Flat-lining a Force Test

I had chance to tell this tale to some people when we were in England recently, so you are allowed to skip this post if and when you realise you have heard the story already! For those who have not yet heard the story let me preface the tale with an assurance that I am perfectly alright, thanks – so don’t worry about me! In fact the cardiologist said I would probably live to be 100… but I am getting ahead of myself….

About six months ago, I guess, just as I was going to sleep one night I had a pain in my left arm at the same time as I felt an unusual heartbeat. Both the pain and the unusual heartbeat lasted about half an hour and then I began to relax and eventually got off to sleep. So…what would YOU think? I wondered, of course, whether I had had a mild “heart attack” – well, wouldn’t you?

If I had, it wasn’t serious because I woke up the next morning…. But we thought it would be best to check things out. Now that I am in Brazil I have taken out health insurance, which I find galling for two reasons, the first of which is that for my age it is, of course, very expensive. The second is that it runs against my Liberal principles, because it leads to a two tier health service and I am a firm believer in a good National health service and would like to be able to rely on such in my ill health.

Unfortunately, Fatima’s previous husband did just that on the basis that he could always go home to England for the British NHS to look after him if he became ill. The problem was, however, that he became ill and was then too ill to travel and had to go into hospital here. Since he had money to pay, Fatima decided to use it to ensure he had the best health care possible, of course. But it was incredibly expensive, since he had to be in hospital for several months and at one point needed intensive care.

It was scary for me, discovering how much all of this cost and the tales that go with that make my investment in health care well worth it, overcoming my first objection. In fact, I have probably already had my money’s worth on the insurance payments… but back to that story in a moment.

The problem is, I am still left with some guilt at my selfishness with respect to the second – polemic – objection. But I am learning to live with that until the Brazilian Health service begins to catch up with the UK experience! Over a year ago, before I had health insurance, I felt unwell one day – probably high blood pressure was the cause, we thought, but we decided it would be better to go and check it out at the local hospital, about quarter of an hour by car from home.

Well, I didn’t have to queue for too long (but Fatima thought that may be because I am a ‘foreigner’ and foreigners seem to get treated with a greater sense of urgency, in order for Brazilian health system not to get a ‘bad name’) When it was my turn to have my blood pressure taken I was ushered into a “treatment room” with about ten or so reasonably comfortable, though quite worn, reclining, armchairs, all but one occupied and several with an accompanying relative nearby on a hard seat, holding her, or his hand, or just looking concerned, as relatives will, with their ill loved ones. There were two or three like me, with probably not much wrong with us, ranging through to a couple of ladies – one quite elderly, one much younger, who seemed to be in considerable difficulty with pain or distress and a young teenage girl who probably had a migraine, or similar.

It wasn’t a large room by any means and you could not walk through it in a straight line without having to avoid outstretched legs or mobile bits of equipment or accompanying relatives. There was a none-too-clean toilet at one end of the room for patients or relatives and the décor was, at best, patched up (to put it kindly) There were, too, several blood spatters/drops on the floor which no-one seemed concerned to clean up…. It was all rather unhealthy looking!

There were two nurses for us all, and there was a modest turnover of ‘patients’ in the 90 minutes or so I was there, so all the seats were pretty much in use all the time I was observing. It has to be said that one of the nurses seemed to be bullying most of the patients at one time or another, though she said nothing to me – but probably only because I was English? I could not understand her words, only her manner, but Fatima confirmed to me that she was very rude to several of the inmates of the room, including the elderly lady who was obviously in considerable distress.

Anyway, forgive me, I have got distracted from my REAL story by trying to justify to myself my paying for health insurance!! The real focus of this story relates to one of the tests I had to undergo, having told my cardiologist of my worrying pain and heart ‘flutters’. (I was really not too worried because I had had such flutters many years ago and my English doc told me it was ‘arrhythmia’ and nothing too much to worry about.)

And they have recurred occasionally since… but then there was that pain in the left arm as well…!?…  So, I was set a battery of tests; blood tests, ECGs, eco-dopplers, ultrasound…and so on. The last of which was to be a “Force Test”. (They force you to work hard and watch your heartbeat etc!) Fatima, concerned about her blood pressure, too, kept me company with many similar tests including the Force Test.

The Force Test…

The day of the force test arrived and we had to take gym shoes and a change of clothes for when we got sweaty doing all the running on the ‘treadmill’! We duly got changed and Fatima went in first, and as I was changing I could hear her pounding along the treadmill for what seemed an age before it was my turn to be invited in to the test room. Fatima, not seeming out of breath, it has to be said (well, only a little bit), stayed in the room to translate for us.

The first thing was that I had to sign a bit of paper, formally agreeing to the test. Turns out that it was a waiver, saying I accepted the risks inherent in the test because just occasionally someone dies on the treadmill…. Only about one in ten thousand, so the risk is small!! The doc smiled and told me not to worry!

