This Friday I will be having an isotope (thallium?) stress test. I have done the web
search, and have read the literature about the test. What I want, more than anything, is to hear you talk about your experience. I am being tested because there is a possibility that I had a small “silent” heart attack, which in turn caused heart damage and congestive heart failure.
Any stories will be greatly appreciated. Thanks - beckwall
Here’s a bump for ya.
Typo Knig had one a few months ago. Turned out he had a severe case of hypochondria 
(well, not really, but the doc followed through on a symptom that ultimately meant nothing but had an initial test result that said “pursue this further”). Hopefully he’ll step in shortly.
I do remember the one funny thing: he was (or could have been?) provided with a letter, stating he’d had a test involving isotopes, in case some rad detectors somewhere flagged him as possibly carrying a nuclear weapon!
beckwall, Wikipedia and WebMD have some pages about this, but when I tried to read about this before my test I started getting scared and worried. So I just skimmed them lightly and took several tries at them.
Mama Zappa, the term my GP used, after all the tests were in, was “de-conditioned”. That’s the nicest way anyone’s called me “fat and lazy”.
I had a non-isotope stress tests this past February, and an isotope stress test in March.
For the first test I was told to bring all of my prescription bottles, and any OTC meds and supplements I take. Fasting was not required, I could eat a light meal before. I was told to wear comfy clothes. I was also told to avoid caffeine - they want to test my non-caffeinated heart rate. Given the amount of sleep I get, and the amount of caffeine I chug, I’m amazed I stayed awake through both tests. For the second test (at the same cardiology practice) they had all that info.
I had a bunch of paperwork to fill out in advance. In retrospect that was the worst part. Except for the fear that I was sick and going to drop dead. (That was the hypochondria part.)
Actually, the worst part was the poor communication skills by the cardiologists. After the first test, the cardio told me I had changes in my EKG. So what - the Dow Jones average changes too. My GP told my that the implication was that not enough blood was getting to my heart muscle. :eek: OK, NOW you’ve got my attention! Hence the second test. After the second test was done, I sat in the treadmill room waiting for my results. And waited. And waited. Then it was lunchtime for everyone else. Finally I was told that the MD who reviewed results had to leave for rounds, and could I call back tomorrow. :mad: - wait, I can’t get mad because I might have a heart attack! :eek:
For the radiation stress test I was supposed to fast. They want to trace the blood flow to my heart, not my stomach. I made a morning appointment. They took me into separate offices than the non-rad test. I noticed that the employees in that area all had radiation monitoring badges (as required by regulation), and so did the rooms. (I used to work with radioisotopes and radiation sources in a previous life. Badging the rooms is new to me, and I think it’s clever.) First I was injected with one isotope. This was just like any other shot I’ve had, I think it was a few ml of saline with the isotope in solution. Then I had to lie down in a scanner for a while. I had to stay still, and it was boring. I think it took 20 minutes to image my ticker while I was “at rest”. Maybe 40 minutes, I don’t remember. Ask them how long it will be when you get there. (I’m amazed how fuzzy the details are from just three months ago. And this was an extremely significant event for me!) I was on my back on a flat platform with a pillow and some other cushioning, and a pillow under my knees, all to keep me relatively still. The scanner was an L-shaped device with a rounded back. The L part was scanned over me under computer control, and I think the bed was moved some (also under computer control) to get me in the right place. The scanner got close to me, but never touched me. I don’t usually get claustrophobia, and definitely did not this time. If you do, you should ask about something to relax you. The device is very open - it’s not enclosed like an MRI (not that I’ve had an MRI, but I’ve seen the machines).
Then I had to wait my the data collection computer processed my images. About 20 minutes or so (I think). If I had moved too much they would have re-taken the scans.
Next was the actual stress test. I got wired up for an EKG at the treadmill, just like the non-isotope test, but they also hooked up an IV. When I reached a target heart rate on the treadmill, and held it for an appropriate time, they injected me with the second isotope. The max heart rate I was supposed to hit during the isotope test was lower than the max for the first test, which was fine with me. They kept me going a minute or two longer, then had me slow down to cool down. After both the non-radiation and radiation tests I was sweaty and tired, but not terribly winded. That was encouraging, since getting extremely winded fairly easily was why I went to my GP in the first place.
I think I had to wait a few minutes after the exercise, after they took out the IV and took off the EKG harness. Then I got scanned again - same as the first scan. Pretty boring. Then I had to wait. I already told about that part. Oh, and I was getting hungry. (Where’s a “frustrated” smiley when you need one?)
When I finally got my results, I was fine. Better than fine - I had medical proof my ticker was good. That was a huge relief! Even if the news had been bad, I would have known what the story was. I hope your results are as good or better.
I had very low radiation exposure from the isotopes. If I did my arithmetic right from the number of micoCuries they said they injected me with, I had 70 picomoles of Thallium 201, and a similar amount of Technicium. The Thallium, and its decay products, are long gone from my body by now. The Technicium is decaying at about 4 atoms per second, so I’ll be stuck with it for its 211,000 year half-life. 
