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Sunday, June 5, 2011

Chest Pains

On the first day I thought I might be having a heart attack I thought it may be simply anxiety and that I'd just go for a good long sprint inveral run.  It didn't help; in fact it got worse. After 2 days of feeling like I was having a heart attack, elephants stampeding on my chest after a Lord of the Dance practice if finally caved, and my coworker’s strong insistence, and went to an urgent care clinic up the street. Low blood pressure, a normal EKG and an clear chest X-ray eliminated any life-threatening cardiac/respitory issues. However, the absence of a said issues does not a diagnosis make. So, the doctor’s bes guess was Costochondritis (Tietze’s Syndrome).

The trusted Wikipedia that knows all says this:

Costochondritis is a benign inflammation of the costal cartilage, which is a length of cartilage which connects each rib, except the eleventh and twelfth, to the sternum. It causes pain in the chest that can be reproduced by pressing on the affected area between the ribs. This pain can be quite excruciating, especially after rigorous exercise. While it can be extremely painful, it is considered to be a benign condition that generally resolves. Though costochondritis appears to resolve itself, it can be a recurring condition that can appear to have little or no signs of onset. Treatment options are quite limited and usually only involve rest and analgesics but in a very small number of cases cortisone injections and even surgery are sometimes necessary.[1]

Costochondritis symptoms can be similar to the chest pain associated with a heart attack. Unexplained chest pain is considered a medical emergency until cardiac issues can be ruled out.[1]

Severe costochondritis is referred to as Tietze's syndrome. The two conditions were initially described separately, the sole difference being that in Tietze's Syndrome there is swelling of the costal cartilages. It is now recognized that the presence or absence of swelling is only an indicator of the severity of the condition. It was at one time thought to be associated with, or caused by, a viral infection acquired during surgery, but this is now known not to be the case. Most sufferers have not had recent surgery. Costochondritis often results from a physical strain or minor injury, but the true causes are not well understood.[1]

So while its good to know, it basically says you really can't do anything about it. On the helpful handout the doctor gave me it gave the following instructions for treatment:
"Use ice for 15-20 minutes PER HOUR while awake for the first 2 days. Place the ice in a plastic bag and place a towel between the bag of ice and your skin.”

“After ice treatments (2 days), you may apply heat to help relieve the pain. You may use a warm heating pad 10-20 minutes every hour while awake.”

You’ve got to be joking. I don’t know if you’ve notice, but I don’t have a lot going on up top to serve as insulation, which really just means, "Here, let me just ice my boobs." Let’s go out on a limb and just presume that’s didn't happen.

The only other treatment is ibprofen and no exercise for 6 weeks.  I'll take it.


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