The Glow in the Dark Test

(well, sort of ...)

I tell you what – they’re going to either stress me out completely or totally distress me doing so many stress(ful) tests on me this year!

The first one I had earlier was just a “regular” stress test – for the very first time! Usually, they have done just the “nuclear” one in the past. This year, the new doc decided to go with the “regular” one first, and then decided that it was not very conclusive, so he ordered a nuclear one, to follow, as well. More trouble for me, more money for them – is how I look at it.

Although I have done the nuclear one at least twice if not three times at my old doctor’s office, in NC, I discovered that this one, another state, another clinic, was slightly different than before. I am still not nervous about it, except for the IV, which I hate, but I was surprised about some things that I was not familiar with, really.

First, they refer to it as the “thallium test”, not the “nuclear one”. So, I am not quite sure whether the substance they inject you with, the one that glows in the pictures, is the same as before. The sensation of cold, when the “poison” goes into your body is the same, however.

The nurse also asked me if I am going to travel by plane in the next week or so. I told her no, but I also asked her why she’s asking – this was the first time I was asked this. She said it’s because thallium will stay in my body for that long and I can set off a security metal detector at the airport because of it. My eyes must have popped out of my head, because she continued: “Oh, no, don’t worry. It is not harmful to anyone around you, nor the environment, so it’s OK!”. This time, I could not stand it, and blurted out: “Harmful to the ENVIRONMENT?? Or OTHER people?! What about to MYSELF? I am a walking, rusting (no doubt!) robot for a week but this is not harmful to ME?!”. She laughed it off and said no, but … are you really convinced?! I am not, and I am not usually paranoid about what might kill me. Just sounds a bit strange!

So, the drill with this test is: you go in preferably early in the morning, definitely fasting. They hook you up to an IV and you wait for about 40 minutes in the waiting room, till the thallium gets through your whole body, I guess. Then, they put you on a table, to take pictures of your heart. You wear a gown for your upper body but you can be dressed in your own clothes from the waist down.

After the pictures, you wait for another 40 minutes or so, not sure why. Then, they ask you to come in the treadmill room. You walk on the treadmill, with them increasing the speed every 3 minutes and the incline, as well. You have to keep going till you reach your required heartbeat rate for your age – mine is 156. At about 146 I thought I was going to choke! But I reached my peak, nonetheless.

My chest never did become heavy, but my throat always chokes up when I am running, like someone is literally strangling me. My throat just becomes very, very narrow, all of a sudden.

While you are running, a different nurse injects more thallium in your IV.

Towards the end of the exercise, they lowered this old fashioned X-ray machine and made me put my chest right up against it WHILE I was running, with an IV in my arm, and stickies with wires stuck all over my upper body, to measure my blood pressure and what not. This was, once again, something new to me. I am not sure what the X-ray machine measures, but I honestly don’t see how 90 year olds do this.

After I reached the heart speed they wanted, they slowed down the treadmill and I was walking normally after that, in a stroll pace. When I stepped down from the treadmill, I was extremely light headed. My blood pressure went during the exercise from 120 over 60 to 147 over 98, and then, within minutes, down to 60 over 40! No idea why!

The nurse shot about 4-5 syringes of saline into my IV and I started to come to. I also drank a lot of water. She did not release me from the room till she got a “normal” blood pressure and the headache and lightheadedness subsided.

After this, I went to the waiting room for another 40 minute wait, and this time, I ate a breakfast bar – as I was told that the fasting part of the test was over.

After another 40 minutes, I went back to the room with the machine that takes the heart pictures. For the pictures, you lie down on a very narrow wooden (I think) table, with your arms folded under your head. You are told to not move whatsoever, even if it is just to clear your throat. The pictures will be blurry otherwise and they will have to start over. You lay there for about 15 minutes while this massive moving metal machine goes around your chest from right to left and shoots pictures of your chest. The pictures show up on a computer screen somewhere, in the room, but the machine blocks your view, so you’re not seeing anything. The machine is not touching you, and although it is terribly close, you don’t panic, like in the MRI tube, from claustrophobia. Not the same feeling at all.

And after the second set of pictures you are done!