“OK, so we will start the test Mr Melton, start by walking quite quickly then I will speed the machine up until you are running, then incline it a little so you are running uphill, then we will go faster and more uphill and so on – as much as you can take please… we need to get your heart beating fast to see how it goes and to see how it recovers from the exercise.”… all of this in Portuguese of course… and so we begin…

Now, before I can continue with this tale, I have to tell you another little tale about my knees, so, if you will forgive me briefly I will take you back nearly forty years to a time I was playing with my nieces in my father’s front garden. They had a big orange blow-up ‘thing’… you know; one of those things with handles on that you sit on and bounce around on, forgotten the name of it again…!

So, I was sitting on it and bouncing….  It was blown up sufficiently for children only and would have needed much more air for an adult and so, on one “bounce” it sort-of-wasn’t-there and I ended up bouncing on my knee joints instead, which tore something with an audible tearing sound…. Leaving me rolling around on the lawn in pain, my nieces giggling at my antics, thinking I was joking around (you know I have forgiven you years ago, girls, honestly!!) … until I managed to persuade them to fetch an adult because it was hurting.

Well, it didn’t seem bad enough to go to hospital at the time but it was definitely uncomfortable for a few days and ever since my knees have ached if I have to sit in a confined space without being able to move them about a bit. Anyway…that, briefly, is the tale about my knees, so back to the Force Test…

So, I was doing OK and had run quite a distance but I was conscious of my knees getting to the stage where they were beginning to hurt. So I said, in typical English understatement, “My knees are beginning to ache a little.” Which would have been enough of a comment in English circumstances to have started a little chain of comments between doctor and patient, the doctor saying “well, we can stop the test if you think you need to” and me saying, “Yes, we’d probably better stop, soon….well… probably now, please!”

Just by the way, my heart was OK and I could have gone on quite a bit longer from that point of view… it was just my knees… and they were beginning to hurt quite a lot, quite quickly, on an exponential scale in fact!!

Unfortunately Fatima did not recognise my “typical English understatement” as such and just thought I was having a bit of a grumble and she did not choose to pass on this remark to the doctor who was sitting in the corner of the room glued to his piece of machinery, racking up the speed and raising the angle of the treadmill and watching all the lines scratching over the screen showing how my heart was beating from the dozen or so electronic tabs he had attached to my chest and abdomen.

Thus, the doctor remained unaware of my aching knees and, for whatever reason, I did not have the presence of mind to simply say “STOP!”…for I was still in “typical English understatement” mode and didn’t want to spoil the monitoring of my heart – which was beating really well, thanks. So, my brain started quickly working on a plan to save my knees from collapsing. My first thought was to jump both feet sideways so they would be perched on the unmoving rims of the treadmill but I thought that would require a degree of athleticism I was not sure I possessed and may result in broken ankles or worse.

Since the knees were beginning to REALLY hurt quite a lot by this time, any presence of mind I might have retained slipped away quite quickly, and I decided I would simply have to dismount the treadmill at the rear whilst it was still in motion. Risky manoeuvre but less risky than the two footed-sideways hop.

So, that’s what I decided upon, and, although the dismount was a little “inelegant”, it was largely successful, since I remained almost upright, though hanging onto the rails of the treadmill. Fatima, through her laughter, will tell you differently, however, and claim that I had fallen over but it is simply not true – I wasn’t on my knees, nor was my face close to the treadmill, still going around, of course – I was ‘almost upright’, honestly!

BUT…and it is quite a significant BUT… what I had not allowed for in my hasty dismounting calculations was that all of the wires attached to my chest were somewhat shorter than the length of the treadmill and in dismounting they had gone “PING, PING…Ping, ping, ping ping…..ping” and all quickly become dis-attached from my vital signs. In my attempts to retain a sense of balance this did not seem to me at the time to be of any particular importance, but, to the doctor it was clearly a shock. All of his charts flatlined at the same time and he was, no doubt, worried that I was one of those “one in ten thousand patients” who had died on the treadmill and, as he had said with a smile at the beginning, “…don’t worry, that has never happened here!!”

I will have to give the man his due, however, he recovered very quickly and managed to reattach half a dozen of the wires very quickly to give him a reading of my heart in recovery mode. I have to say it would have been really interesting to get a reading of HIS heartbeats at that point too. Fatima said he had gone quite pale when it happened….although it was something I had not noticed as I was still recovering my balance at the time!

It must have all been OK in the end, however, as the cardiologist said everything was fine and my heart “…looked in good condition…” and I would “…probably live to be a hundred!” although he did start me on “statins” to counteract the overly high cholesterol readings he had before him.

Oh, and by the way, I ran further and more uphill than Fatima did… not too bad, eh, despite the dicky knees!


About Keith Melton - Green Lib Dem

Retired English liberal environmentalist living in Nottinghamshire; spent six years in Brazil. Author of Historical Novel - Captain Cobbler: the Lincolnshire Uprising 1536. Active member of the Green Liberal Democrats - (pressure group in Liberal Democrats) - was Founding Chair of GLD in 1988
This entry was posted in Brazil General, Health Service, Humour, Life..., Politics, Uncategorized and tagged , , . Bookmark the permalink.

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