Make like a Smurf...
Jud recently discovered that my lips and fingernails turn blue when I am out doing hard or long runs. He mentioned this a few times; I blamed blue Gatorade. Then, earlier this week, I got back from a run where I only lugged water with me, and my lips were still blue. I decided this was probably something worth investigating and called the nurse at Gannett, Cornell's health services building. The nurse didn't seem concerned, but I decided I should probably get checked out just the same.
I went in to see my buddy Dr. Hughes the next day. They took my blood pressure, temperature, and had me do a peak flow test to see how my asthma was doing. My blood pressure was high, but I was feeling really nervous and had just finished off a large mug of coffee. I also started on a decongestant recently. I decided I had better address this problem first.
Dr. Hughes came in and said "Okay, why don't you tell me about your concerns, and then I'll tell you about mine." I won the guessing game, because my first concern happened to be his only concern. (Doctors never read your list of symptoms/complaints before coming into the room. I think you only list the complaints to the nurse because the doctors don't take good notes.) We discussed my family history and drugs for a while, and I finally got around to what was really bugging me--the blue lips. Now, I don't know if you've ever experienced this, but there are certain things a young, healthy person can say to a doctor that visibly shake them. "I have a migraine that woke me up and hasn't gone away for 48 hours" is a good one. "My lips are turning blue when I'm out on runs" works even better.
Soon I was given an EKG and whisked down to another floor to get bloodwork and a chest x-ray. Everything seemed normal so far. They did a pulsox, a test that measures the oxygen saturation level in your blood, and it was fine. I learned I have a small, insignificant heart murmor. The hypertension couldn't be responsible for my symptoms, but I have to change medications and get it checked out periodically before we decide if it was a fluke of nerves and decongestants or if it's an actual problem.
After almost 90 minutes of testing and waiting, I got sent down to the nurse to schedule an exercise echocardiogram, better known as a stress test. Somehow, they got me in at the hospital the following morning.
So Wednesday I went to the hospital, waited with people who were at least fifty years older than me, and got called to the lab. They covered me with electrodes and carefully explained the entire procedure. Then we got a pulsox (100%), blood pressures (resting, standing, and hyperventilating), and did the resting echo. My heart looked great, and they decided they wanted to give me contrast to see one part better. To do that, they first had to make sure I didn't have a large shunt in my heart. It turned out I have a very small one, a problem common to 10-20% of the general population. Later, I learned that up to 50% of migraine sufferers have small shunts (PFOs), so that was interesting. Anyhow, we got the contrast in, and the colors on the echo flipped, which was pretty cool. An echocardiogram works much like ultrasound on a pregnant woman. All the electrodes were for the EKG that would be going as I was on the treadmill.
When you are a young, otherwise healthy runner, they do not give you the treadmill portion of the stress test the same way they give it to other people. Oh, no. That would be too easy on me. They started me at a fast walk at 10% incline. Every two minutes, both the incline and the speed increased. They wouldn't let me use my inhaler before the test. I still managed to last 15 minutes before they decided my pulse was close enough to my maximum heart rate that they should stop the test (you have to hold your breath afterward, so it's hard to get you to your max because it just wastes your energy). Over the course of the entire test, my pulsox plunged 8%, which is "abnormal," but might only have happened because I didn't have my inhalers. At one point, my pulse was around 144, and I decided to try to slow it by 10 bpm. I had it all the way down to 136 when they decided they needed to make the test harder a little early.
My post-exercise heart also looked great. So, as far as we all know, my problem is pulmonary or some other "peripheral" problem, as the cardiologist mentioned.
I now have an appointment to see a pulmonologist to try to figure out if the cyanosis is related to my asthma, and my doctor still wants me to have a regular visit with the cardiologist.
For now, I'm not allowed to do any exercise that might cause my lips to turn blue. In a way, I think it's a good thing because I had been training a little too hard, but I am also frustrated. Running is my major method of dealing with stress and sorting through my day. I feel confident that this whole thing will be cleared up soon. I don't think I could run 17 miles at a stretch if there was anything seriously wrong with me, and at this point, my heart has essentially been cleared. I hope they let me get back to training within the next few weeks!
