Do I need to go to the doctor?
January 12, 2018 12:26 PM   Subscribe

Is it anxiety, heart burn or something else? i know you're not my doctor, lawyer, therapist, meterologist, psychic, etc.

I can barely type out the words "chest pain" but that is what I am experiencing. Actually it's more like a chest ache that comes and goes when I move my neck a certain way / suck in what I believe is known as my diaphragm. It' s not intense or anything, it's just that it's along the left side of my breast bone (which is unfortunately where i store anxiety as well). It has been coming on and off for a while now (since Christmas, which also coincides with a spike in anxiety)

I don't understand why I might be anxious as I have been in between 2 job contracts since Xmas and have had the last 2 weeks off. A few positive momentous things have been circling around me lately such as
1) signed a new job contract at an amazing company yesterday and the imposter syndrome has already kicked in
2) Hooked up for the first time last weekend with someone I've been secretly in love with for the past 4 years.

Also a couple weird things about this week
1)it's humid and has been raining in Montreal for the past 24 hours, all the snow melted and I am seasonally very confused right now
2)I had to go to the hospital to get my blood drawn today, and just in that moment realized that I have a phobia of hospitals especially in Quebec where if I speak English I will be shunned even though I don't know medical terminology in French
3) I had to do all this volunteer work this week for a musical group I am in,, which involved writing, translation, chasing people around for signatures, and picking up slack for others, and I feel really burned out from that even though I am not working full time at the moment!
4) My apartment is a mess and I can't find the organizational prowess to make any dent in the chaos.
5)i've been trying to eat more fruits and veggies lately, which might be causing me heartburn.
6) i might still be recovering from my new-job- celebrations- hangover on wednesday night.

Why am I telling you all of this? Because I need to know if I need to visit the doctor for a mild ache in my left breast that also might be because I need to burp, or because I'm anxious, but I'm only 29, but heart disease does run in my family, anyways, I live alone and I take care of myself but i can't figure out what to do in this situation, and I've had 2 lattes today. I don't know if I'm happy, sad, anxious, gassy, or in cardiac trouble. Thank you.

posted by winterportage to Health & Fitness (31 answers total) 1 user marked this as a favorite
IANYD, but based on what you have written here, it's more likely to be something like costochondritis than anything seriously cardiac. I don't think there is any urgent reason to go to the doctor.
posted by gemutlichkeit at 12:37 PM on January 12

You should at the very least make an appointment with your GP. It sounds a bit like the symptoms for acid reflux, and, while that isn’t immediately dangerous, it’s painful and can cause other problems. Having a plan might reduce anxiety, too. If the pain gets worse, the ER is not a bad idea. Of course, if your GP has an after hours line, you should probably call them and get an actual medical opinion.
posted by GenjiandProust at 12:38 PM on January 12

I'm a licensed EMT, but I am not your EMT and this is not medical advice, etc.

I would always counsel someone with chest pain to seek medical guidance. None of what you've said sounds to me like the classic descriptions of things-that-will-kill-you-in-five-minutes chest pain (like an MI). It doesn't even sound cardiac to me, from what you've said. But none of us can examine you from here, things sometimes present non-typically, and chest pain isn't anything to play around with. Why not get checked out so you know for sure, which should also help reduce your anxiety?
posted by ClaireBear at 12:41 PM on January 12 [8 favorites]

I think you *should* go to the doctor, but also agree it's likely costochondritis.
posted by hollyholly at 12:41 PM on January 12

Just wanted to add: I also meant to ask, if I need to go to the doctor, do I need to go TODAY or can I wait until Monday?
posted by winterportage at 12:43 PM on January 12

I think for both peace of mind and to exclude the possibility that it is something serious, you ought to go ahead and go.
posted by hollyholly at 12:51 PM on January 12

I've had to take people to the ER twice with chest pain that turned out to be heartburn or similar. Both times, everyone we spoke to at the hospitals took us seriously and didn't shame us at all for coming in instead of staying home and burping. I can't say what your chest pain is, but I can say that you won't be looked down upon for seeking medical care for it.
posted by The corpse in the library at 12:57 PM on January 12 [2 favorites]

So, as you didn't mention your gender in your question, I checked your profile.

