Wednesday, August 18, 2010

Burning Truths & Guineas

 I have siblings.
Together we share parents each of whom have cardiac issues. We will soon lose our mother to this  illness or it's side effects. Our dad is otherwise in reasonable health and has a new edition pacemaker.  We hope to enjoy him a few more years. Maybe another decade?

During one of Mama's touch and go hospitalizations, her cardiologist looked at those of us gathered around the bedside and asked this question, " You have each had a cardiac evaluation and baseline stress test, right"? I am sure we looked like a bobble head line up . None of us bobbled affirmatively. He glanced toward our stricken mother then flipped her chart open while saying, " Didn't your grandmother suffer from congestive heart failure too"?  She did.  Before Doc Cardio left the room he illuminated  the genetic probabilities for us.

As far as I can  remember we didn't much comment on these illuminations.
None of  whipped out our cell phones to schedule stress tests either.

Now that I am the official siblings test guinea I can tell the others to come out of  the shadows and step onto the treadmill. It won't kill you. Or hurt you. Really, scouts honor and hope to spit.


Rarely do the waiting room brochures describe your upcoming experiences. That is surely why God invented siblings.


I will admit to a wee twinge of anxiety when they started an IV so not once, but twice, I could have radioactive material injected into my bloodstream. I might have asked about the " first do no harm" idea but the folks doing this part of the prep were not docs and who knows what oaths they utilize? At least the IV got started on the first stick and not the sixth.

Following this introduction they process you into a room where  one technician , one Nuclear Cardiology PA, one treadmill and a CPR cart are  standing by. No question these folks are knowledgeable pros who do their best to explain things clearly to prevent anxiety. They did mention the need to attach a dozen or so electrodes to my chest.  They did NOT mention the need to  first sandpaper my skin to improve adherence of the electrodes being attached.  Okay, this was a bit uncomfortable but not unlike a dozen skinned knees. Nothing
noteworthy. It's not even hard to be still and not itch the sandpapered areas while they take your vitals and  do a baseline EKG before "getting started".

Following this they explain the treadmill, 12% incline at blah-blah speed to get the cardio beats per minute above 140 for a sustained period. The EKG machine records cardiac function under stress and then later an imaging machine allows them to see how well my radioactive injected blood was making the journey through my coronary arteries. Okay. Clever technology to make my blood radioactive so it could be seen without need for scalpels.

They had no  cheerful 12 pack cutie standing by to encourage me to " go for the burn" because, trust me, the burn will get there. My daily hour with wii advanced step aerobics is not even vaguely similar to this treadmill routine. I had muscle burns everywhere . Everywhere.  And then there was the breathing. That loud, labored sucking noise was indeed coming from me.  Twenty years ago , following the great neck breaking debacle, I was forbidden to ever more do any activity which bounces my neck. I have not jogged or run a  single step since then. I have not swum laps since moving to the Pond as I do not bathing suit in public. While I do "power walk" and wii, these mild maintenance protocols are not aerobic workouts. It was not pretty. I was a burning, sweat soaked, air sucking mess trying desperately to not end up face down on a treadmill.  The "team" chattily tell you  everything is fine when your brain is telling you it's time to fall on your knees and repent .  They also tell you they will continue to measure  cardio  function during the  "recovery" from the treadmill exertions.  Right. As if you could actually  hear what they say with that much wooshing in your ears.

The next part is down the hall to spend half an hour getting your coronary arteries imaged. The fact the machine looks like a 007 set where men with metal teeth try to kill you is irerelevant.  It's just a machine and  while it looks like it is going to crush any remaining breath from your tortured lungs, it actually doesn't touch you at all.  You 'get' to return 2.5 hours later to repeat the images.

Not hard in any way.
Unless you have a hard time being still. Or going hungry for 16 hours. They let you know results in 24 hours if they are normal, they call your doc if results are not. 

My results: NORMAL.
No cardiac issues found.
No valve issues.
No compression issues.
No vascular issues.
NORMAL  :- )

So maybe I have dodged a genetic bullet.
What I cannot dodge is this eye opening reality.
Get in shape NOW. It does not get easier as you add years.

20 comments:

Pam said...

Oh Fishy, I so totally identify! This seems very unlike the stress test I did in my regular doctor's office. I do not remember getting injected with radioactive material during that event. I have done the calcium scan thing twice with good results. Heart disease runs in my family also. My mom missed my wedding (out of state) because she had a heart attack the weekend before. My brother dropped dead of a heart attack at age 42. He was working out at the gym at the time, btw. I was afraid to leave the house the year I turned 42!

Meanwhile, my theory is that life is short, live how you want. But do what you can to keep yourself healthy!

fishy said...

