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According to WebMD:

Costochondritis is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone or sternum. The condition causes localized chest pain that you can reproduce by pushing on the cartilage in the front of your ribcage. Costochondritis is a relatively harmless condition and usually goes away without treatment. The cause is usually unknown.

Relatively harmless? Perhaps, but it hurts like bloody hell. This is the current working theory for the health issues I’m having lately. It feels a bit different than the pleurisy that I previously had reoccurring over and over, although when I look back at a couple of those blog entries, I realize some of them were this instead.

And it’s a bit maddening because the symptoms closely resemble a heart attack or heart difficulties, so the first couple times I went to the emergency room (believe me, if I could have avoided out of going, I would have) both I and the doctors freaked the hell right out until it became apparent that my heart is just fine. More from WebMD:

Costochondritis is also considered as a possible diagnosis for adults who have chest pain. Chest pain in adults is considered a potentially serious sign of a heart problem by most doctors until proven otherwise. Chest pain in adults usually leads to a battery of tests to rule out heart disease. If those tests are normal and your physical exam is consistent with costochondritis, your doctor will diagnose costochondritis as the cause of your chest pain. It is important, however, for adults with chest pain to be examined and tested for heart disease before being diagnosed with costochondritis. Often it is difficult to distinguish between the two without further testing. The condition affects females more than males (70% versus 30%). Costochondritis may also occur as the result of an infection or as a complication of surgery on your sternum.

(Emphasis mine.)

This is the fourth time I’ve had this occur, and each time, the emergency room doctors spring to action, and then when they realize I’m not having a heart attack (my EKG is normal, and subsequent testing shows I’m fine) they act kind of disgusted with me for causing a fuss, and then send me home referring me to follow up care with my primary care physician.

By the time I can get in to see my physician, the pain has subsided, and they don’t do a whole lot to try to figure out what the issue was. This time around, I decided to change the game and made an appointment with the doctor first. My regular PCP wasn’t in, but the on call doctor got to see first hand how much pain I was in; enough to want to send me to the emergency room. I explained to him I had had this happen 3 times before and they decided there was nothing wrong with my heart (the most recent time, my cardiologist actually eventually ordered a cardiac catheterization that definitively proved the issue wasn’t my heart.)

This time, the on-call doctor was able to see all that in my charts and put it together. He made me go to the emergency room to rule out a blood clot in my lungs, and once they did that, I went right home, but the emergency room suggested this “Costochondritis” or “chest wall syndrome” as the cause. I need to follow up again with – my PCP.

The gap in my health care is between my Primary Care Physician and the hospital – they like to play a game of hot potato with me. The PCP wants me to go to the hospital for anything they can’t figure out, but the hospital only wants to rule out anything life threatening and send me home without further investigation, so no one ever solves the problem or follows up on anything.

And as far as I’m concerned, I’m so sick of doctors and hospitals and gowns and waiting around with Stephanie — who is as stressed out as I am about the whole business — that I want to avoid the whole thing unless I absolutely can’t function, so I’m not motivated to figure out what the hell is going on, either.

At least this time I’m closer to understanding what’s going on, but no closer to getting anything resolved. I’m loath to keep asking for pain medication because I don’t want to be dependent on it, but without it, I’m completely dysfunctional.

All of this is driving me completely crazy, too. I’m just tired of the whole mess.

Continue ReadingCostochondritis