I have Bipolar Disorder; the most treatment-resistant form of it. In addition to the other meds I take for it, I was also prescribed 2X the maximum daily dose of a tricyclic-antidepressant. Even at that dose it was only partially effective, but it was the only drug available at that time that I didn't have some weird or allergic reaction to. During the first few years I was also taking cimetidine for ulcers. This didn't cause a problem initially, but in the end there was a reaction and my serum level of the antidepressant was suddenly as high as if I had taken a month's worth of pills in one day. I was hospitalized immediately and had to go off all meds until it was out of my system. Afterwards I went back on the same meds, minus the cimetidine, for several more years.
From the time of my diagnosis with Bipolar, I had to start having blood work done every six months. It was always very consistant--severe hypoglycemia (<60) and cholesterol levels below the normal range. This was accompanied by blood pressure so low that it was often unreadable and and a soft slow pulse that many nurses just gave up on. Then I turned 33 and my next blood test showed a glucose level over 400--Type II Diabetes. No amount of diet and exercise worked and I was put on medication within months of diagnosis. That worked for a short time, but I soon had to go on insulin. Within two years of developing diabetes, my cholesterol was almost off the chart; my blood pressure was severely high and my resting pulse rate was 137. I now take medication for all this too.
About five years ago, I started having some mild discomfort in my chest. I ignored it. It gradually got a bit worse, came on more frequently, lasted longer, and began affecting my jaw. I continued to ignore it, just resting during the worst episodes until around three years had passed. I finally told my GP about it, minimizing it as much as possible. She ordered an ECG, which showed that I have Bundle-Branch Block. An overdose of the precise antidepressant I was taking almost guarantees this exact type of heart damage and when I was hospitalized for toxicity, the doctor said I had many times the lethal dose in my blood. But since I wasn't complaining much about my chest the GP didn't see any reason to be too concerned at that point.
The chest and jaw pain continued to get worse, more frequent, and harder to get rid of. But even when it reached the point that I couldn't do a simple household task without resting in the middle, I did not want to admit it to the GP or anyone else. Then a few months later I didn't take my antidepressant for a couple of days and the chest pains were milder. I restarted the antidepressant (to make sure it wasn't a fluke) and the pains got worse again. Normally, I would have waited to talk to the psychiatrist first, but I just stopped taking the antidepressant at that point and told her at my next appointment. She said I can't ever take that antidepressant or any other in its class ever again. Over about the next month, the chest and jaw pain completely went away and the problem seemed solved.
A few months went by before I had another episode. It started out real mild like it had before, but over the next few months it worsened again. The episodes also became more erratic, sometimes real mild sometimes not. They also started happening when I wasn't doing anything--I could be laying on the couch and it could start. This time I figured it was probably time to be more forthright with my GP. At that point she diagnosed Unstable Angina, prescribed Nitrostat, and ordered a nuclear stress test.
Now I've had the nuclear stress test, angiography, a second nuclear stress test, and I have an echocardiogram scheduled for the 19th when I see the cardiologist again. The first stress test showed a small section of tissue is dead and that the bottom of my heart wasn't getting adequate blood flow when stressed, but the second stress test didn't show any lack of blood flow when stressed. The angiogram showed virtually no build up in any of my coronary arteries. Some "very odd thing" that the cardiologist "has never seen or ever even heard of!" did show up in the angiogram though.
It took me at least 40 hours of reading about coronary artery abnormalities before I found a single mention of this "thing," but I did finally find out what it is. The "thing" is called a coronary artery fistula. They are rare, so I can understand the cardiologist not being familiar with it. According to the medical journals, they account for only 1 out of 50,000 congenital heart defects. This fistula is an atery that isn't supposed to exist. It branches off the right coronary artery, a short distance from where the coronary artery branches off the aorta, then it weaves out a bit and loops back, emptying directly into the right atria. Basically the heart pumps blood out and this little artery dumps some right back into the heart. No wonder I never get anything done, even my blood is running around in circles. ;0)
I'm not really sure what to make of all this. Almost makes me wish I'd kept my mouth shut about it!