Pam,
the operating principle here was see what is on by genetic bingo card! Then take any early corrective actions now so that I might have the opportunity to "live how I choose".

I told Mermaid this was a fact finding mission. If my srtaw was short I wanted to know so I could prioritize "me time". I still have quite a list of things I hope to accomplish.

I was advised calcium scoring is less accurate in identifying early trends than a nuclear stess test.
That a nuclear stress test is not the same test as just "a" stress test. Apparently the nuclear part of the test, and the imaging, allows them to see inside arteries and chambers with remarkable accuracy.

What have I learned? Recommendations depend on where your doc trained, what facilities are available, and what your insurance will sanction.

What fun thing do you have on your "me time" list?

Joanna Cake said...

If it's in the family, it doesnt hurt to do everything possible to buck the trend. If that means watching your weight and your cholesterol and having a regular walk or yoga class, surely it's better than spending the time worrying when the hammer is going to fall?

If only I could convince my ex of this fact, it was one of the big 'issues'. My suggestion of a little less cream and butter and a little more exercise was treated as a personal insult :(

I only wanted to keep him alive.

Boxer said...

First, YAY! for Normal. That's great news.

My Mother died of a heart attack at 71 and every male member of her famiy did the same. My Dad? Pacemaker at 74 after quadruple bypass. So, we're all very aware of our legacy.

You're so right about staying in shape, eating properly before it becomes a problem. Reversing heart disease is not as easy as just not letting it happen (or letting it get to the point where it's truly problematic.)

It's why I do my crazy boxing workouts at age 50 and (partly) why I became a vegetarian. I recently lost weight and lowered my blood sugar and cholesterol. "We" don't need to do much for excercise for the heart to be happy; walking is fine as long as it's done EVERY day and for at least an hour. Carrying small weights while you walk will increase your heart rate and keep your fragile neck happy.

Many are fearful of the truth, so congrats on making the appointment.

Did you call your siblings and ask when they're getting THEIR test?

fishy said...

JCake,
I hear you. Blowfish has 5 coronary artery stents and a pacemaker. Years ago I quit buying foods I knew were bad choices for him. So now he goes to the store to come home with three different cheeses and italian cold cuts. I tell him his choices are self indulgent and irresponsible. I might as well be invisible and voiceless.

If that is a recent "ex" status, I wish you comfort. There is no stress test for those cardiac events. On the other hand, I can tell you I think the differences you describe are key. It is a shame ex could not accept your tough love.

Boxer,
Welcome! You were missed.
Yay indeed. Unlike you, I need to shed some pounds. Also my cholesterol has been creeping up lately so I am now consuming quantities of Omega 3-6-9 and improving the sales figures for oatmeal. I like the typical Mediterranean diet but I am looking at cross referencing that with the glycemic index. It's all a struggle for me. I have no measurable metabolic function, have been on thyroid replacement4o years and so forth. Blah, blah, blah ... who doesn't have challenges?

I have been out power walking this week instead of doing the wii aerobics. In the August heat and humidity of the South it is a sauna too. Good thing my mother cannot see this. She told all us girls
"Ladies do NOT sweat, they glisten".
God only knows what she would think of me out in public with sweat rolling and my clothes sticking at every unfortunate location!

chickory said...

i wore a heart monitor for a while -i have an arrythmia and not a damn thing can be done about it. i havent been exercising like i did before Koby killed my knee and so i am fat now. but i plan to whip it and whip it good starting RIGHT NOW. great post fishy...funny and motivational.

Buzz Kill said...

I'm in the same situation that you and your family are in. My father died of a heart attack at 49. My mother had atrial fib and was on her 3rd pacemaker when she had a stroke. My sister has atrial fib and my 48 year old brother had a heart valve replaced last year.

My doctor and I have been doing heart tests since I was 40 because of the history. I had the cardio something scan where they do a cross-sectional picture of your body (I have the cool pictures). I did the stress test last year and failed requiring me to have a heart catheterization (I have the cool video). All was well and the good news is I don't have to do stress tests anymore because of the false reading - just heart caths from now on. Cholesterol is 146 because of diet and medicine.

So, use your parents to prepare for old age I always say. Their history is your history.

Aunty Belle said...

Wha'? this is all ya' got today? I ain't interested in becomin' radioactive. I'se against IVs on principle (the principle is that needle thangs an Aunty do NOT git along)

My brain is aerobic enuf jes' keepin' up wif' all the readin' in the world.

An' I jes' doan like ter sweat none.

But, the sugar is fine, the cholesterol is fine ( I does slug down the Omegas an' more eve'r day.) The doc listend to mah carotids an' said sounded ok--does that count?

Looky, I is old. somethin' has to take ya'.

fishy said...

