At Your Age?

I spent Saturday night in the emergency room.

Around 9 PM Saturday, I felt overwhelmingly tired. We were hosting a family reunion, and I felt bad about retiring early for the night, but I simply could not keep my eyes open any longer. As soon as my head hit my pillow, of course, I began to wake up. While lying there, trying to relax, I grew increasingly aware that I was short of breath. Very short of breath. I sat up, to try to draw a deep breath, and realized that I was also extremely nauseous. I sat on the edge of my bed for about 20 minutes, trying to relax and breathe slow, with no real success. The nausea was increasing and, most alarming, my left arm began to hurt.

I called my parents, to inform them of the matter, and my dad came over to pick me up. I had hoped to make a quiet exit from the reunion, so as not to alarm anyone or dampen the family’s spirits, but Tayler caught me on the way out and asked what I was doing. In the long run, this was a good thing, as I was able to tell Tayler what to relay on to Carina who was at the store buying more beverages.

At the hospital, I was whisked through ER registration and taken to a room. Waiting for me were several nurses and technicians, plus one EKG mahcine. Moments later I was connected, and my vital signs were being read. I was thoroughly impressed with the speed and thoroughness of everyone involved. Shortly thereafter the ER doctor came in and asked me a few questions. I told (and retold) my story, and stated (and restated) my symptoms, as well as my family history.

See, when my mom was my age, she had triple bypass surgery as a result of a heart attack. Her only real symptom, form what I understand, was that she vomitted unexpectedly. My dad called the ambulance, and the EMTs who arrived reported that she was suffering from food poisoning, so my mom tried to lay in bed for several hours. When she finally couldn’t stand it any longer, my dad drove her to the hospital where it was determined that she’d had a massive heart attack.

All through my childhood I’ve known that I’ll likely have heart trouble as I get older. I have high cholesterol, and have been taking medication for this for many years. Even on my meds, my cholesterol is 275. That’s not a horrible figure, but it’s higher than it ought to be.

When I felt that I was symptomatic for a heart attack – the pain in my left arm being the clincher – I didn’t want to fool around, or tough it out, or take any chances. I wanted to play it safe, for myself and my family. Better to go to the ER on a false alarm than not go for the real deal.

So I spent the night in ER, and my dad stayed with me (thanks Dad!!). In the morning another EKG was run, along with some more blood samples. The nurse said that everything looked okay. The doctor agreed, but prescribed a stress test in order to have a more thorough evaluation of any pending problems.

Today I took the stress test. When I arrived, the process was explained to me:

First we'll use an ultrasound to look at your heart. It's just like looking at a baby inside the womb, but a lot harder. Babies only have skin and fluid in front of them, but your heart has ribs, and lungs, and muscle tissue, so finding your heart can take a little while. Then you'll walk on a treadmill to elevate your heart rate. When you reach the target rate, you will immediately lie back down and we'll take another ultrasound of your heart. We have about one minute after you stop walking to get the pictures of your heart working hard.

I was then informed that it was this last part, the second ultrasound, that was the really hard part. Sometimes, in order to see the heart, the technician will ask you to hold your breath. So, you exercise and get worked up and breathing hard, and then you need to hold your breath! It was repeated to me (several times) that this was the hardest part.

Fearing the worst, I moved into the actual testing area. The nurses were all super pleasant, and did a great job putting me at ease. It took almost twenty minutes for first ultrasound to be completed. I craned my neck and was able to watch the monitor showing the image of my heart. It was weird to see that pulsing mass and to know that that was inside of me. The ultrasound operator was like some video production specialist, twisting knobs and moving sliders and pressing buttons. It was fascinating to watch. I asked several questions about what was happening at different stages. One of the images on the screen looked like a heatmap of some sort. It was actually measuring the speed of blood as it was pumped in and out. It was basically a Doppler Radar weather report for my circulation.

Finally it was time to walk on the treadmill. A different nurse prepared the machine, and told me about the specifics of this part of the test. Her first question to me, before we started was

What are you doing in here, at your age?

Upon learning my family history, she nodded, and didn't say anything else about it.

So I walked. Every three minutes the speed of the treadmill increased, as did the angle of incline. My target heart rate was 160. When I started, my heart rate was around 90. The first three minutes were actually the hardest for me, due to my long stride. It was uncomfortable to walk the laboriously slow pace at which they started. The second and third segments weren’t as bad. I made a little small talk with the nurse, mostly because I was bored. I asked about what sorts of things would be alarming in my EKG; what sorts of common problems they had with other patients; why they started so slow instead of just jacking someone’s heart rate up very quickly with rabid dogs … You know, small talk.

I reached a heart rate of 160 around 9 minutes in to the test. The treadmill was moving about 5 miles per hour, at an incline of 18%. I felt okay, with no chest pain, and I wasn’t exhausted, so the nurse kept me walking a bit longer, during which my heart rate climbed to 172. Then we stopped, I leaped back onto the table, and waited.

The ultrasound operator asked me twice to expel all my breath, and to hold it that way. But almost immediately after she finished saying this, she said “Okay, breathe normally.” I was never in agony, and was able to breathe comfortably for most of the ultrasound. All in all, it was not an unpleasant experience.

When it was all finished I asked if I could have a copy of the video of the ultrasound. I was told, quite firmly, “No.” No explanation or additional information was offered, so I let the matter drop.

This evening, while getting my hair cut, my barber was speaking to some other customers about his heart rate during a recent jogging session. He was concerned that he was having heart trouble, and that he should get a stress test. He joked about how difficult it would be, and that it would likely kill him outright. I shared with them all that I’d literally just had a stress test. My barber’s eyes popped out of his head: “At your age?”