After a week or so, I got a call form my cardiologist’s nurse and she told me that the test was fine and that my heart can withstand exercise, so I should continue exercising as much as I can, and come back for another regular checkup in 6 more months.

Mystery solved – and now I am happy that this is behind me, too!

It’s not too bad of a test, and if it is indeed accurate about spotting blockages and their severity is pretty harmless and noninvasive to be worth while in knowing what you’re dealing with. The biggest inconveniences are that it takes about half of your day (and time off from work, etc) and the IV is not very pleasant. And I almost forgot: they sand down (yes, as in sandpaper!) the spots on your torso where they stick the sensors for the EKG wires. They use a small piece of sandpaper to make sure no oil or other residue is under that sensor. When you peel them off, you will lose some skin!

Aside from that, and considering that a regular dental cleaning is more bloody and messy than all this, this is pretty tame. Just don’t get thrown out of a flight for transporting liquid thallium in you! Plan your test a couple of weeks in advance of your flying trips, I’d say, and good luck with the results!

This and That

Not much happening on the medical front lately. I have a thallium stress test scheduled for this Friday, and another doctor appointment in a week with my general doc, to follow up on the most recent labs and on the stress test. So, we shall see.

In the meantime, we have found out that my mom (not my dad who has been the designated “gifter” of the cholesterol and heart disease in my family) has been diagnosed with heart disease, high cholesterol and triglycerides, and cardiac insufficiency, whatever that might mean. She is still to undergo more tests, but basically – it’s all bad. Since her mom died of hear disease as well, I gotta wonder - did it really come all from dad, or … both?! It doesn’t really matter, of course, but just wondering. Plus, given her history, with her mom, this makes me very worried for her!

In the spirit of “I am sick of all this being sick, I’ll do something about it NOW”, I am determined to improve my exercise regimen, even if it’s the last thing I do! I am so saddened when I realize every day that I am a lard butt and do little to get my heart rate going! So, my priceless husband has bought a treadmill for me for Christmas, and I am determined to use it! Effectively and regularly! I live in a part of the world where winter is long and cold! I have no excuse now not to walk! I have a basement and although not finished, it’s never really too cold down there! I want to move. I want the rust to peel off my joints and arteries, and I want to be able to breath normal when I climb up one flight of stairs! I am determined! I will try to keep sort of a journal here, or somewhere to keep me motivated! But I – need – to – move!! Big time!

An interesting piece of news today was this article: http://yourlife.usatoday.com/health/medical/coldflu/story/2011-12-14/Study-Statins-reduce-flu-death-risk-by-half/51914122/1. I knew they called them “miracle drugs” but I didn’t know they did everything! Also, all the doctors I have ever seen have ambushed me into a flu shot – and I have always managed to say “no, thank you” and gotten away with not having one – heart disease and all. And, thank God, I never get the flu! Sure, an occasional sneezy cold here and there, but almost never ever the flu! Of course, not sure whether the Lipitor does anything to it, but thought the article to be interesting, nonetheless.

Hope everyone is well and healthy and with ALL the numbers in check!

Trying out the new treadmill this weekend - my husband couldn't help it and snapped a picture with my phone. It shall be used. I promise you! The treadmill, not the phone, that is. :-)

Holiday Eats

I think you don’t have to be a genius to know that this is the hardest time of the year for keeping a healthy diet! Of course, when you try to eat low fat and no oils nor saturated fats, and low sugar is doubly hard, but generally speaking, the time between Thanksgiving and New Year’s is terror to our arteries and hearts for all of us!

Typically, all during the year, I try to eat just white meat poultry and fish, always. Around this time of the year, however, the options are turkey, duck and ham! I used to buy small Cornish hens (which are actually not that low in fat, really) for Thanksgiving, when I was single, but now, it’s turkey, all the way.

And then, there is the ham! My favorite meat in the whole world, but of which I eat only twice a year – for Easter and Christmas – and maybe New Years, too. Then, all the fixings. If I cook myself, I try to make wise choices: Smart Balance instead of butter, turkey bacon if I want to cook with bacon, 2% milk, fat free shredded cheese for chowders, and the likes. When I do have a choice, I try to be careful what I chose, and use plenty of spices and herbs, to not skimp on the flavor.

