Bill Goes Nuclear

It’s time to go beyond lab work and see how Bill  is doing with the lifestyle changes we put in place two years ago.  So here we are at the nuclear stress test lab, preparing for a followup with Dr. Crandall.

Nuclear Stress Test… sounds kind of ominous, doesn’t it?  It goes by a number of different names but this one’s called nuclear myocardial perfusion imaging (MPI), and it will be done to assess the health of his heart as well as blood flow to the heart. After injecting a radioactive liquid called a tracer into his bloodstream, a series of heart pictures (32 in Bill’s case) will be taken with a special camera before and then again after exercise while his vessels are dilated to assess blood flow. As Bill’s nurse explained, “blockages don’t dilate.”  In his book, The Simple Heart Cure, Dr. Crandall writes, “the heart lights up like a lantern wherever there’s good blood profusion.  If an area of the heart remains dark, we know that blood isn’t flowing as it should.”

(If you are unable to exercise because of an injury or other factors of your health, they are still able to do the test by giving you medication that makes your heart beat faster and harder as it would during exercise.)

I got to wondering about the average age of the people who are prescribed this test, and if it’s more men than women.  So I asked the nurse and she said the average age is 70, but most of the people they see range from 50 to 90, and it’s an equal mix of men and women.

I’m sure there are variations of this test, but here’s how it went for us.  Preparation was pretty simple:  No caffeine for Bill for 24 hours preceding the test, no food 2 hours before the test, wear comfortable clothes and shoes and bring along a snack.  (For you or someone you love, the instructions may be a little different, such as not taking certain medications.)

The first order of business was.. ouch!.. putting an IV in Bill’s hand (he said it didn’t hurt). Then off to the imaging machine where he laid on its bed and the tracer was injected. He was asked to put his arms over his head, relax and stay very still while the machine moved around him and took pictures.  (Of course his nose itched right away.) The process took about 24 minutes.

Next.. the stress test room where the sticky electrode patches were stuck to his chest and abdomen for the electrocardiogram machine (to monitor his heart’s rhythm). A blood pressure cuff was put on his arm so they could check his blood pressure during the test, and now… exercise!

The next 20 minutes were treadmill walking time as they periodically increased the incline and speed until his heart rate reached a set target.

Right at the end, at peak exercise (as he was huffing and puffing a little), they injected the tracer again.  This “marks” the cells right then, like throwing paint on a wall they explained.

Paper towel in hand to blot the little beads of sweat, it’s back to the waiting room for us to have the prescribed snack before going back for the final imaging stage.   Cooled down, they came to get him after a bit for the repeat  set of  pictures (that this time apparently caused his ear to itch).

And that’s it! By the time we were back in the van, the whole process took about 3 hours.  The baseline pictures will be compared with the second set of pictures, and we’ll go back to see Dr. Crandall to learn the results. His office will also do an ultrasound that day and we’ll review new lab work, so it’s an important followup.  I’ll post again soon to share everything with you.

According to Mayo Clinic, the tracer dye will leave your body naturally through your urine and stool, and it’s suggested you drink plenty of water after the test to help flush it out of your system.  But what about radiation exposure?  This test, generally speaking, does expose you to a high level of radiation as compared to other routine tests.   Bill and I are both rather phobic about radiation, resisting tests unless absolutely necessary (much to the annoyance of our dentist).  While neither of us are happy about exposing him to this radiation, we understand it’s a necessary and routine procedure 2 years after having a stent placed in your heart.  I plan to ask Dr. Crandall if Bill will ever need this test again, as long as his other health markers are good.  Hopefully his future lab work and tests like the electrocardiogram, along with other obvious indications of his heart health, such as blood pressure and exercise stamina, will be all that’s needed for a long time.

If you want to read more about this test, there’s a lot of info online.  Check out this Mayo Clinic page.