Omnipod DASH, G6 and Nuclear Stress Test

Saw Cardiologist the Thursday before Memorial Day for the first time. I’d been having chest pains since May 8th. First it was just general pressure plus I was staggering like a drunk person trying to walk into my kitchen and couldn’t catch my balance and fell backwards. Was checked out on May 11th in the ER per my PCP’s request. Diagnosed with Peripheral Vertigo, given Meclizine and was told to use a walker to steady myself. I have been dealing with dizziness and chest paid ever since the 8th. I have been out of work since the 8th as well per PCP’s orders as I am a “fall risk”. PCP referred to Cardiologist & ENT.

Fast forward to 1st Cardiology appt - he talked to me behind his desk, typed up stuff, listened to my heart and said he didn’t think there was anything wrong with my heart but if I wanted to wear a heart monitor for a few days he would order that, and he ordered an echocardiogram. I turned the heart monitor in the Tuesday after Memorial Day. I did the Echocardiogram on Monday of last week. I followed up with Cardiologist today for results:

My heart looks normal and everything on Echocardiogram. However, my heart monitor showed that I’ll have a normal rhythm and then it’ll be rapid for a few seconds and then it’ll go back to normal and then go rapid, etc. He doesn’t feel like that is what is causing my dizziness. He wanted to see how my ENT appointment went today and he also ordered a Nuclear Stress Test which is scheduled for Thursday at 7am this week.

I went to the ENT this afternoon. He checked my ears, we talked about my history and the new information that came out this morning, he had me describe my fall and my dizziness. He said it is NOT inner ear related. It is most definitely heart related and he’d actually like me to have a brain scan to make sure I didn’t have a light stroke when I fell. He also wants to rule out tumor or blood clot.

I’m still processing all of this information. Anyway, my question is…for anyone who has had a nuclear stress test - do I need to remove my pod and my G6 for it? It’s my understanding he’s not going to have me walking/running on the treadmill because of my asthma. He’s just going to do the stuff into my veins to simulate exercising and he told me to bring my inhaler with me.

Y’all…I’m nervous. I’m scared…and it sucks when your husband is only going to drop you off at the hospital and pick you back up. What if I have a heart attack while I’m doing this stuff and drop dead? Wonder how he’d feel then? My biological father died of a massive heart attack in his 40s. I never got to meet him.

Ok…sorry for the mobidity. That’s really where my mind is right now though.

Emily

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The bad news, when conditions are hard to diagnose the two physician specialities often point to each other and assign the other speciality as the problem. The reality is often not correct, i.e. about 20% of Neuro patients should be in cardiology and vice versa. Problems like you are referring to are really hard to diagnose, so that is unfortunately not unusual and sometimes the diagnosis can take a few years (I know not what you want to hear) because you need for it to show more before it can be diagnosed.

The good news, your echo was fine! That rules out a bunch of stuff. They are kind of reaching for straws right now, and it wouldn’t be unheard of for you to come out of the nuclear stress with no definitive diagnosis, they will have just ruled out a bunch of the big bad ugly stuff. I personally wouldn’t worry too much they are going to give you some drugs that will raise your heart rate and capture some pictures. You should be fine.

reference - I used to work selling heart rhythm devices to physicians and spent many many hours in cardiology practices watching tests get done. The test is safe enough that they often run it in offices.

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Thanks @Chris! I’m just really processing all this right now. The Dr. didn’t tell me I couldn’t drive for the procedure. I found that out on my own. So then my husband said he’d drop me off and pick me up. I don’t want to be at the hospital alone. I asked my oldest daughter if she’d go with me and go in to work late…she can’t miss work because she’ll miss out on money. I’ve tried to call and text my mother all day long and she hasn’t responded or answered. She KNEW I was following up with the cardiologist today. So, I’m hurt. I called my Dad and asked if he’d meet me at the hospital and stay with me until it was over and then take me to hubby’s work. Originally he said he would. He called back about 30 minutes ago and said he just got to thinking about it and he’s scared of COVID…so he doesn’t want to go to the hospital. Again, I’m back at being alone. I don’t think I’ve ever been so scared in my life. It’s the fear of the unknown. When I had all my surgeries, I knew what I was getting into. I didn’t know that my kidneys were going to fail while I was having my hysterectomy, but I at least knew most of what my outcome would be. I’ve been dealing with chest pain off and on since May 8th. I’ve been dizzy every day from the time I stand up until the time I sit back down every day. Meclizine does nothing for me except make me sleepy. Sometimes when I’m standing I can feel the beat of my heart in my head like a drum. NOT in my ears…my head. The dizziness is not like the room is spinning around me. It’s more lightheadedness. Like either my O2, my BP, or something isn’t working right. I do know my blood pressure drops some when I stand up. We’ve tested that. My PCP doesn’t feel like it’s drastic enough to cause the dizziness. I also am supposed to wear a CPAP at night along with oxygen (I have hypoxia at night). I can’t wear the CPAP mask because it makes me feel like I’m suffocating. Then on top of it, the family history, the being overweight (by a LOT), the diabetes, the chest pain.

Anyway, do I need to take my Pod & G6 off for this test?

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They should not interfere with the test, except if they are in a location where they need to put the electrodes. So you should keep them off your chest and stomach so that they are not in the way.

