Picture Pages

Picture Pages

As the ultrasound technician moves the wand around my chest, Bren’s insult about “playing picture pages” in the film “Juno” cascades through my ears. I want to make a joke to break the tension, but I know she’s heard the line a million times. She’s an ultrasound tech and that film is what, nine years old? By this time the joke is too old, too tired, to be funny. That’s not even the best reason to keep my mouth shut.

That tension? It’s my tension. It’s not a tension between us. There is no “us.” No her and me. I’m a piece of meat, living meat, but we don’t really need to interact. The tension is mine. All mine. I’m tense. That’s the issue.

She works quickly, her left hand moving, aiming the wand, occasionally adding a bit more warm gel, while her right right hand dabs the keyboard and touchscreen. She’s working from a script long since memorized and if I say anything, any time she takes to interact with me will just be a net delay in her work. I figure I should respect her enough to just shut up and allow her to work as fast as she’s able.

Her work is so quick, so rehearsed, I think about her title—technician. She reminds me of friends I’ve watched as they used a graphics application like Photoshop or InDesign. She knows what she’s going to do even before the screen has caught up. The images and recordings stack up, one after another, each a unique view of the function of my heart. Mostly the stills and video are black and white, but some show waveforms that correspond to recordings of the sound of my heart’s function, while others show a cascade of blues, reds, oranges and flashes of yellow that remind me of Doppler radar.

“Well, you have a strong, slow, consistent heart rate.” Her tone is upbeat, encouraging. My response is that’s the only thing about my heart that wasn’t in doubt. I’m afraid it sounds snippy, but I decide against trying to clarify, that she’s probably smart enough to know just what I mean.

After a few more minutes and another dozen captures, she lowers part of the platform on which I lay and begins to scan me from the side. I’ve been watching the screen the whole time, focusing on my breathing and have lowered my heartrate from 48 when she started down to 41. Pride creeps through me and I note how irrelevant it is, how my low heartrate proves nothing. Were it in any way significant, a sufficient indicator of my health, I wouldn’t be laying here.

And then I realize that the combination of the wand’s position and the video of my heart contracting on the screen has allowed me to feel my heartbeat in keen detail. I can discern both systole and diastole without placing my hand on my chest. Each beat ripples through my chest like a sequence of pebbles dropped in a pond. Wheesh-whow, wheesh-whow, wheesh-whow. So different than the description we normally consider of ba-BUMP, ba-BUMP, ba-BUMP.

She hands me a towel, steps out. I dress, head back to the waiting room, sit down and open Facebook. What else do you do?

Before I can watch a skateboarding video, I’m called into another tech’s room. Off goes the shirt yet again. Two attractive women have seen me shirtless in an hour. Clearly a record. She walks me through the procedure for the Holter monitor and a few of the rules and then inserts a verbal caveat.

“But first, I have to shave a section of your chest. Sorry about that.”

Apparently, I’m still nervous because I feel the need to make a joke.

“No worries, but if you draw blood, we’re going to have to talk.”

She works quickly, without shaving cream. I’m so occupied with trying to think of something funny to say that the surreality of having someone else shave my chest barely registers. “Oops. Sorry, I nicked you. I’m going to apply a bit of pressure to get it to stop.”

“It’s okay. Nothing has killed me yet. And believe me, I’ve tried.” Just as what I’ve said registers, I realize I need to clarify. “Not that they were intentional, mind you.”

I’m such a freak.

She apologizes again, noting that she needs to essentially sand my chest with a little finger scrubber to prepare the surface of my skin. I decide against the joke about how many layers of primer. And then her final apology, she has to wipe my skin with an alcohol swab, which will sting, she assures me, and is cold, the insult to injury in her mind. How decent.

The device she sticks to me looks like a medical-grade cross between a bike blinky and Iron Man’s nuclear heart. I can eat, sleep, shower and exercise just like normal. No baths, no hot tubs, no swimming.

“I have to ask—even though you’ve been really clear—just for the sake of good communication, you’ve said that exercise is okay, but what about really vigorous exercise, where I might sweat a lot, like a hard bike ride?” I can hardly believe I’m asking, because at some level I believe there’s someone with an M.D. who, if asked, would respond, “What the hell is he thinking?!” I figure I’m just giving them the right of first refusal. “I mean, I have a bike race coming up next week.”

Not a flinch. “Well, if you can maybe bring a small towel along and dab the sweat away if you get really wet.” A pause. “I know that could be kinda hard, but just to avoid letting it get too wet. But if it does come off prematurely, just drop it in the box and mail it back.”

I’ve got a diary, a pen and a self-addressed, stamped mailer. If I have an episode, I’m supposed to click the monitor and write down the time of day and describe the event in as much detail as possible.

Let’s party, bitches.

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  1. michael

    been there. done that. though i won’t comment on the type of “vigourous” exercise performed while wearing the monitor lol

    in my case nothing major, and send positive vibrations your way that it ends up being nothing major as well!

    ps – stomp that race, yo

  2. Harris

    Padraig: enjoy the ride and best wishes. I assisted my grandfather and one of my bosses through the sampling phase; it can be an experience with the geriatric set. I hope you reach a firm baseline for your risk tolerance level.

