Hi there. It’s going to be a nice day today. Care to know about a recent diagnostic procedure I had? Well, I’m going to tell you anyway because it was a cool learning experience…costly, but cool.
It’s getting to be about that time in my life when my doctors think that preventive rather than diagnostic tests might be in order. My cardiologist ordered a treadmill stress test for me last year and I did rather poorly. It wasn’t because of my heart. Ever since I had FM and CFS, my quadraceps give out very easily. I can walk two miles on good days on a relatively flat surface, but I can’t walk for long up an incline. All went well until the technician started raising the treadmill then I flunked royally.
This year he still wanted a stress test done so he ordered a nuclear adenosine heart stress test. I was told to be prepared to stay three to four hours. That in itself was just a little stressful when I tried to imagine what they could possibly do to me to take that long. Maxine was full of information about a previous neighbor of ours who was not allowed to drive and was required to stay the whole day in her recliner at home once the test was over. This was at least ten years ago and probably another type of test. I told her that the office informed me I didn’t have to bring anyone with me to drive me home. I think she may have been a little disappointed. She’s always up for learning new stuff as well.
I’m beginning to ask questions now so that the length of time of the test was the first one I asked. The technician told me that patients are informed of that amount of time because of the number of patients being filed through on any given day. He said I came on a good day. My cardiologist has the same equipment that a hospital has. If I had gone to my PCPs hospital, it would have taken the full two hours longer.
I arrived at my appointed time of 11:30 and one of the technicians was actually at the door waiting to escort me to the area. I was impressed. The other technician took me into a small room to insert the IV needle. Normally needles are put in the bend of the elbow, but since I had had a blood test the day before, and the technician counldn’t stop my veins from rolling so had to use both arms, he opted to put it in the back of my hand. I don’t usually flinch, but I did when he said that because I’ve gotten so used to my elbow that I hardlly feel it anymore. The back of my hand is much more sensitive. I asked if he was going to use a butterfly which is a smaller needle. He told me there are now needles smaller than a butterfly. I hardly felt it, much to my relief.
I then waited in line. Within five minutes the technician was done with the patient ahead of me and escorted me into the gamma camera room.
Now the camera my cardiologist used had patients sitting up. It kind of reminded me of a futurisitic pilot’s chair. I had to climb up to sit on the seat. When I said, “Pilot to control tower,” the young techie didn’t know what I was talking about. I raised my arms and rested them on an armrest above my head while he “belted me in” with this foot wide reinforced cloth around my chest like in the above picture. He sat down at the computer and my chair began to rotate around the camera so they could get every possible view. That only took about five minutes. This was my heart at rest.
I again waited in line for the next step. I was escorted into another room where I was hooked up to the EKG machine. The nuclear test guy came in to be with the EKG techie. I knew adenosine sounded familiar but I couldn’t place it. I asked nuclear techie guy if adenosine was an amino acid. Every once in a while I like to challenge my brain to remember what I was supposed to have learned in college. He didn’t know what I was talking about. EKG techie (young woman) said that adenosine triphosphate was part of the RNA …I wasn’t sure that was correct but I did suddenly remember the Kreb’s Energy Cycle where ATP is transformed into ADP…I was so proud of my brain. When I came home I naturally had to check things out. ATP is involved in Dna not Rna. It’s also necessary for the transformation of proteins into amino acids…so I wasn’t entirely off base with my first thoughts. I digress.
I think my mind was trying to divert itself from what was about to happen. I grew up as an asthmatic as a child. I know vividly the feelings of not being able to take in air, heart pounding fast, and chest pressure. I figured that was what was going to happen in a few moments. I try to avoid such occurences as much as possible. I had been advised that all those feelings could happen. I braced myself. The EKG techie took my blood pressure first. It was 130/64. That’s a little high for me. Nuclear Techie inserted the adenosine and the radioactive isotope. Within seconds I started feeling pressure inside my chest. BUT…hold on…it wasn’t all that uncomfortable. Next I felt pressure in my neck and my temples…again, it wasn’t causing a headache…just really noticeable. The only movement I had to make was kicking my feet. I forgot to ask why. The EKG machine continued to record an even heart beat. As soon as the medication was stopped, all symptoms stopped too. She unhooked me and took my BP again…it had actually FALLEN to 124/60!
At that point I got to eat my peanut butter crackers and drink more cold water. Fatty snacks kick start the liver and it disposes of the isotopes that are in the liver and kidneys so that only the heart glows on the gamma camera. Once more I crawled into the “pilot’s seat” and revolved on the “merry-go-round”. Both times the camera techie was working on viewing images of patients before me so I couldn’t tell what was happening in my own heart. It was once again beating at its 68 beat normal rhythm. Techie said the camera can record the exact moment when the heart stops receiving the isotopes…up to SIX hours after the injection. Isn’t that amazing? I didn’t get any more details.
I was completely done with the whole test by 1:00 and driving myself back home. The needle stick and the chest and head pressure were slightly uncomfortable but I wouldn’t rank them above a 1 on a pain scale and they disappeared immediately. The most painful part is paying for the test since I started a new calendar year with my insurance and have to meet my annual deductible again.
Next stop is in a couple of weeks when carotid artery, aneurysm, ASI (hardening of the arteries) and ABI (atherosclerosis) tests occur. All four of those tests are costing me less than only two of them through my insurance and the hospital. Here’s to alternative testing sites! Namaste. Attic Annie