The biggest threat to dialysis patients is heart disease, typically heart attack. Having been on the unit in the past when a patient has died while on dialysis due to an arrest, it underlines the care we need to take. Part of this is mainly down to fluid gains in between sessions – adding a lot of fluid and then taking it all off in a few short hours stresses the heart – and you could be doing this 3 or more times per week.
It therefore becomes essential your heart is checked regularly for irregularities. I have had the usual round of ECG, Echo and more, as well as stress tests running on a treadmill that steadily inclines and gets tough to use.
This year, my consultant sent me for a MIBI test. This is performed in the Nuclear Medicine department of the hospital, and for me this was at Papworth, the world renowned heart unit. The test is performed over two separate weeks, with a stress test in week one, and stressless test in week two. You are in the hospital no more than 3 hours on each occasion.
The stress test involves having a nuclear isotope injected into a vein, and also a drug that stimulates the heart under stress. The isotope is ok, but the stress drug, for me, was very uncomfortable – but for 6 minutes of discomfort, worth doing to get the results. After the injections and the stress period, you have to eat a fatty meal, and the scan using a gamma camera is done an hour later. The scan takes 15 minutes as the scanner revolves around your body to photograph the heart muscle ‘illuminated’ by the nuclear isotope. At Papworth they also finish off with a 2 minute brain CT scan – I’m assuming the found I had one!
The second test is virtually identical save for the stress drug.
The results are much more accurate and will allow your consultant to see if there are any developing problems.
So, if your consultant suggests you need a heart examination of any type, take it – it might be a wake up call about how you are treating your body in between dialysis sessions.