And I know we aren't supposed to mention stuff on your profile that's not in the question, so I won't actually say what your gender is in this reply.

So on the of chance you happen to be a woman, you should be aware that heart symptoms present differently in women.

You're in Canada, it's not like you get a bill for thousands of dollars to go to the hospital and get checked out! Go already!

Us Americans don't go because we have to balance paying the rent against whatever the symptoms are, why wouldn't you go?

I can barely type out the words "chest pain" but that is what I am experiencing

Yes, you need to see a doctor today! Now!
posted by yohko at 1:01 PM on January 12

I can barely type out the words "chest pain" but that is what I am experiencing.

What do you mean by "can barely type"? Do you mean that it causes more pain when you type?

I would, in this order:

1. call your doctor's office and ask to speak to a nurse, ask them what they think
2. if one is not available, make an appointment with your doctor for Monday
3. go to an urgent care if those exist in Canada - is there someone who can act as translator/intermediary for you?
posted by AFABulous at 1:02 PM on January 12

I can barely type out the words "chest pain" but that is what I am experiencing.

What do you mean by "can barely type"? Do you mean that it causes more pain when you type?

Sorry, I worded that really badly. It's not causing me pain to type. I am just deathly afraid of the words "chest pain" because I have a (justified) fear of heart problems. But I also have a phobia of hospitals and doctors.
posted by winterportage at 1:04 PM on January 12

Go see a doctor, or go to Urgent Care or Emergency. It's really unlikely to be a heart attack, but it still should be checked because sometimes it's a heart attack.
posted by theora55 at 1:04 PM on January 12 [1 favorite]

I had some rib pain shortly before Christmas that sounds about like your chest pain -- achy, intermittent, on the left side where my ribs hit my sternum. I called my insurer's nurse line and they told me it was probably nothing dangerous, but that they tell anyone presenting with any pain in their chest to go ahead and see a doctor within 24 hours. I did and they diagnosed me with costochondritis. Everyone involved was very nice about it.

If you can swing a trip to the doctor tomorrow, I'd do that just to help your anxiety. A couple of things I've done that helped my costochondritis pain: ibuprofen and Tylenol (just one dose would not really touch it, but a few in succession helped), stretching my pec muscles (think chest-opening yoga poses), avoiding heavy lifting, applying a hot towel, and sleeping on my back instead of my side.
posted by clavicle at 1:10 PM on January 12

If this pain has been coming and going with no increasing intensity since Christmas (roughly 2 weeks?) it does not sounds like an emergency situation that would require you to head to the hospital immediately. If I'm reading that wrong and the pain has come on suddenly or is suddenly becoming more severe, I'd be more inclined to say hospital now. But absent that, I think waiting until Monday is fine.

Have you taken something that would resolve acid reflux to see if it resolves the symptoms for you? If a Tums resolves the symptoms, you could still make an appointment to get checked out by your doctor (since persistent acid reflux could require more serious medication than a Tums, and your doc could also talk to you about general things to do like avoiding triggers, sleeping propped up, etc. etc.), but at least you'd have a good direction to ask your doctor about.

Separately, if you have a family history of cardiac issues and are worried about this, it's a great thing to raise with your doctor to ensure that you're getting any relevant screenings, doing general heart-healthy things in your life, etc. You can also go over with your doctor what types of symptoms mean they'd want you to go to an ER immediately vs. make an appointment vs. simply raise at your next scheduled visit.
posted by rainbowbrite at 1:15 PM on January 12

Sorry to threadsit but I am confused about the whole/ doctor/ hospital/ ER thing.