In the mornings, and when eating normal meals, not over visits with friends, I stick to my healthy meals – lots of fiber and some greens. Being Eastern Orthodox, I have a “good excuse” to not eat animal products twice a week, from about 6 weeks before, until Christmas, too – so this helps to keep me “in line”, as well. I have kept this tradition since I was a child, mostly for health reasons, and secondly for religious ones.

My husband loves to bake, but lately, he’s been using half the amount of sugar a recipe needs, he replaces butter with vegetable margarine, or Smart Balance, and he makes mostly oatmeal cookies lately – yum! He has also used flaxseed and wheat flours, too.

When I visit other folks, my focus is on portion size, since I have no control over what goes in the dish. I can’t have 15 pieces of ham, no matter how much I love it. And I try to go for the greens – green beans, salads, and no casseroles, if I can, as I am sure everyone uses the “real deal” ingredients in everything else.

We went to our first Christmas party this weekend, and I had a sautéed chicken breast, with mashed potatoes and a spinach salad. I had literally two bites of my husband’s cheesecake, and water to drink. I was full, and never felt like I was missing out. I am somewhat lucky, too, to not care for red meat nor sweets much – so the choices were easier. I also try to focus on the atmosphere and the experience of getting together and celebrating the old year, more than making it about the food.

Just like when I travel, I try not to obsess over the foods on a time like The Holidays. I try to enjoy the moment and tell myself that I can be careful without making my choices the center of my life. In fact, most people that don’t know me very, very well, have no idea I watch what I eat. I always get the “why are YOU dieting? You’re nothing but a little bit!” spiel, and I dread going into details – out of lack of patience more than anything.

But if I go tomorrow, in a middle of a heart attack, I tell you this much: I would regret not having that ham more than I would be proud of myself for always sticking to carrots and cold water fish! There is a time for everything, and at Holidays time, it’s time to enjoy what the table has to offer, but only remember to keep size in check.

Happy Holiday Season to all, and happy eating, too!

A Year of Un-health

It is health that is real wealth and not pieces of gold and silver. (Mohandas Gandhi)

This year has not been a really good one for health in our family. Just one thing after another. It’s not just one member of the family, not just mine or my husband’s family, it’s everyone, it seems. Almost.

The year started with my sister almost giving birth to her second baby 2-3 months before her due date – again! She was on bed rest (and hated it) for two and a half months and in and out of the hospital till she gave birth to her healthy baby boy in February. That was such a wonderful gift to all of us, this little man!

My grandmother, who is my only living grandparent, at 82, has been in a clinic for senile dementia for over a year now, and this year, she has been getting worse. We never really knew this disease is in our family, because I guess back when her parents were suffering from it, they called it “old age”. She has always been the healthiest in my family, physically, a 4’9” (if that) dynamo, so this came as a big shock to all of us. My family could no longer care for her at home, because of her nightly wanderings, which were very hard to supervise, so she had to go to this special place.

Her physical health is declining rapidly, along with her fading mind. It is so unbearable to watch. And to watch those who care for her (like my aunt) fall into depression themselves, as the care giver is equally impossible, at times.

My husband’s aunt has been diagnosed with colon and uterine cancer, at 72. She has undergone a massive surgery to remove most of her colon and all of her reproductive organs, sometimes in the summer (June?!). That, alone, is massive surgery for anyone, at any age, but particularly for an older body. After the surgery, she underwent several (I think five) rounds of chemo, just “preventively”, we are told. During this whole time she has been in the hospital twice with massive abdominal infections, various cysts, just complications of this whole intervention. We saw her last month, a year and a half after we saw her at our wedding, last year, and she was almost the shadow of the woman I remember. Her eyes had the same glitter in them, and her smile the same welcoming warmth. Disease can take a lot out of us, but it cannot and should not kill our spirit.

Around the same time his aunt was diagnosed with cancer, my husband was diagnosed with type 2 diabetes! He jumped on the wagon of medication, constant blood sugar checks, new diet, several doctors’ appointments, reviews at the Diabetes Management Center, and re-designing his eating and exercising habits. It was a tough blow for him (already a high blood pressure patient), although he was kind of expecting it, since it’s a “family disease” on his side. It’s never easy to hear such confirmation, though.

