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Pain (Read 1788 times)
Glen
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Pain
Feb 08th, 2010, 8:42am
 
Hey RLR,
I am back  and wondering if you could shed some light on something for me. My palps are better and my left pain was gone, but a few days ago I started having left jaw pain and chest pain and arm pain, which I have had befor and after all the testing(it has been a year) was not my heart but all of a sudden it is all back and with a clammy feeling. My head says it is not my heart but my emotions say that I could die any minute !! Why would this come back and if not my heart then what !! All you hear anymore is stuff about heart attacks and what a killer it is, how do I put this aside or do I go back to the Dr again !!??
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RLR
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Re: Pain
Reply #1 - Feb 8th, 2010, 5:42pm
 
Okay, it's obvious that I can't make decisions for you regarding visits to your primary care doctor, but let me say that your notions would likely be dispelled if you could observe a patient suffering a cardiac event with referred pain to the left arm and lower jaw. This is not an ambivalent experience where the patient claims "Gee, my arm is aching and I have this rather annoying shooting pain up under my jaw."

It's an outright shreek of pain that every patient I've ever observed is absolutely incapable of tolerating. They literally fold up onto the floor if standing, or roll over on their side if sitting. You have to realize that the pain is from an ischemic event and it's the farthest thing from sublime that you can imagine. Again, it's not a nagging discomfort and the impact is unmistakable. I've been in the halls of the hospital wing and on a couple of occasions heard and recognized it from a far distance. It's a pain you won't have to inquire about, trust me. You also need to realize that other events are taking place during the ischemic event as well.

Many, many years ago when I conducted rounds with medical students, we would visit a room where the patient would subjectively complain of sub-sternal pain, with a vague distinction that it was being felt in the left arm. The students would perform their cursory examination and invariably fish for guidance in making inquiry whether they should perform an ECG and other diagnostic tests to rule out a cardiovascular cause. I would shake my head negatively and tell them to examine the whole patient and not just the pain.

By contrast, when I was hailing from the emergency department and a patient was experiencing an myocardial infarction, the students never once seemed uncertain about what was taking place in those patients.

Persons with anxiety disorder with somatic features are going to universally experience unfamiliar aches and pains. With a little inducement, associations will quickly be made by comparison to characteristic physical signs of diseases which are popularized by preventative medicine.

Again, I'm sure you realize that it's impossible for me to guide you regarding decisions to see your doctor, but you might want to consider taking an anti-inflammatory or similar over-the-counter analgesic to determine if it has a positive effect on the discomfort. If so, then I'd more likely think that the pain is due to musculoskeletal tension.

Best regards and Good Health

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Best Regards and Good Health
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