COSTOCON ... WHAT?

Chest pain should always be taken seriously.  Generally speaking, as a symptom, chest pain could point to a wide range of ailments.  But, when it comes to lupus, chest pain usually indicates serositis.  Serositis is among the list of 11 Criteria for the Diagnosis of Systemic Lupus; per the American College of Rheumatology (ACR).

According to the Lupus Foundation of America, serositis is inflammation of the lining around the lungs (pleuritis) or inflammation of the lining around the heart that causes chest pain which is worse with deep breathing (pericarditis).

When I first experienced chest pain symptoms, it was about 3 years into my lupus diagnosis.  I didn't understand it, was I having a heart attack? The pain was intense and showing no signs of letting up.   After several weeks of this, I realized it wasn't going away and drove myself to the emergency room. In hindsight, probably not the best decision if it had been a heart attack.  But, I was pretty stubborn and didn't want anyone to know what I was going through.  I thought it might in some way cause my co-workers to doubt my abilities or question my performance.  Not what you want when working in law enforcement, your life could depend on whether or not the person next to you has your back.

PERKS OF HAVING Chest PAIN?

So, the one perk to showing up in the ER complaining of chest pain is you go to the front of the line.  You're seen in about 60 seconds of arrival!  The downside is they're required to run the gauntlet of medical tests and you'll be there for hours.  My diagnosis:  pleurisy and costochondritis related to lupus.  At the time, I didn't know what either of these two words meant or even how to spell them; costocon .... what?

Costochondritis (pronounced kos-toe-khon-dri-tis) is inflammation of the cartilage where the upper ribs attach to the breastbone, or sternum.  Chest pain caused by costochondritis ranges from mild to severe.  Mild cases being the chest feels tender to the touch with some pain when you push on the sternum, or chest cartilage.  Severe cases cause unbearable chest pain which intensifies with your life and doesn't go away on its own.

At least now, I had an answer to the cause of my chest pain and I wasn't having a heart attack.  It's very difficult to describe chest pain to someone who's never experienced it.  Try to imagine an intense heaviness in your chest, a crushing feeling like there's a Bradley Fighting Vehicle (a tank) sitting on your chest; preventing you from taking a deep breath.    

According to the experts, costochondritis usually isn't persistent and goes away on its own.  Mild cases can last a few days/weeks and severe/chronic cases can last up to 1 year.  I kept clinging to the hope mine would dissipate and I could return to my normal activities.  I grew more frustrated and hopeless as the pain continued; my doctor ordered me out of work for weeks at a time on bed rest & I kept hoping it would end the pain cycle. At one point in my desperation, I tried steroid injections for the affected area.  Interpretation:  the doctor stuck needles (six of them) filled with a local anesthetic and steroid medication into the cartilage joints in my chest wall & sternum.  Did I mention my phobia of needles? Ouch!

Fast forward 15 years ..... I'm still living with debilitating chest pain as a chronic condition.  Unfortunately, my case was resistant to the usual treatment plan of non-steroidal anti-inflammatories (NSAIDs); but, I have found a way to manage it. 

My long-term care consists of the following:

• hot/cold therapy
• bed rest  
• physical therapy (gentle stretching for chest cavity, rib cage) 
• pain management
• lifestyle changes (avoid any exercise or activity that aggravates this condition; such as, lifting heavy objects, holding arms up to drive, coughing, lying on your left side, etc.)

DON'T IGNORE THE SIGNS