Wednesday, September 9, 2020

The What If PET Scan

 


It has been slightly less than a year since I had a stent put into my LAD (Left Anterior Descending) heart artery to open a 99 percent blockage. Naturally, my internist, who is also my cardiologist, wanted me to to take the necessary tests to be sure that the stent is operating and I am in no current danger of death (as far as anyone could ever tell). 

This time, the first test was to be the last one I had last year. The PET Stress Test. They inject stuff into your veins among which, in the last part of the half hour test, is a medication that stresses the heart as if you were doing strenuous exercise. As the days came closer to my second experience with this test, I found my anxiety percolating. My last experience had not been traumatic, but when my heart was stressed I felt something, and it wasn't a good something, and when I came out of the machine donut, I was given an intravenous shot of something, perhaps nitroglycerin, to calm the discomfort. It was after that the angiogram was done in October, and the stent was placed. 

In the last few days, I have been reading about and watching documentaries about death, last night it was, "Aside From That". I can hear some of my friends laughing as they know I have, at least intellectually, considered death since I was a teenager reading "Thanatopsis", during my lapsed religious phase. I wonder why death preoccupies me, given that, since my return to faith, I profess belief in the afterlife. I was thinking about that, among my other considerations. I rationalize myself as a reasonably good person, and the thing that is most prominent in the musing about death is God saying, "Not so much", about my being good, particularly on aspects of my life I thought weren't a matter of debate. So if I was wrong about what I thought went without dispute, how much more problematic the other aspects of my life as laid out before me in Divine Retrospection. It isn't a particularly mature view of the Private Judgment, but there you are. The other thing, no matter how a young person thinks about death, it isn't the same as when you hit a fifth, sixth or seventh decade. In the former case it is statistically remote. In the latter, statistically more or less, imminent. 

And at this stage of the game, symptomology or not, imagined or not, there are quite a few other things that can go wrong. I put off my colonoscopy last year because of the heart thing. I had a polyp in the past, in an earlier test, but not after that. If everything is ok with the heart, and I can stop the blood thinner (that may not be a medical concern but it is mine), I will have to have it. I need to visit the dermatologist. And have a mammogram. And all that happens when I think of these things is what if this one shows something is wrong? I will have to deal with it, of course. And the earthshaking changes it would bring. But the anticipatory anxiety tends to have a paralyzing effect. "What if?" becomes panicky breathing. I bet some of you know about that. Thoughts and feelings swirl like Dorothy's house on its way to Oz. 

As some of you know, also, I am a bit petulant when it comes to doctors and medical procedure these days. When you need to talk to them, it is like trying to get through Cerberus at the Gates of Hell. When they want to have a million tests, you are a pawn on the chess board moving from room to room, instead of square to square and being asked to sign in case insurance doesn't cover whatever is being done to you.

So, though I looked at the instructions about what I was and was not to do before this test, and though I received a call yesterday with the same instructions, somehow, between my anxiety and my petulance I missed the part where I was not to indulge in any caffeine, including chocolate or soda, for 24 hours before the test. And last night I indulged in all of them while watching the documentary on death. 

This morning, congratulating myself that I had not had my morning coffee (thinking that it was only for four hours I was to abstain) I picked up the paperwork and saw that I had not complied with the instructions. To the extent that my failure was the result of my petulance, I remembered that I usually get chastened for that disposition. And so it was again. I really can't get away with anything. 

Off I went to face the music, to confess my misbehavior. I was like the high school student who thought she might have missed one too many answers on the test. And I didn't want to have to reschedule this particular examination. 

The woman at the desk was civil but not particularly sympathetic. "I called you yesterday!". "Yes," I said with humility that was required because of my stupid mistake, "You did."

She put me into one of the enclosed spaces built especially for the time of Covid, and asked me to wait. She came back about five or ten minutes later with the decision, "You can have the test."

I waited a bit more, encapsulated in the protective walls, until she called me for the preparation in an examining room, quite a multiple of electrodes attached to my chest, and an IV inserted into my arm. And then I was left alone in the white walled room again, for another ten or so minutes. It sounded like someone else was leaving from his turn. I knew that would mean extra time for clean up. 