- I can't call my doctor because he works out of a clinic that doesn't answer the phone and I think he only works monday to Friday and it's an hour away from me

- If I go to ER I will probably be waiting there for 8 hours and this will make my anxiety worse

- What about going to a CLSC (clinic)? are they gonna make me run around in circles to get to the right place and send me to ER anyways?

- i can't call my parents because my mother will just get anxious.
posted by winterportage at 1:15 PM on January 12

I can't speak for Montreal (I'm in Edmonton), but I think that if you decide to be seen today, you might be best off going to a drop-in clinic. If they decide it's serious, they'll requisition an ECG for you, I would imagine. Which you could then do at the nearest lab. I say this because I agree you'll be there for 8 hours. Also, you might get lucky, but when I went to the ER once with chest pain I was treated with disdain by the triage nurse ("Why didn't you just go to a drop-in clinic?"). If you are male, though, you may fare better.
posted by kitcat at 1:21 PM on January 12 [2 favorites]

Another thing to consider is to borrow or purchase a small Blood Pressure Monitor, these devices are helpful for deciding if you should go to ER for minor chest pain. If you go to Emerge for chest pain, the first thing that will happen is a quick blood pressure test, and if you don't have a funny reading then you'll end up sitting in a waiting room chair for a verrry long time. Also note: many pharmacies have free blood pressure monitors, but every time that I've tried them (while bored waiting for scripts) they always read somewhat higher than usual compared to other readings.
posted by ovvl at 1:37 PM on January 12

I think going to a clinic is a good idea, but if you are still on the fence (and for the next time you are in a health situation where you're not sure what to do), call your province's nurseline. In Quebec this is 811. I have used this service in my own province several times when it was after hours and I wasn't sure if I needed to go in or not. The nurses who answer the phone are (in my experience) soothing and professional and reassuring. In two cases they told me I didn't need to go in to the ER but to monitor the situation and as long as it didn't change, just see my doctor the next day; the most recent time, I was told to get to the ER immediately. I find it very calming just to know that 811 is an option for me and I trust them to steer me right.
posted by hurdy gurdy girl at 1:43 PM on January 12 [4 favorites]

Go to the ER or walk in clinic TODAY. Where I live there are clinics that are for mini emergencies, don't they have that where you live. You should know. The hospital would know, you can ask them. Call a Nurse is good but I think you really need someone to look at you in real life. This will ease your anxiety which you desperately need. My husband's father died of a heart attack when husband was 18. When he was about your age he had heartburn but thought it was a heart attack and went to the ER. WHat else could he do? I feel like this is a right of passage for people who have a history of heart problems in their family. Might as well get that first "I think I might be having a heart attack" ER visit over. Meanwhile, learn all you can about heartburn and gall bladder problems. SO you can avoid them. You should probably stay on an anti-heartburn diet. Just have the best diet you can. Most things come down to nutrition. My husband has been having Trump-induced heartburn lately and because of his father's heart problems we have been using flow charts on the Internet that are helpful. They ask questions like Is it worse when you lay down? To help you figure out if it is heartburn, heart attack, etc.
posted by cda at 2:26 PM on January 12

Take some Tums. If you have heartburn, they'll help. If you don't, they're harmless. Call the consulting nurse line recommended above. My experience with consulting nurses has been universally helpful. They're kinder even than nurses you see in person, somehow.
posted by purple_bird at 2:31 PM on January 12

I've been to the ER several times with costochondritis. And every time I go, I feel like an idiot, because at this point I know it's really not a heart attack. And each time I dread going, because I know I'm signing up for at least 4 hours spent in the ER, which is not a pleasant place. But every time I do go, even with my history, the ER treats it like it's important because it is chest pain, and they always tell me that chest pain is a valid reason to go to the ER. I usually end up with some pain relief, but even if all they decide to give me is advil, the relief from the anxiety of the "what ifs" of a heart attack alone is beneficial.

