Last Wednesday, I had to wake up early (for me) to go have a barium swallow (for my lap-band) and a booby ultrasound (again! I have cyst-y boobs). On my way there I had pins and needles (paresthesia) up and down my left arm and, especially, in my fingers. Okay, just a normal part of waking up with FM, I thought; except it didn’t go away like it normally does. And 5 hours later, my fingers (on my left hand) started twitching all by themselves – this had never happened to me before. Other than this I felt normal (or as normal as we can be). What am I supposed to do here? is this a stroke?
I google then go to a mirror: my face is normal, I can lift both arms above my head, and I can speak properly; so, it doesn’t sound like a stroke but what the hell is it? I’m not sure this is an emergency.
I call Mommy (who is still laid up in bed, with a bulging disc sitting on one of her nerves, after 2 weeks). She asks me the same questions about stroke symptoms. She’s not sure this is an emergency.
Then I take her advice and call Nurse-On-Call, describing all my symptoms. Guess what? The nurse is not sure so she puts me through to 000 (911 or 999) and an ambulance. Over the phone, they’re not sure…so, with blazing lights and a screaming siren, an ambulance arrives at my place and takes me to the ER.
We’re probably more sufficiently in tune with our bodies than others to know when the pain is from FM, perhaps the result of cleaning the house a day or two before or eating that third chocolate, or if it’s something else. It’s when pain might signal something more serious that the internal dialogue begins:
“OK, this isn’t something to fool around with.”
“But is it an emergency?”
“And what if it is an emergency and you can’t tell?”
“I’ll give it one more hour.”
So how can we tell? Here are 7 pains you should NOT ignore:
- Worst Headache of Your Life
Get medical attention immediately. “If you have a cold, it could be a sinus headache,” says Sandra Fryhofer, MD, MACP, spokeswoman for the American College of Physicians. “But you could have a brain haemorrhage or brain tumour. With any pain, unless you’re sure of what caused it, get it checked out.”
Sharon Brangman, MD, FACP, spokeswoman for the American Geriatrics Society, says that when someone says they have the worst headache of their life, “what we learned in medical training was that was a classic sign of a brain aneurysm. Go immediately to the ER.”
- Pain or Discomfort in the Chest, Throat, Jaw, Shoulder, Arm, or Abdomen
Chest pain could be pneumonia or a heart attack. But be aware that heart conditions typically appear as discomfort, not pain. “Don’t wait for pain,” says cardiologist Jerome Cohen, MD. “Heart patients talk about pressure. They’ll clench their fist and put it over their chest or say it’s like an elephant sitting on their chest.”
The discomfort associated with heart disease could also be in the upper chest, throat, jaw, left shoulder or arm, or abdomen and might be accompanied by nausea. “I’m not too much worried about the 18-year-old, but if a person has unexplained, persistent discomfort and knows they’re high risk, they shouldn’t wait,” says Cohen. “Too often people delay because they misinterpret it as [heartburn] or GI distress. Call 911 or get to an emergency room or physician’s office. If it turns out to be something else, that’s great.”
“A woman’s discomfort signs can be more subtle,” says Cohen, who is director of preventive cardiology at Saint Louis University School of Medicine. “Heart disease can masquerade as GI symptoms, such as bloating, GI distress, or discomfort in the abdomen. It’s also associated with feeling tired. Risk for heart disease increases dramatically after menopause. It kills more women than men even though men are at higher risk at any age. Women and their physicians need to be on their toes.”
Intermittent discomfort should be taken seriously as well.
The problem here, for us, is we have these kinds of pains all the time – sometimes it’s persistent and sometimes it’s intermittent. If you’re in ANY doubt as to the cause of your pain/discomfort, get medical attention IMMEDIATELY!
- Pain in Lower Back or Between Shoulder Blades
“Most often it’s arthritis,” says Brangman, who is professor and chief of geriatrics at SUNY Upstate Medical University in Syracuse, N.Y. Other possibilities include a heart attack or abdominal problems. “One danger is aortic dissection, which can appear as either a nagging or sudden pain. People who are at risk have conditions that can change the integrity of the vessel wall. These would include high blood pressure, a history of circulation problems, smoking, and diabetes.”
Still have your appendix? Don’t flirt with the possibility of a rupture. Gallbladder and pancreas problems, stomach ulcers, and intestinal blockages are some other possible causes of abdominal pain that need attention.
One of the lesser known dangers is deep vein thrombosis (DVT), a blood clot that can occur in the leg’s deep veins. It can be life-threatening. “The danger is that a piece of the clot could break loose and cause pulmonary embolism [a clot in the lungs], which could be fatal,” says Fryhofer. Cancer, obesity, immobility due to prolonged bed rest or long-distance travel, pregnancy, and advanced age are among the risk factors.
“Sometimes there’s just swelling without pain,” says Brangman. “If you have swelling and pain in your calf muscles, see a doctor immediately.”
Nearly one-quarter of people who have diabetes are undiagnosed, according to the American Diabetes Association. “In some people who don’t know they have diabetes, peripheral neuropathy could be one of the first signs,” says Brangman. “It’s a burning or pins-and-needles sensation in the feet or legs that can indicate nerve damage.”
- Vague, Combined, or Medically Unexplained Pains
Sounds like FM, right?
“Various painful, physical symptoms are common in depression,” says psychiatrist Thomas Wise, MD. “Patients will have vague complaints of headaches, abdominal pain, or limb pain, sometimes in combination.”
Because the pain might be chronic and not terribly debilitating, depressed people, their families, and health care professionals might dismiss the symptoms. “Furthermore, the more depressed you are, the more difficulty you have describing your feelings,” says Wise, who is the psychiatry department chairman at Inova Fairfax Hospital in Fairfax, Va. “All of this can lead the clinician astray.”
Other symptoms must be present before a diagnosis of depression can be made. “Get help when you’ve lost interest in activities, you’re unable to work or think effectively, and you can’t get along with people,” he says. “And don’t suffer silently when you’re hurting.”
He adds there’s more to depression than deterioration of the quality of life. “It has to be treated aggressively before it causes structural changes in the brain.”
Needless to say, my symptoms were not caused from a stroke. I sat in the ER waiting room with a(nother) cannula in my hand (REALLY OW!) for an hour and a half, alone (with all the other ER patients). After that time, I approached the nurse and said, “I came here because my symptoms indicated that there may be something life-threatening going on. Obviously, there isn’t or you guys would have dealt with me, right? So, I’m going home.”
I went to my GP the next day, with fingers and arm still tingling, but everything else was (and still is) fine; so she just told me if it gets worse or changes or there are more symptoms, come back to her or call an ambulance.
The paresthesia went away after 2 days and I am back to my normal FM-ridden self. BUT, please, if you have a new or unexplained pain, or even if you’re just in doubt, get medical attention.