Bringin’ on the Heartache

“It takes a full three minutes, are you sure you can handle it?” I nodded in response to the woman running the test. “You need to be sure. If you have to stop in the middle we need to shut the test down and then start all over again when we can get you a new appointment.”

“I’m pretty confident I can go that long.” I replied. She smiled and said okay and turned to the computer to set some parameters. A week ago I’d gone to the Emergency Room at the VA. I was feeling punk; heart was racing, blood pressure way up, a pressure in my chest and a pain in my left arm with numbness in my left hand fingers. They took blood and did an EGK and shot a chest xray. In the end they weren’t sure what had happened, the telltale enzymes of a heart problem weren’t all that elevated although they were a smidge above normal. My symptoms had diminished over the three hours I spent at the hospital and so they let me go, although the ER doctor said she would admit me if I had any fear of a repeat. On my promise to return if any of the symptoms reappeared, I was sent on home. However, she put in an order for a cardiac stress test.

So here I was, wearing one of those one sided smocks, feeling slightly chilled in the hospital’s cool air. I was given a radioactive dye and then laid out while an xray camera took images of my chest repeatedly over 15 minutes or so as it moved on a rack that carried it from my right to left side in a semicircular path.  When that was finished, I was rolled across the hall to the stress test area. It was a room with a bunch of computer and measurement equipment with a treadmill in the center of the space. They hooked me up with a blood pressure cuff, a pulse oximeter and a six lead EKG. There are two ways to do the test, whose object is to stress the heart heavily and watch it for malfunction. With all the measurement going on, they’d be able to see what was not working properly. They can have you walk the treadmill for three minutes while they give you drugs that cause all your veins to open up while also adding stress to the heart muscle. Or, they can do the whole thing chemically, with the patient laying on a bed. Because they said they tended to get slightly clearer results and there were fewer side effects using the treadmill, I chose to go that route.

They were, of course, concerned about my ability to stand the pain of being erect and walking long enough to complete the test.  If there was an abort, they couldn’t just start things over again. We would have to wait for my body to expel the drugs and dye they’d given me and that takes a few days. As busy as their department was, it would be at least a couple of weeks to get me scheduled again. Since they were chasing a possible heart anomaly, no one wanted to put it off any longer than scheduling had already delayed the testing. But I steeled myself for it, and I was damned if I was going to let the pain stop me. I figured it would just help stress my heart.  I climbed onto the treadmill and they started it up and I began my plodding three minutes of testing. The technician operating the test called out a minute, two minutes, then said thirty more seconds, twenty, ten, and then counted down from ten to zero. I made it.

As the test progressed, it was at first just like walking a treadmill. But as the seconds passed, I became quickly exhausted, feeling the same sensations one would by running as fast as they could up a very steep hill. It got a little difficult to breathe, a touch of nausea kicked in, and I could feel my heart pounding like a trip hammer trying to burst from my chest. Whoom! Whoom! Whoom! At the end, they stopped the treadmill and I stepped off of it, amazed that I was so exhausted. They let me sit and relax for a few minutes while we chatted about the weather, the remodeling being done to the VA complex, and how they were installing such a huge number of security cameras. “Prisons don’t have this many cameras,” commented one of the techs. I said it sounded like the VA was competing with Wal-mart –which has tons of them and even put them in dressing rooms until a lawsuit made them remove them. They told me that Wal-mart dreams of having as many cameras as the VA does now.

With that part of the test done, they told me to go take a break for an hour and a half and to eat greasy foods. “Have a milkshake and fries, greasy stuff to encourage the liver to process faster.” I said OK and rolled out to get my wife from the waiting room she was in. Together we went down to the cafeteria and I asked for a cheeseburger, fries and a milk, my wife got one of their sub sandwiches. The Spokane VA cafeteria makes really good subs. They’re huge and loaded with whatever you like. They put Subway to shame and their big sandwiches, hot or cold, are $4.95 all the time. Seeing hers, I had them make me a roast beef sub to take home for dinner. With an hour still to go before I was due back upstairs, we went out to a little smoking cabana the VA has for patients and staff members.

There was a couple of people already there, both VA medical techs. We started chatting and I commented on the large rise in cameras. One of the tech’s said “Thank God,” so naturally I asked him why he welcomed them. He told us that the VA received hundreds of threatening letters each year, and that in the last 12 months there were a few assaults on doctors and staff members. The worst situation, he said, was just a couple of weeks previous. An unhappy vet had strolled into the smoking cabana we were sitting in, armed to the teeth and in battle dress uniform. A sole inhabitant took one look, crushed his cigarette and moved into the hospital to report the issue.  One of the uniformed federal cops took off his holster, and unarmed, walked into the cabana lighting up a smoke. He sat down and smiled and said hello to the guy as if seeing someone in BDUs and armed with an AK-47 and a pair of Glock 9mm automatics with extra magazines for both was the most normal thing in the world. He asked the guy how things were going, and turned a concerned ear to the answer. He got the guy talking, got him calmed down and guided him inside and up to the psych services unit. Whoa. That took some serious nerve, and it upped my respect for the cops I see wandering about the facility.

We still had twenty minutes to go in our wait as the story finished up and my wife and I decided to just head back up to the waiting room. The doctor met us in the hallway and said “perfect, I’m ready for you right now.” So I rolled in and went through the same multi-xray procedure that started the whole process out. The test was over and I was free to go.

It was a very interesting day, all in all. I learned a lot about my health and the way the heart works, how the blood is supposed to flow, and that fatty items make the liver work harder. I also learned that working at the VA could be a dangerous proposition. When they have threat events, they keep them silent. You never hear about the assaults and threats from the news. That’s the VA taking care of its own. Sure, if someone got killed I’m sure that would make the papers, but the lion’s share of incidents are mostly the work of chronic pain, frustration, emotional damage and stress, and quite often fueled by alcohol. It’s kind of surprising, given that the VA is a federal institution, that there is so much support for full legalization of marijuana. It’s a common preference of pot over alcohol: no one stoned ever came in picking a fight or pulling a knife or gun, yet the vast majority of people who do come in with bad intent come in drunk.

Five minutes after the test concluded, I was seeing the VA medical center in my rear view mirror. I won’t get to know what the test showed until my next appointment in oncology, a month from now. Unless they find something bad, in which case they’ll call and pull me in. It took the rest of that day and all of the next to finally lose the sensations left by the test. Them being the same feeling I might have after running a marathon or something. It wrings you out. But it offers a window to what would otherwise be a mystery; the way the heart of a specific person works at rest and when stressed.