I don't believe in going to the ER for every little thing. But for chest pain, (and *especially* if it's a new symptom), just go. Also - this is not something a clinic can diagnose, because they will most likely give you an EKG, take your blood, and send you for a chest xray. All of which can be done easily in the hospital, but are not available immediately in a clinic. You are fortunate to be in Canada in this situation, where you will presumably not be saddled with crazy medical bills. Just go to the ER. Today. Better safe than sorry. It's probably anxiety, or costochondritis, or some other non-life threatening thing. But you can't know that for sure on your own.
posted by cgg at 2:33 PM on January 12 [1 favorite]

Hi I'm you!

811 is very helpful, even when you're calling them at 3am because you have a fever and your neck hurts and you think you have menangitis (I didn't)

Tums are helpful if it's acid and no harm if it's not. Zantac is also good.

Meditation can be helpful but don't do something that focuses on your inhale exhale because you will be hyper focused on your heart/pain. I like focusing on the feeling of breath moving on the skin under my nose.

I've been to the emergency room twice and a walk in clinic once for chest pressure and they've always taken in seriously. Even in Quebec. A clsc should do similar things as walk-in clinic (either reassure you you're not dying or reassure you the emergency is the right thing, either way you'll feel better).

Tell your doctor this is a thing for you, they can do test that will reassure you that everything's okay. I discovered my iron levels were low which was triggering a bunch of sensations which triggered anxiety which made symptoms worse.

Also get yourself checked out but that's a lot of change! Even good change can trigger anxiety.
posted by platypus of the universe at 2:41 PM on January 12

If the pain goes away based on how you position yourself it isn't cardiac. I've had subluxation of the ribs and it hurts in the chest, sometimes horribly so. It can take a week or two to go away and there really isn't anything to do about it except try not to strain yourself in that area. Also, sleeping on my side tends to make it worse.
posted by waving at 3:13 PM on January 12 [1 favorite]

I don't mean to be crass, but have you pooped recently? I had similarish-seeming symptoms last week and, well, again without being crass, that was the problem for me.
posted by mcbeth at 3:34 PM on January 12

Ok, so I'm at Emerg after getting an ECG and blood tests and am waiting for the next step ( whatever the hell that is) but now I have ànother problem, which is that the Doctor tried to sexually harass me. When I came in he said : "Do you need me to undo your bra?" And then he started feeling around my back. Luckily, my bra doesnt have a hook because it's a sports bra. Then he did the test and it was obvious that my bra didnt need to be off because hé had no trouble finding the right spot with my bra on. So now I'm basically waiting for the next test with him. WTF am I supposed to do?
posted by winterportage at 3:46 PM on January 12

Oh no, I'm sorry you're in a stressful situation like this on top of the stress you're already feeling!

I don't know if it's too late and you've already been seen by him, but if not, can you find a nurse to talk to about this? Tell the nurse you don't feel comfortable with the doctor and ask if you can be seen by a different one.
posted by hurdy gurdy girl at 5:32 PM on January 12

This doctor should have communicated more clearly and told you why they needed you to remove your bra. That being said, for a proper cardiac exam it is important to expose the chest so the doctor can look, feel and listen to specific areas, many of which are around your left breast. It seems this doctor just rushed straight into it without explaining, but it is a normal part of the exam.

I'm guessing the doctor saw you were uncomfortable and decided to let you leave the bra on, but that's really not ideal, you can miss subtle heart sounds if you're trying to listen under a sports bra, and you obviously can't look for visible pulsations. Your doctor could have explained this to you though.
posted by piper4 at 5:49 PM on January 12 [1 favorite]

Please find a nurse and ask to see a different doctor.
posted by fairlynearlyready at 6:16 PM on January 12

OK so it's all over now. He said he couldn't diagnose me with anything but that it's not cardiac. He also said I have a "beautiful aorta" whatever the fuck that means since presumably he felt it would not be kosher to say I have beautiful breasts. Well, it was the Jewish hospital so maybe it would have been kosher but not politically correct.

