Wednesday, August 31, 2016

Diabetes, Family History And The Stress Of A Stress Test

 An insider look at what went on in my head before, during, and after my stress test.  
It’s also a great primer on using your words wisely as HealthCare Professional. 
I didn’t sleep well the night before my stress test. 
Nerves, combined with the third day of out of the blue, higher than normal blood sugars resulting in copious amounts of insulin, especially in the evening, followed by 3 am crashes, did not make for being well rested. 

I was tired as I drove the 45 minutes to the cardiologist's office - I'd never been to the practice's Satellite office and Siri did an excellent job of getting me there. 
I arrived 10 minutes early and tried to relax by taking deep breaths and watching Family Feud that was on the big screen TV in the lobby. 
25 minutes later the nurse came to get me. She apologized for the wait and told me that it was her first day at this branch. 
“That’s Ok, me too. We’ll figure it out together,” I said. 

We walked into the exam room filled with a treadmill and monitors and I immediately recognized the Technician who would be administering the stress test. 
It was Eastern European Dude, the same guy who had administered my stress test back back in 2012. 
I totally remembered him. I also remembered flipping out so bad from the fear of the what ifs that my sister had to calm me down so I wouldn’t burst into tears. 
When you have a crap family history combined with a chronic illness, it’s easy to let the what ifs drive you crazy - and I almost had. 

Of course I didn’t remind him of that - I just smiled and said hello. 
The nurse draws back the curtains in the room, tells me undress from the waist up and hands me a blue gown and says “flaps in the front,” and closes the curtain. 
I hate this part - I hate that I have to be partially naked and totally exposed in front of 3 strangers for a test that scares the fuck out of me.
My nerves are making me breath deeper and I tell her I’m ready. 
She opens the curtain, steps in and closes again. 
She puts foul smelling gelatinous gel on my chest that will help the  sticky part of the leeds, stick and stay. 
We walk over to the treadmill and I stand on it. 

We go over my impressive family history and the nurse clips a heavy belt around my waist and plugs the leeds from chest into the belt. Then she gingerly clips my insulin pump onto the belt so I would have to take it off. 
She explains the Stress Test.
3 minute increments of speed and varying inclines on the treadmill, starting out low and slow and reaching speeds of fast and on an incline. 
My blood pressure and heart rate will continue to be monitored the whole time. 
When the treadmill stops - they will literally throw me on a table and Eastern European Eastern European Dude have less than 2 minutes to get images of my heart and its chambers.
Those images will tell us if my heart is healthy and if there are any blockages around the heart. 
She finishes by telling me that if I feel anything that doesn’t feel right, I am to press the red button and we will stop immediately. 
I think back to 2012,  I was on there for about 16 minutes, the last few minutes I was running the treadmill at top speed and at an incline of 13 - everyone in the room was telling me how great I was doing and that my heart was as strong as a horse. 

4 years later and I wonder what will happen this time.

Yep, I know the drill. 

I think of my father and his brothers - skinny men with skinny legs and blocked arteries. 
I think of my mother - a scarlet fever baby with a damaged heart muscle, who became a Pro skater and mother of 6 - all with an arrhythmic heart that beat to it's own drum.
I think of her mother who died from heart issues and her father, a lumberjack who owned the mill and had a heart attack in the snow on Christmas Day and refused to die. 
Instead, he crawled for 2 miles in the snow until he got to his competitors camp. 
They snowmobiled him to the hospital and he lived another 35 years. 
I think of other family members.

I remind myself that I come from strong stock and that knowledge is power. 
I stand on the treadmill, both hands on the bar and practice my yoga breathing. 
I watch my heart rate on the monitor and the numbers keep going between 88 beats per minute and 104. 
My nerves are fucking with me big time now. 
I close my eyes and think of ocean waves and breathing with their ebb and flow. 
Dr. X walks in with a smile on his face - and immediately says: Hi, I’m Dr. O andmygoodness you’re too young for this test! 
My eyes flicker to the monitor screen and my heart rate jumps to 106 beats per minute and my yoga breathing goes out the window. 

I want to scream at him for saying that because I’m stressed enough and his words are making things worse. 
But I can't because it's a fucking stress test.
Instead I take a deep breath, smile and tell him that I have shitty family history and that my cardiologist likes to have an updated road map of my heart so I can remain healthy.
I try my best not to shed a tear, but I feel my face turning red. 
Then I tell him I have WhiteCoat Syndrome and that he should be prepared
Dr. X takes my blood pressure and says: I see that. 

