10: Stress and Echo

I was incredibly nervous on the day of the stress test and echo. For one, I couldn't eat anything, nor could I take any medications. Not taking my meds is what made me the most nervous. I knew I could go a while without taking Glucophage and just take them later that day with food. Vitamins were no concern. But I was very nervous about not taking the Eliquis, especially the Cardizem. I was worried about what my heart might do without them in my system for a few hours.

The morning of the tests was the longest I had gone without taking Cardizem since July. I had been on the drug since the ER visit and hadn't missed a dose once. So, naturally, my blood pressure and pulse were all elevated that morning of the tests.

Although my anxiety had come down some the weeks leading up, this was a different kind than what I had been experiencing. I legitimately was worried I might have a panic attack at the cardiologist. Leslie accompanied me that morning and even drove just so my anxiety would be a little lower. It still didn't do much for my pulse or blood pressure.

I went back for the tests and got an IV site started for the stress test. They took my blood pressure, which was 140s/90s, but I didn't know my heart rate yet. When I went in for the stress test, they connected me to the leads to prepare to walk on the treadmill. After the tech hooked up all my leads, I saw my heart rate -121 beats per minute. The tech said, "Well if we don't get your heart rate down, we may not be doing this test. Have a seat." I thought, please cancel it! I did not want to do the test. I was so nervous something bad might happen. But I sat down, tried to relax for a few minutes, and even asked God to help me calm down.

Eventually, my heart rate came down to 99. By comparison, in May 2022, my heart rate was 76 before that stress test. I had no real concerns about the test then. For this stress test, I needed to reach the goal of 148 beats per minute. I had reached about 141 beats per minute a few times, walking in August, going up hills and such. Nothing happened bad then, so I thought, I can do this. So, I got on the treadmill, and the test began.

One issue with stress tests, they start you off incredibly slow. I know why they do this: to ensure there are no complications for the person doing the test. But, seriously, it was so slow I thought I might actually walk off the front of the treadmill before I reached the target heart rate. I was used to walking much faster than this. The tech eventually asked me to loosen my grip on the handle because I was going completely to white knuckles holding on to it. That wasn't helping with some of the readings coming up. With that pace, I only got my heart rate up into the 130s, but now she was increasing the elevation and speed. 

The funny part of this test was that I was getting frustrated with myself for not already getting my heart rate up to 148. The tech asked if I had been taking anything to lower my heart rate, and I told her yes, the Cardizem. Of course, I hadn't taken it that morning yet, so it must have been residual effects from the drug, making it take a little longer to reach the goal. Finally, after speeding up the treadmill and elevating it, I reached the goal of 148, and the test was concluded. It only took about 5 minutes, but it was about 3 minutes longer than the year before. If you're reading that, you know that's not bad in either case. I wasn't even breathing hard afterward.

From there, the testing was easy. You lie down for the echo so they can use an ultrasound to visualize the heart's internal structures and record the sounds present. The perfusion test has you lying down on your back with your arms over your head to determine if there is any indication of blockages within the arteries of your heart. In both cases, they can't tell you anything to let you know.

The tests' results would not be shared until November 1 in a follow-up visit. Now, it would be a wait-and-see deal, which can be just as agonizing as leading up to the tests themselves because you don't know anything. But some things came out of that test that helped me. For one, I had no issues with my heart during it or after. I felt good and got to the goal very quickly. I wasn't the least bit fatigued. All of these things said to me there's no blockage. I had even asked one of my relatives who I knew had a blockage once what it felt like. They told me a burning sensation was present, and thus far, I had no effect like that. I felt great, actually.

One thing that helped was receiving the perfusion test results that day. With the perfusion results, they can publish those electronically rather than scanning them in like they do with the echo. When those results came up, it said: Normal perfusion LVEF 59%.

Normal perfusion! That means no blockages were present, and my coronary arteries were good. LVEF means Left Ventricular Ejection Fraction, which is the percentage of your heart's ability to pump blood out of the left ventricle and into the rest of the body. Typically this ranges from 55-75 for a healthy EF. In 2022, my EF was 66%, but on July 14, the day after Afib, my EF was 50-55%, or low normal. Now, 3 months later, my EF was back up to 59%. I wasn't quite where I had been the year before, but I was back up, which is also a very good thing.

All signs pointed to good results in the follow-up visit, and I was so relieved. I was counting my blessings. It would still be nerve-wracking the day of the follow-up, but I believed only good things could come from it. I would have to wait until then to hear the echo results and know how my cardiologist felt about my heart.

Until then, it was time to enjoy the rest of October and the Fall Break to come. 

Tune in for the next segment, 10: Happy Halloween.