I understand that the chest would need to be exposed for that type of test. However, I am perfectly capable of removing my own bra. All that would have been necessary would have been for him to ask me to remove my shirt and bra. No, that is not what happened. The second i got in he came towards me, said "Do you need help undoing your bra" , not even, "I will need you to take off your bra," and then started fishing around for the hook on my back as if he was trying to get to second base.

Then, when he was doing the test, he kept cupping me towards him so that my ass would be touching his leg. He started listing off medical parts of the heart that i don't know because I'm not a doctor, and then he was like: "Do you remember anatomy class? Did you even take anatomy class?" Then he asked if I wanted to see my heart because it was so beautiful. I thought it looked nasty and told him so. I said "that's why I'm not a doctor." He was so creepy I can't even.

Anyways, I still have no idea why I have chest pain. LOL. But at least I'm not literally dying today.
posted by winterportage at 7:06 PM on January 12 [1 favorite]

I am glad you are okay today.

Two things: First, it's not standard for the doctor to touch you without your permission to help you remove your bra. I sometimes work with medical students as a standardized patient, and during one test simulation, I was evaluating the students on their interactions when doing a physical exam. The students were supposed to ask me to remove the top part of my gown (all the SPs were wearing sports bras in prep for this), and wait for me to say okay and remove it myself. All the students followed the procedure except one who rushed it; as he was saying "I need you to remove your gown," he GRABBED THE GOWN and pulled it off my shoulders. I wrote this in my evaluation and reported this separately to the supervising doctor/proctor after the tests were over. It was definitely a big deal. I didn't think he was being creepy, but it was inappropriate and he needed to have that made clear. All this is to say, I agree the doctor may have needed you to remove your bra, but it's not standard practice for him to do it for you without your permission.

Second, please go see your GP and let them know about your chest pains. Heart issues present differently in women and are sometimes missed. This happened to a female friend of mine who ended up having a more serious cardiac event after her doctor missed connecting the dots with the symptoms she had been experiencing.

Good luck and take care.
posted by hurdy gurdy girl at 4:00 PM on January 13 [1 favorite]

I've been thinking about your story and I came back to encourage you to contact the patient ombudsman at the hospital and let them know what happened. A letter or email where you can describe the doctor's behavior (be as factual and professional as possible) finishing up with something that says that this was inappropriate and uncomfortable and that you expect the hospital will want to work with doctor to prevent this behavior in the future.

Even if they agree that it was out of line, they will probably treat it as an internal HR issue and not let you know if they took any action. Still there is a real chance that someone might talk to the doctor and tell him to cool it. Or that if the letter doesn't create a direct action, it will start (or add) to a file that someone can use to discipline the doctor later. It might also make you feel better than you took action and didn't just pretend it was OK when it wasn't.

Glad to know you aren't dying today!
posted by metahawk at 1:19 PM on January 14 [1 favorite]

Thanks so much for the kind words. I have sent an email to the patient ombudsman. I hope it was professional but I kind of think I may have been a little bit upset still and that might have come through in the email.
I am also tempted to post a review on one of those "rate my doctor" websites, although I am not sure if that is right or not. I just want other women to be aware and for this guy to not get away with it. I am so sick of men getting away with stuff like this and now is the time for it to end. It's just so disrespectful! I hope it's not too late to teach an old dog new tricks. I don't feel like I owe him something because he examined my heart. That's his job and his duty and if anything he bears a bigger responsibility than the average man because he is dealing with people in distress and holds the power over them. Though I imagine that in itself must be a lot of pressure to bear. So I don't know how to feel.

I'm still having the chest issues too, so I am going to visit my family doctor this Wednesday.

Thanks again so much for the replies. Even just knowing that someone out there cares that I'm not dying, just feels good, even if it's a kind stranger on the internet who I might never meet. But the world is funny in that way, isn't it
posted by winterportage at 10:00 AM on January 15 [2 favorites]

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