Part I and Part II, if you need to catch up.
Recently I went for the Transesophageal echocardiogram. Arriving at the Jim Pattison Pavillion, a name that I will always associate with car sales, with Siobhan and heading to Station 7 and get checked in. Then down the hall to the cardiac imaging area where, after a short wait and some questions, I was in exam room. The nurse hooked me up to a heart rate monitor (62!) and attached a blood pressure cuff (78 / 122) and inserted an IV. Then my cardiologist, Dr Tsang, stopped in and introduced Dr Spencer, who would be doing the actual procedure.
After a few more questions and an explanation of what was going to happen – like I hadn’t been reading up on it! – he had me sign a release. During this time, in the space of about 5 minutes, there were two “Code Blue. Code Blue in room blah, blah, blah” announcements on the PA. I asked if Code Blue meant the same as it did on TV, if they were both cardiac events? But he said no, code blue just meant that someone was unconscious, and usually it just meant that someone had fainted.
“Oh,” I said, “well no better place than a hospital to faint, right?”
“No no.” He replied. “This is the worst place to faint, You wake up with 200 people crowded around you and someone’s doing chest compressions when you don’t need them. Terrible place to faint.”
Pretty soon he was spraying the back of my throat with a numbing agent and they added the sedative to the IV. I’m pretty sure I remained awake the whole time, after all this is called Conscious Sedation, but I may have dozed off once or twice. Eventually we came to the part where they were adding the agitated saline to do the contrast ultrasound and he had me bear down and relax a couple of time to get images of how much was passing through the hole and to see how big the hole itself it. And then he was done and – this was the worst part – the tube came out and he told me that from what he saw the hole was small (good news!) but he’d send all the images to Dr. Tsang and she would be in touch.
After that they wheeled me to the recovery room – as far as I can remember, this was my first time in a wheel chair – and sat me back in a recliner and told me I had to wait for an hour before leaving. Boring. Just before noon a nurse came by and looked at my docs and said I could go – she went and got Siobhan from the waiting room. They took out the IV and taped some gauze over it and left. So I stood up and took off the hospital gown I had on and started to put my shirt on, one of the nurses rushed over and started pulling the curtains closed.
“Hey, no free shows here!”
And then we left, opting to walk home (it was just a couple of kilometres) because I was feeling pretty clear headed.
Now I had to wait to hear from Dr. Tsang. So fast forward a week and a half and I’m in the waiting room on the 9th floor of the Diamond Health Care Centre. Waiting. And waiting. Finally she calls me in. First up, the hole. Turns out mine is 3.8 mm which is bigger than I’d wanted. 4 mm is the point when intervention is warranted. But. still, I’m under the limit so that’s good.
Next we talk about the enlargement itself. The question is, what’s causing it? Do I just have a big heart? Or is it being caused my the hole? Based on the two measurements she has, Dr Tsang says that it’s getting bigger, but given the margin for error in these measurements, she can’t be sure. Add in the fact that I’m totally asymptomatic and we decided to wait until next March and do another echocardiogram and see what that showed. If it’s getting any bigger, then we move forward with plugging the hole. If not, then we’ll look at doing another echocardiogram further down the road to monitor the situation.
So, as has become the routine with visits to Dr. Tsang, the news isn’t bad, it’s just not as good as I’d hoped.