Stress testing in sixteen steps

Not as fun as it looks

Today's run (street): 3.4 miles

Despite my resistance to the idea of taking a stress test, I finally acquiesced and went through it this week. My experience at the end of the Brooklyn Half provided the impetus to do it. Actually, it was strong encouragement from my wife, the Runsketeers and my friend KWL that made me go through with it.

If you've never gone through a stress test (this was my third), you should know that it's not particularly stressful. But it sure takes a long time. I don't know if the process is universal, but at my doctor, the process goes like this:

1. Arrive at doctor's office at your scheduled time.
2. Wait an hour to be called in.
3. Wait for the doctor in the exam room. You can pass the time by reading your chart on the computer display (at least that's what I did).
4. Have a conversation with the doctor about how you ended up in the medical tent after running a half marathon. Hint: his response will always be, "I want you to run a stress test today."
5. Have an EKG.
6. Have blood taken.
7. Have an heart ECHO sonogram.
8. Go to stress test lab and wait.
9. Get your first injection of thallium, a radioactive isotope that's used as a trace agent during the imaging process. Very reassuring.
10. Go into the imaging room and get scanned for 12 minutes.
11. Go into another sonogram lab and have carotid arteries checked.
12. Go into the room with the medical treadmill, where the technician attaches electrodes all over your body attached to a belt unit that you wear during the process.
13. Start at walking pace, with the goal of getting heart rate over 140. She ended up putting the incline to 16% and the speed to over 5 MPH to get me there.
14. Get your second injection of thallium and wait.
15. Get your second imaging to compare to the first after exercise.
16. Go home six hours after you arrive.

The good news is that you do get feedback throughout the process. My doctor said my EKG and ECHO were fine, the sonogram tech said the same about the carotid check and the treadmill technician said I didn't have a single missed beat during my session. I needed my doctor to review the imaging results. If there were concerns, I would have got a call yesterday. All of that, and no issues.

So why am I running so slow?

My doctor's office should now deliver my clearance form so I can use my company's fitness center. I can then do workouts in the morning when I get into the office. Without that, my options are either to go back to 4 AM runs, or work out when I get home from work. I worked from home today and got in a few miles before I started what turned out to be a busy day. It's the weekend now, and I hope to give those Cascadia's their first experience on the trails either tomorrow or Sunday.

Doctor's orders: more stress

Yesterday's workout (Stress test): 4 hours

Having a top ranked physician as your doctor has its pluses and minuses. On one hand you know that you are getting the best care that medical insurance can buy, but it also means that you are monitored closely and forced to take tests to confirm that everything remains normal. I'm not fanatical about my health but me and my family meet annually or (semi-annually) with our doctors and dentists just to confirm all is well. Yesterday, as a follow up to August's physical, I went through a stress test that involved a number of activities. The process is time consuming and not particularly difficult but in the end it is exhausting.

Soon after my arrival I was injected with Thallium 201, a trace agent for monitoring blood flow through the imaging process. No big deal except for the idea of having a radioisotope coursing through your veins and arteries. The half-life is 73 hours so I won't be boarding any airplanes this week. I was assured a number of times that it's extremely safe. I guess I have to take their word on that. The first activity was a full body scan on a flat imaging bed that required keeping absolutely still for about 15 minutes. Running has taught me much about patience while enduring discomfort so that was a piece of cake, despite the need to hold my arms far forward and holding my head at an unnatural angle. After that I was hooked up to a bunch of electrodes and put on a treadmill that increased in speed and tilt angle over a 20 minute period. Being a runner helped me there, though I'll admit that the apex of speed and elevation became challenging. Still, I never reached the point where I was sweating profusely.  Halfway through the process I was re-injected with Thallium while I was in motion. That was a little weird.

The next part of the test was another round of imaging that seemed longer and even less comfortable. I was then brought into another room for a sonogram of both carotid arteries. During the treadmill and sonogram testing I was asked why I was being tested because my results looked fine. That was good to hear. The final step was to be fitted with a heart monitor with four electrodes that would record cardio-activity for 24 hours. I'll get to take that off at noon and I'm looking forward to that. I can't shower until it's off so I didn't run this morning. I'm deciding whether to run with it just prior to removal or to wait until I take it off. I'd be interested to know how my heart rate varies when monitored by a more sophisticated instrument that the Garmin's HRM but I doubt the doctor will show me the raw data. However, they might share the highlights. The best part of having completed the stress test is that, unlike yesterday morning, I'm now allowed to drink coffee. I missed that a lot yesterday. I far prefer it to Thallium 201.