My Cheating Heart

stay away from doctors
The bad news is now that I have Medicare, my body has decided to take full advantage of this insurance program by falling apart.
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The good news is that I hit the Medicare birthday and now for the small sum of $144.60 a month I get “free” government health care, as opposed to the “free” government health care I had with Tricare, which cost a lot less. The fact that I am still working and paying into Medicare with every paycheck does not in any way deduct from that amount. The bad news is now that I have Medicare, my body has decided to take full advantage of this insurance program by falling apart.

Case in point: I was trucking along in life with the usual old age issues, then BAM! My heart decided to get in on the act. I noticed I was having shortness of breath and just for peace of mind, I foolishly mentioned this to my primary care doctor, hoping he would tell me I was imagining it. Instead, he referred me for a cardiology work-up.

Okay, sounds like the responsible adult thing to do—other than the fact I had no idea what all a cardiology work-up entailed. I thought a stress test was simply walking on a treadmill while hooked up to an ECG monitor. Nope, not that simple. It involves having an IV inserted (I hate IVs) and injecting radioactive substances into my body while taking multiple radiographs of my coronary arteries. Oh, and walking on a treadmill, huffing and puffing while wearing a mask due to Covid. Then on to the ECHO.

An echocardiogram is an ultrasound of the heart. No big deal; no needles, right? On the day of my echo, I dutifully presented myself at the Covid screening table, where a lady asked me if I was checking in for an appointment. I had to fill out a questionnaire with a pen that God only knows how many other germy people had touched. (Hopefully it was disinfected between patients, but I didn’t observe this firsthand.) The lady at the table became alarmed when I checked the box “yes” for shortness of breath. I had to convince her that my shortness of breath was (duh) why I was seeing a cardiologist in the first place and had nothing to do with the pandemic. Past that hurdle, I took my seat and waited for an hour while other patients came and went. Being a medical professional myself, I understand unavoidable delays in appointment times, but finally, I went to the front desk and asked how much longer it would be until my procedure. It turns out I was not checked in. I was only Covid screened. Geesh! That might have been nice to know, as I had been asked at the Covid table if I was checking in and wasn’t told there was an additional step to the process. But fortunately, they were still able to get me in; I just had to wait another half-hour.

Finally, the echo technician brought me back into a room, where she jabbed a cold, slimy probe under my xiphoid, the base of my throat, and finally under my left armpit, where it bounced around uncomfortably against my bony ribs. At this point, turned on my side, I could view the monitor. This is where being somewhat knowledgeable about what things are supposed to look like is a disadvantage. I have done multiple echos on dogs, cats, and even a handful of other species, so I’m not entirely clueless.

As I viewed the images on the screen, I commented, “Does my mitral valve look a little floppy?” Of course, the technicians, although they know darn well what is normal and what is not, are not supposed to relay this information to patients. This doesn’t stop me from asking. Every so often, I get a technician who will level with me with the caveat, “but the doctor will have to review the results.” This is good enough for me. This technician, however, remained tight lipped. Not only did she not reveal anything to me, she refused to acknowledge the fact I had spoken to her. She simply ignored me. Even when I asked several times. You would think she could at least have said, “I can’t really say. The doctor will have to review the images.” So, when I watched the pumping of my left ventricle and thought, that pumping action looks kind of sluggish, I kept my mouth shut, as I knew I wasn’t going to get any information out of her anyway.

The next day, I went back to the cardiologist so he could go over my results and tell me my shortness of breath is all in my head. But before he came in, his young nurse-practitioner had to go over all the ground we had already covered. When I mentioned that I thought my ventricular pumping action looked sluggish on the echo, she replied, “Oh, isn’t it neat to see what your heart looks like on the screen?” To which I replied, “Not when it’s my heart that looks sluggish!” She finally confirmed the truth of this less than stellar muscular action on the part of my betraying heart. Then, since I had a captive medical person who was answering my questions, I stupidly began asking further questions. After a couple minutes, she said, “You seem to be worried about this,” as if that were an unreasonable reaction to being told my heart was not cooperating to its full extent. Well, duh, yeah! I may have even said that aloud.

