Oh ... Really?

Thursday, October 29, 2009

When routine isn’t so routine

I finally got around to getting a complete physical exam last week, my first in several years, and lemme tell ya, there was nothing routine about it. I am still shaking my head in disbelief over what has happened. I see the hand of God at work, but in ways that I do not yet understand.

I went in with the primary objective of finding out why I gained a pile of weight and lose any of it in the last year and a half, despite a low calorie diet and regular exercise. My doctor had blood drawn and in addition to the regular lab tests, said she would check my thyroid and metabolic profile. Then after recalling that my last mammogram was suspicious but never followed up (I was laid off from my job about then, and just now have a job with medical insurance benefits), she ordered another one ... right away, that day. Then she did an EKG. After that, I got dressed and was about to go schedule the mammogram for later that day.

My doctor came back into the exam room. She was quite concerned about my EKG. She showed it to me, where the T waves were inverted or flattened (inverted in aVF and flattened in lead III, for those who know this stuff). From my training and experience as a paramedic, I knew this was not a good thing, and I recognized the abnormality myself. The most likely cause of this change or deviation is a prior anterior myocardial infarction ... that's fancy medical talk for heart attack.

Now imagine not only my shock, but utter disbelief. I already mentioned that I eat a low fat diet - which includes very little beef, even the lean stuff - and that I exercise regularly, but I also have always had low blood pressure - it was 98/72 that day, my resting heart rate is around 68 - 72, and the last time my cholesterol was checked it was 145. I have always enjoyed obnoxiously good health. Heart attack? Me? Surely not!

So then, in addition to the mammogram being scheduled for later that afternoon, I was also set up for a nuclear stress test two days later, an echo cardiogram two weeks later and several follow up visits. Oh, and a referral to a dermatologist for a suspicious freckle on my nose, but more on that later.

So, what does any self-respecting woman do after receiving this kind of news, and who then had two hours to kill before getting her boobies smashed? She goes shoe shopping ... that's what.

The stress test was excruciating ... I was so bored. And hungry, and thirsty. I had to be fasting for 4 hours prior to the test, with water only. And NO CAFFEINE! Auugghh! The technician placed an IV port in my arm and injected the radioactive solution. I sat for about 30 minutes while it circulated, then I laid on a table while my heart was digitally imaged. Yes, I snoozed. Then I was hooked up to the monitor leads, and a resting EKG was run, then I sat for another 30 minutes. I snoozed some more. Then the doctor came in and I got on the treadmill. After walking for about 5 minutes - more slowly than my normal pace - it was sped up to what is for me a brisk pace. When I attained the target heart rate, more radioactive solution was injected. I stopped and they measured how long it took for my heart rate and blood pressure to return to normal, which was not long. Years of regular exercise? Yep. But the doctor said that there were still some concerning changes in the rhythm, so I was ordered to avoid any kind of strenuous activity. Then I sat - and snoozed - some more, then it was back on the imaging table, where I took yet another nap. Then I was done. I left wondering, so when is the *stress* test?

So then the waiting began. This was Thursday, they said the results of the test would be back Monday or Tuesday. Of course, no news Monday, but on Tuesday I got a message while at work from Rich saying the doctor's office had called his cell phone and left a message for me to call. Apparently, they thought his cell was my daytime phone? But when I finally spoke to the nurse, all she had was the results of my blood tests - all normal, except a severe deficiency in Vitamin D, for which they want me to take a supplement plus a once a week prescription strength dose.

Remember that dermatologist referral? Consider that with the Vitamin D thing - you know, the sunshine vitamin? Ponder for a moment and hold that thought ... we shall return to this.

Towards the end of the day Wednesday, with still no call about the stress test results or the mammogram results either for that matter, I finally called the office and asked that someone check to see if they were in. I left work and went to choir practice at church. Of course, they called just as practice was starting, but I discovered later that they left a message for me on their lab line - a phone number that patients can call to get messages and test results.

So I listen to the message left for me - my stress test came back completely normal. No signs of ischemia, tissue damage or dysrhythmia, and all values were within normal limits.

After I picked my jaw up off my lap, and giving praise and thanks to the Lord Almighty, my first thought was, how in the stinkin' heck could this be? I saw the EKGs, I know what the rhythms mean and the possibilities. Remember, almost all my blood work was completely normal. Remember too that during the stress test I had EKG changes that concerned my doctor too. I was and remain baffled. They still want to do the echo cardiogram, but they don't think that I am in any immediate danger.

OK, I will go with that. No problem. I am sure God has a lesson or message for me in there somewhere, and now my prayer is that it be revealed to me.

I also got a letter about my mammogram - recall that it was concerning a few years ago - it too, is completely normal.

Oh yeah, that dermatology appointment. The doctor doesn't like the freckle on my nose. Even though she hasn't seen me in years, she swears that it is bigger now and looks bit scaly. Now, I am quite skeptical about this. I have been a very good girl over the years, and I have always worn makeup with sunscreen in it. I do not leave the house without at least some foundation on, and when at the beach or pool, I put additional sunscreen on not only my face, but my entire body.

Lemme tell ya how devoted I am to protecting my skin from the sun ... remember what the one abnormal blood test was? Yep, Vitamin D ... the sunshine vitamin. Go figure, right?

No wonder men, like my dear husband*, are scared to death of getting physical exams. This has been crazy! Oh, and that primary objective? I guess I am on my own there. My thyroid and metabolic profile are normal, and other than being curious about it, the doctor didn't have much to say about my inability to lose weight.



(*But he better man up and get his butt in there anyway, he is WAY overdue!)

Posted by LissaKay on 10/29/09 at 09:10 PM in ~ Personal
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