It didn't start out well--they had to stick me 5 (yes five) times before successfully getting an IV started. I then waited quite a long while, but it was my cardiologist himself who finally showed up. He was clearly thinking as he watched my heart rate go up, and he let me go until I said I was getting close to my limit. I reached a heart rate of 201, comfortably. The abnormality in the EKG didn't show up this time--he had the previous results in front of him and apparently this time it was just different.
They put the radioactive material in me while I was on the treadmill and then I got to go eat before going under the camera. This time lying absolutely still for 20 minutes was harder--my nose itched. The doctor said he will call with the results tonight.
We had a nice Thanksgiving at St. Christopher on Seabrook Island. I was serious about biking while we were there to prepare for Festavelo. It felt very strange to be riding on the flat (and a bit boring). No coasting down hills! I think the uniformity of the motion could cause more muscle fatigue over 100 miles.
I had the resting nuclear test today, and it seemed peaceful. But I didn't learn a thing. Tomorrow is the stress test.
I had a smooth trip back from Texas yesterday. I didn't push myself at the conference and that worked fairly well. I heard some interesting papers and had some useful conversations. I also walked under the bat bridge, though the bats had already migrated south. Actually, the main thing that was noticeable was the smell, even walking over the bridge.
We are going to St. Christopher for Thanksgiving, which should be some stress relief. My nuclear stress test is scheduled for the Tuesday after Thanksgiving. I'm still hoping to ride a century the following weekend if everything checks out ok.
The visiting speaker left early this morning--I spent significant parts of the last three days taking him around. I'm going out of town Thursday for a professional conference. The nuclear stress test probably won't be until the week after Thanksgiving. I should be glad it didn't work out to schedule it for tomorrow, since I don't know how I would have gotten everything done to be ready to go away, but I just want this mess over with.
I'm trying to get the nuclear stress test scheduled--it could end up as soon as tomorrow. The cardiologist did say that it is not as accurate as a catheterization--85% instead of 99%. I think he is more interested in structural information and I am more interested in functional information. I did hear that everything was normal on the echocardiogram, which reinforces my hope that this is going to turn out to be nothing.
I realized deep down this is reinforcing my feelings of being contaminated. My current approach to that is that I want to learn to harness the darkness inside me, not try to tear it out.
I did get a suggestion from another doctor (at church) and wrote my cardiologist that I wanted a nuclear stress test instead of a catheterization. He said "we can do that."
The cardiologist called me on my cell phone as I was on the way to a lecture by a visiting speaker. After the lecture I had to hurry to Greenville to pick my husband's aunt up at the hospital, where she was ready to come home after recovering from surgery. Home after 9 pm.
Someone told me my cardiologist is too quick to do heart catheterizations (to a 5-year-old with a hammer everything looks like a nail). From a cost-effective medicine point of view it may well be unnecessary. But given that I enjoy pushing myself on my bicycle, I think I want the definitive answer to the question of whether there is any blockage or whether this is just a false positive.
Ok, I found a study (Mora (2003) JAMA 290:1600-7) that says that the finding on my EKG (depressed ST segment with exercise) is not associated with increased mortality among women on a 20 year followup study. The factors that correlated with increased mortality were low exercise capacity, low heart rate recovery (HRR), and not achieving target heart rate--all of them things where I am above average.
I indeed flunked the stress test. If I'm lucky it may be a type of false positive that is fairly common in women. But if I'm unlucky it is a blockage--I have to have a heart catheterization to check it out. Currently scheduled for the Tuesday before Thanksgiving, unless I want to cancel a trip in order to do it sooner.
My heart rate goes high when I exercise, and my doctor wanted me to have that checked out. I had the stress test this morning, first having the fight I expected with the doctor conducting the test, who didn’t want to let me go above the normal maximum heart rate for my age. Luckily I had anticipated the problem and could say that my cardiologist had promised to tell the doctor conducting the test to let me keep going. I did get within 5 points of the highest heart rate I have observed, but I was nowhere near pushing myself to the maximum—I was puffing but could still talk. The doctor conducting the test wouldn’t let me go any farther because there was an abnormality on the EKG. I got a call from my cardiologist’s office that he wants to see me today, and I also have an echocardiogram scheduled.
Now I’m scared. I’ve lost nearly 50 pounds in the last year since I was diagnosed with diabetes, and I’ve been getting into serious bicycling for 4 months. I feel great, and I’m having fun. Exercise clearly has an unusually strong effect on me—my reaction is if it were a drug it would be illegal. The physical changes have also been very important to me in reinforcing my healing journey. I’m so afraid of being told to stop. I could push myself a little less hard, but slowing down very much would take the fun out of it.
It was 46 degrees when I set out this morning, and I went back to the house twice for additional clothing. I cut off tubes from an old sock to make wrist warmers. I ended up fairly comfortable, but feeling it was harder to move because I was bundled up. I got in a good three hour ride.
I had some hope for our Democratic candidate for senate, but she lost by 10 points. What was even more depressing was that president and senate were the only races in which there was a choice--for congress in my district and for all state offices that were up for election, Republicans were running unopposed.
I had Monday and Tuesday off and I guess I let down some, but now I feel desperate that I haven't done more to catch up. I did get a couple of good long bike rides, and signed up to do a 100 mile event the first weekend in December (near Charleston, where it is flat!). I felt last week that finally I had gotten through the therapist transition, but clearly it is going to take me a while to work through the feelings.