I can tell he knows that he made a mistake. 
He’s a nice guy and he’s trying to make things right. He asks me about my summer and asks me if I've been to the beach. I tell him that I love to swim and body surf and he seems impressed.
He asks me how the waves have been and I mention storms brewing in the the Atlantic. 
Then he tells that my numbers are going to go up during this test - which is what they are supposed to do and not to worry. 

The test starts and I walk the treadmill and I try and think about the ocean because it makes me calm.
 For some reason I keep breathing heavy - and it's unusual and weird and it makes me worry. 
Dr. X asks me if I always breathe deep like that when I work out.
I tell him no - and I tell him that I'm scared. 
He tells me he 'gets it, and that it’s my nerves and that I’m doing great. 
We talk about exercise and the heatwave and I tell him my workout schedule has been shitty.
“Everyones has,” he says and tells me not to worry. 
The incline goes up and I go faster - not at a running pace yet, but close. 
I want to run. I want to run off the treadmill, out of the exam and run as far away as humanly possible.
But knowledge is power, even if obtaining that knowledge is stressful and scary. 

9 minutes in they give me a 30 second STOP warning. 
30 seconds later, the treadmill stops, I lie on the exam table next to the treadmill and turn on my left side and with my left arm up.
Eastern European Dude jumps on top of me puts something cold under my left breast and tells me to take a deep breath and hold my breath. 
I do. 
“Now release, then take another deep breath, let a little out and hold!” 
And I do. 
And then I do it again, and again, and again, and again, and again. 

Then it’s over. 

I sit up on the table and mutter to myself, “you're not even going to buy me dinner?”
The Dr stand in front of me tells me that all is well, that everything looks great. 
My heart is strong - no blockages. 
He points out the my blood pressure is decreasing at a great rate and is now lower than before the test.

“Are you sure? Then why didn’t I get to run this time?
He explains that my graphs were great and that the info they were giving was just what that wanted -  and that my leeds were close to giving feedback (not the good kind, the kind that would make us start the test all over again,) so they stopped. 
“Also, your nerves made your blood pressure on the high side - which happens - so we stopped. You’re great and you did great. I’ll write up your report, send it to your Cardiologist and you’ll get a copy too. You're OK, Kel.” 

I get ready to leave, say my goodbyes and sit in the lobby and answer 3 text messages and some emails. I’m calm now. I’m good. I am A-OK. 

I get up from my seat, walk through the automatic doors of the building and into to the sun. My eyes start to tear and I try to not Oprah ugly cry it, in the parking lot. 

I am good, all is fucking fantastic, I am luckier than many and I know it. 

But the staying well, the being strong and the what ifs of it all, have gotten to me as of late and right now they are hard to shake. 
I sit my car and breathe deep - and just as I put my keys in the ignition, I hear the Dr’s voice in my head saying; “Ohmygoodness, you’re too young to be here.” 

And I respond  out loud to the voice in my head like I'd wanted to respond in the room. 
“I am here because I want to stay healthy.
I am here because I have a shitty family history and type 1 diabetes and I’ve been working my damnedest to stay healthy.
I am here and you're a nice guy and you seem like a good Doctor, but you need to work on your greeting, because right now you made my heart rate increase and God only knows what you’re doing to my blood pressure.
I am here because I want to stay healthy, so please watch what you say and help me do that.” 

And then I drive home, but stop halfway tand dictate a version of this post onto my phone's voice recorder. 
 I had let it all out before I could let it go and continue on my journey


Rick Phillips said...

Kelly, I do not like seeing my cardiologist, but she seems to like seeing me. Now to be fair I have 3 stents and I had open heart surgery in 2006, so I guess she has a right to expect a yearly visit.

Now truth be told, she is a fine person and she caught a heart defect in 2005-2006 that I was born with and she helped me correct it with the open heart surgery. I have been seeing her for almost 14 years now and frankly I sort of look forward to hearing her say yep all done. Look at it this way, once you get to know them, they can be your best friend or sometimes not so much.

I just like all done way better than hmm lets take a little closer look.

A Diabetic Abroad said...

Glad to hear everything looks good! Nerves can get the best of us sometimes but, you're right, knowledge is power.