NIH: testing

• Hemoglobin 8.5 (WHO normal 14.0-17.3)
• Absolute neutrophil count 0.65 (normal 1.4-7.5)
• White blood cell count 1.4 (normal 4-10)
• Red blood cell count 2.65 (normal 4.5-5.9)
• Platelet count 111 (normal 150-450)

These blood counts suck. And I feel like roadkill.

NIH, day 1. Got up at 5:30 AM and arrived at the NIH hospital at 6:10 (thank the gods for the time change on Sunday, which lessened the pain). Security screening. Then on to phlebotomy. (No, not lobotomy, though I'm starting to feel as if I'd had one). I was the tech’s first appointment of the morning, so I got to watch her struggle with her computer. Try, reboot, fail, try again, fail, reboot, success. So much for health informatics.

My record showed screen after screen of tests. Her labelmaker spit out 23 labels, one for each tube of blood she drew. Amazing skill she had, holding on to the IV with one hand while putting filled tubes into the rack and grabbing new ones two at a time. Seemed like she had three hands.

Next, an EKG. Hook up a few electrodes, lie back on the bed, turn on the machine, bam, you’re done. They only needed ten heartbeats’ worth of recording.

On to the dreaded sestamibi stress test. They inject you with a radioactive dye, then scan your heart. You lie inside a gamma camera for 20 minutes, with your arms raised over your head. (Yes, your arms go completely to sleep.) You wait an hour and a half, go back. Now they hook you up to a heart monitor, about a dozen electrodes. Some shaving of chest hair involved in this one. Once you’re hooked up, they record a resting baseline. Then you get on a treadmill. Here's a lousy drawing that shows the setup.

It starts low and slow, but they speed it up and raise the incline every 2-3 minutes until you are really sailing along, striding uphill at 3.5 mph. After about 8 minutes I exceeded the 143 bpm threshold they were shooting for — 85 percent of the theoretical maximum for my age — but they kept me going 3 more minutes until my heart rate hit 156 and I was sweating and breathing hard. The doctor and two techs cleverly distracted me from the effort with small talk.

By now it was 12:30 and I’d had nothing but water since 9PM the previous night. Finally I could eat. Half a liter of glucose by IV, plus a bit of ginger ale and some graham crackers. Wait another half hour, then back to the gamma camera for another 20 minute scan.

Off to the salad bar, which I regretted, since some of the vegetables turned out to have been frozen. But it was good to finally eat.

Next, echocardiogram — basically a sonogram of the heart. This one was cool, since I could see the images on the tech’s screen as he slid the ultrasound wand around on my chest. The valves looked like two boys break-dancing.

Met Dr. Kreitman and we went over my medical records, which he had a hard time sifting through because UM delivered them in order by document type, rather than by date.

Finally the last test, an MRI of the spine. Mike, the tech, wedged my head into the headrest with some pieces of foam rubber so I couldn’t move my neck at all. Then I had to lie completely still for 45 minutes. I forgot to take my silver rings off and they began vibrating like crazy when the scan started, so I pressed the little rubber bulb. Turns out that was an over-reaction; it’s really just for emergencies since you can simply talk and the tech will hear you.

Out of the hospital at 6 PM. I had been there almost 12 hours. Back to the hotel, Argentine steak dinner, bed.