This week has been a roller-coaster ride of emotions trying to come to terms with my cardiologist’s diagnosis – that one or more of the arteries in my heart were likely blocked. He arrived at this conclusion after receiving the results of my GXT (Graded eXercise Test – it’s where they hook you up to an EKG while you walk on a treadmill. Then every three minutes they increase the speed and grade until you reach 80% of your maximum heart rate). This all came about after the past 6 months showed that my heart issues (being easily winded after little exertion) were not asthma related (started using Breo, an inhaled steroid, and virtually eliminated my usage of a rescue inhaler). Given the GXT results, my options were presented as one of the following:
- Have an Isotope Stress Test – This is the same as the GXT, except you are given an IV drip with an isotope in it that allows your doctor to see where blood is flowing while at rest and during exercise. This method only allows blockages to be identified, not fixed.
- Have a Transradial Cardiac Catheterization – This is where a catheter is inserted into the radial artery in your wrist and is run up to your heart (similar to a femoral catheter that goes through your groin, but much safer and with quicker recovery times). Once there, a dye is released into your heart with a live X-Ray for the Doctor to watch the flow into the arteries.
Knowing what we know now, the first option would have been the best route to go. However, my cardiologist felt relatively certain with the results from my GXT that there were blockages. So, going with the first option would just confirm it and we’d still have to do the second option. Whereas just going with the second option, he can determine if there is an issue, where it is, and fix it right then and there (assuming there weren’t too many blockages). So, a two birds, one stone type of deal. Of course, he also mentioned that the results of the GXT could also be a false positive.
So, my wife (Alison) and I talked it over and chose to go ahead with the heart catheter. It was NOT an easy decision, and I spent the next couple of days grieving over it and questioning my life choices leading up to this point (I am, after all, only 34. A 34 year old with blockages in their heart is not common). With that said, the procedure took place yesterday morning, with my family there in support (and my work-family sending good vibes) and just like all the YouTube videos said…it wasn’t nearly as scary as it sounds.
Once I arrived at about 6:45am, they called me back very quickly and spent the next hour or so getting me prepped. This included:
- Having me dress down to a gown
- Performing an EKG
- Having me take 1 Valium & 1 Benadryl
- Shaving the spot on my right wrist where the catheter would be inserted
- Shaving two spots on my left arm for two IVs & inserting them
- Shaving multiple spots along my side for electrodes to be attached (as you may have guessed by now, I’m a rather hirsute individual)
- and wrapping up paperwork
After prep, they raised my bed/gurney up and rolled me about 10ft over into the room where the procedure took place. The bed was pushed up beside the operating table and I slid myself over and under the x-ray device hanging from the ceiling, being cautious of all the cords & cables now hanging from me. After getting settled, they taped my right arm down to the table, connected one of my IVs, and placed an oxygen cannula around my face. Next, they had to shave the inside of my legs just in case the procedure couldn’t be done through my wrist. But, to avoid embarrassment, they provided me with a privacy doily over my nether regions. Thankfully, I was starting to feel the effects of Valium & Benadryl by then. Finally, they swabbed me down with a gel-based iodine device that looked like one of those dish-washing sponges that can hold soap in the handle.
Afterwards, without really being able to move, I waited on the table as they did final prep before my cardiologist arrived. Once he arrived, he asked me how I was and then I heard him order something like “250 mzd”. I’m not entirely sure what that is short for (or if that’s even what was said), but I’m fairly certain it was the medication for conscious sedation as I felt much more relaxed after it was pumped into my secondary IV. As I continued to watch him and look at the monitors, I heard one nurse comment “He’s still wide awake” and shortly after something to the effect of “one more”…at that point, the x-ray device right above me appeared to double, come back into focus and then…..just bits & pieces since the medication inhibits memory storage. But, I’m pretty sure I just stared at the ceiling and only turned to look at the monitor once.
Awareness of my surroundings didn’t really return until he finished about 30-40mins later and called out to me that I had ZERO blockages. None – no calcium build-up or anything. The GXT result had indeed been a false positive. So, I went through all of that stress & grief to find out I’m a fat, lazy, out-of-shape guy who needs to lose weight. But, given what I just went through, that’s fucking ok with me.
This may not be the case for everybody, but I find anxiety relief in knowing more about something that seems really scary. While researching transradial cardiac catheterization, I found the following videos to be extremely helpful and insightful.
This video from Dr. Srinivas Attanti answers a lot of questions on stents and atherosclerosis:
Another video from Dr. Srinivas Attanti that talks about cardiac catheterization and the benefits of going the transradial route:
This video is of Dr Ramzan Zakir going through the procedure and narrating what is going on & why: