[Originally posted Feb 5, 2005]
My wife submitted to a stress test the other day … so I thought I would allow others to enjoy the experience vicariously.
The first issue is the self fulfilling prophetic nature of a “stress” test. When one’s physical health is subject to evaluation there is already enough stress to go around. The anticipation of a “stress” test only compounds the anxiety. Karen’s appointment was at Seton Nuclear Imaging Center … anything named “nuclear” tends to automatically raise the “stress” level in my book.
The standard prep instructions ended up being somewhat cryptic: nothing to eat or drink after midnight for an 8:30 AM appointment. But then when you arrive you find that really their only concern was that you hadn’t overeaten to the point of compromising your treadmill activity.
The Center actually was surprisingly efficient for a medical facility. They are used to cranking large numbers through all the paces. The process starts with the paperwork intensive check-in. After you regurgitate your medical history and verify your personal information you sign a number of disclaimers related to the Privacy Act – e.g. your sensitive data will not be released to any unauthorized personnel. So you shouldn’t be expecting any 6 PM telemarketing calls from drug companies who have targeted your medical deficiencies.
Waiting Room Experience #1 – pick your favorite magazine (they actually had a great selection!)
When you get called back to the staging room your heart takes that first abnormal surge as you brace yourself for the realm of the medical unknown – a scary place to enter. The technician inserts an IV into your arm to provide the conduit for the radioactive material. (Again, anything associated with “radioactive” would be another stress pumper for yours truly.) They are careful to educate you all along the way so that you don’t end up imagining the worst. In this instance the message was not to fear the radioactive liquid because you would not be conscious of it or experience any type of reaction to it.
Back to the Waiting Room for Experience #2 – pick up your second favorite magazine… (but understand that you will not be abandoned for long because the liquid dissipates from your body after 45 minutes.)
Now comes the opportunity to prove how photogenic you really are. You are led into the picture room where you must lie motionless on a table while the machine rotates around the body taking all types of pictures of the heart. How long could this take?? Try 20-25 minutes! The instructions are to keep your shoulders flat on the table; position your left arm over your head so that the machine can take pictures from that side without being blocked. The table is so narrow there is no good spot for your right arm … you can try various options … but nothing is very comfortable. The mission is to search for any blockages in the arteries. You would think that some soothing music would be piped in for your listening pleasure … but instead it was a very sterile environment with the silence only broken by the annoying “beep … beep” of the device.
Waiting Room Experience #3 – still plenty of good reading material
Once the treadmill room is available, the fun part finally begins. Instead of being passive you now are called on to impress the medical staff with your level of physical fitness. They kick off the competition by taking your blood pressure and then performing 2 EKG’s back-to-back to get your baseline reading. So now you are hooked up to a bunch of electrodes and look like something out of a sci-fi interrogation scene. You know things are getting serious because the cardiologist is now present (in addition to the nurse and the technician). At least if you are going to die on the spot there will be someone in the room with the expertise to document what actually happened!
The nurse continues to take your blood pressure periodically as you perform the treadmill routine. The medical staff keeps upping the ante by increasing the speed … trying to find your breaking point. If you can hold out for 10 minutes you can probably outlast them (provided your blood pressure readings don’t scare them). Finally they administer a second dose of the radioactive liquid, slow you down for a minute and then see how long it takes for your blood pressure to drop down to its resting point. The whole time the EKG is monitoring your heart rate for any abnormalities.
This is one pass/fail test that you desperately want to pass. You know it is a good sign when the doctor compliments you on having a heart that is in much better shape than most people of your age and gender. (However, given the sorry physical state of the general public, being above average is no great accomplishment.) Still you are not done yet.
Back to the Waiting Room for Experience #4
Now you have the luxury of getting another round of pictures (crank in another 20-25 minutes). Think of it as getting double prints from K-Mart. At last, you are excused with the promise that the written report will be prepared and passed on to your primary care physician in a couple of days. Overall, not a bad investment of time to be assured that your ticker is in relatively good shape.
Optional: Waiting Room Experience #5
To finish that exceptional article in the current news magazine.