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Monday, February 24, 2020

A Stress Echo Test 02/20/2020


02/20/2020 a torture or what
Staring up the ceiling in a small, cramped room, cold as an igloo, I lie down on a half reclined bench while the dimmed fluoresce lights shining on my face. While my empty belly was groaning, with only a thin medical gown, my aging skinny body was shivering. In the warm spring day of So Call, I wished I could have been outside enjoying the blue sky, fresh air and full of sunshine.
How can I end up in this miserable place?
In the past, contacting medical facilities had been my rare occurrences not because illnesses had hardly visited me but mainly I trusted more in body self regulating mechanisms than most medications and other treatments. It didn’t mean I’d refuse necessary procedures, especially in emergent situations. Also preventive measures, diagnose tests, and regular physical all were beneficial. Nevertheless, I would obtain a second or even third opinion before a treatment.
However, a recent mysterious illness proved me over optimistic.
During last year’s Thanksgiving when I stayed with my son Lei’s family in Connecticut, after being in freezing cold field too long without enough warm clothes, I developed a worst illness in years. With my stupidity and over-confidence, as usual, I thought I could fight it, so I didn't even mention to anyone. Unfortunately, my symptoms turned bad to worse. Only when a high fever put me in bed and thick blood discharge from my throat appeared, then I informed my doctor son, who gave me antibiotics right away. A few days later I returned home with no obvious discomfort.
Somehow, when I resumed my physical activities I felt short breath and my usual jogging became difficult. In a doctor visit, when I explained my unpleasant experience, he listened to my lung and heart, and then said, “fortunately due to your son’s medication, you look all right. But for cautions you should have a chest X-ray.”
However, before my doctor could go over the result with me, I took off for a long trip to Australia where my son Yan was getting married. For a mother, nothing could be more important than her children’s needs.
Over there I took it easy and rested well, then my doctor’s email came, “the x-ray showed linear atelectasis in the lingual.”
Of course I had no idea what it meant.
Google it. I was shocked. Part of my lung collapsed, as a sponge, squished together, lost elasticity.
I emailed my nurse stepdaughter and she replied, “Oh, it’s bad and requires treatment. See a doctor ASAP who might suggest oxygen, or just deep breath, depend on its severity.” But I had no health insurance in Australia.
Easy, just deep breathes then.
After a month I came back home and hopped everything going normal, but the short breath stubbornly persisted. I didn't know if it was just psyche or a real problem, moreover, many choirs back home put this on a back burner.
Recent Covid-19 epidemic reminded me that I ought to put my health first and I desired to get to the bottom of the issue.
For an unknown reason, somehow my primary doctor was not easy to visit; often I waited for weeks. Not wanting to put off any longer I rather visited any doctor available right away.
A few days earlier I went to Dr. Morrison, who was a senior and tall guy. It turned out the random doctor was not only attentive but also efficient.
After a short check he ordered a new chest x-ray and EKG test. Less than 10 minutes, a technician came to perform the EKG.
A minute after, Dr. Morrison came in to look at the EKG chat, pointing at a sharp spike, he said, “look, this peak indicates some problem.”
“What?” I had no clue.
“Normally, the height should be 2-step, but yours is over 6. It could mean the thickening of left muscle of your heart.”
“Oh, oh,” I said.
“We are not sure about it though,” he continued, “since we have no previous chart to compare with. To be safe, you need a stress echo right away.”
That eased my worry a bit.
The second day I made calls. Most facilities I phoned had only openings in March, at least 3 weeks away. Finally a schedule squeezed me in for the next day at Saint Jude Medical Center.
Following the instruction that I should have fastened, based on the fact that I could hardly miss any meal because my body required fuel constantly, in previous evening I had a huge meal after our evening class ended after 9:30 pm.
This morning I didn't have any food except a cup of water. Punctually, I arrived at 8:45, 15 minutes before the scheduled time. The receptionist was warm and kind, may have had enough coffee, checked me in. But before I could go into the test room, I filled many forms with a dozen of signatures and initials.
Do I have to read each line of each page? No, I told myself.
A young technician, George, led me into a room, where I changed into a very thin gown, and waited in the small cramped place, full of equipment and medical supplies, more like storage. Following his instruction I lie down on a reclined bench.
“Hey, it's too cold,” I complained; the temperature was set at 65, I guessed.
“I am sorry,” he said with a curtsey, “we have no control.”
Next he took my blood pressure. Somehow when the gadget would not register, he said, “For an unknown reason, sometimes the machine doesn't work. Lets try the other arm.”
Finally, the machine gave out the number 182/72.
“I never had such kind of blood pressure before,” I cried out.
“Well, that is it.”
Shortly afterwards he started the procedure, greasing cold sticky gel on my chest and then sticking on the electrical sensors.
While the ultra-sound probe traced at various spots on my skin, twinkling, and chill were all I felt.
He added more gels and took several rounds.
The cold gel made my body even colder, so I tensed up and felt the time ticked slowly as if the process lasted forever.
“Do you see all four chambers?” I asked with a shaky voice, trying to diverse my attention.
“Yes,” he said, “I can show you.” He turned the screen towards me.
“Wow,” I was amazed, viewing my heart pumping and four sections were clearly visible.
“Do you just take stationary photos?” I asked again.