And thank heavens for health insurance! I had a small co-payment for the test. Mama Zappa said the bill for the tests was several $K - all covered!
Make sure to ask your tech if you will glow after your injection. I hear they love that one! 
Well, ultimately it may have cost us 150-200 bucks but compared with the total “pre-insurance” figures that’s cheap enough.
Really, the coolest part of the whole thing is the new “spidey” superpowers he developed, though the neighbors have begun to complain about him swinging from one house to another via the rooflines. Oh, and the whole bit about if the kids annoy him, he turns green and roars. The kids were scared at first but now they’re talking about taking Daddy in for Show And Tell when school starts up in September :eek: 
I’m a nuclear medicine technologist who’s been doing these tests for ten years and I really can’t expand on Typo Knig’s description much at all, it was very thorough! Some places do the tests with both thallium and technetium, some places do them with both Tc doses; Some places use a two day protocol but, either way, your study will probably be much like his. If you are unable to walk on the treadmill or achieve your target heart rate they may stress you artificially using a medication like adenosine or persantine.
The only correction I would make is that the isotope of technetium we use in nuclear medicine is Tc-99m, whose half-life is actually about 6 hours. Tl-201’s half-life is about 72 hours. So, the Tc should be completely gone in 60 hours(ten half-lives is considered zero activity) and the Tl should be completely gone in 720 hours. The truth of the matter is that they are both gone far sooner, since the biological half life is much shorter, and the isotopes will pass out of the body through urine, feces and sweat within two or three days. We can rarely detect any Tc activity in a patient even 24 hours later.
Don’t make me angry. You wouldn’t like me when I’m ANGRY.
Demo, Tc99m decays (with a 6 hour half-life) to plain old Tc99. Tc99 has the 211 kilo-year half-life. I don’t know the biological half-life of Tc, but I’ve got few enough atoms of it in me to worry about. I’m sure I have more atoms in me of other naturally occurring radioactive isotopes than of Tc, even if Tc was never excreted from my body.
From what I can remember about mine, it went like this:
Went to the hospital where the test was to be at and filled out a bunch of paperwork.
Had an IV catheter put in my wrist.
Went to the actual testing area and got the electrodes put on my chest. If you are a guy, you might get the areas where the electrodes go shaved. Since I’m a girl I didn’t have to worry about that, but they did use a little brillo pad thing to rough up the skin in the areas where the electrodes went.
Got on the treadmill and walked until they told me to stop. Someone came along and injected the thallium using the IV line.
Laid out on a scanner table. The machine they did mine with had one or two big round plates on it that moved around me. The technician told me that they would get very close at times but they wouldn’t touch me. That was a little freaky.
After that was done, they told me I could go home for awhile and come back in a few hours. I went home and ate lunch.
After coming back, they scanned me again and then had me sit in the waiting room and drink a carton of milk (people who didn’t want to drink the milk got peanut butter and crackers). I was told the reason for this was that the radioactive material collects in the gall bladder and eating/drinking something fatty helps to get it out of your system faster.
And that was all. It was a little weird, but it didn’t hurt or anything. I do remember it was quite expensive, though, and I was glad I had good insurance to cover it.
I also like Typo Knig’s description. I had the test about half a year ago. It went generally the same way but different in a few boring details. One thing different from the other posts, though - they worked me a good deal harder on the treadmill than I would have worked myself. I’d be afraid I was going to give myself a heart attack or something, racing uphill that hard, but they were heart experts in a hospital so I figured it was the thing to do.
At age 41yrs 2days, I found myself unable to to the treadmill due to a funky knee problem and shortness of breath. So “no problem” they had an injection which simulates exertion.
I do NOT recommend it. It created sensations that felt so bad that I thought I was dying. It really stressed me out, I kept saying, “Oh, this is bad!” They kept reassuring me that I was not dying. And after five minutes I discovered they were correct. The injection is a 4min deal and by the fifth minute it has been processed and is in the waste stream. So at that point one begins to feel less stressed out.
I believe that is where the name comes from.
So I am going resume exercising and going be nice to my knee so when I have to do this again in 20yrs I actually can. I really need to be in better physical condition.
I have Obstructive Sleep Apnea, really bad OSA, and two years ago I had uncontrolled HBP for about 10-18 mths that created a problem in my pumping station (heart) which at age 40 showed up as odd results on the in-room EKG, 2x! The good news is that I am using a CPAP and it looks like I won’t die in my sleep from OSA in the near future.
So the procedure is really dull and boring if you DO Not opt for the injection. I recommend following the expected procedures. And only opt for the injection if limbs hurt beyond what your regular exercise program creates. I didn’t exercise at all. Due to how the OSA and knee made me feel. But I am working on myself and will soon have an exercise regime in place.
I hope yours is nice and boring in the best way.