The Mayo Machine

The Mayo Clinic, I mean, not some new way of putting the Hellmann's on your sandwich.

I went down to the Mayo Clinic yesterday to do a treadmill stress test and to get another Holter monitor (24-hour EKG) put on.  My cardiologist had said he really hadn't seen anything on the Holter, including PVC's...which was strange, because I had felt a lot of them. He was the second cardiologist to say this (the first being my original Mayo cardiologist, who was moving to greener pastures soon and so sent me to the second cardiologist, and who I wasn't sure had gotten the correct monitor results.  Confused yet? ).  Anyway, New Cardiologist recommended a stress EKG and another Holter, so I scheduled them and down to Rochester I went.

I've been to the Mayo several times before, and it is a truly impressive place.  Once you find it, I mean.  Minnesota has a bad habit of being very vague with its road signage, and the Mayo is no exception.  The signs from Highway 52 are great...until you are about a block from the Mayo, at which time all signs cease and you're left to wander the maze of one-way streets and tall buildings, attempting to guess which of the parking ramps in view are actually a good choice.

Anyway, once you get there the Mayo is great.  The clinic is a well-oiled machine, with printed itineraries for your test schedules, helpful helpers pointing you in the right direction, and even someone playing piano in the lobby.  You follow your itinerary and proceed from floor to floor, test to test, and if a new test is added based on what the doctors are seeing, a new itinerary is printed immediately and off you go to the newly scheduled exams.  I took my dad to the Mayo a couple of years ago for cardiac testing (as I mentioned before, he has arrhythmia problems too), and took him to so many tests that once, when I left him in a test and went down to the cafeteria, I forgot where I'd left him and the always helpful helpers had to help me re-locate him.  Everyone I have ever dealt with there, even just people on the phone, is extremely nice and helpful.  This turned out to be a good thing yesterday, since my appointment had somehow gotten screwed up and they were expecting me today instead of yesterday.  Despite that, they managed to get me in for my stress test and my Holter at exactly the times I was scheduled--all while still smiling pleasantly.

The stress test is interesting.  I've done it probably four times before, not counting some VO2 Max testing I did   a couple of times.  I'm amazed that they can get you to your max heart rate without having the treadmill go any faster than a slow jog (they do it by manipulating the angle).  Which is a good thing for me, since I'm not a treadmill runner (I'm not any kind of runner anymore), and I'd imagine flying off the back of a treadmill while connected to EKG leads and an O2 sensor mask would be frowned upon.

My one focus this time--other than not flying off the back of the treadmill, and not quitting too soon--was to see if, when I felt what I've always been told is a PVC, the EKG showed a PVC.  As it turns out, I was apparently right on--every time I felt what I thought was a PVC and mentioned it, the technicians confirmed that it was, indeed, a PVC.  This still doesn't explain why no one saw any on the Holter from the Pack racing weekend, but at least I know I'm not feeling something that's not there!

So I do feel PVC's, I didn't fly off the back of the treadmill, and I didn't quit early.  Or, not much.  The procedure is that the technicians ask you, every couple minutes, to rate your effort on a 1-20 scale.  I assumed they wouldn't pull the plug until I said "20," or grabbed the treadmill handles, or begged them to stop.  When I reported a 19, though, they told me I was done.  I think they can tell when you're at your max heart rate, though, and there's no point continuing beyond that.  In my case, max turned out to be 202--pretty high for my age.

"I was told it's just genetic, though," I said, "and not an indicator of fitness."

"Yes," the technicians said, "and also you're a small person, and smaller people tend to have higher heart rates."

Me?  Small?

As I said, everyone at the Mayo is VERY nice.

Then I got the Holter put on.  The Mayo Holter techs are very thorough, and application of the electrode sticky-things necessitates much vigorous use of alcohol and sandpaper (fortunately in that order).  I'm glad they're thorough, though...maybe this one will show the PVC's when I feel them, as well as anything else that might or might not be going on.

I wore the Holter for 24 hours, including for an easy inline skate in the Dome.  Then I popped it in the mail back to Mayo today.  And tonight, my cardiologist called.

He mentioned seeing the PVC's, asked how I'd felt during the stress test (fine), and confirmed that I'd done the Holter.  Then he said the Holter should be interesting, and we'd wait for the results and then make a plan from there.

So now I'm wondering...what the heck does that mean?  If he'd seen nothing in the stress EKG, would he have said so?  Is he implying that he's waiting to confirm something, or am I just reading into what he said? And why didn't I think to ask these questions when I was talking to him?

So, I wait again...