“Actually I mainly take motion shots,” he explained with patience, “Later on when you are on stress test, more motion shots taken can compare with those.
Looking at my watch, I realized this procedure took about twenty minutes. Very long.
“We need an EKG machine set up here,” he said, pointing the right of the room, full of stuff, before he disappeared.
Now my gown had wet spots, touching my bare chest, and you can image how much agony I was enduring.
Lifting the wet part of my gown and folded upwards that made a space between the wet part and my skin was all I could ease my suffering. Nevertheless, I started to shiver and my tooth clicking was annoying, but I just couldn't help it.
A worker pushed a machine to the door and then he moved my bench away before setting up the EKG.
“I am shivering,” I told him.
“Ok, I’ll tell George to get some blankets for you.”
 After the machine was up he left and shortly George returned with a white blanket.
That was better.
“When can we start the stress test?” I asked.
“Sorry, we can't do it right away, Meanwhile, you have to wait patiently.”
“No. No waiting please,” I begged, “It’s ten O’clock already. You know I didn't eat since last night. I am cold, and worse is I am starving.”
“I know, the test requires fasting, but we are waiting for a doctor to come then we can start.”
I recall the last time I had echo tests, which was like more than 20 years earlier when I worked at Caltech and it had only taken total 20 minutes. What a change.
“We don’t need a doctor. I am sure you know how to do it,” I cried loudly.
“No, we can’t, have to follow the protocol. Stress echo tests require a physician present,” George said firmly.
“I can sign to waive your liability, please.”
“Are you kidding? No such a form to sign. Be patient. I’ll find out why the doctor didn't show.” He softened the tone and left.
That was the time I stared at the ceiling and cold, hungry, really miserable.
“Take a deep breath,” I told to myself, “calm down, no point to be upset.” But rationality and emotions are not always in the same frequency.
A warm blanket on my freezing body eased a bit of the pain, but my stomach complained louder and louder, and I could feel my head get lighter and lighter. “I want to cry out,” I murmured.
When George came back, I said, “could you speed the process, please, I'm going to faint from the starvation.”
“Sorry, I am really sorry for the delay,” he said, “We have only one cardiologists assigned to echo tests, and unfortunately he is tied up in the emergency room, so nothing we can do but wait.” After a short pause, he continued, “I can tell it became a torture for you instead of just a simple test. I’ll see what else I can do to help.”
“Yes, George,” I said, “I know there is nothing you can do. Thanks for your kindness.”
He left the room and I was alone waiting timelessly.
I didn't know how long I could stay awake, so I pinched my arms and talked to myself. It had been more than two hours since I checked in, but end of the test seemed so far. So tires, I closed my eyes, taking deep breathes, counting numbers, and try to be patient.
When George returned, waving a small card to me said, “Right after the test, you can go to the cafeteria for a full meal. Here is a ticket I got for you.”
“Thanks. But you didn’t have to do that.” So nice of him, not because I lacked money, his empathy really eased my pain and anxiety. I could tell my breathing easier, my heart pounding slower.
It seemed waiting for eternity, time ticked slowly.
Any little commotion would rouse my attention from a half sleeping mode.
At last, three new people showed up.
In addition to George, a middle aged MD, a young blonde nurse, and a nurse assistant walked into the tiny space.
I let a long breath out.
“Let's check your blood pressure,” the nurse said.
“Again? It might be very high,” I said with worry.
“We will see.”
Definitely. Finally, the measurement was 192/90.
So high. Am I going to have a heart attack? I wondered but kept quiet.
George strapped my feet on paddles joined with the bench, and I started to work out.
“My usual purse was only 40s, “ I declared, “Like this morning, it was 45. It's not easy to raise my heart rate.”
“Let's find out,” the nurse said.
“Now you should pedal as fast as you can,” the MD said.
So I sped up the pedaling. Striking harder and harder, I hoped everything could be over soon, and then I could fill up my empty belly.
“You are not cold. Are you?” George said, “I am sure you’ll sweat soon.”
 “We supposed to see your rate up to 124,” the nurse announced.
“What rate is it right now?” I asked, paddling as faster and faster.
“At 92. You got to push harder.”
No wonder I felt my heart complaining, the rate was doubled.
A long way to go I told myself but my legs got sore.
“I have worked with 100% effort,” I announced.
”You doing well,” the MD said, “you can reach it, yes you can, try harder, try harder.”
I could tell my heart pounding so fast it made my vision blur, too much blood rushing to my head, I guessed.
I struggled as hard as I had ever had.
“Ok. You got it. Well done,” they cried out in unison.
I felt my heart could jump out of my throat any moment. I didn’t remember I had ever felt this way.
Thank goodness, it was over.
Strangely enough, I didn’t sweat, unlike they predicted, though I didn’t feel cold anymore.
Have lived 36 years in the states, I had visited clinics and hospitals a handful times where I tried hard to take the minimum either medications or treatments.
After one sleeping pill had put me sleeping for 48 hours I was extremely careful for any medications. Also, I have refused morphine to ease the pain when I had bone fractures. A very important lesson I learned was the patient should voice his or her preference and get what was suitable for an individual, because everyone was created differently.
I respect my doctor caring about my situation, I respect George taking his job seriously, trying to accommodate my needs, I appreciate the health system, taking good care of the patients and serving them well.
Meanwhile, I have been waiting for my doctor to discuss about my echo results, tell me what's wrong with me, if there is any, however, I'm sure I'm in good hands.

