Heart disease is often referred to as a "silent killer" because the symptoms can come on both subtly and suddenly then escalate quickly with deadly consequences. Sitting alone in the middle of the night in my Tokyo hotel room, there was nothing silent about the discomfort I was feeling in my chest. Well aware that chest pains should always be taken seriously, I had managed to convince myself that what I was feeling was not so dire. A few years back I had had similar pains and a visit to the doctor led to the hospital and the cardiologist and full day of monitoring and testing and a conclusion of "nothing here." The current tightness and random aches had begun a couple days before my trip, but it was feeling much worse than the past few days. Still, I reasoned that other than the discomfort no other serious symptoms had manifested (i.e. no shortness of breath). Furthermore, I had actually gone for a morning run and felt fine for the full 7 miles and my heart-rate had kept pretty much in the 150s. My online research added further fodder for my beliefs as heart issues generally get worse with exercise and almost never feel worse upon resting or change with shifts in body position. I was having the worst time while lying down and the twinges would move to different parts of my chest as I tossed and turned.
Of course, my paranoid self kept me thinking that maybe all these rationalizations are the typical last thoughts of people who forcefully ignore all the warning signs. However, what could I do? Here I was thousands of miles from home and I didn't really speak the language that well. This certainly didn't feel like an emergency as I could get up and walk around fine. How could I explain that "I don't think I was having a heart attack, but I have some issues in my chest and maybe I should have it checked out or something?" Eventually, I'd make it through another restless night, awake too tired to run, eat a healthy breakfast and go through the day feeling mostly OK. After a night of typical Tokyo business dinner and drinks I would return to my hotel room. Each night my hypochondria waged a fierce battle with my rationalizations. I took aspirin as the best defense for a "worst case scenario" of heart disease or blood clots. However, it's the worst defense for the more likely issue of gastrointestinal origins. I obviously, made it through those nights and even managed a few runs in the mornings where I felt well enough. These, more than anything else, bolstered my confidence. Some trends emerged. When I managed to drink less, especially staying away from anything other than high-quality Sake, I felt better. I felt fine when running, but would have problems later in that day. The one morning where I partook of the buffet breakfast I felt terrible.
When I finally returned home on Saturday morning, I told my wife I was going to see the doctor on Monday. This was hint enough for her that something out of the norm was up as I am terrible about going to the doctor unless something feels really bad. After describing my symptoms and situation to the doctor she said that with chest pain they generally look at three things, heart, lungs and esophagus. Right off the bat, she didn't think it was my heart especially given my fairly normal 124/84 blood pressure and extremely low resting heart rate (sub-50). Also, my lungs sounded normal. Basically, her assessment was that it was a severe case of heartburn that could be indicative of GERD (gastroesophageal reflux disease) and prescribed some prescription strength acid reducers. So far they seem to be working and now that I am nearly over my jet-lag I am starting to feel normal.
So what's the lesson here? Does this mean that it should be acceptable to ignore chest pain, self diagnose and use the internet in exchange for a doctor's expert advice? Well, probably not. In fact, I could have saved myself an awful lot of physical and emotional distress had I just gone to see the doctor before flying off to Tokyo. Sitting in a lonely hotel room in a foreign city with an ocean separating you from your loved one's, wondering if maybe your heart might decide to seize up and stop beating isn't nearly as much fun as it might sound. While my past experience and specific symptoms did lead me to the correct conclusions, it is certainly not a path that I would recommend to anyone else finding themselves in a similar situation. Basically, if you feel it, get it checked!
OK, so yesterday I got my first run in since returning home. I feel like I might be able to get my head back on running and get my training towards the new year started. There is that long list of potential races on the right side over there that I need to mull through. That will be the focus my next post as there is another scare already scheduled out there in March.
