Welcome to Middle Age

Behind the curtain

Last year, I started fitness training with Heather. It’s been really good for me, toning up and being able to see my body respond to regular, controlled exercise.

A few months ago, I noticed that during a few of the more difficult exercises I had a hard time getting a full breath. I also haven’t felt like I’ve gotten as far along as I’d like in terms of being able to finish the workout without feeling like I was about to die. That is hyperbole, but the nature of working with a trainer is that they continually push you. I had to realize that instead of barely 10 reps in a set, I could do 15 and do two to three sets. Major improvement. But the breath thing was disconcerting. I toned it down a little, started using an antihistamine regularly, started taking ADD meds and noticed that I was getting some good (for me) muscle tone where before I had none.

As part of my ongoing mental health assessment, I decided to ask my psychiatrist if we could pair an anti-depressant with my ADD meds. He suggested Wellbutrin. I said ok and about two weeks ago, I started taking Wellbutrin XL along with the ADD meds. Didn’t really notice much at first. Felt ok. Thought maybe I had found the wonder cocktail. Felt better than when I’d started Prozac, which was like halfway between stoned and sleep. Prozac evened out, but there were still side effects for me, dissociative feelings being the most prevalent. Since 2008, I generally have taken Prozac for the winter months only. I did take it for about 18 months; most of 2009 and half of 2010.

I’ve also been seeing a chiropractor. The adjustments have felt wonderful and the stretches are really helping my lower back. However, the last visit, I felt something weird when laying on the traction table and having the stim pads on my back. I don’t think the stim pads caused any problems, but that was when I noticed that the short breath was getting worse. It was like I couldn’t get a good breath, not just when working out, but doing normal stuff like sitting at a desk and driving a car. My posture has always been horrible, and I just chalked it up to that. Until Thursday of last week, when I was really struggling to get a solid breath and it hurt to breath all the time. The pain was a steady pressure against my lungs and my ribs were very tender. I wondered if I hadn’t fractured a rib, but I didn’t have any accidents or incidents that would have caused a fracture.

Thursday afternoon, I got in to see my doctor and got a battery of tests; chest x-rays, EKG, blood work. Inconclusive. He did discover, surprise! another sinus infection. Gave me a couple of prescriptions for antibiotics and 800 mg ibuprofen, a shot of antibiotics in my butt and told me that if the pain worsened in any way, to go to an ER immediately and get a CT scan of my lungs.

Friday, we ended up in ER. Heather has written about it here. It’s much better than I can do right now.

We’ll skip ahead to the part where the nicest person in the world, my friend Jon, came to relieve Heather so she could take over from the sitter. I’ve known Jon since 1989, when I spent a semester working for the underground student newspaper in Provo. You might know him as @zuhl (twitter/Tumblr) or from his blog. He informed of how weird a CT scan can be in terms of the internal sensations. People mention these as thought they are routine things, nothing to worry about. However, when you can’t get a good breath? It’s more terrifying to think about what they’ll find than anything else.

So I’m lying flat on my back in the CT Scan tube, arms stretched above my head, the iodine lead hooked to the IV dangling out of my right arm. They give me instructions about breathing and then the nurse tells me she’s starting the iodine and immediately, as in microseconds, I feel very warm over my entire body. A feeling that starts to freak me out until I realize that I’m not getting any hotter and then the scan is over.

I’m then shown to my observation room and given dinner at about 5:30pm. Jon visits with me for awhile and then headed out once he was convinced I’m not going to die. Heather’s mom and stepdad came over to the house and Heather came back up to be with me. She’s obviously very shaken by the events of the day. I’m so used to being the one to comfort her that the role reversal is strange for me, lying down in my adjustable bed, that I’m more concerned about how she’s coping than I am about whatever is wrong with me. We share a couple of honest, hard tearful hours.

They dose me intravenously with Toradol (Ketorolac) and Heather goes home. I fall asleep around 9, 9:30 and don’t wake up until a vital signs check at midnight. I dozed in and out for an hour until 1am and another blood draw (my third of the day). I can’t get back to sleep until after 2am. I wake again as the caregiver on duty tells me one of the six pulse monitor clips has fallen or been pulled off. I fall immediately back asleep and then awake for another vital signs check and blood draw at 5am. I fell back asleep until just after 7 when Heather came to be with me to hear what the cardiologist has to say about the CT scan and cardio stress test I’m due to take. I don’t get in until about 11 a.m. (and another blood draw) to take the cardio stress test. I’m in hospital scrubs on the bottom and socks. I should have put on the shoes that Heather kindly brought up for me. I get 14 miinutes in and I’m dry mouthed, sweaty and my feet are slipping on the 15% grade of the treadmill. The tech tells me she wants to get my heart above 170 “or so”. I last about 30 seconds beyond that. Heather tells me later that my heart rate was about 173. She can’t believe it, because she can’t get her heart rate that high in spin class. I know this is not as funny as Heather’s post. I’m sharing this just so I have a record I can look back on later.