Like this:
image

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I am sorry you are having all these issues. As everyone here knows any health issue sucks, and having more than one at the same time is even worse. Hang in there, and I feel for you it is clear that your family is not supporting you the way that you would like.

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@egreen76 I’m sending you lots of hugs and well wishes! This is so much to deal with but you’ve got too. If I were able, I would go with you, so please know, I’m there, we’re all there (FUD), with you … in spirit!

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Thank you, Tapestry! They ordered a brain MRI as well to rule out possible light stroke, blood clot or tumor. I’m supposed to go Friday afternoon but may have to change it. They are going to have to order an open MRI or sedate me one. I am VERY claustrophobic and went into a full blown panic attack the last time they tried to put me in that tube!!

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So my stress test is in the morning and I’m having trouble getting to sleep! My Brain MRI has been rescheduled until late Monday afternoon. I’m a wreck.

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Here’s hoping you got some sleep and that the test is over and you did well!

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@Tapestry - not much sleep. Test is THANKFULLY over, but I still don’t feel right. I just got back to my house. I drove to hubby’s work this morning, he drove me to the hospital. He picked me up when it was over and I had lunch and stayed with him til I was ready to lay down. I originally was going to go to my best friend’s house to hang with her afterwards, but I’m just not feeling right and wanted to take my heart medicine and lay down.

Thank you for checking on me! I appreciate it!

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One down, one to go - your brain MRI. You’re doing great, hang in there!

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Hi Emily,

I am so sorry that you are going through all of this. It is very difficult when specialists do not agree leaving you without any answers. Each specialist has their own perspective in attempting to diagnose your problem. I agree with Chris that these tests are performed to rule out the really bad conditions that can potentially kill you. The great news is that your Echocardiogram was fine which rules out most of the cardiac causes of your symptoms. You should not worry at all about the chemically induced perfusion stress test as it is pretty benign and well tolerated. I had one completed back in January with the worst thing being restricted from having caffeine for a day and the entire exam took maybe an hour. I wore my G6 throughout and most likely there will be no issues with the omni pod since the this is not magnetic like an MRI where you do need to remove your sensors and Omnipod because it is metal. Your ENT exam was normal so that eliminated another cause. I am not a fan of meclizine which is commonly prescribed for vertigo but it sounds like you did not have vertigo.

There are three things in your experiences that do concern me. You stated that the monitor showed bursts of a rapid heart rate, that your were lightheaded, and your blood pressure dropped. These could be signs of low blood pressure during changes in position (lying down, sitting up, and standing too quickly that your body cannot adjust fast enough called orthostatic hypotension. People usually feel a fast heart rate followed by lightheadedness, and even passing out when sitting or standing. The rapid heart rate is a normal response in an attempt to maintain blood flow to your brain otherwise you will pass out. If you are on any medications that lower your blood pressure they will make your symptoms worse. A good internist should have been able to put that together if they were listening to you. Blood pressures in each position should be performed. Low blood sugars may also cause these same symptoms that you are experiencing. The last thing that would be helpful would be a Zio patch which is an extended cardiac monitor for 30 days that can determine if your fast heart rates are more frequent.

I hope this is helpful for you. Please let me know the results of the stress test and MRI but easy beside tests and questions about medications should be done by all of these physicians.

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@G6newbie
While the Cardiologist did not do the exam for laying back, sitting and standing blood pressures…my PCP did. I can’t remember what my drop rate was but when I stood up it did drop. She said she didn’t feel it was a significant enough drop to cause the lightheadedness. This was performed before we got the results back showing the arrhythmia. Also, I am not on any blood pressure medications. As far as the Lexicam Stress Test…I’m just glad it’s over! It caused my chest pain to return, it made the lightheadedness worse, it caused nausea and made my head feel like it was in a vice grip.

My Dr moved my Open MRI to a location closer to me but it now won’t be until next Thursday. I will be seeing my PCP on Tuesday to have my A1C blood draw and go over my numbers. On a good note I have been in range 92% this week!!! I think I am finally finding my numbers during my honeymoon with Omnipod!!

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Are you staying well-hydrated? Being dehydrated can also sometimes cause your blood pressure to drop, simply because it reduces your blood volume. Just like with less air in a balloon, there is less pressure.

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Hi Emily,

I hope you are doing alright. Great news on your in range time.

The symptoms that you felt during the pharmacologic stress test are all common due to the medication injected to increase blood flow to your heart. This usually lasts maybe 15 minutes with the headache possibly lasting a little longer. They observe patients for at least 30 minutes afterwards for these reasons and can administer another medication to counteract the first medication if symptoms do not go away.

Keep me posted on the results. I am hoping for the best!

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@Eric I think I am. I drink a lot of water these days.

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@G6newbie I’m okay. Just seem to be tired all the time lately. My brain scan has been moved to Thursday. I see my PCP on Tuesday of this week and follow up with my cardiologist on the 23rd.

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Also, knowing that you also have sleep apnea I am wondering if that is causing some of the fatigue and it would be interesting to know what your oxygen levels are while walking. Just something that your PCP should consider if all your test results are normal. My thoughts are with you.

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@G6newbie I do know I have sleep related hypoxia…

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Sorry you are going through all this! Makes sense it would be scary. Thinking about you, and wishing you well!

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