<s>[INST] hi in 2010 i work 38 hour shifts slept 12 hour and another 38 hours and so on and so on for about 9 months but now for that last 6 months i been having chest pains and i feel a twitch under my rib cage by my heart is it possible i got sick work in that manner [/INST] Hi thanks for contacting Chat Doctor... You had done 36-hour shift duty in the past. And your job not smooth .and doing shift of different time.... So your pain here seems to be musculoskeletal pain by over work... Mostly muscular strain present.... Rest done...If you need analgesic given... Apply hot pads ... Avoid overexertion... Take sleep in supine position ... Try to avoid movement causing pain. If still condition worsen then your examination done to investigate further... Take care. Chat Doctor.  </s>