I was on a Zoom call in my office a few months ago when I heard my youngest son, 11, cry out in pain. He was in the next room over, but cried out so loud that my coworkers on the Zoom call could hear it. I ran into the living room and he was clutching at his chest, screaming in pain like a child several years younger. It’d been a long time since I’d heard one of my kids scream like that. He didn’t know what it was, or what had caused it. He didn’t know if it would end, and God did that frighten him.
“It hurts!” he screamed.
“Right in your chest?” I asked him.
“Yes! Owwwww-ooh!! What is happening?”
I knew what was happening. You never forget your first tangle with heartburn. One moment you’re a kid, minding your own business and eating junk food like you should. The next moment your chest explodes. You feel an incisive pain, one you didn’t even realize your body could inflict upon you. All because you had some nachos.
I told the boy what was going on. I told him to breathe in and out. He was not interested in breathing in and out. He wanted this pain GONE. An impatient boy, just like his father still is. I gave him some Tums, which don’t taste quite enough like candy to pass as candy. It still hurt. I remembered my days of caring for my kids when they had reflux as infants and put the boy on an immediate BRAT diet (bananas, rice, apples, toast). The heartburn eventually subsided, and with it the screaming. But the memory is still fresh in the boy’s mind.
“Remember when I had heartburn?” he’ll ask us randomly. “I felt like my chest was on fire!”
A few weeks later, I’d feel a match strike within my own body.
I don't deserve heartburn. I was counting calories and keeping excess weight off. I wasn’t drinking. I was biking my ass off. I was also a TBI survivor. As far as I was concerned, all of my brain problems should have exempted me permanently from any other health problems, like when you’re excused from jury duty. But I’m 46 now, which means that you can do a lot of things right and still have your body go wrong. There are no guarantees and no free passes. It’s absolute horseshit.
Two weeks ago, I felt a strain of heartburn I hadn’t experienced before. It came on slow, which would be a mercy if not for what would follow. It started in my throat: that kind of heartburn that makes you feel like you just swallowed a shard of glass. Then it spread down to my chest, across my shoulders, down to the corners of my elbows, and then—and this was the weird part—up into my jaw. I was getting heartburn in my fucking teeth. It had no discernible pattern to it. It only struck once or twice a day, but seemed to have no identifiable trigger. It caused my blood pressure to spike a bit (uh oh). And it would subside relatively quickly, so much so that I could go about my daily business without much of a fuss. I still worked. I still biked. I was still fine, only not. I took Tums, like the boy did. Nothing. The pain still came back, to the point where I had to stop what I was doing just to absorb its onslaught. I could still feel it in not one but both of my arms.
My arms.
You don’t have to be an EMT to have a casual knowledge of heart attack warning signs. You’ve seen them demonstrated on TV shows, in movies, in ads, in CPR training, and in biology textbooks. Or you’ve had an older friend or relative live through the real deal. You come to know these warning signs instinctively: tightness in the chest, shortness of breath, lightheadedness, a strange pain in one or both arms…
That last one. That was me. I had the arm thing. When you’re 20, the arm thing is an intriguing factoid. When you’re 46, it’s stapled to the front door of your mind. You have been surreptitiously trained to look out for the arm thing, just as you are trained to notice irregularly shaped moles, lumps on your body, and blood in your stool. You become your own WebMD, archiving symptoms and linking them to the deadliest possible malady associated with it. Why is my pee coming out so slow? That must an enlarged prostate. What’s that weird red thing on my leg? That must be melanoma. Why are my hands lightly swollen after eating all that takeout? That must be lupus. DEATH HAS COME FOR ME.
I thought it might be stress, because working does cause me strain on occasion. I scheduled an emergency session with my therapist, the first time I’d ever done so. You’d have thought I’d lost a child in my haste to make this appointment, but no. No, I just had to talk out how blogging gets to me, which it does. We had a great session. I excised a psychic payload more gratifying than any bowel movement I’d ever had. I was good now. I drove home and hopped on my bike.
I still got the heartburn. I probably should have seen a doctor before I saw a therapist, but I was invested in the general hypothesis that I was fine. Paranoia and denial are best buds in your headspace that way. Also, if I went to the doctor, my wife would want to know why, and I hadn’t told her about the heartburn thing yet. I was worried she’d blame it on me watching too much football or something. I was already mentally scrolling through a list of potential culprits—pizza, coffee, weed carts, too much screen time—and I didn’t want another voice commandeering the investigation. If I did have to lose yet another vice, I wanted it to be MY decision. No one else’s.
