Yesterday was an interesting day. I interviewed about 12 students who are about to finish their Echocardiography program at Lone Star College. We are expanding our services to include Echo exams because many schools are fine with ECG screening but others want Echo included. We recently purchased some portable Echo machines and need someone to operate them. It is relatively easy to train someone how to perform an ECG. Where to put the electrodes is the most difficult part but once you do a few hundred you get what is important and what is not. While I was on the operating table last week being hooked up for multiple ECGs, I talked to the nurse about placement of the electrodes. It turns out that their placement is critical and they need to think of things like having monitors for one doctor, monitors for another doctor, and a potential third for emergency situations. We had a long discussion on the placement of the V1 and V2 electrodes. It turns out that the placement of V3-V6 is not as critical as long as you get separation and coverage of the heart. The V1 and V2 placement is a little more critical when a metal object will be inserted into the heart from a vein in the groin area.
When I tried to engage the Echo students about ECG placement, many of them had no clue because they have seen the procedure done but have never done it themselves. It made me realize how specialized we are all becoming and don't understand the basic concepts of everything. I understand a little more about IV placement and why you don't want to re-insert an IV into the same area the next day. I had trouble talking the students lingo when describing the views that we are looking for and realized that I know the term injection fraction but don't know how to measure it. I was able to explain that we are primarily looking for wall thickness and valve structure with an Echo. I could also explain that the medical industry is significantly divided when it comes to what diseases you can find with ECG and what you can find with Echo. What most doctors agree on is that you can catch cardiac disease with screening. Most agree that ECG is a good tool for looking at LongQT and arrhythmias. Echo is the tool to look at wall thickness. Both are good at looking at Brugada Syndrome.
What surprised me most about having an ablation done is how easy the recovery time was. I had the surgery on Friday and Sunday morning I was walking the neighborhood. I went for a bike ride on Tuesday (just to the store to see how it felt) and am ready for a more challenging ride. I now understand why an athlete is ready to get back into the game and start training for the next event. The surgery is complex but low impact on the body. There wasn't a large scar that I had to put a new bandage on every day. I can barely find there the incision was and do not have lingering effects of muscle ache from the surgery. I do have two large bruises that I got from injections of blood thinner but these will go away in time.
I am convinced that screening is something that everyone should do. Early detection is the key to simple treatment. I keep playing different scenarios in my head about alternative outcomes and early screening with preventative surgery is the best case option I can think of. I will summarize the cost of screening and treatment in later weeks as bills come in and help me document my experience.
Our next screening events are at the end of July as football players start returning to campus for summer workouts. As my son starts swimming for his new school I will as a parent pressure the coaches to screen their students. Given that swimming is one of the high risk sports I will work to educate the coaches on the risks and how easy it is to screen to avoid them. My advice is to call your athletic director or head coach and ask why they are not offering screening to their students and parents. It does not cost the district anything and parents can choose to participate or not. Not offering it is admitting that it is not something important and the medical community admits that it is something worthy of looking for but disagrees on the cost of looking and what tests are needed.
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