Until then, just call me Smurfette. =)
I went in to see my buddy Dr. Hughes the next day. They took my blood pressure, temperature, and had me do a peak flow test to see how my asthma was doing. My blood pressure was high, but I was feeling really nervous and had just finished off a large mug of coffee. I also started on a decongestant recently. I decided I had better address this problem first.
Dr. Hughes came in and said "Okay, why don't you tell me about your concerns, and then I'll tell you about mine." I won the guessing game, because my first concern happened to be his only concern. (Doctors never read your list of symptoms/complaints before coming into the room. I think you only list the complaints to the nurse because the doctors don't take good notes.) We discussed my family history and drugs for a while, and I finally got around to what was really bugging me--the blue lips. Now, I don't know if you've ever experienced this, but there are certain things a young, healthy person can say to a doctor that visibly shake them. "I have a migraine that woke me up and hasn't gone away for 48 hours" is a good one. "My lips are turning blue when I'm out on runs" works even better.
Soon I was given an EKG and whisked down to another floor to get bloodwork and a chest x-ray. Everything seemed normal so far. They did a pulsox, a test that measures the oxygen saturation level in your blood, and it was fine. I learned I have a small, insignificant heart murmor. The hypertension couldn't be responsible for my symptoms, but I have to change medications and get it checked out periodically before we decide if it was a fluke of nerves and decongestants or if it's an actual problem.
After almost 90 minutes of testing and waiting, I got sent down to the nurse to schedule an exercise echocardiogram, better known as a stress test. Somehow, they got me in at the hospital the following morning.
So Wednesday I went to the hospital, waited with people who were at least fifty years older than me, and got called to the lab. They covered me with electrodes and carefully explained the entire procedure. Then we got a pulsox (100%), blood pressures (resting, standing, and hyperventilating), and did the resting echo. My heart looked great, and they decided they wanted to give me contrast to see one part better. To do that, they first had to make sure I didn't have a large shunt in my heart. It turned out I have a very small one, a problem common to 10-20% of the general population. Later, I learned that up to 50% of migraine sufferers have small shunts (PFOs), so that was interesting. Anyhow, we got the contrast in, and the colors on the echo flipped, which was pretty cool. An echocardiogram works much like ultrasound on a pregnant woman. All the electrodes were for the EKG that would be going as I was on the treadmill.
When you are a young, otherwise healthy runner, they do not give you the treadmill portion of the stress test the same way they give it to other people. Oh, no. That would be too easy on me. They started me at a fast walk at 10% incline. Every two minutes, both the incline and the speed increased. They wouldn't let me use my inhaler before the test. I still managed to last 15 minutes before they decided my pulse was close enough to my maximum heart rate that they should stop the test (you have to hold your breath afterward, so it's hard to get you to your max because it just wastes your energy). Over the course of the entire test, my pulsox plunged 8%, which is "abnormal," but might only have happened because I didn't have my inhalers. At one point, my pulse was around 144, and I decided to try to slow it by 10 bpm. I had it all the way down to 136 when they decided they needed to make the test harder a little early.
My post-exercise heart also looked great. So, as far as we all know, my problem is pulmonary or some other "peripheral" problem, as the cardiologist mentioned.
I now have an appointment to see a pulmonologist to try to figure out if the cyanosis is related to my asthma, and my doctor still wants me to have a regular visit with the cardiologist.
For now, I'm not allowed to do any exercise that might cause my lips to turn blue. In a way, I think it's a good thing because I had been training a little too hard, but I am also frustrated. Running is my major method of dealing with stress and sorting through my day. I feel confident that this whole thing will be cleared up soon. I don't think I could run 17 miles at a stretch if there was anything seriously wrong with me, and at this point, my heart has essentially been cleared. I hope they let me get back to training within the next few weeks!
Until then, just call me Smurfette. =)
posted by megan at
11:16 PM
1 Comments:
Megan, It could be worse. My first echo found me on a bike and not a treadmill. The technician (who apparently had not begun her day well) piped up, "We have a problem!" My internal, panic button was activated..but it was the computer, not me. Later during the testing process she remarked casually, "It looks like an anurism....but it's not." I passed the test with flying colors, (and she failed)! You know the rest of my story over the years, and I remain, your bionic grandfather Peace and love,
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