It occurred to me, as I lay in a dark room with a stranger poking a cold wand insistently into my chest, that I’d truly grown as a person these last months. At the very least, I’d survived a bunch of medical procedures that tested my mental mettle.
This one was the finale. An echocardiogram, which is basically an ultrasound of the heart. Prior to it, I’d enjoyed a pap smear, mammogram, referral to a cardiologist, an EKG, a colonoscopy, and just minutes before, an exercise stress test. All in the space of a couple of months. Thank goodness for my health plan and supportive employer.
Before anyone gets worried, I’m fine. Other than the heart things, this was all the routine stuff that comes of being a) above a certain age and b) a woman above a certain age. I passed them all with nothing to be overly concerned about. We’ll get into more about the heart stuff later.
I’ve never spent any time in a hospital for my own medical issues. Oh sure, I’ve visited doctors who practice there, but I’ve never been put in a bed, hooked up to an IV, or wheeled down any hallways while lying under a thin blanket in a well-worn, well-washed, very clean, light green gown.
I realize I’m very blessed by this fact.
But it means I have basically no idea how it all works. Like, for the colonoscopy, I had no idea (until the nurse told me in our pre-call) that I was going to have to strip down and become unconscious while strangers rolled my body around to suit their needs. Or that, for the echocardiogram, I’d have to lie on my side while bared to the waist and let another stranger prod my chest and ribs with a surprisingly strident wand. I was familiar with, but still struck by, the absurdity of allowing yet another stranger to shove my breasts into a hydraulic press while getting a mammogram, and let’s not even talk about the mental gymnastics required to have a cogent conversation with a medical professional while they are giving you a pelvic exam.
Many of you won’t be surprised to know that it wasn’t entirely the results of the tests that were stressing me out. It was having to show off my body to people I don’t know while they poke and prod me. As anyone who has ever worked in the medical field will kindly tell me (and if they are lying, I choose to ignore it for my own sanity), no one really cares what I look like while smearing gel on me or shoving a needle into my arm. Still, I can’t help but be self-conscious. That said, I was pleasantly surprised by how attentive to modesty everyone was, with artfully draped gowns and whatnot. It definitely made a difference.
So now I sit on the other side of all of that, with nothing but a dentist appointment on the near horizon, and ponder what I’ve learned and could share to make your lives easier.
On the colonoscopy front:
Colonoscopies, the actual procedures themselves, aren’t much to worry about. If you’re lucky like me, you’ll find yourself in a hospital that does 50-60 of them a day, and can process you through there like just one more sheep in the flock. It’s the prep that sucks, and wow…it well and truly sucks. I was so hungry. But don’t let that put you off, people. Think of Chadwick Boseman and get it done.
Being single while getting a colonoscopy presents a unique challenge; they won’t let you take a Lyft or taxi home alone. You need a nearby friend willing to come get you, so make a special effort not to piss those friends off.
With a high-deductible health care plan, the pre-op call for a colonoscopy isn’t covered. You will get billed for it. And whatever health plan you’re on, ask in advance if the anesthesiologist will be in network. They may ignore you, like they did me, but at least you have it on the record if they surprise bill you.
IVs to the hand kinda hurt when the anesthesia starts. But if you’re lucky like me, you’ll mention this to the anesthesiologist, and he'll give a good effort to mean it when he says “I know, I’m sorry” and then you’ll pass blissfully out.
On the heart front:
It was disconcerting when my OBGYN paused for longer than normal while listening to my heart. When she asked me if I’d ever had any kind of irregular heartbeat I said no, but was grateful when she asked the follow up about chest pain or pressure. Because those, I’d had, and I remembered that I wanted to talk to someone about them. I was pretty sure they were stress related.
We talked, and she agreed it was probably stress, but recommended I see a cardiologist just to be sure nothing was wrong. So I did.
From that whole process, I learned a few more things to pass on.
When a doctor asks you if you experience shortness of breath, don’t answer with a joke: “well, sure, when I’m running or hiking a steep hill!” They will write that down and your exercise-induced shortness of breath will follow your records around.
You probably know this, but cardiologists are likely going to order all the tests they can without regard to cost. Because I’m on a high-deductible healthcare plan, after being told to get three separate heart tests even when my EKG was normal, I researched them and asked the doctor if I could skip the super expensive one unless the others flagged anything. He agreed readily and I saved myself a few thousand dollars just like that.
It’s unnerving to lie on a bed in a dark room (I appreciate that they turn the lights off before asking you to open your gown for the echocardiogram) with your head next to the ultrasound machine that is looking at your heart in real time. Unless you’re about to die, the tech is likely not going to say a word to you other than asking you to hold your breath, so I’d advise taking that as good news.
Echocardiograms are pricey. Stress tests are not (at least in my case). I picked a bad year to switch to a high-deductible plan, it’s seems.
If you have a health portal, beware! They may publish your results before the doctor reviews them. I advise against googling what it all means if you don’t want to add to your stress.
And speaking of stress, now we arrive at the final learning of these last few months. It’s worth noting that I’m watching my beloved dog, Sadie, go through her final months. The cancer we’ve kept at bay for a year and a half is starting to make its presence more known. She’s been a miracle dog, sticking around much longer than anyone thought she would. But that has to end sometime. And I won’t lie…watching and waiting and wondering just hurts my heart.
I’m not a doctor, but I do believe this with all my heart, pun intended, that the physiological effects of stress are real.
My dad asked me last night, when we were talking about this, what, other than my dog, is stressing me out. I felt a flicker of defensiveness; was he implying that I was being dramatic, overreacting, that I should just suck it up and be grateful for all that I have? Then I stopped that thought. I don’t think he was. I think he was genuinely asking, because I am really, really bad at talking about this stuff with actual people.
As I answered, I spoke aloud what I hadn’t even articulated to myself, that, in addition to the dog stuff, I was worried about the medical stuff. Plus all the daily worries about am I doing a good job at work, eating right, working out, cleaning house, keeping up friendships, etc. Yes, other people have it worse than me. It doesn’t make my body’s reaction to this stress any less real.
The tools we use to manage this must be deployed regularly and with intention. For me it’s hard exercise, drinking lots of water, writing, and talking to people about what’s bothering me. As I’ve said, I’m pretty bad at that last one. But I have noticed that, when I do open up about these things, I feel better, in my entire body. It’s uncanny how true that is.
So now we’ve arrived at the end of this rambling post. And after all these words, what’s my conclusion? The diagnosis is clear: I’m mechanically sound of heart, but emotionally bruised of heart. I have to forgive myself for that, and do the things that will help it heal, or at least get through the times that try it.
You see, this is why we have poets. I’ve never claimed to be one, but I’m glad they give us words to articulate how the heart is not just a muscle to be measured and scanned. It’s a vessel that holds our pain and our longing and our worry, and it gives us signs that we need to look after ourselves. We need to listen. Take care of your hearts, my friends, and know that I’m here if you need a little heart-to-heart. Pun absolutely, 100% intended.
My favorite phrase is your conclusion...I’m mechanically sound of heart, but emotionally bruised of heart. Either way (if your heart is not mechanically sound or is bruised), it is a tough conclusion, but so much truth. Thanks for sharing and allowing us to grow through your words.
So beautifully written. Happy your heart is sound and sending love for the tough moments a head. Your pup absolutely knows she is loved.