The Real Stress Test

It's been just over a week since the Mr went to the ER for what was diagnosed as "GERD"  (heartburn.)  They scheduled a stress test for him a week ago today because despite being told all was normal, the ECG noted "possible infarct- age undetermined."  This means he could've had a heart attack that healed itself and the stress test on the treadmill with an ECG would be able to determine this.  We didn't like that because it wasn't even mentioned and we consulted Google and were like "why didn't they mention that?"  Maybe to keep us off Google.  Sorry.  His dad died as a direct result of malpractice and that ain't happening with him.  The night before, we were doing one of our workouts, and he was pushing himself so he could prove he would be all studly on the test.  Yes, honey, I see how far and fast you did those skaters but going through the drywall into the stairs doesn't earn you points.

Men.

We knew from some research that it takes the average person 6-7 minutes to get to their max heart rate on the treadmill test.  I think he needed numbers to beat.  So they go in and do an ultrasound of his heart at rest.  They said the walls were a bit less defined than they'd like for a clear pic, so they were going to have to use that dye which then turned it into a nuclear stress test.  He used to do the treadmill all the time when we owned one and did a 5K on it, so he's no stranger to it.  Many people can't do a traditional stress test because of bad knees and such, so they can give you a medicine that speeds up your heart rate and they image you then.  (No thanks.)  It took him 10 minutes and 9 seconds to finally get up to a heart rate they could image, and his recovery rate was so fast it stunned the nurse.  Obviously, that's good for his overall health.  He has the heart of a runner recovery wise.  The test results were in the same day, and the lady left a voice mail explaining all of it.    "All normal (blah blah blah) first degree AV block  (blah blah blah) aortic root dilation...high end of normal is 4, and you're 4.2 (blah blah blah) follow up with family doc."

(Accurate reaction via GIPHY.com)

We both hop on the laptops and begin Googling.  AV block is not an actual block of anything, it's an electrical issue.  "First-degree heart block generally does not cause symptoms and does not require treatment. This type of heart block is not uncommon among well-trained athletes who have slow resting heart rates."  Our previous doctor, the crunchy granola one that was the size of a twig and blamed everything we had wrong with us from hangnails to possible skin cancer to weight diagnosed that condition about 10 years ago and said it was no big deal.  In case you're wondering why we don't go to her anymore, she had a stroke and had to close her practice. Not sure if there was family history there or not but it came as quite the shock to us because she was the picture of supposed perfect health.  Thankfully, the Mr had no family history, or so we thought.  We'll get to that.

So then it was time to Google the other thing.  Basically, the size of 4.2cm puts him on a yearly monitoring protocol.  Your aorta grows with age anyway but some people who have this never have it grow, and others do.  This is not something that they specifically look for so had he not had this GERD episode, we may have gone the whole rest of his life not knowing this existed.  For those wondering, this undetected condition was what John Ritter had.  If you've been here for any length of time, you know that I choose to bring attention to that very cause on 9/11, the date of John's passing to know the Ritter Rules to have doctors check for it with heart attack symptoms.  It is not something they will check for routinely and can only be ruled out via CT scan or MRI.  An EKG or ultrasound will not detect this.  John was able to save his brother's life when he got tested for it and found out he had the same issue, had corrective surgery and is now fine.  Corrective, preventative surgery is the only treatment for this.  Obviously, keeping your blood pressure low (which the Mr. does have that of an athlete along with his resting heart rate which is excellent), not regularly drinking or smoking (he does neither) are also important.  The only other thing he can do is lose weight.  Shocker but with all of the other factors, he is still a low-risk patient, even with the family history, he didn't know he had.

We had to come up with a way to ask his mom if there was any family history without saying what was going on.  Until we know more, we don't need him being the topic of discussion with every family member, friend, neighbor, and grocery bagger.  I suggested he tell her he's having a big ol' midlife physical and they ask a lot about family history especially with heart stuff so tell him everything she knows if there's anything to tell.  She did.  They all have "good hearts" except you know when his grandma died of a bacterial infection that can only attach to the heart if there is damage and she had a heart attack that healed itself?

(Actual reaction to email via GIPHY.com)

They ended up treating his grandma's infection with medicine she was allergic to and killed her, which I knew so you can imagine with two cases of medical malpractice in his family that *I* will be on a doc like brown on rice.  He's either going to have to deal or piss off and on to the next person.

So on Friday, I spent all day researching cardiologists.  I found my top three that all rated high from patients and sent them to him.  We decided to wait to see what our family doc said Monday before making an appointment with him in case she recommended someone specifically.  Well, that was a friggin' waste of time just like we thought.  She mainly just looked at the chart real quick and said: "everything looks good, looks normal."  The Mr said his previous doc discovered the AV block about 10 years ago and she said that was normal and most people who exercise and have really good blood pressure on their own have it.  She seemed to be ready to dismiss us at that point, and I said, "yeah but then there's the aortic root dilation."  She said, "yeah, just maybe touch base with a cardiologist and establish a relationship there to get it checked out and monitored yearly."  That was the extent of it.  She really seemed to act like she didn't know why we were there either but wanted to make sure we scheduled our wellness visits before we left.  Gotta pay for that new office, ya know?  (I know, we do need to do it, it's been a few years.)  The only thing we did get was the full doctor's version of his test results for everything, not the dumbed down version for patients.  He noted a few things on there that he didn't like and got himself a little riled up, but I pointed out key words he left out and hopefully eased his mind.  We highlighted anything that caused us concern that we want clarified with a cardiologist.

He made an appointment and we couldn't get in for just over 2 months.  I had him call to get on a cancellation list and hopefully we can get in there sooner than later.  I hope to get him on a schedule of another scan in 6 months then 6 months later to see if there is any growth that we should be concerned about.  I also want to get clear answers on if he needs to cut back on any specific type of exercise since we do HIIT and strength training.  It's those very things that have kept his heart healthy enough for three docs to see his results and call his heart "normal and healthy."  I know his dreams for Mr, Olympia have now come to an end...

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... but we want a recommendation based on his specifics, not someone on the internet.

So that's where we are right now...being told he has heartburn to looking for cardiologists.  We've been doing a lot of praying, and we are very much looking at this as a blessing even though it's scary as hell.  This is not screened for, and I think I read in 80% of cases they find it accidentally as a result of something else.

The lessons you should take from this:

1)  If you have chest pain, get it checked out.  If they offer a stress test, do it.

2)  Search reputable sources if an issue is discovered to gather important questions to ask a specialist.  (Like I was unaware that if a general surgeon does vascular surgery, death rates can be as high as 76% versus only 5% if a trained vascular surgeon does it.  Therefore a general surgeon won't come within 10' of my husband.)

3)  Share your family history.  If you're a parent, daughter, sibling and you have a heart or major health event, you need to share it with your family so they can update their family history!!!  The thing that has seemed to shake the Mr the most during this whole ordeal is that he was lulled into a false sense of security that 'at least my family doesn't have heart issues.'   That stuff is very important to share and especially if you have an aortic dilation, there is a 20% chance others in your family might have it as well.   They should be tested so they can begin a prevention plan of their own.

(Schoolhouse Rock fo' life!  GIPHY.com)

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