What a Tuesday!

Tuesday, July 29.

I took it for granted that the annual stress echocardiogram to assess the condition of my heart and it's gimpy valve would be like all the others I'd had: uneventful. I was wrong.

For starters, there was a new crew at the lab. Different technician, an added exercise physiologist and the soft-spoken Indian cardiologist whose mannerisms I'd come to understand was away. No worries, the new team all seemed fine.

The exam started like normal: I waved off the gown, pulled off my shirt and jumped onto the examining table. Once wired up to the EKG, I assumed the position to have the gel-covered probe slid around my chest as the tech stared intently at her screen. I was in a good mood and kept thinking of jokes I'd be cracking if she weren't so focused on her work.

When it came time to exercise, the tech said she wanted to check one thing with the cardiologist before we started. Soon the doctor was in the room peering at the recorded images and quizzing the tech about her measurements. Then the tech from next door came in and repeated the key exam. There was clearly something they didn't like and soon the cardiologist told me: the size of the aorta bothered them.

The cardiologist put the test on hold to talk to my internist, Dr. Havey--who was officed down the hall. He came back to report that they'd decided I should skip the stress part of the exam. Instead, I was to see Havey about scheduling a CT scan to confirm the measurements of the echocardiogram.

I figured the CT would take a few weeks to schedule, but when I asked they said I should have it done "today or tomorrow." Things had definitely taken on a sense of immediacy that I hadn't seen around this issue before.

The CT scan started an hour later and extended my day at Northwestern to nearly 5 pm--I'd lost half a day that I hadn't planned on. But despite the gentle warnings that the echo readings--if confirmed by the CT--"weren't something to mess around with" as Havey had said, I figured that at worst I would face surgery sometime after my vacation in Hawaii. After all, I was exercising regularly and vigorously and had ridden my unicycle for an hour and a half just the night before. How bad off could I be?

That night, Havey called me, not once but twice. We missed connecting the first time, but I picked up the second time--at 9:30 pm--and he laid it out. The aorta was hazardously enlarged with some real chance of rupture during my regular activities. He had scheduled me to meet with the cardiac surgeon the next day and, he said, the surgeon did not think it wise for me to proceed with the Hawaii trip. With an aorta swollen as much as mine, the chances of rupture were 10-15 percent. Were it to rupture, the consequences would obviously be dire.