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.