Jennifer Van Syckle  0:00  
Thank you for joining us for this episode of talking health in the 406, where we're one community under the big sky. I'm your host, Jennifer Vansickle, longtime health care worker, turned health educator. And today we're going to hear from Kelly. Imagine being young, fit, healthy and 30 something years old, when all of a sudden you wake up one night with horrendous chest pain, life goes in a whole new direction

I don't even know where to begin on what your story should be, or what how do you want to share your story? What what do you?

Kelly Little  0:44  
Um, yeah, so that's a great point. So um, my story started about a year ago, it was December 1 2021. So I'm kind of coming up on an anniversary for me. And I think your point alludes to having trouble pinpointing this, because I am a very, at that time, very healthy person, especially I worked out regularly, I enjoyed being active. And so it was in the middle of the night. And I had woke up with chest pain. So it wasn't alarming. But it was kind of inconvenient. Because I was tired. It was just a normal night for me. And I vividly remember turning onto my left side, and the pain kind of subsided and I was able to fall asleep.

Jennifer Van Syckle  1:36  
I think it would have been like gas or indigestion or it was something.

Kelly Little  1:39  
Yeah, kind of and again, to having a medical background myself. I was in the Air Force. I did surgery training. And I'm familiar with public health. These are familiar faces around here. I know warning signs. And so nothing. Nothing was a bell that said, you know, this is a medical emergency. So yeah, it's just I thought it was weird. You know, I couldn't pinpoint it. But so yeah, I fell back asleep. And it was I went back to my normal life. And that morning, I got up and went into work. And I remember when I came into work, things started changing a little bit more, and I the chest pain came back. And so same thing, you know, the logical brain would go to a acid reflux or heartburn. So I remember, I gotten into work, and I didn't have any other symptoms, but that but asked a couple people I work with, you know, to get heartburn. Because I didn't normally I'd never really experienced heartburn. So I didn't really know like, how have serious can that be? I've heard some people say it's horrible, you know? And

Jennifer Van Syckle  2:58  
was the pain the same as the night before it just like plateaued at or it kind

Kelly Little  3:02  
of came back worse? That's a good question. So um, and at that point, too, I didn't really know what to think I was like, let me this can be a little bit serious. So I did the logical things and kind of looking talking to coworkers. One person said, Yeah, you know, I get severe if I have a pepper, and it's horrible. So I'm kind of thinking to myself, well, I didn't have anything that would trigger the pain. So this is weird. So I went and got some and acids, like Pepcid, I think it was took them and you know, nothing triggered, again, going to see getting medical care, because I'm like, this is probably going to go away. And it's about you know, 10am on. Again, it's December 1 2021. And it's not going away. So at that point, I'm, I'm I have a little bit of anxiety starting to creep in, kind of some shortness of breath. So I text my husband called him he was at work that day. And he was in a meeting with his his supervisor who kind of he just kind of took it as, oh, there's something medical going on with my wife. So you know, I'm going to take this call. The guy goes, Oh, yeah, fine, you know, and he came back and told his supervisor, my husband, like, she's having chest pain, she was getting worse. And so Trevor, my husband told me that his boss said you need to go take her to a doctor. You know, and that's not something that you so I said, okay, and at this point, I wasn't really again concerned about anything serious but I you know, told told my work and all that it was about noon I'm gonna head home because this chest pain is pretty bad. So when I get home, it's about an hour later and we get into the UFC. At the you see, they

Jennifer Van Syckle  4:53  
and that's the hospital or what kind of see oh, sorry.

Kelly Little  4:57  
Urgent. Yeah, okay, got it. Um, because again at that time we're not thinking this is a medical emergency. We're thinking like you said, you know, this you had a, something you ate is something you're going to learn not to eat again or you know, some something logical that you would think with a healthy active 37 year old, or some chronic flare

Jennifer Van Syckle  5:16  
up, like gallbladder can portray itself as chest pain and heart attack. Yeah, yeah,