I did pray. But it was in between these thoughts about how this room could be the last place I ever spent any time in, alive and well, if something went wrong in the other room. I mean, I was being a bit overdramatic, I know. These tests can but don't usually lead to an in extremis moment. But I am after all a person with heart disease, whether I feel like it or not (I don't you know, even having the stent came after rather nominal events, for which I am very lucky or blessed or both, but it tends to color one's sense of frailty). A few weeks ago I was having palpatations, and a rather high level of blood pressure, and through the on line text process, when I got in touch with my doctor, he suggested it was anxiety. But what if it wasn't? Life chugs along apace, and then, in a room like this, it can just stop, and people are cleaning out your apartment, and trying to unload tchotchkes that nobody wants. 

Allow me further dramatics (from your point of view, not mine I imagine). As I sat in that room thinking that I don't want to do this, I don't want to go into that room, I don't want to have that test, I don't want to hear that something is potentially wrong (were it to be so), I want to run away, I did think of Jesus at Gethsamane, and how His experience was ten thousand fold mine in this room, but that there was some small similarity. Well, enough for me. 

And then David, the technician, the same Physician Assistant who was in charge of my test the last time, was sitting with me. I remembered he was kind, and took the time to talk before we left for the room next door. Asked me a couple of questions. Said that most people found the second time having the test less difficult during the "exercise" phase.

And off I went. The first twenty minutes is the slight clank of the machine and complete reminders to myself "I must not move". I am an antsy soul and sitting still for three minutes let alone thirty is a challenge. 

There is a mantra I have adopted (I have adopted others, nothing yet has quite stuck, but maybe this one will) and in between dishevelled thoughts and trying to remember to breathe, I said to myself, "Jesus Christ, Son of the Living God, have mercy on me, a sinner". That one seems to be a keeper. We shall see. The technician (not David, but also nice) came in every ten minutes to see how I was doing. I was appreciative that he allowed me to take off the mask just after I was stuck in the donut, since as he said, "You are mostly alone in the room." It made a difference. My face staring up at the concave of the machine with a slight glimpse of the ceiling outside, with a mask, might have been problematic. I was going to face it as I am coming to realize that whatever I feel about masks is irrelevant. That was the other thing that came to me during all this. I am already at that stage in the Bible (maybe we are all our lives since there are always people with authority telling us what to do and where to be) where I will be taken where I do not want to go. Maybe it will be a matter of less anxiety if I just let things go where they go. If at some time there is a hill on which I must stand with the great "No!" to someone in authority, well, this wasn't it. And I was not, as is usually the case, not in charge. 

It came to the third part of the test, the one which, the last time, confirmed at least one blockage in my heart. I had decided that when my heart rushed that I would pretend I was back in the Townsend Avenue Courtyard of my childhood, where we kids would run fast up and down the small stone stairs out into the sidewalk. That was a favorite time, I loved the feeling of being sweaty and out of breath for some reason. I felt liberated at those moments, then. That would be a good way to experience it, this time. Also, I prepared myself for a rush of strange warmth after the injenction of the medication from the top of my head to the tips of my toes and quite frankly every where in between. 

But it didn't happen. And though I felt a slight intensity in what was going on in my chest, it was nothing like what had happened before, and I was both surprised, and relieved. Now, I don't know what the results will actually be. My non-medical opinion, at the moment, is that the stent is doing its job. And there was no need for anything to relieve a distress I happily did not have on this occasion.

I felt the odd tear of gratefulness. 

They had a cup of coffee outside the room for me (as caffeine helps with any ill effects, the same caffeine I shouldn't have had the night before). But it was the worst cup of coffee I ever had. I left, stopped at home, and walked to the Pace Joint, which has a lovely outside courtyard and had one of the items from "Breakfast All Day". 

Today's "What If?" is done. I am sure there will be others. But perhaps one day I will learn to be dependent on whatever God's Will is in the matter of my health, and anything else if it comes to that. And will finally live my life day to day with fewer "What ifs?". 


P.S. I got the report on the text link from my doctor: "Marked improvement in blood flow t o the heart." I am glad we concur.



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