Saturday, February 22, 2020

柱着拐杖游佛州 1


柱着拐杖游佛州

我原本计划于十月中从加州去新英格兰看望儿子一家并同去波斯顿一游。但在九月中旬不慎受伤,造成右脚和背脊骨折,数周卧床不起,十月的出游计划泡汤。经数周休养,背脊骨折恢复出乎意料地快,我已可从事以往的作息日程。但不料脚部骨折却顽固不愈。经检查,原来骨伤比我估计的严重,是脚跟骨粉碎性骨折并有轻度移位。医生告知这样的骨伤很有可能需要手术,但基于我的骨折已有一段时间,就让可以自然愈合的机会继续为好。并嘱咐一些注意事项。当我问他我是否可去佛州旅行时,他答道,应当可以,只是在飞机上要注意活动双腿,以避免血栓。当即我决定两周后的旅游,去佛州。
佛卅是我去游玩最多次的地方。我弟弟就住在那里。我有免费的住宿和用餐。加之我弟媳好客款待,我从二十多年前起已去过不下十次。迪斯尼世界,肯尼迪宇航中心,爱佛格雷德国家公园,西棕榈滩,匙西角等地都统统玩过。自从两小孙子加入我们的队伍后,我们的旅游点又延伸到位于佛卅中部的恐龙展览馆,麻亚米野生动物园,还有每次必去的Gumbo Limbo自然研究中心。当地各公园,海滩更是就近方便。到佛卅,不愁无处可去,无事可为,每次离开时,总感到游兴未艾。

