This week, I got a Nuclear Cardiac Scan in preparation for two upcoming surgeries. The test process reminded me of a specific psychological time domain of a patient: the stresses of an invasive diagnostic medical test.
First, there was pre-test stress: the stress of thinking about the mortality risk of the test itself. In my case, I understand both the need for the test, and what it means to have a mortality risk of less than 0.1%, so this stress was minimal. (Holding off of coffee for 24 hours? Well, that was hard!)
Then there is the actual stress of the test itself: There was a small amount of trepidation during the test—after all, I was injected with a medication meant to induce an elevated heart rate—but once again this stress was mild. If anything, I was more curious than worried.
Next came the most difficult part. The one-day wait for the test results: Here’s the “what if” part. What if I need a heart catheterization? What if I had an undiagnosed heart attack? What if it shows extensive disease? What if, what if, what if. Here being a doctor doesn’t help, because I do understand how the results of a functional heart test can in one moment dramatically change an individual and a family’s future. Knowledge + Creativity is a dangerous weapon while worrying.
Finally, there is the stress after the test: dealing with the results. In my case not bad news—no evidence of ischemia (heart disease)—but still some work to do on my general health and conditioning with diet and exercise. This type of stress (for me) is a healthy stress, more motivational than worry.
Anyway, stress has nuance. it comes in many flavors. Something to keep in mind as both a physician and a patient.