHY AGAIN. I take a Xanax and lay (lie) down. They don't go away. Now I'm having shortness of breath but think this is because I'm beginning to become fearful. What if this is the end? Should I go to the ER? Should I wait for it to pass? What if I was having a heart attack and am wasting time. But what if it was just my excitable heart being...well, excitable?
Finally, I turn to John and say, "Let's go - just to make sure."
Of COURSE, on the way over, my heart starts to calm down a bit.
Upon arriving at Doylestown ER, they hook me up to a monitor and take a quick look at my heart. It looks good. It ALWAYS does when they do this. Back in 2006 when I was in ER for palpitations, they did the same thing and everything looked fine. Then they hooked me up to bedside monitor and the PVC's were so frequent they kept setting off alarms!
They take me to a room, hook me up to the monitor and things look ok. A bit fast, a rare PVC, but nothing for me to freak out about. The nurse, Jean, seems really annoyed by me. Is it because this is my third visit in a month? Perhaps. But I'm being extremely co-operative and nice (as I always am). I worked in EMS, I know ER nurses and docs are often overwhelmed and are treated like crap from a few patients (and nurses are treated like crap from some docs too). But man, is this old lady nurse named Jean REALLY giving me attitude. My blood work comes back - my red cells and my  hemocrit are down and my MCH is high. This concerns me. During my other 2 ER visits, my blood work came back abnormal also. SOMETHING WAS WRONG. Since the end of February when this all started, I'd seen 7 doctors, been in the ER 3times, and though everyone seemed to admit something was wrong, no one could seem to figure out WHAT.
Dr. McHugh was the ER doc and he seemed nice enough - but very busy. He sent me for a chest Xray and when I came back - I was suddenly thirsty and had a raging headache. My blood pressure (which is normally 90/60 - was now 134/86. My heart rate was climbing - I felt the pounding in my chest and started to panic. I buzzed the nurse. Jean came in all but rolling her eyes. "Yes?"
"My blood pressure shot up, I have a sudden headache - my heart is racing." - I pointed to the monitor which my heart rate was 140 and rising.
She sighed as if I'd just told her I shit the bed and she'd have to clean it up.
"It's just because you're in the hospital - your blood pressure is actually fine."
"Not for me, my pressure is very low normally."
"Well, your fine."
OHMYFUCKINGGOD. She was a royal bitch and instead of calming me down or reassuring me, she was making my situation WORSE. When she left, I took out my iPhone and recorded the SVT rhythm that my heart was now in. I buzzed again.
Jean shuffled in. "I want a new nurse - you're not taking me seriously."
"Fine."
In comes the nurse in charge. She took Jean's side. She was a bitch too. I couldn't believe this. I wasn't in the ER looking for drugs. I didn't get any and didn't ask for any. What I wanted was answers and to be assured I wasn't having a fucking heart attack! And instead of calming me, they were provoking me.
Dr. McHugh came in the room and said all reports (except my labs) looked fine and I was free to go. He saw the SVT on the monitor and while he talked to me, the rate slowly climbed down. While he was nice enough, and I understand there's really not much he could have done, he failed to mention my run of SVT in the report. Nor did he mention in the report the spike in my blood pressure. The EKG report mentioned that my ST was now depressed when compared to the EKG they had taken on 3/13/2014.
The nurse that came in to give me my discharge papers was very very cool. He explained that Jean was close to retiring and she wasn't just that way with me, she was that way with most people. He said the staff had the same complaints about her!
I left that ER feeling beaten, mortified, embarrassed, and angry. Now I seriously was starting to distrust the Doylestown medical system. Again, the reason why I'm frustrated is that when it comes to my cardiac history, I went to Doylestown ER in 2006 with palpations, followed up with cardiac testing only to be told it was "nothing" and "harmless" - so I believed this. Then when I had surgery in 2007 - I went into bigemny and trigemny under anesthesia. Even when I came out of that, I blew it off because I was told a year prior, all was well. So the past few years, I shrugged off palpitations and now am wondering...wait, could it be my heart causing all this abnormal blood work? Is my heart causing my fatigue, and anemia? And yet, I guess because there is no OBVIOUS flags (I'm not unresponsive!) they just send me on my merry way.

DR. Kmetzo

On March 25 I had two appointments: Dr. Kmetzo a cardiologist and Dr. Eddy - a family doctor that was recommended by Dr. Jennifer White.
This entry is about Dr. Kmetzo.

I needed to see a cardiac doctor to clear me for surgery because of my cardiac history.

Dr. Kmetzo was recommended by a friend of the family. Later, when I decided to really get pro-active about becoming in charge of my health, I would learn that Dr. Kmetzo had reviewed my echocardiography report that I'd had on 10/23/2006. It noted mild mitral, tricuspid, and pulmonic regurgitation and mild buckling to the mitral valve (I was never told about this, however, I wouldn't learn this until 8 years later after searching for and requesting reports).

Kmetzo was nice enough. His nurse who set up the EKG was totally nice. Had just moved to the area and she was very friendly.

Kmetzo - he was okay. Not a great bedside manner, but not a cold one either. He seemed a bit dismissive of me - a young cheeful woman healthy woman compared to the 80 year old blue haired wispy ladies using oxygen tanks shuffling in the waiting room.

He gave me a script for a Nuclear Stress test.