Sunday, February 9, 2014

Avoiding ..THE TEST and Other Patient Thoughts

I'm giving up coffee until some time tomorrow.  Well ...I have an hour to go.  I can't have coffee for 24 hours prior to the nuclear test I am having done.  What test you ask?

Ugh.  A nuclear stress test that I really, really do-not-want-to-do.  (Heck ...I'd rather have a ureteral stent removed in the office than do this test.  And anyone who followed my uro posts knows how I feel about that #10 exquisitely painful pain and so that is saying something.) I don't have any cardiac issues and actually ...this test was suggested to me the first time in May, 2009 and then in November 2011.  I did have normal echocardiograms at the time - both times.

The catalyst for my wanting to have a cardiac evaluation was because I was having heart palpitations.  The first time was in the spring ...of 2009 ...but my mother had died that April.  They stopped in May.  So I decided I didn't need the stress test, since the echo was normal.  "YOU decided?", you say.  I know ..but it just didn't seem necessary.  Plus wouldn't any doctor seriously concerned have tracked me down and insisted?  Okay ...I know patients can get lost in the mix of busy practices and human error

But then between August 2011 and October, 2011 ...I was having significant palpitations.  But that is when my lifelong friend, Iris was dying of stage IV lung cancer.  I was very involved in her care and glad to be.  I couldn't do enough for her although I think I was burning out a bit toward the end.  I tried so hard to be perfect ..or rather to do things perfectly for her be a blessing.  I know I wrote about this before, but twice she gave me the ultimate compliment ...seemingly in awe herself and so very grateful ...she said, "Patty, no one has treated me this good except for my father."  Believe me ...I know how he doted on her.  I wasn't trying to be like her father.  That never crossed my mind. I was trying to give my friend all the love and support I could before she died.  It was both a joy and a privilege.  I definitely tried. But I digress.

The thing about the palpitations during those last couple of months with her that they were fairly regular ...but they stopped right after she died.  If that isn't a demonstration of the strong connection between mind and body ..I don't know what else is.  Boy heart really was reacting to being shattered in pieces over losing my childhood friend of 52 years.  I imagine my heart was crying out  and crying ..."NO!  NO!  NO!  THIS ISN'T HAPPENING!"

 Then she died. 

And the palpitations of resistance...along with profound stress and feared loss ...stopped.

However, I still decided to get checked.

I was alarmed when I heard a message left by my new pcp's medical assistant ...that the echocardiogram indicated that I had a weak heart wall.  "WHAT?"  But ...I never called their office.  I don't know why exactly.  I guess because my new PCP was still relatively new to me and if that is how he chose to deliver the message to me ...then he did not want to discuss it.  And then I reasoned and besides ..what can he tell me?  This is why he is telling me to see a specialist and they will forward the report.  So ...instead ...I  just followed instructions to see a cardiologist.  That was one l-o-n-g week ...let me tell you.  And I should not have googled anything about it because it is hard to differentiate what is applicable and what is not ..thus I scared myself even more.  I also did not like getting the news that way and 100% believe that my doctor should have called directly.  My old PCP absolutely would have.  So would my gynecologist.  And my urologist would never let important news be delivered via anyone but himself.  And I realize ..wait ...COFFEE BREAK!  I only have until 1pm to drink coffee or have caffeine ...which I only want in the form of coffee.  Oh ..anyone familiar with my medical pre-test ..pre-op posts knows ..that I am wanting all the coffee in the world right now and that I am feeling like I will never have it again because now they say I can't.  Forbidden fruit and all that.  The upside is that I can drink water. (and other things ...sans caffeine.)  If you want to torture me ..tell me I can't drink water.  That IS the WORST!  BRB.  :)

Okay so I practically chug-a-lugged the 2nd cup and am now on my third.  The time is set for 10 minutes to drink one more.  Hey ...I had a real busy and long day yesterday and I need this stimulation right now.  I want to go to Macy's and Penny's and be awake to drive.  :)

Anyway ..I did say something to my new PCP and he said that he only calls for emergencies and serious reasons.  I said but a weak heart wall IS a serious reason. ?  Then he countered with he can't call for everything when he has (I think he said 60 calls) to make at the end of the day.  That sounds ridiculously high ..but the number was high and I don't recall it now, but he also has 2 other specialties besides being an internist.  And I really do like him a lot and we've been establishing a good rapport as time goes on.  I am amused at the way he challenges me.  But that is another post.  I have actually been remiss with getting back in there and that too is another post.  But ..I will be seeing him in a couple of weeks ..once other reports come in and he can clear me for the knee surgery ...again ...yet another post.  :)

And I will just say that I know the days of Dr Welby are dead.  I find that to be so sad though ...and frustrating.  I can only imagine how physicians feel ...especially with all the added pressures of complying with the ACA  regulations and it seems it will get worse before better.  I pray it will get better for all ...doctors, their patients and all involved in patient care.