可是这次的访问不同往常,柱着拐杖游佛卅。
在得到医生的许可后,我马上上网查询机票,仔细考虑后,迭择了美国航空,虽然去程要中转一次,因中间间隔时间长达两小时半,即使第一程晚点,加之我行动不便等因素,一般不会错过第二程。只是到达时间晚,十一点过后,好在是西棕榈滩机场,离我弟弟家颇近。回程是感恩节早八时半从孚特劳特代尔直达洛杉矶机场。到达时间为早十一时一刻。我们将有充裕余地,而不致于耽误去参加感恩节聚会。

我弟弟一家就住在美丽的西棕绿海滩附近,那里是北方寒鸟过冬的理想选择。寒冬季节,我那住在新英格兰的儿子的一家总会去那里避寒一周。这次我决计成行。问题是我的右脚仍然很不中用,步行离不开拐杖,可想而知,走不了几步。在家我用轮椅,出门用拐杖。定了美国航空公司的班机,并要求轮椅服务。好在美国对残疾人的服务是十分周到的。我大可放心旅程的问题。但不知这次旅游的质量会如何。
我先生驾车送我到洛杉矶机场,美国航空使用第四终端,汽车就仃在路边检票台旁,等我递交了证件,服务员很快操作后,为我打印出登机卡,并告知我很快有人会推轮椅来接我。我让先生离开,因这路边只允许载客或放客而仃车。我拄着拐杖进入大厅在一长板凳上坐下,不一会,就有一员工推着轮椅,并巡视着,我向她招手,她查看了我的登机卡就推我上了升降梯,到了安检口,稍等片刻,我们就进入了可为残疾人安检的通道,一切身外之物都经透视检索,包括鞋帽,外套。坐轮椅者不能用自动探测口,因而都被安检人员搜身检查。九一一事件以后的乘机旅行确
实是件麻烦事。安检后,我被直接推到四十二号登机口。 我给了服务员小费后就近坐下静候。离
起飞时间还有一个多小时,我有很多打发时间的方法。
这次出门,只能轻装,临行前,我选择一个最轻的跨肩背包,可腾出双手使用拐杖。内衣裤,汗衫短裤,牙具,还有几件十分必须电子用品,如手机,iPod和 iPad轻松地装入背包。为备天气不测,又加了一套轻薄的长衣裤,一共也不过几磅份量,在坐等之际我可阅读在iPad里的各种书籍,也可听音乐,作笔记。在有的地方,象星际咖啡,麦克当劳,还可以上网浏览。

