Archive for the ‘(mis)adventures’ Category

Posted on January 15, 2010 - by Ashley Jackson

Shot Through the Heart

I’ve mentioned several times over the past week or so that my shoulder and neck have been hurting since the first of the year. I figured it was a muscle spasm, possibly brought on by my running my slow 5K in chilly weather. It was aching pretty badly on Sunday, and I told myself that if it wasn’t feeling better by Wednesday I’d call the doctor’s office. Meanwhile, I tried everything I could think of to help with the spasm.

Well, Tuesday morning I woke up and couldn’t move my neck without pain. I took the dog out, then crawled back into bed and put my heating pad on my shoulder. I ended up not going into work until 9AM. Around lunchtime, I realized that if it was hurting badly enough that it was keeping me from coming to work, it was hurting bad enough to go to the doctor. I made the call and while my doctor was out of the office on Tuesday and booked for the rest of the week, I made an appointment with a PA for Thursday morning.

Wednesday was much better–so much better, in fact, that I felt silly for making an appointment. In moments of wishful thinking, I even questioned whether I still had the muscle spasm. I decided to keep my appointment even if my neck and shoulder still felt better on Thursday morning, since it seemed to hurt every couple of days.

Thursday I went into work for an hour, then headed to the doctor’s office. My pulse was 109 and my blood pressure was 157/92! I explained to the PA that my numbers were always high, although not that high, and he checked out my shoulder and suggested doing two or three trigger point injections into the muscle to help ease the spasm.

He left the room for a few minutes and came back with an RN and a clinical assistant. He made a joke about how many people were in the room and I didn’t really think anything of it. I did think it was a little strange that the RN was standing right in front of me, though. The PA picked out the two places where the injections were going to go–the two spots where it hurt the most when he pressed down–and marked them, the assistant sprayed some freezing numbing spray on my back, and the first shot went in…

…and a few seconds later, I realized why there were so many people in the room.

“Am I supposed to be light-headed?”

“That’s normal.”

“…okay, I feel really nauseous now…”

At that point, the RN grabbed my wrists and told me to take slow, deep breaths (I hadn’t realized I wasn’t breathing!) while the PA, now with the second needle in my shoulder, explained that I was having a vagal response. In a vagal response, the body overreacts to a stimulus–the sight of blood, hearing that General Sherman has invaded Atlanta (“Uncle Peter, my smelling salts…!”), having two needles full of corticosteroids and saline injected into your shoulder–by activating your vagus nerve. The resulting drop in blood pressure and pulse cause a person to faint. Once the person has fainted, blood-flow to the brain is restored and the problem corrects itself.

Fortunately for me, I had two people holding me up from behind and one person pulling me forward from the front, so I didn’t pass out with a needle still in my back. On the other hand, in those brief seconds it took for the PA to finish the injection, remove the needle, and lay me down on the exam table, I got extremely light-headed and nauseous, my hearing got very muffled (I could still hear people talking, but it was like I was wearing earplugs), and my vision started going dark in some places. I almost blacked out completely and I’m positive that if I had been upright for another second or so I would’ve passed out completely. As it was, I’m not entirely certain that I didn’t pass out for half a second or so.

While I was laying down on the table trying not to throw up and waiting for the weird feeling in my ears to subside, the PA told me all about vagal responses while pressing on the hotspots on my shoulder and rotating my arm. He was a nice PA and assured me that this happens all the time and I was going to be fine. Unfortunately, it was many, many minutes before I was able to leave the exam room (I was in the exam room by 9:05 and by the time I got to my car it was 10:15)–every time I sat up I started getting woozy again and had to lay back down. I was assured that I could stay in the room as long as I wanted to, and I think maybe I left a little sooner than the PA wanted me to, but I was burning up and thought that going outside would help. I was shaking by the time I got to my car and, as promised, sat there (talking to my mom on my cell phone) until I felt okay to drive. And then (as promised) I drove the five minutes back to my apartment instead of the 25 minutes back to work. Good thing, too, because by the time I turned my car into my apartment complex, I was feeling nauseous again.

I e-mailed my boss, told him what happened and that I very likely wouldn’t be back in that day, and took a nap. Once I get nauseous I tend to stay that way until I finally throw up, so I felt like crap until about 11:30 that night. But the good news is, I could move my neck with no pain by the time I left the exam room, and my shoulder was numb for the rest of the morning and by now pretty much only hurts at the injection sites (and then only if I move my arm the wrong way). Every now and then it feels a little achy, but I have a two-week program of shoulder/neck stretches to follow that will help move the medicine around and stretch out the muscles.

My time in that exam room was definitely one of the weirdest experiences of my life, though. A couple of people asked me at work today what it felt like. I think if it had happened in an uncontrolled environment it would’ve been pretty frightening, but with three medical personnel around me I wasn’t scared at all. I was more concerned that I was having an allergic reaction the medication when I started feeling light-headed and when the PA explained what was going on, it was more like, “Oh, cool, I’m passing out…good thing I’m in a doctor’s office.” Imagine what waking up, very, very slowly would feel like…in reverse.

We shall resume regular programming tomorrow!