So I saw the cardiologist for an ultrasound of my heart (aka echocardiogram) the other day.
The test itself was pretty interesting. Something quite primal about seeing your heart pumping. thump-thump...thump-thump. I even got to see it in color. Artificially generated color, true, but still cool.
I saw the cardiologist afterwards and I was anticipating a conversation about mitral valve repair. I've had a heart murmur forever and about 15 years ago a doctor told me I had mitral valve prolapse, a fairly common heart valve defect. That diagnosis is what resulted in me being allergic to almost every common antibiotic.
Some creative thinker came up with the theory that if you have mitral valve prolapse (or any heart valve defect for that matter) getting your teeth cleaned could dislodge bacteria which would travel through your bloodstream, settle in your defective valve, lead to endocarditis (an infection in your heart) and you could die. So for several years like a good girl, as recommended by the American Dental Association and the American Heart Association, I took antibiotics every time I went to the dentist. Had one allergic reaction after another until even my doctor agreed that for my health I should stop taking antibiotics to prevent a potential infection. God forbid I get an actual infection and not be able to treat it. Found out later that the whole endocarditis from dental work theory is just that, a theory. Even the American Heart Association now says the former policy was overly aggressive. Just another example of why I hate the medical industry.
Where was I? Oh yeah. Mitral valve repair. So I'm expecting them to find some regurgitation (which is just like it sounds, blood leaks backwards through the valve) and then try to talk me into heart valve repair surgery. So I get the echo. I wait and wait for the doc and we finally get blessed with his presence. Echo? "Heart function at rest completely normal." Totally and completely normal. What about my mitral valve prolapse? Any signs of regurgitation? Um, yeah, about that. No sign of mitral valve prolapse. You just have a noisy valve, that's it.
So after seeing the cardiologist I find out I'm healthier than I thought I was when I walked in, which is always a good thing, but all those years with those fucking antibiotics were now even more of a waste. Forget theoretical discussions about heart infections from getting your teeth cleaned, I don't even have a heart valve defect. Fuck me.
"And you're declining the stress test?" Well, yeah. Elevating my heart rate is one of the things that sets back my recovery, I'm not keen on doing that for no reason. So give me a good reason doc. "Because that's what we do when someone presents with your symptoms." Someone. Your standard issue fat, sedentary 45 yr old who smokes socially comes in complaining of chest pain and me...more physically fit than most 30 year olds, excellent diet, low blood pressure, low resting heart rate, quit smoking a million years ago...we both get the same test. That's just terrific. My husband and I pressed him again...what is he looking for in a stress test that lines up with my symptoms (delayed inflammatory reaction to talking, bad air, and yes elevated heart rate...but no symptoms at the time - which is why I keep overdoing it - they show up 12-24 hrs later). Is the stress test going to uncover something that doesn't show up until the next day? Um, no, but still, "it's what we do". Do I have symptoms of blocked arteries? No. Do I have signs of coronary artery disease? No. But still it's the test they do. Well, not to me, doc. I'll pass.
I see the pulmonologist for a follow up on Wednesday. I'm confident my answers lie there.
Sunday, October 07, 2007
Tuesday, October 02, 2007
Full Pulmonary Function Test
I got to sit in a phone booth and breathe into a tube. Over. And over. And over again.
For the sake of information I did what I know is one of my triggers...I breathed hard. Really hard. Several times.
When you do a pulmonary function test they have you breathe out all your air as fast and as hard as you can, and then keep breathing for 6 seconds, then breathe in a full breath. They measure all sorts of things, volume in, volume out, expiration rate, inspiration rate (eureka!? no, not that kind of inspiration). I've been doing Buteyko breathing exercises for almost a year, working on not breathing lots of air and here I was sucking in and blowing out as much as I could. Definitely not in keeping with Buteyko!
Then they give you a drug that open up your breathing passages, albuterol in my case, and do the test again and compare the results. If the drugs help, you have asthma (well, maybe). Anyone who knows me knows it took a lot for me to suck in drugs for the sake of research!
They also did a test where they have you pant against resistance that can tell them if you have "air trapping" where you aren't getting your breath because you have stale air stuck in your lungs.
I found out from the tech at the time that I definitely don't have air trapping, so that's good. And the albuterol did help a bit with my "small airways", whatever the hell that means. And she saw an indication of vocal chord dysfunction, which is an interesting piece of information, will have to research that now.
Pulmonologist reviews the rests, and the results of the echocardiagram next Wednesday. Will get complete answers to things like what does improved function in small airways mean? and do I have vocal chord dysfunction (certainly talking is one of my major stressors)? Could I be getting close to some sort of answer? Should be interesting.
For the sake of information I did what I know is one of my triggers...I breathed hard. Really hard. Several times.
When you do a pulmonary function test they have you breathe out all your air as fast and as hard as you can, and then keep breathing for 6 seconds, then breathe in a full breath. They measure all sorts of things, volume in, volume out, expiration rate, inspiration rate (eureka!? no, not that kind of inspiration). I've been doing Buteyko breathing exercises for almost a year, working on not breathing lots of air and here I was sucking in and blowing out as much as I could. Definitely not in keeping with Buteyko!
Then they give you a drug that open up your breathing passages, albuterol in my case, and do the test again and compare the results. If the drugs help, you have asthma (well, maybe). Anyone who knows me knows it took a lot for me to suck in drugs for the sake of research!
They also did a test where they have you pant against resistance that can tell them if you have "air trapping" where you aren't getting your breath because you have stale air stuck in your lungs.
I found out from the tech at the time that I definitely don't have air trapping, so that's good. And the albuterol did help a bit with my "small airways", whatever the hell that means. And she saw an indication of vocal chord dysfunction, which is an interesting piece of information, will have to research that now.
