Wednesday, January 28, 2009

Say Nuclear



I am really going to miss President Bush 43. And I am not intending to open a political discussion, I will keep those opinions to myself (for now at least). Regardless your political bent, you are going to have to admit we have had a great 8 year run of jokes. How long will we have to wait before we can start in on Barack?

Actually what made me think of this has nothing to do with politics, I am just trying to lighten up the mood before I begin what some will consider a very serious post. So mom, as you read below, feel free to go back to the video frequently, it should help to put things in the proper perspective.

On Monday at 7:30 am I am scheduled for a Thallium Stress Test (sometimes also referred to as a nuclear stress test). My physician and I agreed it would be wise to do this test based on an episode of lightheadedness and shortness of breath after my December 21 run and my cardiac risk factors. (I'm a male over 50, taking blood pressure and cholesterol meds, have a stressful job, am 'overweight' and have a family history of coronary artery disease and diabetes).

So out of an abundance of caution we started the process by requesting a preapproval from my health insurance, and after an initial refusal they did relent and authorize the test. Here's a desription of the test from the American Heart Association website:

Thallium Stress Test

What is a thallium stress test?

thallium stress test

This is a type of nuclear scanning test or myocardial perfusion (mi"o-KAR'de-al per-FU'zhun) imaging test. It shows how well blood flows to the heart muscle. It's usually done along with an exercise stress test on a treadmill or bicycle.

The thallium stress test is useful to determine:

  • Extent of a coronary artery blockage
  • Prognosis of patients who've suffered a heart attack
  • Effectiveness of cardiac procedures done to improve circulation in coronary arteries
  • Cause(s) of chest pain
  • Level of exercise that a patient can safely perform

When the patient reaches his or her maximum level of exercise, a small amount of a radioactive substance called thallium is injected into the bloodstream. Then the patient lies down on a special table under a camera ("gamma camera") that can see the thallium and make pictures. The thallium mixes with the blood in the bloodstream and heart's arteries and enters heart muscle cells. If a part of the heart muscle doesn't receive a normal blood supply, less than a normal amount of thallium will be in those heart muscle cells.

The first pictures are made shortly after the exercise test and show blood flow to the heart during exercise. The heart is "stressed" during the exercise test — thus the name "stress test." The patient then lies quietly for 2-3 hours and another series of pictures is made. These show blood flow to the heart muscle during rest.

What does the thallium stress test show?

  • If the test is normal during both exercise and rest, then blood flow through the coronary arteries is normal. The coronary arteries supply blood to the heart muscle.
  • If the test shows that perfusion (blood flow) is normal during rest but not during exercise (a perfusion defect), then the heart isn't getting enough blood when it must work harder than normal. This may be due to a blockage in one or more coronary arteries.
  • If the test is abnormal during both exercise and rest, there's limited blood flow to that part of the heart at all times.
  • If no thallium is seen in some part of the heart muscle, the cells in this part of the heart are dead from a prior heart attack. (They have become scar tissue.)

What if I can't perform an exercise test?

Sometimes you can't do an exercise test because you're too sick or have physical problems. In this case, a drug such as dipyridamole (di-pi-RID'ah-mol) or adenosine is given. This drug increases blood flow to the heart and thus "mimics" an exercise test. Then the thallium test is given.

Hey by the way I like the idea of a drug to mimic exercise. Why aren't we all using this every day?

Anyway, I scheduled the test as soon as I got the preapproval. In the meantime I am doing about 8 hours a week of intervals cycling and running, and I feel fine. Actually, I feel great. I am even kind of looking forward to this test, treating it like a race of sorts. Maybe I can get them to give me a max heart rate measurement? I will ask them to snap a few photos and post a report.

The worst thing I can see so far is, no caffeine for 24 hours before the test, and its the day after the super bowl, so I need to go easy on the chicken wings and Toasted Lager Sunday night.

4 comments:

HolisticGuru said...

It sounds to me like an extra weekend day. You get to ride then lie around for a few hours. The only difference is that you aren't injected with radioactive substances in between, unless of course you have jumped on the hornet juice wagon. What are you going to do with the hours of lying around?

I wish you the best (obviously) and I'll be thinking of you on Monday morning.

ramster said...

Thanks Guru!

I was thinking i would do that silly core workout you've been doing, right there in the waiting room, but apparently i am supposed to rest. So i am going to bring a book, I think "Last Exit to Brooklyn" by Hubert Selby Jr. I might also just close my eyes and breathe some.

TriJD said...

Don't try to cross the border! One of my employees got the "deluxe" treatment at the US border after tripping their radiation detectors after a similar test!

Javier said...

I suspect that by the time you het to IM LP you will have been the most scientifically documented athlete there :)

Good luck with the test! How do you study for this I wonder?