Xah: Heart Ache and Burn

By Xah Lee. Date:

Am having a kinda chest pain. A very vague, sensation of constriction in the heart area. This has happened a few times in the past month, each time lasting maybe a hour or few. It would be odd to think i have anything related to a Cardiovascular disease, since i'm rather skinny for all my life, being in a athletic condition up to my early 30s (am now 37), eat rather extremely scientifically and health-oriented…

To be sure, my body hasn't had many Aerobic exercise since about 2004. Since late 2003, i've hardly ever sweated. And, i've been smoking roughly on average maybe one cig a day for the past 2 years. Nevertheless, i'm rather fit, and can burst into jogging for prolonged period of time (am sure).

This is a puzzle. Maybe it's time for me to check with a doc.

Ok, finally, i need to see a doc. I had vague chest pains, each bout lasting several hours. Perhaps once a week or two weeks, since maybe 2006-09. I'm puzzled, because from what i read, it all reads like the pain associated with heart attack or coronary related disease, which i likely could not have. (being thin and athletic all my life, and with a diet that is extremely health-nerdy and i consume meat on average perhaps twice in a week, and mostly chicken, and always lean.) Yesterday (2006-11-12), there is a new development.

There is pain, at the location between the lower parts of my rib cage. (feel the two lowest ribs in your body, then the center between them is my pain spot.). This pain is not the vague sensation of the chest “pain”. This pain, is “real” pain. It is pain when i jump or otherwise walk or stomp on the floor as to cause internal organs to jog. When i press or tap the spot between my ribs, it hurts. When i take a deep breath, it hurts.

Ok, i went to see a doc today. After calling El Camino Medical Center, apparently my Personal Doctor which i last seen in 2001 or so, and my record is no longer there. They told me that for my heart pain, i probably should go to their Urgent Care center in Sunnyvale, as opposed to make a new appointment as a new patient. So, i went to Urgent Care center in Sunnyvale.

They are not busy at all today. There's nobody there before me. Since i don't have insurance, upfront, i'm told the visit will be $200. And any x-ray, or other things will be extra. I had to lay down my credit card there. I got called in within few minutes. First, a nurse or something asked my symptoms and get my pulse and temperature. In another 5 min the doctor saw me. She's a Indian lady, aged about 40 perhaps. I told her about my heart pain that happens perhaps once a week for the past couple of months, and told her my acute pain in the center of my ribcage that started yesterday. She used that hearing-scope and poked me front and back on a few spots. (with my T-shirt on) Then, had me lie down and poked me with her fingers on few spots in my abdomen and chest. The only pain spot is the center of my lower ribcage. So far, she didn't tell me what's my problem, but seems to be concerned about my heart pain. She told me we'll be taking a ECG and something to drink.

Then, i'm lead into another room. There, another nurse (a white woman aged perhaps 40-something, which i sense not having affinity with), had me lie down. Then, about 10 electrode glue-pads are placed on me. (they are cold) One on each arms and legs, with the other 6 around my chest. After perhaps 5 seconds, it's done! The electrodes are removed. Then, i was given a green-goo to drink. Perhaps 2 or 3 tablespoon in quantity.

After drinking the goo, in few minutes i feel numbness in my mouth and tongue. Apparently it's some strong numbing drug. And, so far i'm still puzzled what could my illness be.

Then, perhaps 15 min (for the goo to take effect) the Indian-blood female doc came again. Asking me how i feel. I'm not sure i feel any different. I asked her what's the green-goo, and she said it's for my stomach! “My Stomach!”, i proclaimed. Gee, all this feeling of impending doom is just a upset stomach? I should've known, yeah, the center of the last two ribs is where stomach lies. Why did i eliminate the most obvious organ? And i was told, that ache in the heart that goes on hours and hours, is nothing but heartburn? The chest pain of heart attack would only last a few min. My ECG looks all good.

Her: “have you been drinking coffee?” Me: «Yes, a cup a day in the past months.» “have you been drinking tea?” «Yes, several cups of green tea a day.» “have you been eating raw garlic?” «Raw garlic is a permanent part of my diet.»

That's basically the content of our conversation. She also admonishes against spicy food, smoking, carbonated drinks, stress and few others… but coffee, tea, raw garlic is what i recall since i consume them regularly. In particular i've been frequently drinking coffee and green tea on empty stomach. So, all the nervousness of heartache or the acute pain is just goddamn heartburn. This psychologically calming trip for a medical-reality lesson costs $300.

The drug she prescribed for me are Ranitidine 300 MG tablets, 60 of them.

OK, it's wikipedia time. I'll need to read about ECG, stomach, Heartburn acidity, ranitidine (the medicine i'm prescribed of), and see what food i should consume more or less.

According to Wikipedia (and the web), these i should avoid.

* Coffee, tea
* Dry foods such as peanuts
* Citrus fruits and juices
* Raw garlic
  * Spicy foods
  * Fatty foods such as ice cream
  * Tomatoes and tomato sauces (such as pizza and pasta sauce)
    * Chocolate
    * Alcohol
    * cola, caffeinated and carbonated beverages
    * Peppermint and spearmint

The list is ordered by the frequency of my ingestion. The one on top i eat almost daily. The ones in the middle perhaps once a week. The bottom ones once a month or never.

Among, these, i don't eat much of fatty foods, chocolate, and never peppermint, but all the others are on my diet. In particular, i drink a lot of green tea daily, and also all sorts of nuts just about every other day.

Other things to watch out:

Of the above, i have some stress. However, i almost never do big meals (as i eat like 5 or 6 times a day, or on average every 4 hours). Also, as a long-term habit i usually don't eat the 4 or more hours before i sleep.

After few hours of wikip reading… what i want to know but didn't find is: What or why tea, citrus fruits, spicy foods, or dry foods such as peanuts, causes over-acidity in the stomach? Or, i wished to have a basic understanding of acidity, stomach, digestion.

Some of these contains caffeine, which causes more acid in stomach. However, exactly why caffeine increases the production of stomach acid is not explained. And, i suspect, there's more than just caffeine in tea that irritates the stomach.

…caffeine increases the production of stomach acid, high usage over time can lead to peptic ulcers, erosive esophagitis, and gastroesophageal reflux disease. However, since both “regular” and decaffeinated coffees have also been shown to stimulate the gastric mucosa and increase stomach acid secretion, caffeine is probably not the only component of coffee responsible. -- Wikipedia Caffeine

The wikipedia ECG article is rather incomprehensible. It showcases, just how specialized wikipedia can be when it comes to specialized subjects, and, that doctors didn't go thru years of school for shit. For example, i'm a computing professional. If we count 8 hours as a day, then i have spend over a decade studying or writing computer software. And, to a doctor or someone who doesn't have computer training, what i know or can tell of a computing matter would be like magic. They wouldn't understand shit if they tried to read LISP or Internet Protocol.