Stress Test Questions

[mtlieb]

Re: Stress Test Questions

Thanks for all the input.

I've had a stress test before, so I'm familiar with the procedure. I know that there will be at least one doctor there at all times, in fact i believe my specialist himself will be there for much of it.

My concern was in having to do the test unmedicated, after being off my beta blocker for two days, and possibly doing some unnecessary and permanent damage to the ol' ticker. This is the first time in over a year that anyone has even wanted me to attempt a stress test, much less without meds. When i was in Boston in fact, my stress test was canceled when they found my gradient to be so high at rest, and several doctors since then have told me they would never want to try one. I guess that more than anything has been giving me doubts about this.

But at this point, i'm willing to do anything that may even remotely help with my treatment. In fact, i almost hope that something does happen during the test. I feel it coming down the road anyway... it might as well be in a hospital. I'm SOB with chest pain all the time now, so i'm not quite sure what 'signs' to watch out for on the treadmill that i don't already have. Just walk till i pass out?

I'll be quitting my meds over a weekend, so getting in touch with my doctors may be difficult if i start to have problems, but the ER is less than a mile up the road. Again though, i'm not quite sure what warning signs to watch out for that would send me to the hospital. I already have all of them, and i haven't even stopped my meds yet. LOL.

Anyway... forgive me for rambling again. It's been another night with no sleep and i'm probably not thinking too straight

Thanks again,

Jim

[Burton Borrok]

Re: Stress Test Questions

I believe you can get comparable results from a chemical stress test under much more controlled circumstances. You are right however, my experience was the rare (I hope) exception to the rule. But then doctors are human too, and are not immune to being distracted.

I do not say to not have the exercise stress test. I say be sure the test is in your best interests and has the possibility to produce results of value in determining what treatment plan is best in your case. Also, if you feel too stressed, you can step to the side of the tread and end it – if it becomes absolutely necessary – but then they don’t call it a stress test for nothing.
Burt

[Darren1]

Re: Stress Test Questions

Jim,

I'm pretty sure that Burton's experience is a rare exception. When I've had my stress test done, there was a nurse and doctor in the room and they we constantly watching me (and the monitoring gear). They actually told me to slow down a bit! The feedback from a stress test seems invaluable and the benefits greatly outweigh the risks.

[Burton Borrok]

Re: Stress Test Questions

Hi Jim,

Way back in 1985 following my first Heart Cath my cardio gave me a stress test. There was both the doctor and his nurse in the room, but as soon as the test started the phone rang and the doctor turned his back and started talking on the phone. I was very quickly in trouble and looked at the nurse to stop the test, but she said the doctor had to do it.

He was still on the phone when I went flying off the back of the treadmill and landed in a heap on the floor. They both could not lift me so I lay there huffing and puffing mightily. He yelled that I should have stepped on the sides of the machine – off the tread, and I was shocked that I hadn’t thought of it myself. I was also mad as h-ll, and too short of breath to make my feelings known. After about five minutes I had regained enough strength to get onto the examination table with both of them helping, and after another ten to fifteen minutes I had regained enough strength and breath to wobble out of his office – never to return.

That was my last physical stress test. After that they were all of the chemical stress variety. My latest test was last December, and I have to say it was rather rugged. I had not reduced any of my meds, and would think long and hard, and have to hear very compelling reasons before I would complicate such a course of action.

That was not meant to scare you so much as it was meant to make you think. We are of course different people and in all probability will have different reactions to stress – but please be sure you agree with the course of action decided on in your case.
Burt

[Sarah]

Re: Stress Test Questions

dear jim

pam is right ---there is a nurse and usuallyy a doctor right next to you the whole time and YOU can stop at any time once the test starts.

i was at the mayo and i lasted about 2 minutes ---i quit from the pain of having alcohol rubbed onto the patches they sanded for a good connection on my chest and the GIANT tube in my mouth (i'm a tiny person and this thing was built for guys like you, so it hurt!) looooong before i had any cardiac symptoms.

the point of a stress test is to see how much you can do without getting out of whack --not to force you to the point of exhaustion.

if you are ok with the no-medication thing, then you don't have anything to worry about. truly.

s

[Pam Alexson]

Re: Stress Test Questions

Jim, one of the 1st things is while you are having such a test you are very well monitored and if I am correct a cardiologist is in the room at all times. They stop it at the 1st sign of trouble or at your say so as with increase SOB & or CP. When I had my initial dx . I was only on 150mgs. of Atenolol and resting gradient was at 140 and sometimes higher. Provoked gradient was 240 ++ . So be assured they will not allow you to pop your cork . I know this is nerve racking but you won't have to last long for them to see results. I lasted less then 7 minutes with CP at 7/10 and puffing like a locomotive. They are prepared and will give you O2 if you need it as well. I have had it both ways with and without atenolol . But only skipped it the one day. You know that with one dose missed you will feel symptoms increase because you feel sx's with 200mgs. Is he going to consider going up on the beta? I did much better for a while at the 300mgs. ;150mg bid. I felt better also . Do you have a lot of neck vein distention and feeling of congestion in your head? Well take it slow ,with everyones info you will be well prepared to ask the questions. It will be ok Jim. Pam

[mtlieb]

Re: Stress Test Questions

Okay folks...

