Have a Heart!

Last Sunday, we left for my biannual diabetes appointment with Dr. George Dailey, head of Endocrinology at Scripps Institute in La Jolla. I had scheduled both an office visit with Dr D and an echocardiogram, which is an ultrasound that shows heart function under stress. This type of stress test is done for people who are unable or unwilling to do the treadmill test.

My tender right foot refers excruciating pain to my lower back if I exert too much pressure on it by walking (that's why I swim), so this was the test of choice. The reason for my having a myocardial function test was becuz of my use of the oral medication, Actos, which comes with a warning about potential heart failure as a side effect.

Get to the cardio lab, all suited up in a glamorous open front nightie, and ready to go, IV pumping toxins into me, electrodes glued down in the netherlands of my anatomy, when the ultrasound technician reported that she couldn't see my heart on the screen. Where was the li'l bugger?

She and the nurse who was going to inject the drugs to stress me tried every which way to move my left boob to get a glimpse of the ticker.

Unable to locate it, they summoned the cardiologist on duty that day, Mike Smith. He looked at the screen, moved the mouse around a bit (the computer kind), then turned to me and said, "Do you have breast implants?"

Indignant, I replied, "Why, I BEG YOUR PARDON!" They all laughed sheepishly, and then I just couldn't resist the opportunity to use a line from an old Seinfeld show where Jerry is trying to find out if a girl he's dating has implants. I continued by saying proudly, "They're REAL....and they're SPECTACULAR!"

We all had a good laugh.

Turns out that there was no way of seeing my heart with ultrasound becuz my breast tissue is too dense. They couldn't get a peek at the heart thru the rib cage either, becuz i have dense and gigantic ribs as well. Next step?

The IV comes out, the electrodes pulled off and i get dressed for a hike over to my endocrinologist's office to try to get approval for one of the best myocardial function tests on the market: the PET scan. After duress with the nurse (Doc had left and didn't answer his pager), another Doc in the endocrinology dept approved the PET scan.

Next day, i have to fast from 8 am til the test at 2:45 pm. Lovely. This test uses a radioisotope (rubidium) to illuminate the heart and every blood vessel you own. Side effects are myriad. My side effect of choice was a booming migraine. I'd had many migraines in my life, most of them associated with changes in barometric pressure and cyclic female hormone changes. With this test, I learned emphatically that changes in barometric pressure cause my sinus tissue to dilate, which produces the sinus headache that eventually continues long enough to give the symptoms of migraine.

But I digress......the bottom line is that you get a stimulant injected into your IV to dilate every blood vessel, then rubidium injected in the IV to glow in the dark on the CT scan that follows. For about 15 minutes, you are in the CT machine enjoying your own personal side effect. Some people have chest pressure, others have tingling fingers and toes. I knew my head was going to explode.

They finish by injecting a drug that reverse the dilation and takes most of the migraine away. 800 mg of ibuprofen to polish off the pain and i was done.

Good news is that the myocardial function was outstanding. And my doctor took me off the Actos anyway, because weight loss and exercise has helped my blood glucose levels remain low.

Not-so-good news was that the scan also shows the lungs hiding behind the heart, and i had a 4cm shadow on the upper lobe of the right lung. I'd been off work with a nasty cough for a week before this, so it was no surprise to me. Dr. Dailey recommended a follow up CT scan here in Tucson with a visit to a pulmonologist. He sent me an email with the reading on April 3, and I've not yet been able to schedule a follow up. Most folks I call say they are booked until September. I have an Obgyn annual on May 5, and if I've been unable to hook up with anyone, I'll ask her to help.

Other stuff: weather was cool in SD but still lovely, flowers were bursting at the seams in all colors of the rainbow cuz of winter rains. Ate at our usual haunts, but this was a rather short visit, so we didn't get to do much but go to the doc and test labs.

On April 7, here in Tucson, I had my second oral surgery for placement of 2 dental implants on the left lower jaw. In a few weeks, I'll have impressions made and they'll order the crowns. David's had to recently undergo 2-hr (not kidding) sandblastings of his gums because of scale buildup. The pH of your mouth is a big determinant of whether or not you get scale; i've lucked out on that, and he suffers.

david got his sleep apnea machine and is resting much better. SO AM I. It keeps him from snoring like a freight train, so I too sleep like a baby when we are in the same bed/room. He thinks it may need some adjusting, but overall is pleased with its results. He no longer comes home in the afternoon and collapses in a dead funk.

i've been having some very interesting dreams again...lots of visitation by dead relatives and crazy activities in them. Not worth repeating, but let me say that when i wake up, for a few hours, i don't know if they're truth or fiction!

hope all who read this are well and blessed.
a