Wednesday, February 26, 2014

A SeaSpray's Nuclear Stress Test Experience ...

Okay here is an update regarding the nuclear stress test that I was afraid to have.  It actually wasn't a big deal at all because I BREEZED right through it.  Not that it was a day at the beach, but was nothing scary like I had imagined it to be.  And yes was a creepy ...unsettling thought to think that a medication could induce my heart to work harder.  I mean ...seriously ...*I* don't even make it do that.  Such a disturbing concept I tell you ...and admittedly it had magnified in my mind ...over the course of 4 years if I even seriously contemplated going along with this test.  Just saying.  ;)  So ...I want to share my experience and perhaps this post will help someone else.

But first here are the test results:  Normal heart function.  No defects.

Woohoo!!  :)

Thank you, thank you, thank you Dear God!!!

I mostly believed I would get a good report ...but I still have to lose more weight, do have hypertension and sometimes the numbers do elevate ...and I'm not always the most compliant patient ... and I guess mostly the weight was concerning me.  Sometimes I feel like walking sin in terms of what I have done to my body for what I perceive to be the catalyst of anything wrong ...being overweight.  I mean only God knows for sure ...but I do not believe I would have Type II diabetes, hypertension or knee issues- now needing replacements if I hadn't gained weight.

And I guess because I know there is a cardiac history on my maternal side ...although they were all elderly before they had those issues ...and because of the weight ...lack of exercise ...I allowed fear to cause me to avoid.  Which is the wrong thing to do - I know.

BTW, I am still counting on outliving ..with a quality life paternal great grandmother who lived until almost 103.   :)
And now I shall tell you about my experience and the phone call after the test.

First of all ...the receptionist and other staff that came in and out of her registration area and out to get the patients to bring in the back, were warm and friendly... with easy smiles.  It had a calming ...welcoming effect that put me at ease.  To physicians and office managers (I know you know this), it truly matters what type of person represents you in your reception area.  They are the people on the front lines of your office that represent you and could possibly set the tone for the rest of their experience.  No patient should ever have to feel uncomfortable because of a cold, uncaring ...possibly judging employee. UGH! Fortunately most reception experiences are positive ...but every now and then you have to interact with someone who should be working in a cubicle somewhere away from people.  Most likely they have a gift for some other job ...away from people.    I've said it many times before and I will say it one more time here (it's been awhile :), I am so grateful for the staff at the urology office I went to when I had to go through all the things that I did. Of course my doctor was amazing and having the trust and good rapport with him was most important. I was truly blessed with the right people involved in my care at the right time. Oh how horrible it would've been had they been the unfriendly, mechanical sort know I was just a number standing in line at the deli.  Good staffing matters.  And perhaps I am more attuned to this because I was in the business for 20 years, often going out of my way to be supportive and helpful to patients.  And then I became keenly aware of the patient experience once I became the frequent flier patient on the other side of the desk.  Thankfully ...the worst of that is behind me now.

Anyway ...and I know this may seem silly ...I loved the artwork on the walls in this testing facility..  I could've gotten lost in it.  Pretty ...peaceful ..very nice.  *And something I never would've thought of until having the knee pain ...they had a comfortable raised chair in the waiting room.  Same style/fabric as all the other chairs ...just more patient friendly for those that need it.  The first time I saw one of those was this past summer, in the operating orthopedic doc's waiting room.  They are for the comfort of both hip and knee patients. And I have found they really help minimize pain because it is much easier to get up from the higher position.  I think every medical office should have at least one for their patients.

Okay to the nuclear stress test experience. 

 The thing about a nuclear stress test prepared to wait around awhile.  My test time was about 3 hours.  One woman was there before I got there and still there when I left.

The 2 technicians and the PA that worked with me in the back were terrific.   My favorite tech was the one that laughed at all my jokes.  Ha ha!  Don't you just love it when someone's humor is totally in sync with yours?  :)   But they were all efficient, compassionate, reassuring ...and even interested ...asking me questions about a story I shared.  I don't expect the latter ...but it was nice.  It showed they cared and that helped to put me at ease too. 
I'm not sure, but I think the appointment could've been shorter because it seemed they rotate patients through each step of the way.  So in my case ..the first thing was to be set up so the IV line could go in my arm for when they called me back in for the stress part of the test.  It was at this point that I told the first two techs why I was afraid to do the test.  I figured doing so would explain why they had to pry my feet and then the nails on my hands out of their metal doorway to pull me into the testing room.  Oh and so they would be alerted to reassure me ...assurances I soaked up like a healing balm to my mind and I suppose body since they did relax me a bit more..

After the IV was in, I went back out to the waiting room for awhile, until they called me back in for the photo shoot of my heart.  ;) Okay technically it was a nuclear scan of my heart prior to having the nuclear substance in my body.

This picture process takes a little over 11 minutes, while lying down in the scanner.  I am pretty sure my heart was smiling back at them when they read the scans.  That tech was so darned funny that I told her she had to stop being funny or I be laughing in the machine. And what a CONTRAST (pun intended), in my mood from when I first arrived at the facility.  :) 

At this point, she also put the electrodes on me so they could monitor me during the stress test.

Then back out to the waiting room for awhile.

And then the moment arrived.

