Tuesday, March 29, 2011

My Mayo Clinic Adventure - A Very Busy Day 3

flags flying at the Mayo Clinic in Arizona
Welcome back to my third installment of my Mayo Clinic adventure.

I'm recounting the events that took place on my third day in Scottsdale, Arizona. This was a very busy day. This is also the day that the thermometer hit 90°, so I was glad to be spending most of my day inside an air-conditioned building.

Day Three - Wednesday, March 16

10:30 a.m.: Thankfully this busy day had a later starting time. However, with fasting blood tests scheduled for this morning, I arrived at the clinic hungry, having not eaten anything since dinner Tuesday evening. Being a type 2 diabetic, I've learned to have a contingency plan for these types of situations and so I packed a juice box and a piece of string cheese into my backpack to eat after the blood work was completed.

The instructions on my itinerary let me know that I would be going for a plasma catecholamine test which measures hormones that are produced by the adrenal glands. These hormones can affect blood pressure, heart rate and other organs as well. The procedure which took place in a lab area on the second floor entailed the insertion of an IV port into my arm. Several tubes of blood were filled from the IV port for some routine blood work. Then I was asked to lay down quietly on a bed in a darkened room to rest for 30 minutes. At the 30 minute mark, another blood sample was taken and then I was asked to stand for 10 minutes. At the end of 10 minutes, another blood sample was taken and then the IV was removed.

The trickiest part of this test was actually getting the IV port in. You see, my veins are deep in my arm and not visible. I chalk that up to my year of cancer treatment back in 1988 when I received four courses of chemotherapy. Ever since, I think my veins hide because they don't want medical professionals tampering with them anymore.

All in all, this wasn't a very difficult test. Fortunately for me, my blood sugar stayed in the normal range over the hour and a half in which this test took place.

My next stop was to the cafeteria for a late breakfast/early lunch with Robert.

1:15 p.m.: After lunch, I was off to the cardiology clinic on the concourse level to be given a Holter monitor. A Holter monitor is worn for 24 hours and it records your heart rate during that entire time. Four electrodes were stuck to my chest and connected by wires to a device about the size of a deck of cards. The tech put the monitor into a paper fabric pouch with strings attached which she tied around my neck. I immediately knew that this was going to aggravate my neck pain but I waited until I could get to the bathroom to move it into my bra where it would be less irritating.

The purpose of this test was to see what my heart rate looked like over the course of the day. In the past, this same test was used to capture data to calculate something called a heart rate variability study. I wasn't sure if Dr. Goodman was repeating the heart rate variability study but I decided to wait until I got the results to see what he had ordered.

1:45 p.m.: With two appointments down and one left to go, Robert and I decided to headed outside for a little while to soak up some of the desert atmosphere. I pulled out my camera and took some pictures of the landscape, the flora and the flags flying in the constant breeze. We found a bench in the shade where we sat for a while. Despite the 90° temperature, the combination of the breeze and the shade made sitting outdoors comfortable.

I then headed to the patient lounge on the concourse level where there was a room set aside with recliners and dim lighting for patients to rest. So I pulled out my MP3 player, plugged in my headphones, pulled out my Kindle and put my feet up to rest up before my next appointment. Before I knew it, the ambience of the room lulled me into a 30 minute nap. I woke up with just enough time to grab a quick snack and something to drink before I headed to my third and final appointment of the day.

3:15 p.m.: Out of all of the tests that Dr. Goodman had ordered for me, I was most worried about the EMG and nerve conduction study. My previous experience with this particular test at UCLA was not a pleasant one. I felt so dizzy and nauseated afterward I was unable to drive myself home and needed to call a friend to come pick me up. This time, I knew I had Robert with me so at least getting back to the hotel wasn't going to be an issue.

I also worried that I'd be in for even more problems this time since the testing would involve both my arm and leg. Yet despite all my concerns, the technicians and doctors who performed these tests did an outstanding job. I certainly see the benefits of having experienced medical personnel conducting these tests.

As for the actual tests themselves, they aren't the most pleasant things to endure.

The nerve conduction part of the test was performed by two technicians who tested my right leg and right arm. Electrodes were placed on the skin along the pathway of the nerve to be tested. So for example, for the median nerve which travels from the wrist to the fingers, an electrode was placed at the wrist and then three electrodes were placed, one each, on the thumb and the first two fingers. An electric shock was generated by the electrode at the wrist and information about how that shock traveled along the nerve to the fingertips was recorded in the electrodes placed there.

The EMG portion of the test was conducted by a physician. Ultra fine wires were inserted through the skin into the belly of a muscle. Once in place, the wires record the electrical activity of that muscle both at rest and during a contraction. During the test the doctor shared with me that the muscles in my shoulder were unable to relax completely which seems to be consistent with the chronic pain and muscle spasms I experience on a daily basis in this part of my body.

When he completed the EMG he shared with me that the most significant finding on the nerve conduction study was evidence of moderate carpal tunnel syndrome affecting my right hand. He explained that surgery would be indicated if I was bothered by the symptoms in my right hand. Once again, his findings were consistent with the numbness, tingling and pain I experience on a daily basis in my right hand.

After spending about an hour and a half in the exam room, my EMG and nerve conduction studies were complete and I was able to get dressed and head back out to the waiting room to meet up with Robert. I was pleasantly surprised that I was feeling no ill effects from the tests and wouldn't need to hurry back to the hotel room to spend time in bed recovering.

Phew! That concludes day 3 of my Mayo Clinic adventure. I'll be back to talk about my fourth and final day tomorrow, which includes my second visit with Dr. Goodman.

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Felicia Fibro said...

Just like you, I have been told that I'm not relaxing the neck/shoulders. I was told that from a physical therapist and even doing all that I could to relax, I just couldn't relax them completely.

Anonymous said...

Very interesting to read about all your adventures!!! I've never had any of these autonomic tests done so it's cool to hear it from a fibro. potsy's point of view. The EMG and NCT seem very painful! My best friend had one done and was in terrible pain from it, but it can unleash such interesting info. from it!

Anonymous said...

Oh Selena! That nerve test sounds painful! Can't wait to hear Chapter 4!