Because I had already had a great deal of things taken away from me. Can’t drink anymore. Can’t play sports anymore. Can’t smell anymore. Can’t even hear anymore. You get older and life has a way of wresting away some of your fundamental pleasures. I didn’t want to lose anything else. I didn’t want be told You can’t do this one more time. I didn’t want to be remanded to a BRAT diet for life. It’s why guys like me are hesitant to bring up their problems to begin with. The potential cure always seems worse than the disease.
But the pain was still fucking killing me, in ways it hadn’t before. I was frightened. I didn’t say it, but I felt it.
I fessed up to my wife and then went to the nurse practitioner. The nurse had me take my shirt off, stuck some EKG electrodes to my torso, and checked my ticker. My heart was fine. She told me to buy some Prilosec, and then I left her office to go buy groceries. While I was in the meat aisle, my phone rang. It was the nurse again.
Why is she calling? She said I was groovy.
“Mr. Margery?”
“Yes.” I don’t bother correcting strangers when they botch my name anymore.
“OK, so I showed the EKG to our cardio specialist and he says there might be a slight abnormality in it, so you should definitely go to the emergency room and get your blood tested for troponin.”
Elevated troponin levels in your blood mean that you have either had a heart attack, or are in the middle of one. I was still in the grocery store. My wife and daughter were out together and my two sons were home alone. I finished shopping—which seemed oddly insensitive—drove home, dropped off the food and told my boy to put it away, and then checked myself into the hospital. Either this would be an intrusive errand, or I would end the day with my breastbone sawed open.
“What’s the reason for your visit?”
“I’m suffering from heartburn and they told me to come here to get my blood tested for turpentine.”
“Troponin.”
“Right, tryptophan.”
The clerk made me initial 50 forms and then slapped an admitting bracelet on my wrist. She also handed me a sheet of 20–30 labels with my name and information on them. I hoped I would not need them. A nurse took me to my room and took my blood pressure. Whenever that sleeve gets tighter, I feel equal parts violated and irritated. Probably not a good sign. My BP was high. She dug a needle into my left hand, taped it down, drew blood, and left the aperture open for future draws. Then she slapped more electrodes onto my chest and hooked me up to a heart monitor. They brought in a portable x-ray machine to take a scan. I saw its lighted crosshairs fall onto my chest.
I’d been through all this before. I knew all of this equipment: the needle, the sleeve, the electrodes poised to tear my hair out at the root. When I told the nurse I had to take a piss, she offered me a “urinal” (a plastic jug) so I could go without having to be disconnected from all the machines. I knew this jug, too. I knew it all. It was like a high school reunion for my coma. I didn’t care to stay at the reception for long.
I didn’t. After just two hours and a couple of tests, I got the news. My troponin levels were normal. I was not having a heart attack, which was good because it was pizza night.
I went home, ate the pizza, and my chest hurt worse than it ever had. Yup, it was heartburn. Yup, I knew what was causing it. But the Prilosec did nothing and the hospital had told me to see a cardiologist anyway. If you’re a middle-aged man, seeing a cardiologist is your destiny. So, a few days later, I went one. Another blood pressure test. Another EKG. More patches of hair ripped clean off my body.
“Nothing you’re describing presents as a heart problem,” he told me.
“Then what was the issue with my first EKG?”
“Your current EKG shows no problems at all. What your nurse likely saw on that first one was something called early repolarization, which we usually see in military personnel or athletes.”
“Oh?”
“Totally normal, nothing to worry about. But I will prescribe you stronger meds for the heartburn, and we’ll follow up in a couple of weeks to make sure it’s subsided. You have no restrictions on activity.”
Again, I was freed. I haven’t gotten the bill for all of this yet, but I’m sure it’ll be an entertaining one. Insurance will cover what it feels like covering, and I’ll be stuck with the rest. All for nothing. The older you get, the more hoops you have to jump through just to confirm that that your heart isn’t a time bomb, that you are not killing yourself by eating pie, that you are not dying. You’re not getting anything MORE than that, but you’re going to live.
I got my scrip, went home, took the first round of meds, and felt them smother the heartburn just as it was bubbling up. A few more days of this and I’ll have conquered the ailment. In theory. The doctor didn’t guarantee it would go away completely, and I still felt the burn in my jaw earlier this morning. The pain is still fresh, and so is the memory of it. It was just heartburn. This time. Nothing else is ever certain.
