You oughta be in pictures

ER visit this week…my first ever albuterol treatment and shot of Solu-Medrol.  That is a story for another post maybe – the short version is another trick.  I am still having some chest pain and shortness of breath, although my lungs sound and look clear and my EKG is normal.  Pleurisy from dehydration is the ER doc’s hypothesis, follow up with primary care.  Which I did, today.  And started feeling super shitty in his office.  Did the flush and faint thing.  As in I get flushed and I feel faint, I didn’t actually faint today.  “Have you fainted recently?” the endocrinologist I saw last month asked.  “No.  Because I know to lay down, eat, drink, and cool myself off now.”

Which is what we did in the doc’s office today.  Blood sugar was a bit low, 84, I got super hot, and my blood pressure dropped from 116 over something in the 60s to 90 over something in the 50s  Not massive but then we didn’t keep me upright for long enough for the big drop to set in.

While we were pondering what the fuck is going on, I showed my doc a “montage” of me in various stages of flush/no flush.  I explained that this montage was prompted by the endocrinologists inquiry of “well what do you look like when you flush? is it all over red? (to me)  What does she look like?  (to my husband)”  and my response “you know, next time I’ll take pictures.  Primary care asked me to email the pictures to him.  It’s quite a gallery of “things that turn red on me” that we’re building here, still with no answer but at least there’s documentation…which is important since I also just dropped off my work accommodation forms.  More on that later too, if I can stand to discuss it.

Anyhow, here’s the cropped version of some of the pics.  Now I can say with authority “what I look like when it happens is THIS”.

three images of the left side of a woman's face in various stages of flushing.

Hot, less hot, not hot.

The caption refers to how I felt, not how I looked.  I think that how I looked correlates pretty well in terms of intensity and coverage of red splotchy nastiness.

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  1. Was it go to the ER week this week? You too? Hope the neb and steroids helped at least a little.

  2. Ack it posted before I was done. I want to say your bp sounds awfully low. I usually institute salt loading at 100/60 as that’s when I start to feel a bit woozy. I’ve been 80/50 and it sucks. M

    • yeah, the plummeting BP is one of the problems. Having the monitors on in the ER did demonstrate something interesting though. When I came in, it was ok but after a while, a nurse came into my room from the hall and said “are you ok? your face is red…” and the BPs had just started going down there too. Pre-medication, so I think it was a demonstration of whatever is going on. I don’t usually have a blood pressure cuff attached to me to have the correlation between BP and flush. The ER BP was down in the 80s over 40s range. I feel sick when it dips below 95/60.

  3. Pop

     /  November 4, 2011

    If you can, get a bp unit because you’ll start to learn when you feel low and you can treat it, eventually, without checking. Salt has really helped me a lot. I try to never let it go below 100/60 as then it gets kind of pass out-ish. M

    • I have one in fact. It’s how I know, for example, that when I was feeling really rotten for a stretch this summer, I couldn’t get my systolic over 90. It’s useful. I won’t bring it to work though, so I’m limited in when I can check. Also, I find I get self conscious even at home if I check it “too often”. :/

  4. queenofoptimism

     /  November 5, 2011

    I’m so anxious to hear primary doc’s reaction to the photos. Do you ever track your own BP? I saw there is an app and BP cuff you can attach to your computer or tablet. Would be interesting to see the combination of flushing and BP.

    Toradol is now my Rx for migraine and I recently got Sprix – the nasal spray version.

    As usual, with your body, it just doesn’t seem right – that we’re missing something important and major. Ugh.

    • Yummy, nasal toradol! I love toradol but it’s rough on the stomach I hear. But if I’m at a hospital for pain, I usually ask for it. Narcotics + my already low low blood pressure = zonked.

      I think he wants the pix mostly just for my file. He saw them, and he also saw me get red and feel gross in his office this last visit so he’s seen it. This is a big part of the “rule out carcinoid/rule out pheochromocytoma” thing. So more peeing in jugs. And then following up with endocrine, and when they find only mildly elevated stuff again and write it off as my PPI (pantoprazole) and refuse to test the other possible cardinoid products because I’m on a PPI, I’ll just bounce back to the primary care again. He did mention this summer that he’ll do genetic testing and scanning/imaging (nuclear med) if need be. I think he and I are just both trying to go by the book and let endocrine have another go at it before striking out without them. But my experiences with them echo those I’ve seen on others’ blogs (yours included I think, certainly POP’s) of them being largely useless for anything other than diabetes.

  5. drag

     /  January 19, 2014

    When you flush, do you find that the flushing starts off as unilateral (non-symmetrical)?

    When I flush, it tends to be unilateral and weird. By “weird” I mean my cheeks, forehead, and nose are all spared the redness, which primarily seems to be on my neck, the sides of my jaw, and then random bits of my trunk sometimes. I also use the word “weird” here because when I flush from exertion (working out), I turn SUPER PINK! Everywhere. Forehead, nose, cheeks — very pink. (My skin complexion is “pasty white Irish with freckles,” so the super pink color isn’t new to me.)

    However, there are other times (not related to alcohol consumption, exertion/exercise, or sun exposure) when I flush RED (not SUPERPINK! but angry!Red) and in a similar pattern that you have photographed here. The worst part is that it’s HOT!!! As in you wave your hand over it and you can feel how warm it is. Also, since it’s angry!Red and unilateral for me, if it happens around people, they tend to freak out. “Are you having a stroke or something?!” No joke.

    Anyway, I was just wondering if you had any new insight on this — I haven’t been able to get my doctor to thinking that it’s very important… but it’s uncool and definitely an issue for me… I’m concerned mine might be something like reactive hypoglycemia or a nerve being compressed or something, and this is the first post I’ve read/seen that seems anything like what I experience…


    • Hi Drago,
      Thanks for writing. It does start off asymmetric. I can have one ear flush for what seems like hours before it spreads to my face and neck. My trunk is usually spared, but hands, feet, face, and neck definitely get red. I’ve recently (since this post) discovered that I’m not really sweating in response to heat, so I’m wondering if the sweating is part of my body trying to cool off.


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