Chickory,
No knee, no exercise is tough. Can you ride a bike? I know , I know but it isn't weight bearing so maybe a viable alternative? If not, get a hula hoop and crank it.
Stay inspired .... and please post more farm market photos and which triangle chicken did Buzz get?

Buzz,
Woe, remind me not to complain about my dna lottery. Is family history one of the reasons you developed an interest in cooking?
I do think fitness and dietary prudence are valuable tools but not always.

My mom's youngest brother is on his third replacement heart valve. The first was porcine the latest titanium and Lord only remembers what was second. No amount of diet or exercise or cholesterol lowering meds could aid him.

The surprise to me is it sounds as if you prefer catherterization over stress testing. But keep doing 'em Buzz, you don't want to miss the great Eagle event.


Aunty ,
Youse given me a stitch in mah side. Some confused too, aintcha ever read nutthin that made ya sweat? Like them reports on cardiac invalids? I reckon I am hankering to stay put on my own patch and not the community patch for the broken down.

Buzz Kill said...

The primary reason I cook is because the Mrs doesn't. But cooking does allow me to control the diet to a certain extent.

I mis-spoke on my brother. He had a valve repair. They thought they were going to have to replace it, but it turns out the valve was mis-shaped and they were able to sew a ring around it to reshape it. And they didn't have to crack his chest. They went in through his side between 2 ribs. Made recovery much easier and less painful. But it still looked pretty painful to me.

I like the heart cath because it "sees" everything in your heart and arteries where the stress test guesses based on readings. Yeah it's invasive but you know for sure what you're dealing with. And if stents are required, they do them right then and there.

I think there are plenty of other things that will kill me before my heart does. And being proactive because of my family history has gone a long way.

Karl said...

Good morning Fishy,

Good that the test came back to normal. You're right about getting in shape keep it in your mind and on your schedule. Make exercise so it becomes routine to you and soon you will miss not getting exercise.
Have you thought of getting your own treadmill? You could get a good low impact cardiac workout and stay out of the heat. I have one built into the floor of my office. I can walk and work at the same time. As I write this I'm walking at 1 1/2 miles an hour. I can't go any faster and still type. I realize this may be a little over the top for some, but it works for me. You could walk while watching television or surfing the net.

After the accident, they took some x-rays of my chest for the broken sternum and found a spot on my heart. So I had to have a nuclear stress test to prove I was healthy enough to survive the shoulder surgery. It was the first time running on the freshly healed vertebrae, boy was that a ton of fun. The spot turned out to be bruising on the outside of the heart.

Anyway some of the places I work monitor for radiation. Just imagine the excitement, six weeks post procedure, walking through a threshold and setting off the alarms. Yup, that was a ton of fun too.

fishy said...

Buzz,
Medical technological advances are amazing. It isn't just the life saving aspects either. Who wants to be saved to be an invalid? What is truly remarkable about today's medicine as it actually gives patients an opportunity to live , not just survive.
Blowfish is on your page, he declines stress tests in favor of catheterizations too.

No doubt Mrs. Buzz has other talents :-)

Karl,
Well you can be sure I love the idea of a built-in treadmill. I do
stretching exercises while I am on the phone and I try to take a break every hour or so for either a 5 minute deep breathing exercise, more stretching or,
do NOT laugh at this,
a 5 minute round of Chubby Checker and "the twist".

Er .... no one mentioned being radioactive for six months. I am getting on a plane in a few days, wonder what will happen?

Mermaid said...

Thank GOD!!!!!!! I can't handle another Heart issue!!!!!!!!!! Maybe there's hope for me in the long run! At least my lifestyle is super active, and I hope to keep it that way til my dieing day.

fishy said...

Mermaid,
It is wonderful for your generation to have medical-genetic data early in life. "Knowledge is power" was never more true. What a gift! Your generation can make wise choices now which will spare you grief and suffering later. Pretty easy babe,
keep that active lifestyle, earn and maintain aerobic fitness, eat smart, avoid smokers, laugh a lot.

moi said...

Unfortunately, genetics plays a large role in one's over all health. My mother, a super active woman, fell over dead from a massive coronary at the age of 61. That summer, her twin sister had a heart attack. Her daughter, my cousin, has heart issues, too.

As far as I know, I do not. My blood pressure is super low and my resting heart rate is around 55 bpm, but, my cholesterol flirts with the edges of 200. So, it's time for me to get this test. Even though I exercise like mad and eat well, I know that's only a part of it. "Remember your genetics," whispers my brain.

Joanna Cake said...

Fishy, ex as of one year. I have accepted that I cannot save him from himself but now I have to try to save my children from the bad dietary habits he is setting in place :(

My daughter has already said that she doesn't want to be 'like dad's side of the family', all of whom are overweight with blood pressure and heart problems. I guess that's at least a basis to work from.

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