Some Long Overdue Tests

I’m not a fan of Cardio-Pulmonary exercise tests (CPET). They’re exhausting. Professional athletes regularly enjoy them as part of their training regimes. Keen amateurs pay big bucks to have a go. And Phil would love love love to strap on the probes and push himself really hard. πŸ˜‰ But not me- I’m not a fan. I dread them! Pedaling with dodgy lungs is hard. Pedaling with dodgy lungs, as the resistance increases, whilst covered in wires, wearing a suffocating mask… is incredibly hard. Especially as you can’t stop until you’ve no breathe left! πŸ˜› Since developing Pulmonary Venous Occlusive Disease, they’ve been a yearly treat to monitor how effectively my lungs work during activity. However, one silver lining of Covid, is that all respiratory exams were postponed… until now. After almost a two year hiatus, I have been catching up on some long overdue tests.

As Covid-19 is an airborne virus, it has been unsafe for doctors to carry out tests than monitor respiratory conditions for the past year. Although I’ve had scans and x-rays and prods and pricks; all checks that involve exhaling and inhaling deeply, pushing out air as much as possible, or panting, have been a no-no. As, even when trying to only breathe into the tube or mask, at some point during the procedure, lungs react, or throats tickle… and the patient will inevitably cough and splutter all over the room. Leaving airborne particles floating around! Poor doctor, poor other patients! Particularly if they’d spluttered with coronavirus!

However at the start of this year, when coronavirus tests became more reliable and more readily available, my local hospitals recommenced respiratory tests once again. To ensure that I didn’t have Covid-19, I had to have a PCR test a few days before, and isolate until the appointment. Oxfordshire Hospital Trust had a drive-through coronavirus test centre for for this sole purpose. Cars queued up, answered questions at the first stop, and then were tested further on- kind of like McDonalds, but without the burgers! πŸ˜‰ I have a sensitive gag-reflex, so was worried when the nurse wanted to stick the swab up my nose and throat himself. But amazingly he didn’t make me gag or sneeze or cough, and it was over in twenty seconds! He needs to teach me his technique! For one respiratory appointment, I was able to order a postal PCR test through the government system, as they now have an option for non-symptomatic people at their doctors request. So much quicker! And for all other non-respiratory appointments, I’ve been checking myself weekly with free lateral flow tests.

And it all went well. πŸ™‚ Amazingly, even the CPET wasn’t as horrendous as expected. πŸ˜› The army doctor didn’t shout at me this time, so there were no tears. Instead I had a room full of cheerleaders, as apparently I’m an interesting case study, so had many medical spectators! πŸ˜› Although the CPET is designed to test physical ability, it’s certainly a trial of the head too. It took enormous mental strength to keep calm, continue pedaling and not pull off my mask, when I reached my absolute limit and could not breathe! The lung function tests were over quicker than expected. Even though I’d not done any for almost two years, I remembered what to do, so didn’t need to repeat any. Phew. In the past few months, I’ve also had a chest X-ray, ECG, Echo-cardiogram, an INR self-monitor review, and the Six Minute Walk Test. I did the latter with my face mask on, as was doing it in a hospital corridor. Gees- I could barely breathe! Unsurprisingly, despite being currently functionally strong, I managed much less than normal (380m compared to 460m). So it kinda turned into a test of the affect of facemasks on breathing! πŸ˜‰ I’ve also had face-to-face consultations with my GP and Pulmonary Hypertension team, and phone-call appointments with my transplant and respiratory teams. Back on the treadmill!

And amazingly, wonderfully, thankfully, everything is still looking good. πŸ™‚ My heart is continuing to cope brilliantly despite the two chronic conditions, and looks almost normal. And my lungs seem stable. My TLCO score (how much oxygen my body can extract from my blood) was slightly lower than last time- 34% compared to 38% (a typical 40 year old woman of my size would score 100%). However we’re hoping the variance is due to doing the tests at a different hospital to normal, due to the pandemic. Apparently different machines and rooms and even weather can affect results! (hence why I repeat tests for different teams at different hospitals- as they only trust their own!). Amazingly, the Cardio-Pulmonary Exercise test showed that the amount of air my lungs can hold has slightly increased. And even better, my peak VO2 -the maximum amount of oxygen I use during intense exercise- has increased also (53% compared to 48%). However they also believe that I have a slight decrease in ventilatory efficiency, meaning my body is finding it harder to extract carbon dioxide. Unfortunately we’re not sure how much Co2 I’m retaining, as although they successfully extracted arterial blood before I started pedaling, they couldn’t get any afterwards, despite repeated prodding! Ergo poorly bruised arm! Retaining Co2 is bad news, but I don’t believe there’s anything we can do, so will just continue monitoring it. Physically, I’m feeling great and functioning well. Probably the strongest and healthiest since developing PH eight years ago. I’m able to garden for longer, play energetically with the dogs, and do more jobs and chores than ever before. I even nip up-and-down the dreaded stairs a few times daily! Life is good. πŸ™‚

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