  3. Les.B.

    About 4 years ago when I was having palpitations my doctor wanted to likewise monitor my heart function before sending me to the cardio man. So he gave me what he had in his office, which was this ancient-tech thing, a cassette recorder device that I wore on my belt all day, with probes strapped up to my chest. The installation was an easier process, not involving being physically abused by attractive females. I don’t know if that’s a good thing or bad. PoV, I s’ppose.

  4. Andrew

    I had to do the Holter thing. Not a big deal. I figured I’d give them a couple of hard rides to evaluate, which lead to my HR numbers going from my base in the 40’s up into the 170’s. The poor guy who had to read it remarked “marked sinus bradycardia and tachycardia”. The most interesting thing about it was that my lowest HR of the day was when I was at work, doing something that a lot of people would consider stressful. Apparently I find it relaxing- I guess I am in the right field!

    The one piece of advice I would have for you about the whole process is to find a cardiologist who understands athletes. For what I have, a lot of cardiologists would have had a knee-jerk reaction of “no vigorous exercise’. My guy, probably the foremost expert on this in the world, just told me it was fine to do long hard stuff, but just to watch it about racing, pushing it beyond my limits to win.

    You’re going to be fine.


  5. Frederick B.

    At my last checkup my doc commented on my low heart rate (not as low as yours) ….”to be expected with a trained athlete.” (The only athletic compliment I’ve ever got, LOL!) I agree with Andrew ^^^ regarding working with a cardiologist who understands athletes…low heart rate is aka bradycardia ( less than 60 bpm) which, as I understand it, is only a problem if the heart is not pumping enough oxygenated blood…pretty sure yours is pumping plenty! BTW, how the hell do you get to have a condition with your own name in it? I s’pose you can tell everyone that the docs are so impressed with your heart rate that they named the condition for you… Have fun racing! : )

  6. Dave

    Having had essentially the same experience as Andrew, my advice is to be verbose and specific in that diary. I just wrote, ‘bike ride’ in mine, so when my MD saw the report (4 days later) he scheduled me for an emergency pacemaker. When the cardiologist walked in to see me getting prepped for surgery, he laughed and sent me home.

    Hope your results turn out as well.

  7. wayno

    went for 2 rides with a holter on, it was encouraged when i had what sounds like the same thing. your do-dad is much cooler than the old school brick I had with wires fed out of a jersey and monitor in the back pocket. good luck brother.

  8. Shawn

    Yep ! Make sure you have a PCP and a Cardiologist who understands athletes. Those physicians who treat older folks and obese youngsters may not know how to properly treat someone who has been an athlete for many years. I went through and am going through similar issues and continue to ride as before. Although, as I get older, I know that pushing the limits as I did when I was younger and most likely racing, requires a bit more consideration and paying attention to my body. Fortunately now I’m just in it for the fun….

    Good luck and remember that we are beginning to experience what those older and wiser racers warned us would happen….

  9. Peter Leach

    Like Michael above, “… been there, done that …” – although, like like Wayno, I had a brick on a belt and wires everywhere.
    My week with the monitor detected ‘prolonged QT’ syndrome and resulted in a monitor being implanted. Roll on nearly three years and I think that I’ve pressed the ‘record’ button twice.
    I don’t think that I’ve ever matched your low heart rate, but I did manage to beat my age during testing 🙂
    I hope all goes well with any diagnosis and ‘positive vibrations’ from me, too.

  10. Author

    Everyone: Thanks for your comments and encouragement.

    A little update is in order. The Holter monitor, despite following the directions I was given regarding riding and showering, fell off well shy of the two week mark. Frustrated would be the polite way of saying what I feel. I didn’t feel any episodes while I was wearing it, so it seems unlikely that we are any closer to knowing what’s up with me.

  11. Don Jagoe

    Hey, they’ve really gotten smaller — like everything I guess. I had to wear mine around my waist in a little holster. But it proved I was fine so it was worth it. Totally concur on finding someone who understands the non-normal, skinny athlete. Doctors are so enured to seeing obese adults who don’t even walk that they have cognitive dissonance when you jump on the table at 9% body fat. Freaks most of them out. Crush the race! Great writing, as always. Love you on The Paceline too….

  12. Bart

    I just want to say thank you for sharing these personal parts of your life. I feel like knowing these things about makes your other writing (reviews, commentary, etc) that much more real. Thank you.

  13. A Tallent

    Suffered some transient chest pain years ago but only at rest. Never had any issues lifting, running or riding. My team physician just ordered a stress test without even seeing me. Cardiologist just looked at me and shook his head as I completed what may have been a submax for most but much higher workloads without any issues. Turned out I had(have) a stenosis in my c-spine that irritated a nerve leading to the surface of my left chest when in certain positions. No worries and all the best to you.

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