From the hospital bed

I’m given a the clearance to be discharged. I’m exhausted, dehydrated and starving. When we got home, I napped for about four hours straight. The Toradol was really nice and smoothed out the pains. In terms of how I felt compared to when we entered the ER on Friday, my pain was dramatically reduced and everyone, including me, viewed that as a very positive sign.

Sunday, I resumed my regimen of ADD meds and Wellbutrin. About 3pm, the difficulty breathing and a reduced level of pain came back. We took at walk as a family and then came back home to this. The same not me above mentioned Jon delivered this on Sunday, appropriately dressed in his nerd FTP client shirt:

Logistics

He’s good people.

Yesterday I did not take any meds, except the antibiotic that my regular doctor prescribed and the 800 mg ibuprofen tablets. Still had some pain, still had the tightness, still wasn’t entirely comfortable breathing. Fell asleep at 8 something pm and didn’t wake up until 5:50 this morning. I didn’t take my regular meds except the antibiotic and the 800mg of ibuprofen. Mid-morning Heather and I decide I need to go back and talk to the regular doctor again. I do. They give me a “pink lady” which is a mixture of an antacid and lidocaine. I feel a little better and my doctor prescribed me Omeprazole. I started that today as well. I’m scheduled for an ultrasound of my stomach/liver/gall bladder this Friday, unless I start feeling better. They also gave me an injection of Toradol before I left.

We’re getting to the bottom of this mess. I’ll keep you posted. p.s. Thanks to the members of the dooce® community who gave us the lovely orchid!

  • http://twitter.com/PinballGraham Graham West

    Glad to hear you’re feeling at least a bit better and that they have more things to pursue. Toradol is great stuff; when I had kidney stones it cut right through that pain. Hope everything works out and you get well soon!

  • http://ferryfolk.com Danalan

    Hope it is something simple, and I’m glad you’ve got a good support system and excellent insurance. Kind of ironic to tie in the health crisis with the workouts, don’t you think?

    I still think it’s going to be related to your trip. Maybe the food down there (ceviche, in particular) irritated your cardiac sphincter (top valve of the stomach), and you’re experiencing severe reactions to some gastric reflux.

  • http://twitter.com/BeckyCochrane BeckyCochrane

    I can only imagine how frightening this is for the two of you. Hope it turns out to be something simple, easily treatable, and you’re back to your frisky self soon. So glad that you’re getting lots of in-person and online support.

  • http://www.kimskitchensink.blogspot.com Kim’s Kitchen Sink

    Thanks for sharing. Glad to see you’re on the road to figuring this out; health stuff can be scary, but it’s wonderful that you have such a close family and community to have your back. Virtual high fives for feeling (even slightly) better!

  • http://twitter.com/theotherlion theotherlion

    Glad you’re still getting tests done. I wondered about your gall bladder when I read Heather’s post. That pain is awful, just awful. Maybe it’s a med thing, too, though? Who knows. I had a bad reaction to Effexor and the doctors couldn’t figure it out for a long time.

  • http://pulse.yahoo.com/_R5SKXCALWJJ5K4BN6WRL3YHLEU Desire’ Gonzales

    I too am glad that you are working on finding out what is causing the problem. Too often once the crisis is past, everyone ignores it until it comes back to really bite you in the ass harder next time.

    Glad you are home with your family and friends with all their love.

  • http://www.facebook.com/people/Amy-Jacobs/590861439 Amy Jacobs

    Jon…glad you’re feeling better. Your symptoms don’t sound like gallbladder. I’ve had gallstones for about 7 years…the pain is very specific. Usually about 30 minutes after eating, something with a bit of fat in it especially, you have a pain right under your right rib…SHARP, sort of like a muscle spasm. It will last up to three hours and then subside. To test it yourself, eat a couple of slices of cheese pizza and then wait…if you have pain, most likely gallbladder.

