Nuclear Stress Test

I'm having a nuclear stress test next week. I have no known cardiac issues. Because I've had Type 1 for 35 years and am approaching Age 60, my internist feels that it is a good idea to get a baseline test and just check that there is nothing going on that is asymptomatic.

I am not worried about the treadmill part of the test. I had an echo treadmill test about 7 years ago. They kept upping the speed and resistance and I never got tired. Finally my doctor said that everyone needed to go to lunch and they had seen enough.

I am assuming that I'll keep my pump on except for the scanning parts of the test. I also figure that the Dexcom transmitter can be left in, since it won't be directly in the scanning field.

I can't eat or drink within 3 hours of the test, but I'll just test often and adjust insulin as required. I never have problems exercising right after eating, but I'll follow their rules to keep them happy. I will have orange juice and glucose tabs with me, but hopefully won't need them.

Does anyone have any experiences to share or any advice? Especially on handling the Dexcom and the pump?

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Permalink Reply by Kelly WPA on August 25, 2011 at 7:07pm

I have had 4 of them but none with a pump or CGMS. Stick a book in your purse because there is a lot of waiting around in between parts of the test – it gets boring. Good luck with it!

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Permalink Reply by Lathump on August 25, 2011 at 7:26pm

Thanks, Kelly. I thought I remembered that you had had one of these, but didn't know that you had had 4. Do you have cardiac issues? You really have your plate full with medical stuff. So many of us have been lucky enough to escape complications. You've gotten more than your share.

I'll be sure to take a book. I was told on the phone that the test would take anywhere from 2-4 hours. I'm hoping for 2.

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Permalink Reply by Kelly WPA on August 26, 2011 at 6:50am

I have problems with irregular heartbeat, but no serious heart issues. The first one, I was having chest pain & shortness of breath. My stress test came back questionable and I had to have a heart cath. After that came back clean, they did some stomach tests. I had been using Advil for neuropathy pain & it ate the lining of my stomach – that mimicked heart problems. The 2nd & 3rd were done as a regular screening. No. 4 was when my thyroid went out of whack 2 years ago and I was having shortness of breath again. I flunked that one also and had to have another heart cath. I am guessing I flunked the stress test because of neuropathy but no one will actually say that. The cardiologist said my veins were really clean and to keep doing whatever I was doing.

I think the time has to do with if they are running on time shuffling patients & if the cardiologist is on time for the part they have to be in the room. I have had to wait for the cardiologist on several of the tests I had. The last one was done at a cardiologist office and they only had one tech doing them. There were 4 of us having the stress test & he would ship up back to the waiting room and take someone else back in between the different parts. When it came time for the part the cardiologist had to be there, he was late getting back to the office so that delayed it even more. I have had 2 done at doctor’s offices & 2 at the hospital. The shortest one was actually at the hospital – the cardiologist was on time for his part.

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Permalink Reply by Trisha01 on August 25, 2011 at 8:18pm

If that is the same as a chemical stress test, hubby had one 3 weeks ago. They told him 2-4 hours, but it was over in just under 2 hours. He did fine (he's 71), and has had 2 previous heart attacks; plus a stop and restart in ER; and some stents. He's not 'betic though, and a whole bunch healthier than Kelly and I put together! . I'm not sure if the *chemical* stress test is the same as the nuclear one, unless in our area they refer to chemicals as isotopes. I know, not much help. :(

Good luck, sounds like you'll do fine!

Trisha

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Permalink Reply by Lathump on August 26, 2011 at 5:43am

I think that the chemical stress test is when they use drugs to stress the heart instead of a treadmill. I will be using a treadmill, but will be injected with isotopes or whatever to show up on the nuclear scans.

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Permalink Reply by Kelly WPA on August 26, 2011 at 6:54am

Trisha, Lathump is right that the chemical one is when they give you something to simulate being on the treadmill. Three of my 4 have been done that way. The first one wasn't due to neuropathy but because of a broken foot. Even though I can walk on a treadmill, I can't do it fast enough for what they need so I get to have those. They also do the dye regardless of whether or not you can do the treadmill. Ask him if he had to lay on a table a couple times for them to take pictures of his heart separate from them watching on a EKG type thing once they injected him.

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Permalink Reply by tmana on August 26, 2011 at 5:49am

I've had two of these, and the technology and wait times changed between the two. They take baseline measurements and pump you with contrast, wait for it to distribute (about a half-hour), then take an initial set of images. A cannula is left in your arm for the duration of the test. This takes about a half hour in a whole-body nuclear imaging device. In one version, the imagers rotate around you; in another, you rotate around them. Then they do the treadmill thing. If you're on any medication that inhibits heart rate -- such as beta blockers -- they may choose to give you a shot of adrenaline instead. Then they pump you with contrast again, let it distribute, and take another set of images.

The last time I had one done with contrast, they had some graham crackers and water that they wanted us to snack on during some of the waits.

While I've never needed an insulin pump and never worn a CGM, based on everything I would suggest disconnecting your pump to prevent the electronics from getting fried, and removing any metal canulas or sensors to prevent you from getting fried. Just to be sure, though, I'd check with the lab a day or two before the test is scheduled.

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Permalink Reply by Lathump on August 26, 2011 at 7:12am

I just called the Nuclear Medicine lab where I'm having the test. The tech indicated the the scanning is done by a Gamma scanner which picks up the radioactive stuff that has been injected. She said that unlike x-rays and MRI's, the camera does not emit anything. She indicated that there is no reason to take off my pump or Dexcom sensor.

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Permalink Reply by s6954118 on August 26, 2011 at 6:13am

I had a nuclear stress test about 7 years about before my type 2 diagnosis. We were trying to run down the cause of my edema and they shot the solution inbetween your toes. I had to walk around for 3 hours before they did the scan. The results were good but I still have edema

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Permalink Reply by Zoe on August 26, 2011 at 9:56am

I had the pharmacological version of the stress test just last week! First they injected the radioactive dye, then they had me lay still for 20 minutes (torturous to me as I am claustrophobic), while the machine rotated above my heart and took pics. Then they injected me with Lasix (which made me feel a bit "funny" but no big deal and I liked it better than the treadmill!), then 20 minutes still again for more pics. You actually can't bring a book because you have to lie perfectly still with your arms back. The second set of pictures I knew how much I would hate it so I had them find NPR on the radio in the room and let myself get absorbed in the stories which was much better.

I asked about my pump and they said it would be fine as the machine was above, focused on my heart. (It was fine). The hand-out sheet said to "lower your morning basal to 2/3" but when I called and asked about a pump she said there was no need to lower my basals, and I just tested before we started.

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Permalink Reply by Kelly WPA on August 26, 2011 at 9:59am

Zoe, I didn't mean that she could read a book during the test part, but during the shuffling part. I have always had to wait periods in between doing it. The last one I had done, I was sent out to the waiting in between each section, including after being injected with the dye part.

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Permalink Reply by Zoe on August 26, 2011 at 11:55am

Oh, that was me, Kelly; I wished I could have read a book - my favorite escape from things! I actually didn't have to do any shuffling except that they told me ahead of time to bring lunch and coffee. The Lasix (which stimulates the heart instead of a treadmill) sometimes causes side effects and food and coffee can take care of them. So I was given 1/2 hour to eat lunch and I sat out in the sun with my lunch and my book and that gave me time to gear up mentally for my second bout of claustrophobia. After they injected the dye they just had me walk up and down a couple times then it was right into the room for the first set of pics. I liked that there wasn't much waiting. I'm not good with having to wait to do things I really don't want to do!