Nerdvana

Ohhhh……Colors:

On December 17th @ 2 pm I had a date with a Siemens SOMATOM Force CT Scanner at Stanford's Palo Alto imaging center. That is the only location with the Force CT in Stanford's system and is where all of Dr. Schnittger's pre-op bridge patients go to get their bridges mapped.

The first, and most impressive, aspect of the clinic was hands down the staff. Everyone was very polite and focused on making what could be an intimidating experience really easy going. Lots of smiles and even a pair of warm socks to go with the typically flattering hospital gown. (Since the Sedona attack I have been significantly less tolerant of cold than I used to be so the socks were extra welcome)

Set-up for the test was pretty minimal. Some questions, an IV, ECG, and that was about it. As we were finishing up the prep work the tech mentioned that just before the scan I needed to take a nitroglycerine tablet to dilate the blood vessels in my heart – crap. After that little bit of fun news it was off to the scanner room.

The scanner itself was one of the coolest machines I have gotten to experience on this journey. I have had one CT scan myself, years ago. I have also been with my daughter for some of hers (both NICU and post NICU as she has no functional sense of self preservation). My experience of these machines is that they are really cool and useful but I would never have described them as "friendly" or "patient oriented" in any way.

The scanner I was facing this day however was very different from ones I had seen in the past.

First, it was physically very impressive. Larger than any previous scanner I had seen as it almost completely filled yet another really cold room. But, the most interesting aspect of the machine (from the perspective of the person that is going to get inserted into it) was the lighting. It has LED "mood" lighting inside the tunnel. So as your laying there the tunnel is softly cycling through the colors of the rainbow. It really is a cool effect; and, it makes for a nice distraction.

After getting up on the table and getting situated the nurse gave me…breathing lessons. The machine is really impressive in that it can create a full 3d scan of a beating heart. However, there clearly are some limits. Your pulse needs to be less than 60. (NP for me - especially with the beta blockers I have been taking since Sedona.) Plus, you can't breathe while the scan is running. I guess a beating heart with moving lungs are just too much for the computer. So after I proved I could hold my breath on command, at the right lung inflation, it was Nitroglycerine time…OW…but at least the headache only lasted for about 15 - 20 mins.

Then the scan: the main mechanism started up and maintained a much softer whirring than I expected (think medium-ish room fan), some sliding around of the table, a couple of commands to stop / start breathing, contrast injection, and I was done. Easy.

Back to the room for a granola bar and some orange juice provided by the staff. Which was nice since I had not eaten since midnight the night before.

Stanford has the ability after an automated scan like this to burn the scan data onto a CD.  I decided to hang out for an extra 15 mins while they burned one. It was harder to find a machine with a drive to read the thing than it was to get the CD.

The result was absolutely nerd-tastic: I now have a 256 pixel x 256 pixel 3d image of my heart. (Plus a few hundred .8mm slices)

These images do sorta show the bridges but not very clearly. At issue is that the software that creates the 3d image is not intended to render bridges. The problem: the heart is covered by a layer of fat and encased in a sort of fibrous sack called the pericardium. Because the purpose of the software is to show the arteries it tries to ignore the things that cover them, like the pericardium and the layer of fat. This means it often mistakes the muscle of a bridge for fat / pericardium and does not render it. 

But, you can clearly see the bridges in the individual slices.  

(And, yes, I posted the 3d renders just because I think they are cool)