My brother in law, at 32, just found out that his cholesterol and blood pressure are off the charts, too and whereas his blood sugar is not scary yet, his A1c test showed clear disposition to type 2 diabetes, as well. My sister and I are exchanging diabetes and heart disease friendly recipes now. Another big, unwelcomed “surprise”, of two very traumatic diseases, for someone so young!

Lastly, but not in the least, there is my mother in law. She is a double amputee, having lost both of her arms in a farming accident when she was 4. She is 70 now and has lived all her life with prosthetic arms, doing everything we are doing as “normal” people. She is my role model of strength and perseverance despite all odds! She is a walking lesson.

She is also a diabetic. In the past year or so she has lost a lot, and I mean a lot, of weight, trying to keep her diabetes under control. She walks 3-4 miles every day from spring to fall (she lives in Michigan, so winter walks are tricky to say the least, but she does walk on the treadmill then), and she has totally revamped what she eats. After 69 years one can still change what and how they eat, and how they manage their exercise routine! She is living proof of that! But all these changes caused her to lose so much weight (while her blood sugar is back to normal values!) that she has needed new prosthetic arms. The old ones are too large now, and she can’t work them too well anymore. Well, after months of waiting and close to $12,000 paid, she got arms that are made completely wrong for her! Totally unusable. The arms, much like ours that we take for granted, are her freedom. The old ones are cumbersome and hurt a lot, since they don’t fit her “stumps”, and she needs new ones. After months of explaining to the makers of them what is wrong with them, she gave up and she is back to her old ones, in pain, but still free.

And then, there have been my own issues. On top of everything else I knew about, on top of the perpetual “flunk” tests and off numbers (the usual), I also found out about my defective heart (not because of cholesterol, alas, this time, but just because of pure faulty genetic anatomy), and about uterine fibroids that are a pain (pun not intended) to live with, every day!

Despite everything, though, I still consider myself lucky. Looking at all my relatives who have crossed large abysses this year in their fear for their (or their baby’s) life, I feel lucky that whatever I have been “blessed” with has not landed me one day in a hospital, or one hour disabled!

I am grateful for what I have and I am learning, every day, from these wonderful people around me, how one can survive a bad diagnosis, no matter how horrible, and still go on. One foot in front of the other, one day at a time, one prayer and “thank you” at a time, we will continue to walk on. There is no other possible alternative.

Stressed About the Stress Test

(no, not really ...)

And here we are again. You know, I think I need to visit more often and just tell you all about my normal days, not only about days when I visit “that” place. You know, the place where they wear scrubs. I need to tell people that we, people with FH, do have a life, a real one that doesn’t involve tests and drugs and IV’s and all … I think I’ll make that pledge now, and if I bore you to tears with my other, “normal” life, shout out, and I’ll change the tune …

But anyway, today was one of “those” days. The PA that I saw a couple of weeks ago, or so, asked that I repeat the heart eco they did last year, just to check on this leaking valve and its progress. Since last year was the first time they found it, they used that as the baseline and they need to understand how fast it’s getting worse, because, as they “promised” me, it will get worse. So, they needed to repeat that this year – if the progress (or regress) is slow, then, they’ll do this every two years or even further apart. They also wanted to repeat the stress test, which I normally get done every two years, and it was time for that.

Every time I go in for these things I am thinking: “someone has an ex-wife they need to pay off or a boat payment that’s due”. But let’s not be cynical, shall we, I am sure this is all helpful, and I am grateful for health insurance.

I am not going to find out the eco results till some time later since they need to be read by the radiology doctor and then sent to my cardiologist – both in the same clinic though – I have an appointment next week for that. The stress test, however, was performed by my heart doctor’s PA (the one who said no to Diovan), so she read it to me today.

She said “I flunk it”! Everything was fine, till I got my heart rate at around 152 and I started choking up. My chest was heavy, not so much painful, but heavy and I was out of breath, and my neck was clutching on me. I felt like there was no air going through from my nose to my lungs. I had to get my heart rate to 166, according to the literature she had there, so she would not stop the treadmill till I reached that … I was exhausted and completely out of breath by the time I was done. The discomfort in my chest was about a six on a scale from 1 to 10, I’d say. Like I said, it was not pain, or pressure, but more like a tightness. And a massive, out of control, blinding migraine, too!