    You can actually test if it’s your gallbladder when you’re in pain. Lay on your back…have Heather press in the area…right under your ribs, to the right (basically making a line straight from your nipple, to right under where your rib ends at your abdomen). Have her give a good bit of pressure, but nothing painful. As she presses, take a deep breath. If you come up off the floor…it’s your gallbladder. : ) It’s called a positive Murphy’s sign. Dave diagnosed my stones that way even before I had a scan done years ago. I have yet to get my gallbladder taken out…but it’s coming. Men don’t get gallbladder issues as much as women. What about kidney stones? That can present as pain when breathing…radiating from mid-back, to the side of ribs, to the front. Men are prime for those stones and before you ever pass it, it can present as back/breathing pain which can be helped by NSAIDS.

    However, I’d bet anything it’s medication related. My hubs took Wellbutrin once years ago and had THE worst panic attack. It was completely freaky and it effected his breathing. He stopped it the next day.

    Good luck. I’m sure it’s nothing serious. Dealing with stuff like this is always so tiring and stressful.

  • http://twitter.com/daddyscratches Daddy Scratches

    Sorry you’re going through all this.

    Coincidentally, I take Wellbutrin for depression/ADD. A little over a year ago, I went off of it for a few months — which was roughly how long it took for me to determine that I am the reason Wellbutrin was invented. Thus, I decided to start taking it again … and, seeing as how I’m a doctor, I figured I could taper back up to a full dosage on my own by employing a pill cutter.

    Except, I’m not a doctor … which explains how, in the middle of the night last March, I ended up wired to an EKG in the emergency room. Turned out I was having a Wellbutrin-induced anxiety attack of epic proportions, which can happen if you ramp up too fast.

    As I was reading the Wellbutrin part of your post, I was thinking perhaps that’s where this story was headed.

    I hope your mystery gets resolved quickly, and that you get a clean bill of health ASAP.

    • http://blurbomat.com blurb

      I’m staying off of Wellbutrin until I feel better. Thanks for sharing your story… this is a secondary benefit to posting personal health issues online: learning from others.

    • http://twitter.com/kristenhowerton Kristen Howerton

      I’ve also had this experience with Wellbutrin, and I was wondering if you were leading up to that. I work in mental healthy and I’ve definitely had clients have anxiety (and even psychosis) from a Wellbutrin ramp-up. It’s a tricky med and it can also be a hard one to taper down from. But when it’s good, it’s oh so good …

      But paired with a stimulant for ADD, I would think the potential for anxiety symptoms could be even greater? Anyways, Jon, hope you figure it out and glad to hear all the vital tests came out with good results.

      • http://blurbomat.com blurb

        My psychiatrist said that pairing Wellbutrin (also used for ADD) is common. I don’t think this is about Wellbutrin. I’ve been off if for four days and it’s half-life (as well as my ADD med half life) is short. I experienced no negative side effects coming off or on Wellbutrin that I can see. Thanks for your perspective!

  • http://kristanhoffman.com/ Kristan

    Oh geez. I’m glad you guys are still investigating, although I feel awful that it’s even necessary. I truly have been thinking of you guys, and I’m sure I’m not the only one. Here’s to hoping it’s something “easy” and that you figure it out and fix it soon.

  • http://twitter.com/JohnLeJeune John LeJeune

    Hang in there buddy!

  • http://twitter.com/littleredwkshp Wendy

    Good grief. Way to start off the new year, eh?

    My husband went through a similar round of weird health problems last year—40 years old, depression, low energy, hospitalized for chest pains, tests that turned up nothing, and all-around Eeyore-ness. Turns out the root of the problem was rock bottom testosterone levels, of all things. (Which apparently can be a side effect of aging or stress-induced.) It’s so bizarre, but now that it’s regulated he’s like a brand new person and all the weird health stuff has subsided.

    Hope everything checks out soon!

  • http://ericalucci.myopenid.com/ EricaLucci

    Hope you health continues to improve.

  • http://pulse.yahoo.com/_AUASVWAHKO22V3UQEJIBXFPRRU Jeme

    Sending all my positive vibes and best wishes your way. I hope they figure this out quickly for you. I was on Wellbutrin for many years without any problems.

    All my prayers to the Armstrong household.