Now i really AM beginning to get freaked out a little!

I have calls put in to both my local cardio and my HCM specialist who is performing the stress test. Rest assured that i will not go through with it unless i am completely comfortable with it. I didn't come this far, only to be killed by a stress test

I'm not so much worried about weaning myself off of the Atenolol... because that can be done before the test. And i'm not so much worried about how i'm going to feel without the beta-blockers... because i feel like crap right now anyway even with the Atenolol. What worries me is the impact that pushing my gradient through the roof is going to have on my heart. Even with 200+ mg of Atenolol per day, my gradient has been clocked at 144, at rest. What's it going to be without the beta-blocker, much less getting my butt up on a treadmill?

Having an active imagination, i envision my gradient as a balloon filled with too much air, and suddenly popping. Does that happen with the heart? Or maybe the increased gradient pressure finally makes my mitral valve give out once and for all, and i get rushed into emergency surgery?

I guess these are all questions that are best answered by my doctors, and i hope to hear from them soon, but i do appreciate and respect all of your input. You are the folks with HCM, and your opinion matters to me more than any doctor

Jim

[Reenie]

Re: Stress Test Questions

Jim, the stress test may not be out of the ordinary. I would just ask the doctor directly about stopping the meds. I think they can learn a lot through the stress tests. I think you haven't ever had one, right? It may help your treatment plan if they know more of what they're looking at.

Reenie

[cynthiaG]

Re: Stress Test Questions

I had a thalium stress test just last May. I was on 50 mg. of atenolol. I was told by my doctor in Boston not to take it the night before...then I resumed taking the next day. Actually, I felt just fine with the skipped dose.....

[bryan]

Re: Stress Test Questions

My last stress test I had to do it unmedicated. It scared the heck out of me but I got through it.

[liona]

Re: Stress Test Questions

Frankly, if I was in this situation, I'd cancel the stress test and look for another Dr. You are receiving run-of-the-mill medical advice and you deserve better.

I only take 50mg a day of atenol, and I forgot my pill the day I went to see my GP. All my symptoms were coming back and we were really confused, until I realized that I had forgotten my pills----

You are not going to Doctors for them to satisfy their scientific curiousity by doing tests on you. You must insist that your own wellness is the priority, or else, they're FIRED!

[Ronnie]

Re: Stress Test Questions

In all the years of Stress tests, I have never been instructed to stop my Beta-Blockers. I agree, with the general consensus of discussing this directly with your cardiologist-what does he hope to benefit by this? I in fact think, that at a certain point, a stress Test is pointless & unnecessary to put the patient thru. If you've been diagnosed (over a long period of time) have increased symptoms & gradients (per echos), why do this? You know you're going to fell crummy-you know the diagnosis! I said this at my last Mayo appointment (I actually was anxious about taking a stress) and the Dr. agreed with me
RONNIE

[Linda]

Re: Stress Test Questions

Jim, as Lisa said, speak to the doctor actually doing the test. The hospital staff does these tests all the time, but probably not that often on someone with the diagnosis of HCM. It makes a difference. The med doses are different for different problems and the withdrawl response is different. If he knows how concerned you are, even if it was his original instructions, he may rethink the whole thing. Safety is a big deal, and the stress from not really being comfortable with the situation will only make things worse for you. You want to be able to go into the test at ease, not already charged up with anxiety, and I can only imagine that all our advice here has only added to your concerns. You see, we all care about each other. Linda

[Lisa Salberg]

Re: Stress Test Questions

Jim,
I would speak to the doctor doing the test directly. Voice your concerns and make sure that you feel comfortable with this befor you move forward.

Lisa

[Dorothy]

Re: Stress Test Questions

Jim, hopefully you are doing it as a step-down procedure, not just stop taking them and wait the two days. Are you going to take one every-other day with Saturday being you last? That would be my method of step-down. I know all too well what can happen if you miss two dosages, two days in a row.

Good luck on your stress test. May your much-needed answers be found.