When you enter an emergency room you know how serious you are by how quickly you are taken care of, apparently I was in a pretty serious place. I was immediately given a baby aspirin – I will never forget the look of disbelief when I told her why I had refused one. Heart attack beats irritation to the stomach lining hands down – I now carry a bottle of baby aspirin everywhere I go! A further look of disbelief occurred when I was asked approximately what time the pain started and I answered 1:43 PM. As my receipt for the candles was marked 1:45 I thought that was as accurate as you could get. They were somewhat in awe of my lack of accepting the reality of what was happening here. They also were not impressed when I told them the only thing I had taken was a TUMS. I think the one thing they were impressed by was my seemingly delusional behavior, if you know me well you know the worse things are, the calmer I seem. I was as cool as a cucumber, except for the moments when my chest felt like it was getting stepped on by a giant and alternately when my head felt as if it were being squeezed in a vise. As the ER team did an amazing job of mobilizing, I looked at Anthony and the moment I saw his face it hit me just how bad this might be. All of the things I had been in denial about hit me with brute force, after all I had done to get to where I was in life how could it all be taken away??
A doctor returned with news, bizarre news. So far my cardiogram looked okay, but I would wear a telemetry monitor and have blood enzymes drawn throughout the night to see if that showed a cardiac incident. The bigger issue; however, was that I was severely anemic, so anemic that I needed an immediate transfusion. In my continuing effort to act as if this wasn’t really a big deal I very helpfully told them I knew my blood type was A+, they assured me that they would handle the typing & matching in the lab. My body was not producing enough red blood cells, and the ones it was producing were small (microcytic anemia). This severe lack of iron rich blood limited the oxygen traveling around in my body which in turn limited the oxygen sent to my heart. Prime reason for a heart attack – lack of oxygen sent to the heart. So apparently I had a seemingly non heart attack heart attack – all the symptoms and pain caused by an undiagnosed case of severe iron deficiency anemia. As the doctors explained what steps would be followed to figure out how this happened and how to prevent it from happening again this is what it sounded like to me: “blah blah blah bone marrow biopsy blah blah bone marrow biopsy”. Could I have cancer? Believe me at that moment I was having no problem facing the reality of the situation, and it wasn’t good. The following morning I passed a stress test with flying colors, but there was still no explanation for the anemia. The doctor did add that I was also low on B12, so while we were figuring out exactly what was going on I also was told to add 3000 mcg of B12 sublingually (love that word). After a lengthy chat with a doctor filled with lots of what ifs I was discharged that evening with quite a date card full of upcoming appointments – and a lot of trepidation.
The following weeks consisted of me laying down and going to medical appointments. In hindsight I had every one of the symptoms of severe iron deficiency anemia – most notably an unbelievable urge to chew ice – constantly, by the tray, by the glass, at all times. We knew it seemed weird, but didn’t think it signaled something that could be potentially life threatening. I am one oscopy shy of having had every oscopy one could have (never fear, the final one is happening soon). No bleeding, no explanation for the severe iron deficiency – and no feeling any better. As a final act of avoidance – primarily of the bone marrow biopsy – I asked to see the hematologist first. At this appointment he explained to me that for various reasons a person’s body can stop absorbing iron and that is what he thought was happening to me. Despite a very healthy diet high in protein (60 grams plus per day) and iron supplements (60 mg per day) my body was not taking the iron in. My body had stopped absorbing iron, and when this happens the only way you can get iron is via iron infusion therapy. After having the iron infusion therapy, you then regularly check your blood to make sure you are not running on low. Ideally this is done every six months to a year depending on how your body stores the iron it receives, and from here on in this is how your body will receive iron. Well at least now we had a plan.
According to the World Health Organization, iron deficiency anemia is one of the most common nutrient deficiencies in the world. It can be caused by a low dietary intake of iron, poor iron absorption, or excessive blood loss. Signs of anemia include: constantly feeling weak and tired; short attention span; irritability; decreased performance at work or school; delayed cognitive development in infants and young children; decreased immune function leading to increased illness; swollen and red tongue (glossitis), and difficulty maintaining body temperature. Several groups are at an increased risk for iron deficiency including children and adolescents, pregnant women, women of child-bearing age, athletes, and older adults. Iron: An Essential Nutrient by J. Anderson and C. Fitzgerald1 (6/2010), Colorado State University
Part III – The Adamantium Cure or how I found a way to think positively about someone coming at me with a large syringe filled with dark liquid.