It was time to have the nuclear stress test.  Admittedly ...I was again apprehensive about the whole making-my-heart-work-thing and hoping they wouldn't make any mistakes.  And I was concerned about what it would feel like.  Mind you ...I knew better and I was more relaxed thanks to their being so friendly and upbeat ...yet ...mental notes made ...of the exits as I walked back down the hall..  ;)  I'm kidding.  I didn't look for exits.  I already knew where they were.  ;)

So now I had the tech at my side who administered the medication and also called out my blood pressure numbers throughout the test.  And the PA was at my head focused on the information provided during the testing process and telling me what and when to anticipate the different sensations.  Just prior to their starting the test, I was thinking I was glad we were across the street from the hospital.  I really couldn't imagine what it would feel like to have my heart induced to speed up or whatever it would do.  Anyway ...just before they started, I focused on the light above and said a prayer.  Then I amused myself (humor still intact ...although they say there is an element of truth to all humor:), when I thought ...I don't want to go to the light ...look a-w-a-y from the light and I looked away.  Ha ha! :)

And right then the PA began talking me through it ..stating it would be about 6 minutes and I would peak in the middle.  I focused back on the light because it just helped to have a focus.  The PA talked to me every step of the way as the medication ran it's course ...telling me when the medicine was working ... that I would feel a flush in my face when it peaked and then it was already on it's way back down.  It really helped to hear the tech call out my blood pressure numbers which sounded great to me.  Heck ...I've had them higher just sitting in the doctor's office.

It went way faster then I thought and interestingly ...I never felt the face flush she described (And I KNOW what a face flush feels like :) and I wouldn't even have known I peaked if she didn't tell me.  I said, "HOT FLASHES must trump nuclear cardio flushes."  :)

Of COURSE they do!   HOT FLASH vs Nuclear cardio flush? NO contest! 

So then feeling quite relieved ...and surprised ...I said, "Gee ...this must go a LOT faster then the walking -jogging stress test. (I was a real Einstein with that comment. ;) And I didn't get a headache or any side effects either." They both laughed ..and agreed the nuclear tests are faster. And the PA explained that they use a different medication then they used a few years back and it is easier for the patients to tolerate and is a better experience. 

After the stress test they instructed me to go back to the waiting room and to drink three 8 oz cups of water every 10 minutes and then I would be brought back in for another photo shoot scan of my heart with the nuclear medication in it for a before and after comparison.

If I am good at anything is drinking water. I had finished my own bottle and so used their cooler.  And at the cooler an elderly man with the most gorgeous turquoise eyes turquoise as a tropical sea ... began telling me his entire life story. I tried to be supportive when he shared the difficult things, but he couldn't hear me.  And then I was a bit mortified ...when he blurted out how he stopped getting erections in his marriage. He used the "E" word THREE times and only men were in the waiting room at that point ...including Mr SeaSpray, but he was in the far corner ...and probably glad too.  I really was not wanting to discuss some stranger's erection history - EGADS!  But ..I think I stayed as cool as a cucumber  ...outwardly ...and MERCIFULLY the tech came out to get me not long after that.  I smiled graciously, waved a little goodbye to him and then in the next second, I think the guys in that waiting room saw me disappear in a cloud of dust from my propelled like a rocket escape (knees be damned), from that conversation.  Okay I embellished a bit ...but I was dying a thousand mortifying deaths being stuck int he "E" conversation at the end.  Talk about water cooler conversations!  And it's not that I can't handle an erection conversation ...but this was so out of the blue and with a male filled waiting room really shocked me and I felt trapped like a dear in headlights for the entire 30 minutes ...and I was standing too.  I should've just overrode his conversation, smiled and walked away, but he was so intent on talking and I didn't want to hurt his feelings.

The last scan of my heart was uneventful ...although not only was I certain my heart was smiling a big ...happy smile for the camera ...I was so happy to be done and leaving eight after the last scan, that I think the doctor must've seen my heart wink and wave back at him too.  No wonder I got a good report.  :)

Going home!  YAY!  I thanked them and complimented them on how great they all were.

*So the stress part of the test was not difficult at all.  It did feel a little different as the rate went up and I did look back at the light above ...but it really was not bad at all.  I honestly expected something awful and was genuinely surprised that was all it was.  And as I said above was reassuring that they were telling me what was happening during the test.  I think constant communication with the patients is important for this test.  The long waiting was the worst part.  Maybe it was pretty much uneventful because I don't have heart issues.  But having gone through it ...I would not be afraid to do it again.

Oh ...they wanted to know if I'd be flying in the next couple of days and I was not.  But I suppose I could've taunted the TSA  in Newark airport for fun if I wanted to ...setting of their machines for radioactive materials.  :)

I thanked them all as I left and told them that it was a much better experience because of how they all interacted with me and that it had been a positive experience.

We were going to go our for a bite to eat ...but after all the fluid intake and sitting in rush hour traffic bossy bladder called the shots and we just went straight home.  I also drove home since I felt normal and they said I could.  This test really was a breeze and I feel silly to have put it off for so long.  (I hope I feel the same way about my impending knee surgery.)

Then the next day ...  I came in to hear a message left by the cardiology office medical assistant to call them back.  She didn't say I had good test results.  And I do recall my doctor stating he would only call me if there was a problem.  My calm heart instantly went to pounding mode ...way more of a workout than what I remember during the stress test.  Who needs a medication when all they had to do was scare me to get my adrenaline going?!

I couldn't call back fast enough!  It turned out my doctor was away and so she wanted to schedule me to come in for a follow-up even though it was a good report. Be still my heart!  Well ...never be still my heart ...but gee that was a clear example of how the mind can directly affect the body.

That appointment was supposed to be today, but they had to cancel because he had to fly overseas for an emergency.   So we'll wrap this up next month.

And that is all I have to say about the nuclear stress test.  :)

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