Pulmonologist reviews the rests, and the results of the echocardiagram next Wednesday. Will get complete answers to things like what does improved function in small airways mean? and do I have vocal chord dysfunction (certainly talking is one of my major stressors)? Could I be getting close to some sort of answer? Should be interesting.
Got a LITTLE overenthusiastic!
After seeing the cardiologist and the pulmonologist I felt emotionally better if nothing else. Yes, the cardiologist freaked me out a bit with his focus on my wacky heart valve, but after Mike talked me down and made me realize my symptoms don't line up with heart failure, I decided that kicking it up a notch wasn't going to kill me. After all, the cardiologist wanted me to do a full on stress test, getting my heart rate up into the 130's, so clearly he wasn't afraid I was going to drop dead from a little cardiovascular exercise!
I was feeling the best I've felt in a long time a week ago Friday...couldn't help singing in the car even (funny how simply not being scared will make you feel better!), so I kicked it up last week. Wednesday was cardio day. For the last few weeks I've been doing LOW level cardio (keepin' the old heart rate under 100), but last Wednesday I let it hover 115-120 for about 15 minutes. My lungs did start to tighten up, but I concentrated on relaxing, not letting them be in charge, and they settled down. Felt good. Also let my heart rate drift to 120 when weight training. I kept it civilized, making sure I rested between sets, but allowed myself a little exertion. Felt great afterwards.
Thursday I trained my Pilates teacher (I know, that sounds backwards), and she was teaching a Reformer class after our session and asked if I wanted to take it. I didn't have my heart rate monitor with me, but said "Fuck It! Yes!". I could tell I was pushing it a couple of times, and I stopped myself before getting crazy, but I'm guessing again I was pushing it into the 120's. At one point my teacher if she was getting me up there and I said yes, she was, but I decided I was pissed off and my body was just going to have to deal! That's my new attitude toward my lungs...deal with it you lazy fuckers!
After teaching my private client on Friday morning people started to drift in for the noon Reformer class at the studio, but hmm, no instructor. I called her to see if she was on her way and she thought the class started at 12:30. Oops! I asked if she wanted me to teach the class for her, which she appreciated. That, as it turns out, was my big mistake. Not pushing it with cardio on Wednesday. Not pushing it with Pilates on Thursday. Teaching that fucking class on Friday was the killer. First of all can I just say I hate teaching classes? No time to correct people's form, I didn't have time to prepare and had to think on my feet which I also don't much care for, and I have to TALK TOO DAMNED LOUD!
One of my Saturday clients didn't show so I worked out instead, again without my heart rate monitor (thought I'd be teaching, not doing!). That was not a bright idea. An hour later it was clear I should have rested. Not that I felt terrible, but the body was saying "hey! dumbshit! You just taught that stupid class yesterday after pushing it 2 days in a row and now you expect me to work out? WTF?". Sorry, wasn't paying attention! My "spot" in my chest wall returned, tightness like someone was pressing on me returned, just general "oh shit, I overdid it" feeling returned. Oh well, nothing a little (or a lot) of rest won't cure!
Rested the remainder of Saturday and all of Sunday. Chilled the fuck out. And didn't work out yesterday in preparation for the breathing test which I knew would be a little stressful on the old lungs. Pulmonary Function Test in the next post.
I was feeling the best I've felt in a long time a week ago Friday...couldn't help singing in the car even (funny how simply not being scared will make you feel better!), so I kicked it up last week. Wednesday was cardio day. For the last few weeks I've been doing LOW level cardio (keepin' the old heart rate under 100), but last Wednesday I let it hover 115-120 for about 15 minutes. My lungs did start to tighten up, but I concentrated on relaxing, not letting them be in charge, and they settled down. Felt good. Also let my heart rate drift to 120 when weight training. I kept it civilized, making sure I rested between sets, but allowed myself a little exertion. Felt great afterwards.
Thursday I trained my Pilates teacher (I know, that sounds backwards), and she was teaching a Reformer class after our session and asked if I wanted to take it. I didn't have my heart rate monitor with me, but said "Fuck It! Yes!". I could tell I was pushing it a couple of times, and I stopped myself before getting crazy, but I'm guessing again I was pushing it into the 120's. At one point my teacher if she was getting me up there and I said yes, she was, but I decided I was pissed off and my body was just going to have to deal! That's my new attitude toward my lungs...deal with it you lazy fuckers!
After teaching my private client on Friday morning people started to drift in for the noon Reformer class at the studio, but hmm, no instructor. I called her to see if she was on her way and she thought the class started at 12:30. Oops! I asked if she wanted me to teach the class for her, which she appreciated. That, as it turns out, was my big mistake. Not pushing it with cardio on Wednesday. Not pushing it with Pilates on Thursday. Teaching that fucking class on Friday was the killer. First of all can I just say I hate teaching classes? No time to correct people's form, I didn't have time to prepare and had to think on my feet which I also don't much care for, and I have to TALK TOO DAMNED LOUD!
One of my Saturday clients didn't show so I worked out instead, again without my heart rate monitor (thought I'd be teaching, not doing!). That was not a bright idea. An hour later it was clear I should have rested. Not that I felt terrible, but the body was saying "hey! dumbshit! You just taught that stupid class yesterday after pushing it 2 days in a row and now you expect me to work out? WTF?". Sorry, wasn't paying attention! My "spot" in my chest wall returned, tightness like someone was pressing on me returned, just general "oh shit, I overdid it" feeling returned. Oh well, nothing a little (or a lot) of rest won't cure!
Rested the remainder of Saturday and all of Sunday. Chilled the fuck out. And didn't work out yesterday in preparation for the breathing test which I knew would be a little stressful on the old lungs. Pulmonary Function Test in the next post.