A few weeks ago, I started having an odd sensation in my left chest, around my heart. It’s so mild the word ‘pain’ seems like overkill. I dismissed as just something weird at first, but I kept noticing it. Mild as it is, it’s not how my chest is supposed to feel.
What pushed me to act was remembering what happened to my uncle. When he felt something weird in his chest, he considered not doing anything about it, but he went to an urgent care clinic just in case. That choice saved his life.
I dug myself out of denial and did some reading on the internet. Based on my symptoms and my body, myocarditis seems like the most likely diagnosis. If this is myocarditis, odds are it will go away without treatment. There’s a tiny chance it will kill me.
I talked to a doctor. Upon hearing a description of my symptoms, he said, “you should go to a cardiologist.” He was the first to bring up the word ‘myocarditis’ in that conversation, not me, which confirms that it’s a likely diagnosis. He thinks that whatever I have is probably nothing and will resolve itself, but I should go to a cardiologist for peace of mind—and perhaps it’s not ‘nothing.’
Going to a cardiologist for a physical exam is a good idea, I agree.
Ah, but here’s the rub: viral infections are the most common cause of myocarditis. Including Covid-19.
As far as I know, I’ve never caught Covid-19. I’ve never lost my sense of smell, and the respiratory ‘illnesses’ I’ve had this year didn’t even rise to the severity of the common cold. (I have some mild allergies). This year, whenever I had the slightest suspicion of a covid infection, I took a rapid test. In recent months, whenever I had any suspicion I had covid, I always took a minimum of two rapid tests two days apart, or a rapid test and a PCR test. The test results have always been negative.
That doesn’t prove I’ve never had covid-19. Maybe covid slipped in without me noticing the symptoms, and I didn’t take the tests at the right time, or the tests gave me false negatives. Maybe sneaky covid caused whatever is going on in my left chest now. Or maybe it was one of the other viruses which trigger myocarditis. I don’t know.
If this is myocarditis, and I get a new covid infection on top of it… what happens? Will that escalate the myocarditis? No source I’ve seen says this outright, but it makes sense. Since covid can cause myocarditis, surely it can make an existing case of myocarditis worse.
What are the odds I’ll get covid-19 if I go to a cardiologist?
In a clinic which had good anti-covid protocols, the odds are low enough that I’d choose to see the cardiologist. Alas.. at the only cardiology clinic I found which seems to seriously try to prevent covid transmission, it’d take at least two months to get an appointment.
The other clinics I checked? For some, there’s little information about what they do to prevent covid spread, but the little information I found suggests that they make litter effort to stop the spread of airborne pathogens. I confirmed that one clinic tells people to remove their N95 respirators and put on flimsy surgical masks instead.
If I could wear an N95 or a P100 the entire time while indoors, I’d consider the risk of covid low enough that it wouldn’t stop me from seeing a cardiologist, especially since local laws have required health care facilities to have good ventilation for a long time (though I’ve read news articles which say the ventilation isn’t always up to code…) I’d prefer it if everyone wore a respirator (KN94/N95/P100) except the people who can’t for medical reasons, but I’d settle for having my own protection 100% of the time.
Before the omicron wave, surgical masks satisfied me. No more. In public indoor settings, I wear a respirator (usually N95, sometimes P100). Period.
Without my strict rule about wearing respirators in indoor public spaces, I believe I would’ve caught covid-19 this year.
Being required to remove my own respirator in a public indoor area—especially a public indoor area where many sick people go—is a red line I won’t cross.
Yes, the reports say the clinic may let people wear a respirator as long as they put a surgical mask on top of it. But that weirds me out. Putting a surgical mask on a respirator does nothing to stop the transmission of covid—if the respirator isn’t good enough, a surgical mask won’t improve it. It makes me question their competence. And what if they make me take off my respirator, even with the silly surgical mask on top? What if the cardiologist tells me to take it off so he can see me smile?
The doctor tried to persuade me not to worry about it, yet he made me worry about it more. He said ‘people don’t die of covid anymore.’ (That is literally false. According to the CDC about 2,500 people died of covid in the United States in the week of October 26-November 2). He said that he wears a surgical mask, but since he doesn’t treat covid, his N95 is buried deep in his drawer.
If he wanted to reassure me, he should’ve told me about what health care clinics do to prevent the transmission of covid, or that they do constant covid tests and have hard data which shows transmission rates are low. Instead, he convinced me that I can’t trust doctors when it comes to covid safety.
He also mentioned that his hospital is 30% overcapacity because so many children are sick with RSV—another respiratory virus. Since he said they only wear respirators around covid-positive patients, that implies they aren’t wearing respirators around the RSV patients.
As an adult, I’m sure RSV has infected me many times. Maybe RSV infected me recently and triggered myocarditis, I don’t know. Ordinarily, I wouldn’t worry about catching RSV, but… might RSV escalate whatever is going on in my left chest? I suspect it could.
In the middle of a surge of RSV where doctors don’t try to limit transmission—not to mention the new covid variants for which no monoclonal treatments work—is it a good idea to visit the cardiologist for a physical exam?
I envision three plausible scenarios:
- 1. The cardiologist tells me it’s nothing. I get peace of mind—but I exposed myself to covid for it.
- 2. The cardiologist tells me it’s mild myocarditis, I should rest, avoid strenuous physical activity, eat a low-sodium diet, and maybe take some anti-inflammation drugs and/or blood pressure drugs. I get confirmation—but I exposed myself to covid for it.
- 3. The cardiologist tells me it’s something more dangerous than mild myocarditis. In this scenario, it was good to see the cardiologist—but this is also the scenario in which Covid-19 might cause me the most harm.
Measures to stop covid transmission in health care clinics: mandatory respirators for everyone who can wear them, frequent covid tests, etc. would end this dilemma.
Instead, doctors declare covid isn’t a big deal.
Therefore, I don’t think a visit to a cardiologist is worth the risk unless my symptoms escalate.
I’m moving to a low-sodium diet, I’m refusing all alcohol, and I’m reducing my physical activity. The last is the hardest, but I’m doing it. None of this requires a doctor, much less a cardiologist. If it’s unnecessary, it won’t do me lasting harm, and if I have myocarditis, this might prevent an escalation.
My mother has avoided all medical care except renewing her prescriptions and getting vaccines since the pandemic started. She needs some professional medical attention by now, but she doesn’t want to catch covid. If I believed that health care clinics had good protocols to prevent transmission, I’d encourage her to go. As things stand… I think she’s making the right choice.
I’m pissed that the medical system has put people like us in this dilemma.