A New Adventure

• by donr
• 2017-10-04 01:43:40
• Conditions, Meds & Tests
• 1278 views
• 2 comments

Back in late August I thought my PM had a dead/dying battery.  I suddenly felt like something you step in when you own a dog.  Went to daughter's office & we ran an ECG.  PM fine, but the old ticker wasn't!  Running in steady Trigeminy (Triplets of 2 NSR beats & 1 PVC)  That 'splained a lot. 

500 mies from cardio & that happens.  Time to get a new Cardo/EP.  Daughter found one in jackson, MS, about 50 miles from home & made an appt.  He sounded AOK.  Had an undergrad degree as an engineer, so we might communicate.  Turned out to be fine. First words out of his mouth were that he'd reviewed my records from Atlanta - all 95 pages of them.  That was the short version!  Appt went on for over 2 hours & a fine time was had by all!.  Saw something he didn't like in disagreement between last echo & Lexiscan stress test  EF's didn't remotely match.  Echo said 65% & Lexi said 40%.  Also, there was a hint that I'd had a silent infarct in the septum, down at the Apex of my heart.  I'm on Flecainide, & that is NEVER given after a heart attack. What to do?  I'm a walking heart attack waiting to happen.  Simple - he changes my Beta Blocker, Acebutolol, to Metoprolol & the Flecainide to Amiodarone.  Also - new Echo & a Lexiscan/Rubidium chemical stress test to find out what is really going on. 

But first!  My old cardio wanted to put me on 200 Mg/day of Flecainide, but I resisted & he gave in, so now I added a third 50 Mg pill to see what would happen.  That, plus the new Metoprolol dropped my PVC's back to normal - about 1 per minute, instead of 20.  (more on that later.)  I told the new EP about it & he did not oppose it.

Had the Echo w/i a week & it came out good.  All the physical measurements were fine & my EF was 50-55%.

Had the Lexi/Rubidium stress test today.  THIS is the new adventure!!!  I went into the test fearing the worst in terms of misery.  I gave a detailed description of the Lexiscan/Carediolite stress test a year or so ago for those who had never had it, so they knew exactly what they were headed for.  I expected the rubidium version to be equally uncomfy.

The Carediolite version takes about 3-4 hours start to finish, w/ two "Photo" sessions of about 15 min each.  Also when they inject the cardiolite the effect is dramatic.  It feels like your heart is made of lead & is going to drop through your back & rest on the floor.  Cardiolite is a radioactive tracer using an element called "Technetium."  It decays relatively fast - about half of it is gone every 6 hours, so it is effectively out of your body in 30 hrs.

Rubidium is a race horse - half of it is gone in 75 seconds!  It is effectively gone from your body in a little more than 6 minutes. 

So I walk into the diagnostics lab, wishing I could trade having my fingernails pulled out w/ a pair of pliers for the test.  First I meet Eric, who inserts the jagged nail they call a butterfly into the back of my hand.  he insists that I'll feel nothing during this test.  No matter how much I scoffed, he insisted!  Then he introduces me to Claudia & Robin, the two RN's who will actually run the test.  Patch remembers Eve Arden & Kaye Ballard, I'm sure.  These two nutcases made Arden & Ballard seem to be undertakers.  Digger O'Dell, for the aged among us w/ intact memories.  They kept chortling about how pleasant the test would be.  I kept telling them they were crazy - they agreed w/ me. 

Here's how it goes - the scanner is a donut, just like on a CAT scanner.    You lie on a bed made from cold, hard steel that slides you into the donut.  There is a gap in the bed where the heart will be so the scanner can "See" the radiation coming from the back of the heart.  Your arms are up over the head & you grab one wrist in  the other hand (You think you could grab your left wrist w/ the left hand?)  You are charged w/ lying perfectly still for the duration of the test.  NO talking, itching, scratching, belching, twitching, wiggling. rolling - NOTHING!  Oh, you can breath!  And swallow.  But God help you if your nose itches - live with it or learn how to wiggle it really fast. 

The test runs 38 minutes - to the second - I think.  You stay in the machine the whole time, remaining perfectly still.  They take three sets of photos (I think).  That's still a fog.

The Rubidium generator sits right at your head w/ as short an IV line as possible.  They don't want to waste any time getting the Ru into you.  After all, it has a very short life.They very pleasantly talked me through every step as they did it. 

Robin stayed right there when she could, but had to leave me when the Ru was flowing, due to the radiatrion in the room.  (Remember, she's there every day, all day.  I'm there for just a few seconds.  The total radiation I got was about the same as the background at Colorado Springs, at 6000 ft elevation.)

Here's the kicker that made this different - Robin tells me that instead of running the Lexiscan/Ru solution into me in 15 seconds, they push it gently for a minute.  Makes all the diffeerence in the world, she says.  Also, she makes me take about a dozen very deep breaths in through the nose & out through the mouth just before injecting the solution.  I did as I was told (Darned unusual).  I did NOT feel the injection or my heart's reaction to it at all.  Matter of fact - I went to sleep during this phase.  It was a non-event.  I cannot say I was disappointed!

The best part of the whole drill was Robin trying to find a PVC in a 38 min ECG.  She could not - but they were there, about 1 per minute.

BTW:  This is called a PET scan - stands for "Positron Emission Tomography."  Costs about $5,000 each, mainly because of the cost of generating the Rubidium.  Apparently it gives very detailed images.  I'll let you know after I get my results.

Donr