Kelly Little  5:21  
exactly. So they gave me a cocktail and I get to the UC, which they do is sometimes you can get kind of an inflamed esophagus, that's a symptom with a GERD or acid reflux. And the nurse says, you know, oh, you'll be feeling good after this. You know, it'll it is kind of a numbing agent and of course, do their standard things bloodwork because it was centralized to the chest. They're kind of thinking, well, maybe an EKG at 12 lead. Again, no one's worried at this point. So we're just kind of sitting around waiting around. And my mind is starting to get a little bit more concerned because I'm like, I've been taking so much Pepcid, I've been taking, you know, these high level and acids and I still have pretty bad chest pain. So then they hook me up to a 12 lead and a really wonderful pa comes in and says, you know, we're soldiers trying to figure out what's wrong. We don't think anything too serious, but you have with some elevated lab work. And she said this thing that I've never heard before no one had it. My husband hadn't. And she said you have an elevated troponin. So we're like, Okay, well, what's that, and she said it, it's an enzyme in your heart. And she says it's just slightly elevated. So it's probably nothing. But in the UC, we don't have the continual monitors here. And she's already like to admit you to the ER. And so we'll finish the 12 lead. And she's like, you know, don't worry, you're probably fine. But, and there's other things that could cause elevated heart enzymes. So I was a little bit nervous at that point, because again, I have a met a nurse, but I do like it was a surgical tech. And I'm just kind of thinking, you know, there, there isn't much else that can be going on, but like a heart condition. But the good news was the 12 lead they did came back completely normal. So all everything else said you're an incredibly healthy person, you just have this elevated cardiac enzyme. And what does a 12 lead measure? Like? Yeah, great question. So a 12, lead is a common for a heart event is a common indicator that are a common measure that they would assess. And that is your, you put the leads on your body, and it's measuring the electrical activity of your heart. So if you're having a cardiac arrest, some sort of other cardiac event, something isn't pumping right in your heart, that would that would be indicated there. Some people can have an abnormal 12 lead, and it's not necessarily an indicator of a cardiac arrest, you might have a fib, you might have something wrong with your heart. Um, and so the fact that mine came back completely normal was a very good sign that you're not really you're not super worried about something with my heart right away. So that so that was how she explained it to me. And I remember at that point, too, of course, you're getting admitted to an ER, so I did. I called my mom and dad and just said, you know, because their parents were, you know, and they weren't overly worried, either. My mom was kind of perplexed and they lived in the nearby town. But she just said, you know, I shouldn't say she wasn't worried. But you know, keep me posted. And again, too, I'm I have no medical history, as they say, so they weren't. Nobody's wheels. were spinning like, oh, my gosh, I'm right.

Jennifer Van Syckle  8:55  
Oh, man, here it's come out. We're waiting for Yeah, exactly. But it

Kelly Little  8:59  
for me, the pain is still increasing. So I'm uncomfortable, you know, and I'm wanting answers. Of course, I'm getting more anxiety. So we, we go ahead and admit me, it was a busy day in our er, you know, not surprised by that. But of course, it was stressful, and nobody wants to be in an ER, and you get the rush of nurses and you kind of get all of that. But it sat different for me as someone who has never had any major trauma or any medical condition before, because I don't have a diagnosis. So I'm here with pain. And I'm here with kind of this unsettling anxiety because the origin of the pain is in my heart in my chest. And those are kind of scary things. But I keep getting told, we don't know. And so my anxiety was really kind of spiking for a couple of things for one. The origin of the hane, it kind of had a, a gave me a sense of urgency, it kind of gave me as an individual, that gut feeling that says, you need to look into this. So I kind of starting to change my mindset a little bit on, you know, I'm not going to be walking out of here tonight, and but at the same time you you want to be level headed, you don't want to make yourself anxious if you don't need to be. So this is going into the evening of that day. And I had a couple of clinicians come in and they do their usual I was hooked up to a 12 lead continuously. So again, the electrical electrical activity of my heart was being continuously monitored. So there was no sign of cardiac arrest. And I'm just kind of in there on monitors and my blood pressure started increasing. But again, my blood pressure being someone who I would run 5k, stuff like that. And I always was exercised, Latin was very healthy. And my blood pressure, my normal blood pressure was like 90 over 60. And so even my blood pressure was elevated, it wasn't clinically off by any means, like some people would have a normal blood pressure of what mine was elevated for me. So at that time, that compounded with the troponin was the only indicator. And we're just kind of googling as we sit here, my husband and I like troponin, and it tells you if your troponin is elevated, it's a sign of a, your cardiac tissue is getting damaged. So we're kind of like, well, what is this and they came in and they said, We're gonna keep measuring your troponin. So there was a little bit of confusion because there was a shift change. And we were kind of left there for a bit and the the next thing that we're waiting for was to get this blood draw in the next couple of hours and see if it will continue to elevate. Maybe it wouldn't, and maybe it would just kind of be a, you know, other tests need to be non situation, they went ahead at that time and did chest X ray, a CT with contrast, and not came back completely normal and nothing in the 12 lead showed any sort of abnormal cardiac activity. So we're kind of just waiting here, and it's getting pretty frustrating because you're in an ER so long. And another doctor had come in over shift and said that, you know, we had shift change. So sorry, we kind of had some confusion and getting these reports to you, but your troponin is spiking. And then my anxiety started to kind of really escalate and I said, well tell me what's going on like, right? And then, you know, very polite er, Doctor, this guy was a medical doctor, at this point, continued to say, you know, we don't know you're, you're so healthy. And he did a full assessment of me again, he said, well go back to the basics, like what did they teach you in medical school? So I got a head to toe workout, but it wasn't neurological. It wasn't and where's the pain centralized? And I just I, you know, kept this broken record, it feels like heartburn. That's the only symptom that I have. Nothing makes it go away. So he wasn't really sure. You know, he said, I My advice would be to kind of admit you and continue to monitor. But he said All things kind of lead to to you know, something gastric, and

