Days 8 through 17 were pretty uneventful. Continued medications. Continued diet changes. Lots more water. Way less Pepsi — almost none. Greatly reduced salt intake, even though I'm not convinced salt is a real issue for me. Weight loss has leveled out, but I'm staying the course on the diet changes and looking to drop another 40 pounds.

On Wednesday, July 22nd, I got a message from Doc R's nurse practitioner about my blood pressure readings over the past week. Instructions were to increase my evening medication from 5mg to 10mg to see if we can bring my blood pressure down a bit more — especially in the mornings. I started the new dosage that evening.

Thursday, July 23rd was a big day: my echocardiogram and pharmacological heart stress test.

Echocardiogram

An echocardiogram is basically an ultrasound of your heart. If you've ever seen one of those black-and-white photographs of a baby in the womb — same thing. The process is painless, although you're required to hold a position that can get uncomfortable over about 45 minutes. If you're like me and don't love going shirtless around strangers, prepare yourself to deal with that for about an hour.

After having an IV placed in my left arm, I was asked to lay on my left side with my left arm raised and my hand behind my head — essentially using my arm as a pillow. From there, the technician used the gel and the wand to thoroughly examine my heart: recording audio and video, taking measurements, and making notations. Then they repeated the process from a different angle. Finally, I was able to roll onto my back while they went through it one more time. A few times I was asked to take a deep breath, hold it, and let it go.

The frustrating part — beyond the physical discomfort and eventually needing to use the bathroom very badly with no option to do so — was watching the screen and not knowing what I was looking at. For what these services cost, I feel like a detailed explanation should be part of the deal. I'm not asking for an on-the-spot diagnosis from someone not qualified to give one. I'm just a curious person staring at something I've never seen before, something that happens to be my own heart. It's a tremendous opportunity to learn. And honestly, part of my brain was also wondering: who wrote the software running this machine? What language is it in? How long did it take to build? Where is all that data stored? Unfortunately, it was a missed opportunity for all of that.

After finishing the final round of imaging on my back, I got a towel to wipe the gel off my chest, put my shirt back on [RELIEF], made a beeline for the bathroom, and then headed to the next room for the stress test.

Pharmacological Heart Stress Test

Every part of this process was completed with my shirt on. YAY.

As far as I know, there are two ways doctors stress out the human heart to get the diagnostic data they need. Option one — which works for a lot of people — is a treadmill. They put you on it and crank it up until your heart is beating upwards of 160+ beats per minute. Some people can't reach that kind of heart rate on a treadmill due to knee, hip, or weight issues. For those people, there's the pharmacological stress test: they inject something your heart and body absolutely do not enjoy straight into your veins, causing your heart rate to spike dramatically and instantly.

In the second room of my hospital journey, I was greeted by a very large machine — the kind you lay down on. It actually looked comfortable. I laid back with my legs elevated on a pillow and my arms raised with my hands on top of my head. This position allowed the imaging panels — three large rectangular units — to travel up from my feet to my chest and lower to within a few inches of my body. For about 15 minutes, the machine moved back and forth over my chest, taking pictures. That's it. Shirt stayed on. I even nodded off for a few minutes. (They had me up at 5:30 AM for this. Why not?)

After the first round of images, I moved to the third room — a space with a comfortable medical recliner and a treadmill. I settled into the chair while a team of three took my blood pressure and walked me through the procedure. They hooked up sensors to capture a variety of readings before and during the test. Within five minutes, another person arrived and pushed three syringes of something into my IV.

Game on.

That drug hit me like a train. It felt like someone had fired a sonic cannon directly into my chest and knocked the wind out of me. I felt heavy — like a dump truck had just parked on top of me. I turned very red (they told me later) and started breathing deeply. For a moment I thought I might pass out, but I focused on my breathing and kept my feet moving in a circular motion as instructed. And then, almost as quickly as it came on, the dump truck drove away. My breathing steadied. My body relaxed. My mind pulled back from the edge of panic.

After that, they handed me an ice-cold Pepsi and a pack of peanut butter crackers and told me to consume both immediately. "And you can stop moving your feet now." LOL.

Then came a 30-minute wait before heading back to the imaging room for a second set of pictures — this time post-stress, for comparison against the baseline. The second set went a little faster. I did not nod off this time.

All together, everything wrapped up in a couple of hours. They cut me loose to go home and wait for results.

The Results

Thursday evening I received one set of results from the stress test. There was some good news in there, but also a lot of information I didn't fully understand, so I decided to let it sit until the care team had reviewed everything and was ready to talk.

Most of Friday passed without word. Then, sometime after lunch, my phone rang. I saw the city on the caller ID and knew it was one of the physicians. I turned off the ringer and let it go to voicemail. I really wasn't ready to have "the talk." Doc R's nurse practitioner left a kind message that essentially said: "You need to call me back, or I'm going to call you again." I tried to call back but got lost in their phone system, so I waited. She called back within 30 minutes.

Here's the nuts and bolts of what I learned:

• My heart is functioning below ideal strength.
• My condition is not related to heart disease, pulmonary blockage, or blood flow issues. The primary problem is something I was born with.
• My lungs look and sound good.
• The absence of chest or back pain — my primary symptom has been shortness of breath — is a good sign.
• 3 of 4 human heart valves normally have three flaps. One of mine has two. This bicuspid valve is contributing to a lower-than-ideal ejection fraction. Normal range is 50–70%; mine is currently 45%. My heart is working harder than it should to do its job.
• My aorta is dilated — likely because of the extra strain that funky valve has been putting on my heart.

What's Next

We're replacing my current blood pressure medication with something different — one that will also help lower my resting heart rate, which is an important factor for the next test. A CT scan of my chest and abdomen is scheduled for next week. For that scan, my resting heart rate needs to be in the 60s; right now I'm sitting at 70–75 bpm. The new medication is supposed to get us there. I picked it up this morning and will be starting it tonight.

Each test I've gone through — from that first blood pressure reading and EKG, through the echocardiogram and pharmacological stress test, and now heading into the CT scan — has given the physicians a progressively clearer picture of what's going on inside my chest. Lowering my blood pressure has already had a huge positive impact on my breathing and sleep. But these tests are revealing an underlying condition that needs to be fully understood before anything else can be addressed.

Without that understanding, I feel like I'm walking on eggshells. I'm not sure how much physical activity is appropriate. I'm paranoid about doing something wrong — getting up from a chair too fast, pushing too hard — with some of these medications. I'm grateful for the benefits, but treating my body chemically like this doesn't sit entirely easy with me. And of course, I'm wondering where this road leads. Let's keep it real: my mom had a leaky heart valve. She went through replacement surgery and everything that comes with it.

I'm not there yet. But I'm paying attention.

This blog and every article in it documents one person's journey — Sparky's journey. Every person's health situation is unique, and what applies here may not apply to you. Sparky is not a physician or medical professional. The information shared in these posts reflects his own experiences and what he believes he understood from conversations with his care team — and he doesn't always get it right. Nothing written here should be taken as medical advice. If you have concerns or questions about your own health, please contact your physician. And if you don't have one — get one.