The Nuclear Stress Test

Sounds like something that NASA would do. But, in the event you find yourself in an office with a cardiologist, and they mention one of these, it means they are looking for arterial blockages of the heart. The nuclear stress test allows the doctor a clear view of all areas of the heart where blockages might occur. I also learned that they use this test to review stents and valve repairs to be sure they are still working.

Before you go, you'll fast for at least 6 hours and have no caffeine in your system for at least 24 hours. So expect to have a headache and be hungry. And, if you take a beta blocker or other heart medication, you skip those; though prednisone is ok.

1. The first step is to put in an IV line, then they inject you with a radioactive isotope that will help highlight all of the arteries and veins of the heart when they do the imaging.

2. Wait

3. The first image takes about 10 minutes. You sit in a big chair with your arms elevated and stay very still as the chair rotates and the images are taken.

4. Wait

5. Treadmill test. They place a bunch of monitors on and watch your blood pressure as you walk on flat and hilly surfaces.

6. Second injection of radioactive isotope.

7. Wait

8. Second set of images. This is done in about 3 minutes, but same as #3.

9. Wait

10. Get preliminary results from the doctor.

In my case I also had to make a second appointment for an EKG and ultrasound because my heart decided to be funky during the treadmill test. Will learn more on this later.

In the interim, no blockages, so that's good! My husband was quite relieved, because I warned him that if 20+ years of vegan diet and exercise and low weight ended up with heart blockages, there would be much yelling and screaming happening.

I'm not happy about having to go back. But, I am trying to just take this stuff one step at a time. The Sarcoid thing is difficult and sometimes scary, but I'll just keep living my life and throwing in the doctor appointments as I have to.

Understanding Sarcoidosis and Dealing with the Treatment

As my treatment plan has continued, I've been trying to better understand Sarcoidosis and to get a sense of how long I'll be dealing with this disease. The problem, I've found, is that so little is really known about Sarcoid that getting clear information is difficult. Even my doctors, who are knowledgeable about treating the disease, are always careful to say that the treatment plan is based on trial and error because there is no clear undertstanding of either why people get this disease or how to effectively treat it across the board.

Yesterday I had my checkup with the pulmonologist. For part of the appointment we spent time going through one recent article from The Cleveland Clinic, that gives perhaps the clearest overview possible of Sarcoidosis and what I'm dealing with. The article reviews all of the current understanding of Sarcoid and addresses directly the fact that so little is yet known. Despite all the unkowns, it was helpful to read something that at least addressed the disease systematically and explained what is happening. The article is available at http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/pulmonary/sarcoidosis/

After we reviewed the disease, we reviewed how I'm doing on the high-dose steroids. My doctor thinks it is starting to work, I'm definitley coughing less. So, he wants to keep me on the high doses for another 2 months. Yikes.

The problem, though, is that the steroids have their own side effects. While I'm not getting the classic weight gain or moon face this time, I have developed some issues with my heart that kind of make me wish for moon face! They are not so bad that I have to stop the steroid, but we do have to add one more pill to help my heart deal with the steroid. And, because I have a famly history that is riddled with heart disease, he wants a cardiologist to look at me again just to be sure no permanent damage is going on. So, one more pill, one more doctor.

My last question for the doctor yesterday was, "Am I going to have to live like this forever, or will I get better someday?" He promises I'll get better. I'm holding him to that promise and praying for sooner rather than later.