Jennifer Van Syckle  13:30  
yet on the same hand, how does gastric cause your heart? Yeah, times to that? Yeah. So you on the street now? Oh, yeah. Going Cal.

Kelly Little  13:39  
Yeah. So they were giving me they gave me Nitro. And then my husband's ears kind of perked up because his background is in engineering. And so I again, I had never had any health conditions in my life. But they give you that when they're worried you're having a heart attack. And then I'm kind of texting my mom, and she was googling stuff. And we're kind of like, you know, this looks like a heart issue. So they kind of left it. That was in the evening of that night with, you know, all we have is this clinical indicator troponin, which keeps elevating. And they said, there are other things that can cause it. But I had a great nurse come in. And you know, essentially, she kind of talked to us and said her name was Kelly, I remember that he our nurse, Tim Kelly. She said, you know, what we know is there's something going on with your heart or in that something's not right with you. You're telling me as a patient, you don't feel well. And so you know, the season ER nurse, she said you need to stay in a hospital. She said maybe it's something similar and are smaller, and that's fine. But she said on my watch, I don't want you walking out of this hospital. And so I said, Yeah, you know, I agree. We went ahead and admitted me. And again, we don't really have any clinical hints of like, this is what we think is happening to you. So I think it was around 10pm That night and I'm admitted into the hospital. The hospitalist came in and said he was about to leave for that night and have a shift change. And he said, we took your last troponin and it was in the 7000s. So normal troponin and you can get this, you know, from a Google when you're a patient is about four to 59. And it could be zero if you didn't have any inflammation in your body, because it's kind of essentially measuring that. But troponin is specific to your cardiac enzymes. So

Jennifer Van Syckle  15:33  
you're off the charts. And this has been going on for almost 24 hours now. Exactly.

Kelly Little  15:38  
So then, they kind of said, you know, we won't want you to eat tonight. And again, being a surgical tech in the background, I kind of understood, well, they might want to do some sort of surgery, you know, I don't know what that would look like, I didn't know at that point, if I'd be needed to transfer to a higher level of care. And we just thought it was good news, it's that I was being monitored, because again, the holter monitor on me at that time. So a cath lab is really not in the hospital, had I been discharged, you know, I wouldn't have had that continuous monitoring. But really, all the indicator we're watching is this, every couple of hours a blood draw in this cardiac enzyme. So they kind of were like, you know, tried to go to sleep, but we'll wake you up and take this enzyme. And, you know, we'll kind of go from there. I asked at that time for like, I remember asking for something to help me sleep because I was like, There's no way I'm going to relax at this point. And surprisingly, I did get get some sleep that night. And so the following morning, there protocol, I had a scenographer come in. And so same thing I said, you know, the chest pain hasn't really subsided. And she says, Okay, we're going to do some imaging of your heart. So the stenographer kind of puts you on your side, and an echocardiogram was performed. And that shows the, you can see the valves of the heart, you can see that pumping action of the heart. And this monography there, they have, they're well trained in this so she can see things. But again, they're not trained to give you a diagnosis, or some kind of anxiously asking her, you know, well, what do you see in there? And she's like, well, everything, you know, looks pretty good. And she gives you kind of this imaging, but she said, you know, your cardiologist will have to review that. Just briefly, I'm feeling like a little bit better, like, well, you know, I've had every test that that I can think of. So you know, I'm in the right place. And so it was that the morning of the second after the echocardiogram. And things got a little bit more serious when a cardiologist came into my room that morning. And she said, so I had a chance to look at your echocardiogram. And there's some quote, unquote, body wall abnormalities. I didn't know what that meant, but she said it was pretty concerning. And she said, so I need to well, you're down to the cath lab. So I'm kind of just, you know, this was the escalation of all these well, we don't know, we don't know. And some kinda like, well, what, you know, is it serious? Do I need to have it done now? And my husband and my mom were sitting there too, and we were pretty kind of confused, you know? Because it's like, what, what does it mean? And she said, I don't know. But yeah, she needed to go now. It's urgent. So I said, you know, okay, I don't have a have an option. So they prepped me for that, which was essentially just, you're awake during the procedure, but they'll give you like, some verse said, for anxiety. I remember speaking to when they will be back and I was on the table, a surgical tech and I remember, he was just so polite, and he told me everything that was going to happen. And I remember kind of feeling a bit comforted because I was like, wow, you know, I know what he's gonna do. I've been trained in this and but feeling a bit perplexed too, because I still didn't know what was going on.

Jennifer Van Syckle  19:06  
And your pain was still there. You do still changed. Okay. Yep.

Kelly Little  19:11  
So that procedure probably went quick, but again, my time would have been distorted because I had quite a bit of reverse ed for the pain and memory. And I was wheeled to, they put a clamp in your, they go into your wrist or your groin and mine went into my wrist. So when you're out of the cath lab, they put a big clamp on it and that's kind of their main check. There's they want to make sure that that clamp stays tight because it goes right into your artery there and if that's not tight, so I'm I remember feeling quite a bit of pain there. And you know, my memories are pretty distorted because I don't, I'm on the medications. And so some point midday that day, I get back up to my room. med surg. And I'm kind of coming out of the medication more. And the next thing is the same doctor who I ended up having a pretty close relationship with. She was kind of very deadpan. So that was a bit nerve racking. She came in and just blight you know, pretty kind of coldly said that you've had a heart attack. And I'm like, what? Because, you know, we we've had so many people in and out and I hadn't had any really definitive what's going on, you know, I figured it was going to be kind of a longer explanation, or we're going to do more testing or something. And again, I'm under medication. But it was just that was that you've had a heart attack? Well, why? So she proceeded to tell me that it was called scab, which was something I had never heard of. Well, what's that? So she said, your coronary artery had dissected. She said, We don't know why she said it's a condition. And she encouraged me to reach out to Mayo Clinic. She said, it's something that they don't know much about, but they're studying it. And she said that it, you're a typical patient that we would see with it, she said, you're a female, you're healthy, you have no other medical condition. And she said, I'm really, it's hard for me to tell you, but I don't know why this happened to you. But I encourage you to reach out to Mayo Clinic because they have a research study about it. And she said once you can kind of, you know, get your head around this potentially even being part of the research study. And she said that she was going to keep me in the hospital for a few days, because they wanted to make sure the to monitor the tear. But she said the good news was they didn't have to stent it. Because when they take the when they go into your artery, that's the risk because it's already torn that they could tear it more. But she said we want to kind of monitor you for a few days, and then kind of relax. And when you go home, and you know, hopefully our goal is to have that tear heal on its own. So as you can imagine, I'm completely you know, baffled by this. And really, I think kind of a feeling of depression came in right away. And you know, you know, I kind of got the I hate to say it, but the why knees a little bit. Because I'm kind of thinking, you know, like I did everything I should have in life. I said I didn't smoke. I was really drawn to healthcare at an early age. I said, you know, this is me thinking in myself that I've been, I was drawn to you as a career, helping people lead healthy lifestyles, because when I worked in surgery, you know, that I wanted to get to that early intervention, and that, so it's kind of it was really hard to sit there in the hospital bed and think, you know, like, how is this happening to me? So it took me a while after I was discharged, when I got home to kind of even look into it, to start researching it to look at my discharge paperwork and just say like, this isn't a joke. This wasn't a dream that you didn't wake up from. This is your life.

Jennifer Van Syckle  23:18  
Thank you so much to Kelly for sharing her story and helping us learn about sudden coronary artery dissection. For more information on that and anything else you heard in today's podcast, please visit our website at talking health and the 406 dot m t.gov. And join us again for our next podcast as Kelly continues her story. Until next time, take care

Transcribed by https://otter.ai