She left the room, probably to get away from my uncomfortable questions, and finally returned with the doctor. Okay, at last, let’s get down to business of what we need to do to make my heart work better. Nope. What we need to do is—wait for it—more tests! Of course. Now we’re up to a full cardiac catheterization. If I had only known, I would have kept my big mouth shut with my primary care physician.

So, it’s on to a cardiac catheterization.

The one thing that is a tad disconcerting is that nobody seems to be in any hurry. All this cardiology work up started several months ago, as it took a while to get the initial appointment, then several more weeks to get the individual tests, then another appointment to review the tests. I’m glad my heart has held on this long.

So, after another several weeks, I finally got an appointment for the cardiac catheterization. It fell, of course, on the week of Hurricane Sally. I had to make yet another appointment for a nurse to give me paperwork for the procedure. This is the first time I have ever had a “paperwork” appointment. (Seriously, this couldn’t have been faxed or emailed?) Prior to the procedure, yet more lab work and another chest radiograph were required (never mind the fact my primary care physician had just done all these tests prior to the referral). But, as a medical professional, I understand. Things change from day to day. Okay. I had to call and check in with the cardiac center the day before to confirm my appointment. Of course, I was given the wrong number, so I had to make the phone rounds until I finally got to the right place.

The procedure was scheduled for 3:00 pm, which meant I couldn’t eat or drink anything after 7:00 am that morning, and even if I chose to rise at that ungodly hour just to eat, I could only have dry toast or plain yogurt. Why bother? Not worth it. I arrived at the cardiac center to find the doors locked due to Covid and I had to go around to the main entrance of the hospital in the pouring rain. I checked in with a very nice lady at the reception desk, who informed me I didn’t have my pre-anesthetic paperwork that I was supposed to have gotten at my paperwork appointment. I wondered again how much Medicare was billed for the “paperwork” appointment. She had me fill out yet another ream of paperwork, and at last, I was almost there.

Things went smoothly after that. All the staff were extremely efficient (even though I had to have yet another IV inserted, which I hate) and very friendly. Blessedly, I was given Xanax, along with a couple other pre-surgical medications, but although I asked for two Xanax, I guess one is the limit. I did complain that the Xanax hadn’t kicked in when they wheeled me back for the procedure, so the nurse cracked jokes to put me at ease. The procedure ahead of me ended up taking longer than usual, so I was parked in the hallway outside the Cath lab where I could view all the scary stuff. But my Xanax finally kicked in, so I didn’t care.

Once it was my turn, I was wheeled into the Cath lab to be injected with yet more radioactive dye, and mercifully given a wonderful concoction that put me in La-La Land. It’s a wonder I’m not glowing in the dark with all the radiation I’ve had been exposed to in the last few weeks. I could rent myself out as a personal glow stick for Halloween. Although vaguely aware of things going on around me, I was happily detached from it all. Before I knew it, I heard the doctor telling me he was finished and everyone saying how well I did. I felt unworthy of the praise because I didn’t actually “do” anything but lie there.

Back in my little cubicle, I discovered my right arm felt numb from all the pressure applied to keep my radial artery from spurting blood across the room. This tourniquet-like compression, apparently, is normal procedure. I also discovered I was not allowed to bend my wrist for 24 hours and was fitted with an enormous plastic contraption to ensure that didn’t happen. Try sleeping in that thing, even with Xanax. For some reason, I was under the mistaken impression that I would simply walk out of there and life would resume as usual. Why am I always so naïve?

On the positive side, my coronary arteries are clear, and the doctor says my heart function looks better than it did on the echo. At least I think that’s what he said, as I was still under the influence of heavy sedating drugs and my husband is medically-jargon challenged. I can’t immerse my arm in water for three days, so that means my husband has to do the dishes. I also can’t lift anything over five pounds, so he has to clean the kitty boxes, do the laundry, and take out the trash. And in another several weeks, I will once again see the doctor, who will go over the results. If there’s one thing I’ve learned from all this, it’s that Medicare is great. But why I felt the need to get my money’s worth from the system, I still don’t know. 

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