  • http://www.sugarleg.com sugarleg

    I don’t even know you but I feel like you’re my bro. thanks to both of you for sharing, and in your unique ways. I have added the Armstrong health issues to my list of concerns like I have known you guys for years or something. funny.

    sorry about the scare. as an asthmatic and a 40 year old runner and a former taker of trazadone/Paxil/Celexa over the years, all this hits home. most importantly, you are connected to your body and not ignoring what you know is not right. keep pursuing it, but also make sure to rest enough to keep that clarity. I honestly think this is your body readjusting itself to all the wonderful things you have been doing for it, namely the exercise, better food, the chiropractor, the meds tweaks, all of it. that may sound simplistic, but bodies are smart and need time to calibrate when we ask them to do new stuff.

    you will be well.

  • http://twitter.com/zuhl Jon Deal

    Heck, you guys gave me ice cream before I left. I got *paid*!

  • http://www.facebook.com/profile.php?id=1359494210 Amanda Brumfield

    I am so glad you are OK. What ever that was the other night…stop it!

    xoxo,
    Shanay-nay

  • http://theseatedview.blogspot.com/ Lene

    This all sounds terribly scary – middle age sucks. I hope they figure out what’s wrong soon so you can get back to normal. Wish I could offer advice or waive a magic wand for you, but alas…

    I do have a suggestion about the sinus infections. I have severe rheumatoid arthritis and have been taking immunosuppressants for years, especially biologic modifiers (Enbrel, Humira). They are notorious for causing sinus infections and I used to have to take antibiotics for sinus infections every six weeks so. Through trial and error and with some input from my naturopath„ I found something that helps keep it at bay. Lots and lots of water (to dilute the gunk in your sinuses), lots of garlic (antibacterial properties, keeps the gunk from festering) and lots of 100% pineapple juice like e.g., Dole (pineapple has vitamin C, but more importantly an anti-inflammatory enzyme which reduces the inflammation in your sinuses, allowing the now diluted gunk to drain more. When I feel a sinus infection coming on, I increase the quantity of all three and add snorting salt water, but I remember you once boasting about having a Neti pot, so you’re already getting that. I haven’t had to take antibiotics for a sinus infection in three years. Don’t know if it will do the same for you, but it might help at least reduce the number of sinus infections you get. The pineapple juice and garlic can sometimes be a bit hard on your stomach, but the Omeprazole should help with that (I’m on Pantoloc myself).

    This won’t deal the scary, but it might help with the irritating.

  • http://theseatedview.blogspot.com/ Lene

    This all sounds terribly scary – middle age sucks. I hope they figure out what’s wrong soon so you can get back to normal. Wish I could offer advice or waive a magic wand for you, but alas…

    I do have a suggestion about the sinus infections. I have severe rheumatoid arthritis and have been taking immunosuppressants for years, especially biologic modifiers (Enbrel, Humira). They are notorious for causing sinus infections and I used to have to take antibiotics for sinus infections every six weeks so. Through trial and error and with some input from my naturopath„ I found something that helps keep it at bay. Lots and lots of water (to dilute the gunk in your sinuses), lots of garlic (antibacterial properties, keeps the gunk from festering) and lots of 100% pineapple juice like e.g., Dole (pineapple has vitamin C, but more importantly an anti-inflammatory enzyme which reduces the inflammation in your sinuses, allowing the now diluted gunk to drain more. When I feel a sinus infection coming on, I increase the quantity of all three and add snorting salt water, but I remember you once boasting about having a Neti pot, so you’re already getting that. I haven’t had to take antibiotics for a sinus infection in three years. Don’t know if it will do the same for you, but it might help at least reduce the number of sinus infections you get. The pineapple juice and garlic can sometimes be a bit hard on your stomach, but the Omeprazole should help with that (I’m on Pantoloc myself).

    This won’t deal the scary, but it might help with the irritating.

  • http://twitter.com/mommybyday Hi, I’m Natalie.

    YIKES. Glad you’re out of hospital — And I hope things go well tomorrow!

  • http://pulse.yahoo.com/_OWZQMNFECVSKHJ5PEZFFQUCMNM Anna Coleman

    I’m sorry you’re going through all this, it must have been a really scary experience. Do keep us posted. I’m wondering what the ADD meds are for? Well, ADD obviously, but could you maybe go into that a bit more? I’m just asking as I’ve continually found problems with focus and concentration during my life, and I’m beginning to wonder whether those kind of meda would help, but know very little about them.

    Hope you are recovering well. I’m sorry you are suffering depression too, maybe counselling would help (not sure if you see a therapist for it already). I have a friend who has trouble breathing often, and it was diagnosed as anxiety. It comes on even when she thinks she’s not particularly freaking out about anything, mostly from underlying stress. Don’t take that as annoying unsolicited advice though, I’m sure the doctors know what they’re doing!

    Feel better!