Dyspnea

I was settling into a 24-hour hospital shift on a cold day in mid-December, 2018. I was talking to my patient, trying to convince him to stay in the hospital. He was having an asthma exacerbation and wasn’t breathing very well. There was an obvious pneumonia on his chest radiograph, and he was requiring extra oxygen to breathe. He didn’t want to stay. He had to go home to his daughter. 

During my physical examination, I started coughing and excused myself.  “Doc, maybe you need to stay in the hospital instead of me, that cough doesn’t sound too good.”   

Cough. We laughed about it. I left the room. Cough. I went and examined my next patient.  

Cough. I got myself various medications to help with my congestion, cough, and runny nose. And then I convinced my resilient self that they were working.  

A few days later, one of my supervising doctors (side note: in training, we call them our “attending doctors” and they are our educators, role models, mentors, and lifesavers) noticed the symptoms. “Why are you so dyspneic?” she asked. Cough. Shrug

Dyspnea was a frightening term to hear. It translates directly to “difficulty breathing,” stemming from the Greek words dys (“ill”) and pnea (“breathing”). Nobody wants to be dyspneic. 

I chalked it all up to a “bad upper respiratory infection” that I was having— I’d get it checked out. The following morning, I called and made an appointment with my primary care doctor for an office visit in a few weeks.

I was going to be okay. For the next three days, I worked hard and continued to see my patients. I wrote out clinical case reports, & reviewed medical board questions. I went out with my friends, read my books, and continued to have my fun. Normal life things!!

Cough

There’s a part of this story that I only remembered in retrospect, and it “says a lot about me” (according to my close ones). I recall taking the subway to work and having difficulty going up the stairs without getting short of breath. Because I had stopped so suddenly to catch my breath, I pretended that I wanted to snap a photo in the middle of the staircase, so that the people behind me wouldn’t ask if I needed help. It ended up being a beautiful photo of the tiled subway walls, but a picture is worth a thousand words...

Dyspnea is almost always a bad sign, and I was getting worse. 

(Disclaimer: these symptoms worsened in a very short time period. I strongly urge AGAINST waiting a month to see your doctor if you are becoming dyspneic. Please use our emergency departments to get checked out if you can’t make an appointment soon enough— we are happy to help you.)

The next day was a blur, and the details will eventually surface throughout my stories. But let’s flash forward to me being forced into realizing that I needed to get evaluated by a physician. I walked into our emergency department, backpack in hand. There I was, scurrying around as a frightened, anxious patient in the Emergency Department and not as a young, confident Emergency Department doctor. Those around me said that I looked terribly sick. I was pale. I wasn’t breathing well. And how did all of this happen so quickly?  

My preliminary imaging and work-up was pointing to an infection of some sort. I was young and healthy otherwise, and the symptoms were abrupt in onset. 

But we have these sayings in Emergency Medicine that we follow religiously. Passed down by the generations of The Great Emergentologists that came before us... 

“Young people are able to compensate well... until they’re not and they’re crashing.”

With a pale, sweaty complexion, a heart rate in the 140s (normal being between 60-100 beats per minute), blue lips, and a respiratory rate in the 40s (normal being less than 20 breaths per minute), I was admitted to my own beloved second home— my training hospital, with my friends and colleagues around me for support. But for the first time ever, I didn’t want to be there. I was afraid of what was going to happen. 

Ironically, I spend hours daily convincing my own sick patients to stay because I care about their well-being. I never understood the hesitation that they had until this moment in my life. The denial that they are sick. The fear of the unknown. Cough

The rest of the details come later, so stay tuned.   

To end this post, I call this photo (taken the day before I was hospitalized), “Dyspneic in the Subway.” I know, my humor can be so dry sometimes. 

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Dyspneic in the Subway

Philadelphia, PA || December 2018

The Background

I was born in Los Angeles on January 29, 1988 to a very loving and supportive family. Somehow, everything came together. I grew into— and I had to ask my closest friends to describe me— a “loud, fun-loving, sarcastic, bubbly” doctor with some strange hobbies, an obsession with true crime documentaries, and an innate determination to change the world. I have lived (& continue to live) a good, beautiful life.

In 2018, I was completing my medical training in the captivating field of Emergency Medicine, while spending my free time with loving friends, good food, and crisp wine. I was obsessed with my lifelong hobby of photography. I enjoyed being involved with extracurriculars, interest groups, and academic research. I exercised when I had the chance to, and I cooked a few times a week to get my mind off of my stressful schedule. 

I was happily getting ready for a big move to New York City to specialize in Critical Care Medicine. I wanted to become a “lifesaver on steroids.” I was the definition of a patient advocate. Passionate about my career, I was ready for my next challenging chapter in training. I was stubborn, but enthusiastic and whole-hearted about everything that I did.

I followed the cliche sayings of “Carpe diem, never say never, c’est la vie” and all of the likes. I was living a good, beautiful life.

But on December 21, 2018, I almost died.

And then … miraculously … on January 15, 2019, I was reborn with a new heart, all thanks to a selfless organ donor who happened to have my matching blood type (B+, to be exact, wink face). 

I decided to create this blog to share my journey into what happened, why it happened, and what I’m going to take away from my experience. You see, there are several ways to interpret these “inconvenient" life events (let’s call these ILEs). You can genuinely see them as setbacks and let them take over your thoughts. You can blame yourself or others (or even a higher being) and dwell on the reasons why such ILE happened to happen to good, ol’ you.

Me? I gracefully embraced my ILE. I am continuing to learn from it every day, even in my hospital room on Post-Op Day 7. You see, blogging on Cardiac Transplant Post-Op Day 7 is record-setting.

This project will become my creative space to tell my story, promote health and wellness, give out any life tips as needed, and advocate for transplant research & organ donation. I may ramble endlessly, or do a few “Top Ten” Lists to change things around. Some posts will be longer than others, but I’m generally a concise & straightforward person.

I won’t keep you bored. 

I would like to end each post with a tasteful quote, lyric, photo, or book suggestion, so here goes my first one:

“At nearly 80, with a scattering of medical and surgical problems, none disabling, I feel glad to be alive — "I'm glad I'm not dead!" sometimes bursts out of me when the weather is perfect.” 

Tastefully stated by Oliver Sacks (one of my influencers, a clinician-storyteller with a beautiful knack for words, who died in 2015 of metastatic cancer). 

Until next time, World. Perhaps I will be out of the hospital by then.