Muscle cramps began in a few hours? Or, is it PE?

This is a cautionary tale for ER people, and also for anyone that has sudden muscle cramping from inhaling, and may assume it came from coughing. In my case, when discussing it with my physician, they were convinced I had just coughed too hard and pulled some muscles. Nope... In my case, my cough was really minimal, 3-5 times a day, and not hard at all. That should have been my clue... No known reason for these cramps, when it just started hours earlier, and got quite painful over only several hours.

I had been coughing up blood for no known reason for about 5-6 days, and then it stopped. X-ray CT, blood tests, showed no known cause. Then the bleeding stopped for about a month.

A month after it stopped, the bleeding started again for a few days. Then starting about 11 PM, one side of my chest muscles were sore. If you've ever coughed way too hard, you know you can make those muscles sore. They hurt so much, it hurts to take a deep breath or cough, and then it cramps, making the pain worse from the cramp. But, by 2 AM, it hurt a lot more. I laid down in a 45 degree reclining position. That hurt slightly worse. So then, I flattened the bed so now I laid flat. That hurt a lot more! I moved the bed back up to reclining 45. The pain was bad enough, I took 5 MG of hydrocodone, (Yeah, from my dentist, a decade ago). The cramping stopped in about 15-30 minutes, and so it still hurt, but I could almost inhale slowly without triggering a cramp.

Then I spent about five minutes, coincidentally studying PE on the MAYO site... "Coughing up blood... hurts to inhale...." OK, that's NOT GOOD. We are off to see the wizards in the ER.

By the time I reached the ER in 15 minutes, the pain was almost all gone. As I checked in, the pain level = 1=2, so no one was freaking out. They did an X-ray first, and about an hour later, a CT. They confirmed I had bilateral PE's. They were not huge, and there was no heart involvement, but still... you lose some part of your lung tissue, even if small.

About 9 AM, I was in worse pain then when I was home at my worst. I couldn't inhale much without triggering a muscle cramp! I was offered one acetaminophen... Nope -- stronger, or nothing. An hour later now in really bad pain, I asked again. I told them that it eliminated the terrible pain before, and likely would stop the cramping again, Instead of helping, they wanted to know where I got that ONE hydrocodone at home from... MY DENTIST!! @#%^^** Finally, by 4 PM, I was on my way home with Eliquis.

This story is mainly for other people, not me. Especially people that had never had a PE, and have no clue what it REALLY feels like. Were my muscles REALLY sore, or was it my imagination?? No, they REALLY WERE VERY SORE. And, just like if you had strained any muscle, as soon as you tried to use it, that muscle would cramp. In PE or for ANY other reason, they are sore, and cramp painfully, just by inhaling.

What is going on then?? The pain from the PE is felt by passing the pain on TO THE INHALING chest muscles. And then when you inhale, they CRAMP. And, that makes it hurt MUCH WORSE. So, most of us that have had cramping like that before, WITH NO PE, thinking that somehow you really strained them.

But, in my case, the onset was from nothing--no pain at all. Then three hours later, the pain was very bad.... Muscles do not get sore THAT fast. Also, laying down flat should not hurt that much worse, should it? I don't think normally sore muscles hurt worse when resting, either. It hurt A LOT (== 6-8) when laying down, even without inhaling.

Obviously in my case, the maybe slight PE pain, TRIGGERED the muscle cramping. But, if you remove the cramping, and it barely hurt at all... This pain cycled several times, from bad each time to totally relieved with just a small amount of opioid, IMO, most people would totally MISS any indication that they were having a PE.

My coughing up blood was certainly a strong reason to consider PE. But, suppose that my PE's started during the month I had NO bleeding?? The only clue would have been the nuances of the cramping I mentioned.

I'd be interested to hear from the experts. If I'm right, some training to ER folks needs to occur, if not the public. "intense chest pain" is just not specific enough to be helpful in diagnosing, or even looking for PE.