She read the paper that comes out of the machine and she also said it doesn’t look good, because my heart doesn’t come back “to baseline” when I exercise. It tries, but it doesn’t make it back to the same spot it was a beat earlier.

She called in the doctor, and he said I need to have (you guessed it!) yet another test: a thallium (nuclear) stress test which will show him more precisely what is going on inside of my heart – is it a blockage and where, or is it my valve that’s causing the pain/ discomfort?! In NC, I had this done twice. Given my history, my doctor there felt like a “simple” (non-nuclear/ non-thallium) test, the kind I had done today, would not tell him much, so he always went for the more “advanced” once. I guess the doctor here is still learning?!

Anyway, another test we schedule. And if that one comes out all inconclusive or bad, then we go in again for an angiogram. Fun-fun!

I have felt OK lately, heart-wise, although my pulse is very accelerated. I am going to switch to decaf in the morning for a while and see if that helps. My headaches is what has driven me crazy lately, though: they have been more severe than usual and almost constant, with no break between days. It’s been kind of a pain (pun intended).

I am seriously thinking I must re-start yoga again, too – I must seriously get in the habit of that, again, with no more excuses! I feel rusty … We walk some, but not consistently, which is a shame. I would not call myself a real couch potato though, because between cleaning two levels of a house twice a week and cooking every night and running errands at lunch and sitting down at 8.30 PM every night for the day, I am moving a lot. But I need more! More consistency and a regimen! Looking for a treadmill for this winter! Cannot wait!! And the fact that we enter comfort food season is not very helpful, health-wise, either. Must work extra hard to compensate.

No Go for Diovan

If you remember back in July, my heart doctor put me on Diovan once a day. He said a small dose of 40 mg would not cause any trouble for my yo-yo BP. Well, I tried it, as I mentioned before, and when my BP was normal (which is most of the time), it would bring it even more down, and I would feel lethargic, light headed and in a fog for a couple of hours.

As you also may remember, I called the PA and she was not sure what to try, but gave me a whole spectrum of choices: take ½ instead of a full one; take it at night, when the BP is higher, take it ONLY when I measure the blood pressure and I know for sure that it’s high… etc. After reading more online, and considering her “recommendations” as very volatile – I decided to stop taking it unless my BP is so high that it scares me.

That is – in case I measure it and I know it’s high. I measure it several times a week, but not every day. And occasionally, it’ll be high, like in the 150’s (for the systolic value), and I’d take ½ of a pill – usually at night. I have only one account of when I took ½ a pill and I measured the blood pressure after several hours, and it had come down to 110 over 60 from 150 over 95, I believe. So, it works! But how are you supposed to keep measuring it twice a day, every day, and walk around with your pressure meter and your pills, and your notepad, and have a life on top of that?!

Sure, I don’t recommend anything to anyone. But for me, I decided I’m not going to be paranoid about it. I’ll take ½ of a pill only if it’s high. It still makes me uncomfortable to take BP meds randomly, but I’d rather do that than take them all the time, add more chemicals to my cocktail, and feel like crap, when my blood pressure is too low!

My blood pressure has been better, because I have been more active than I normally am in the winter, and also because I have tried to keep the wine consumption low at night, when the BP was rising. So far, so good on the numbers.

Other than the (very!) occasional Diovan (maybe 2-3 times a month), the only thing added was the 50,000 IU Vitamin D which apparently did the trick for my D levels. No side effects that I can see there. I have stopped, however, the calcium I was taking as in many reports online you are advised against taking it while on high dosages of D, especially when you have a history of hardened arteries and plaque deposits. The doctor never recommended for or against the calcium – this is, again, my own decision, if you will.

But after all, it is our own life, isn’t it?!

Study: Stents for the Brain

Because there is virtually no history of heart attacks in my FH family, but there are tons of examples of stroke, of all sorts of severity levels, I found this article interesting:

http://www.nytimes.com/2011/09/08/health/research/08stent.html?_r=1&emc=tnt&tntemail1=y