The week I waited to see the cardiologist seemed like the longest week of my life.  There is something about thinking your heart is faulty that just sucks the breath right out of you.  I mean ..after all ...every beat keeps you alive.  I couldn't wait to get in to the appointment and I was afraid to go to the appointment.  ha!  That is indicative of the walking paradox I can be at times.  If I believed in astrology, I'd say it was the Gemini in me.  :) 

And so as soon as he walked into the exam room and sat down ..he looked at the report ..then looked up and said, "Why are you here?"  That took me aback because ..the report was right in front of him and he is the cardiologist and I figured he'd know better than anyone why I was there.  I stammered out how I was told I had a weak heart wall.  He seemed to delight in stating that most doctors don't know how to read these reports.  Then he said, "You DON'T have a weak heart wall."  OMGOSH!  The entire weight of the burden I carried all week just lifted right off of me and I felt as light as the breeze.  Then he had to coax me back down from the ceiling I had floated up to, so that we could continue our discussion.  My blood pressure was up though.  And that is another post I never wrote and maybe still will.  I had a horrible reaction to a brand new med he prescribed.  But ...I digress. 

Anyway ...I never did get the nuclear stress test he recommended.

And now I am wanting to (even though I really do not want to), because I want to be sure before I do the knee replacement surgery.

So ...why am I resistant to doing this test?  After all ...I'm no stranger to nuclear testing, as I've had several Mag III renal scans with Lasix to follow up on the uro condition I wrestled with for awhile.  Now resolved BTW.  :)  I already glow with the fireflies in the backyard during the summer.  ;)

Well ...I know this seems weird ...but I guess it is just because:

1. The idea of injecting something into my body that will make my heart speed up or do whatever it will do.  I'd feel much better if I was walking, running, etc., if I could because that would seem more natural.

2.  Although ...years ago, I read a book and saw the reenactment of a story told by a cardiologist (Dr Maurice Rawlings) I saw interviewed on TV ...regarding how he came to believe in heaven and hell.  He was doing a stress test on a patient ...a mailman ...while in his office.  The man dropped dead of a heart attack right in front of him and the nurse.  The doctor immediately initiated CPR and the patient ...vacillating between life and death during the process, was crying out to be saved because he was seeing hell. They did end up saving his life.  And that experience was the catalyst for the doctor to renew his own faith and seek out information on NDE's, etc., and THAT is another post too.  Gosh - I sure could write a lot of posts.  :)  Anyway ...patients can have heart attacks while doing this test?  GOD FORBID!

3.  A friend of mine had a bad experience while having one done (the nuclear stress test) and she told me they told her she could have certain reactions.  Now I forget what they are.  But I do recall that she said they advised her to bring coffee to drink after the test because it could give her a bad headache and the caffeine could help alleviate it.  She got a horrendous headache.  Neither the doctor or scheduling staff warned me of any negative effects or told me to bring coffee.  I will just bring coffee ..although it will be cold.  I will be driving down and back.  My friend said she wouldn't advise driving after the test.  But the scheduler said I could drive.

4.  The test can be anywhere from 1 1/2 to 5 hours.  I'm guessing longer time frame would be indicative of a problem.  GOD FORBID!

5.  I'm just NOT in the mood to do this!  Also ...I would prefer doing this in my community hospital.  Not in this other office building ...across from the hospital.  Although ...honestly ...I don't want to do this test up here ...down there ..I do not want to do this test ANYWHERE!  

However ...the upside will be to get a good report.  Heck the upside will be to go back home too!  And seriously ...get a good report ...and to finally have this behind me more procrastinating which really is just a slow torture because you're just delaying something you ALWAYS know you are going to have to do.  So it is always in the back of your mind ..hanging over you.  I always used to be a bite the bullet ...just get it done and get through it kind of SeaSpray.  I don't know why or when I exactly changed.  I guess I became rather proficient at avoiding doing the uro surgery and it has carried over into other areas.  DENIAL.  AVOID.  DENIAL AND MORE DENIAL ..AND  MORE AVOIDING.  :)

And the logic of doing what you have to do does not escape me.  Nor does the fact that I am being silly.  Well ..there have been surgical concerns.   And ...I absolutely would encourage family or friends to just go get the test ...ASAP ..and they will most likely have GOOD news, but if they don't then they will catch something early that the doctors could still treat.  Something like that anyway.  Just do as I say ..not as I do.  :)

Then at the end of the week ...on Valentines day ...I will be meeting with another specialist.  Hopefully, I really don't have to and again it is just a matter of me wanting to dot every "i" and cross every "t" prior to the knee surgery.  I know there are inherent risks to all surgeries and now that I am not so naive about being an OR patient I just want to be ready.  That being said ...I should have lost all the weight I needed to and I have not done that.  God knows I've had the time to do so.

About a year and a half ago, my new PCP said, "You are healthier than you think you are."  I think I just became so enmeshed into being afraid to have the uro surgery  (because I was considered high risk.  I am guessing I still am ..although I have lost more weight since then.), and ...waiting for the other shoe to drop with relapses ...that I became hypervigilant about everything medical.  And for the first time ...I let fear in.  I mean let it set-up-house-kind-of-let-fear-in.  And that is so opposite faith ...having faith.  Fear is opposite faith.  I honestly never let it take hold as I did during that time.  Allowing fear in has become the antithesis of how I viewed life prior to these things.  Of course perhaps it is easier to be brave when you have nothing challenging your faith.  That being said ...I know there is power in our words.  I think it is important to express your feelings that fear doesn't magnify within ...but then once released you HAVE to be positive and believe for the best all things ...not just medically speaking.

And so now having vented about tomorrow's test and then some ...I am believing the test will go smoothly ..without side effects and that I will get a good report from the doctor.  Actually news is good news in this case because he said he doesn't call with good results.  So truly ...I don't want to hear from this doctor again.  :)

And now I don't feel like going to Macy's or Penny's today.  Finally ...I'm in a blogging mood.  :)

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