广播放出种种通知,在同一登机口,原来在我的航班前的同一目的地的航班延期了,原因是飞机发现有机械故障,为安全性,不能使用。上百名旅客焦急地等待消息,不久被告知,航空公司设法调用一驾备用机来服务,起飞时间推迟了大约一小时。还是用原定的四十二号机窗口。那我们的航班只好另找登机口,广播通知道我们的航班转到四十号登机口。虽然这两登机口相距不远,也就是二三十米,但在这游人拥挤的过道行走,对我这站立都不稳当的人来说却不是轻而易举任务。我挣扎到服务台,服务员热心地推出轮椅,让我坐稳,推我到四十号登机口。我们的飞机
迟迟才飞到。服务员等所有旅客离机,要作很多清理等准备工作,才能让下一班的乘客登机,我们的航班迟了半个小时。由于很多旅客要中转就怕误了下一航班,所以分分秒秒都要计较。机长告知,他将尽力缩短延迟时间,终于只迟了十七分钟,安抵德卅达拉斯机场。因我有充裕的连接时间,等所有乘客离机后,我才慢步移出飞机,门口标着我名字的轮椅和服务人员己等候着。达拉斯机场相当大,五个终端由有轧机车连接,我下机终端为D,而下一程航班的登机口在终端F,服务员推我乘坐有轨机车后推我到登机口,并告诉我登机时再来推我到机门旁。我倒不在乎自己走入,但机内经济舱的过道很窄,拄拐杖经过十分困难,上一班我坐在经济舱的第四排,勉强对付了, 这一程我的位子较靠后,我决心去服务台试试我的运气。没想到我刚提上登机卡,服务员就对我说,虽然旅客很多,我们还是可以给你找一个前面的座位,第七排,也就是经济舱的第一排,但是一个中间座位。我说这已是再好不过了,多谢多谢。我们准时登机,但飞机迟迟不起飞。机长广播说检查员告知有一降落轮胎有问题,他必须亲自下机查看。十余分钟后又传出机长的声音,说轮胎必须更换,新轮胎马上就送到,希望大家谅解和耐心等待。终于在延迟一小时以后,飞机上了路。在航程中机长告知,我飞机允许加快,以缩短延迟时间,我们将迟到四十五分钟。真糟糕,因预计抵达时间已是晚十一点以后,这一迟,就会推到午夜了,我弟弟明天还要上班,实在太麻烦他了。
第二天,我弟媳请假,一则陪伴我,二则购物整理床铺为我儿子全家四口的到来。


第三天我们去玛亚蜜附近的蝴蝶世界,据称,其品种之繁,数目之大,以及其蝴蝶生态中心的规模都是世界之最。除了象我们这样的游客,还有大批乘着校车来参观的当地学生。好在这里有轮椅出租服务,我舒服地坐上轮椅进馆参观。第一个景点是蝴蝶厅,这是一个有拱状纱窗顶的露天建筑,里面有花草树木,清澈流水,当然更多的是色彩缤纷的蝴蝶。
大个儿的浅蓝色首先映入眼帘,它们时儿双双飞午,时儿各奔一方。还有那红白黑三色间隔的小蝴蝶,不知是因为众多数目,还是高速飞翔,它们总是不邀而来地出现在我的眼前。那硕大而雪白的蝴蝶是我只有在这里见到
的。黑色和金黄色相间的蝴蝶种类繁多,有大有小,有各种不同的花纹和形状。据说,不要看它们大同小异,其生命过程可天差地别。天气不大帮忙,阴沉沉的乌云开始洒下豆粒大的雨滴。我儿子赶紧将我推到室内避雨,好在室内也有不少展品可看。那研究中心有培育生长各种蝴蝶的设备,有一些就陈列在研究所玻璃墙的框架里。很幸运,我们看到了新生蝴蝶从蝉囝里脱颖而出的活生生过程,这转换用不了几分钟就完成。雨仃了,我又进入蝴蝶厅,正遇一工作人员带领一群学生参观,我也加仨旁听了一会儿。得知蝴蝶一生四个过程,卵状,毛毛虫状,茧状,最后为蝴
蝶,只有在毛毛虫阶段,有咀吃食,成了蝴蝶后,只用象吸管一样的器官寻觅花蜜为食。它们生命的过程虽然短暂,短至两周,长至数月,但它们却是保持生态平衡不可忽视的别动队。也是为大自然锦上添花的一使者。这里有几十种不同的蝴蝶,拿那有浅兰色彩的一群来看,就有好几个品种,有的翅膀两面都逞兰色,而大多只在上方现兰色,有的是整个翅膀中间显得大片兰色,有的只是有从前到后的兰色条纹。它们原来是不同种类的。大大的嫩黄色的成员为数不多,但那婀娜多姿的舞蹈宣告它是这世界的娇娇者。