August 11, 2022

Heart Feelings

 During one particularly fatigue-filled night, I felt a sensation high in my chest that was distinct from the constant nausea sitting in the bottom of my stomach. The nausea gnawed in a wispy way that I couldn’t grasp, like it didn’t weigh anything despite bringing my whole self down. This feeling was a stickiness, like if I could insert my hand into my chest I could get my fingers enmeshed in it. It hurt to swallow, and to take deep breaths, because every substance had to make its way through the stickiness. I realized it was something I’d seen hundreds of patients experience, and had never had myself -- heartburn. 

As doctors we’re always very flippant about heartburn, because compared to its doppelganger, the heart attack, it doesn’t cause serious illness. But for many people it is excruciating, which is why they often think they’re having a heart attack and end up in the emergency room, only to be sent home with maalox. And whether it’s the momentary perception or long term reality that matters most - well, I’d argue that depends on the context. When your context is swimming in estrogen, progesterone and this new hCG hormone that your body never even knew before, the moment fills your entire frame of existence.

This hormone-infused pain shot straight through my visceral self to my sentient one, and I crumpled down into dozens of tiny tears. It wasn’t so much the pain itself as much as its surprise appearance, its sudden addition to already existing discomfort. At least I didn’t wake up or go to sleep thinking that a day’s beginning or end would bring reprieve to my nausea. After the first week of its stubborn presence, I knew it would be there, and I knew what to expect. 

But heartburn, what was this? I had thought that heartburn started much later in pregnancy, when the belly’s size impedes on the chest’s anatomy. But a google search unearthed what I hadn’t learned at any period in my medical training, that it can often start in the first trimester. It was too much to face another symptom before the seemingly never-ending nausea and fatigue had dissolved. I didn’t have the mental energy or digestive reserve to battle this new onslaught, and I just let the tears pour over me. 

It was a tangible instance of what would happen many times over, in more and less concrete forms, to my body: a perpetual stacking of new weight that feels just on the edge of unbearable atop the collection of burdens below. I honestly didn’t think I could take it anymore, and I’m pretty sure I bawled that very declaration to my husband.  Then I cried hard enough to sleep, and then the pain that seemed so foreign was now embedded in my familiar, and I did as my body was meant to -- continue.  

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