Dr. Hackenbush: [Taking a pulse] Either he’s dead or my watch has stopped.
—A Day at the Races (1937)
No, it’s not a typo.
HANDLS is a long-term medical research project which is being done by the National Institutes of Health and the National Institute on Aging. It stands for “Healthy Aging in Neighborhoods of Diversity Across the Life Span”. (Ooh, look! Web Site!) And, as it happens, I’m a participant in the study. Recently I was given a physical exam as part of the study.
Let me turn back the clock a bit. About two years or so ago, I was approached by the HANDLS field reps. They asked a few questions, I gave a few answers, they took that information back to their office, and Presto! I didn’t qualify for the study.
A few weeks ago I got a call from them: “Do you remember taking a survey, blah blah blah?” I said I did, about two years ago and several miles away. Apparently I was screened out the first time around, but the standards they’d originally set were weeding out too many people, so they recalibrated and both GF and I were screened back in.
The first stage was another field interview. Someone came out and asked a bunch of questions about our health history, everything we’d eaten the day before (“Yeah, but how much salsa was on the chips?” would be a typical question), how much did we make, how long have we lived in thus-and-such location, and so on. We were ready for the next step, which is what happened this week.
GF and I, having fasted since late the night before, made our way to the Bayview Campus of Johns Hopkins, where we immediately got lost looking for the building. (Low blood sugar will affect your cognitive functioning, after all.) The building itself is part of NIH and, as a government building, we needed to be escorted absolutely everywhere. Our first stop was an office where we signed away our lives and gave them all kinds of medical history information: when were we in the Emergency Room last, what did our grandfather die of, etc. Then it was off to…The Trailer. Under escort, of course.
The trailer is fifty feet long and has several rooms in it. My first stop was in the room at the far left (as you see the photo). In there, they took a urine sample and drew no fewer than nine vials of blood. Nine! If I wasn’t anemic going in, I was by then. They also took cheek swabs for DNA testing. After that I was sent to the extreme opposite end of the trailer and my blood pressure, height and weight were measured. Happily, I’ve lost 12 pounds since April 12. At this rate of loss, I’ll be down to my ideal weight by this time next century. Okay, not really, but at this rate it will be about a year or so. Come the Summer of 2010, I’ll be hitting the beaches without fear of rescue workers trying to drag me back into the surf. Woo Hoo! After that, of course, is when they give me my breakfast, a fried egg and sausage patty on a hamburger bun, with a fruit cup on the side and a juice box of Apple. Laissez les bontemps rouler!
At this point I change into a hospital gown and it’s back to the first room, where I’m measured in all kinds of ways, both traditional (waist, hips) and odd (length of arms, length from chin to navel). Then I lie on a table and some clamps are attached to my neck, my wrist and another sensor is placed atop my femoral artery. My blood pressure is taken again (several points lower, ’cause I’m lying down) and these sensors are put into action, apparently measuring my blood flow. Apparently, the sensors can tell how well the blood is flowing by calculating the differences in the timing for my pulse at each location. The closer together they are, the better. Ideally, they should all pulse simultaneously. I don’t know the specifics, but apparently I’ve got pretty good arteries.
Back to the other end and now, I have to undergo something called DEXA Scanning. The unit looks a lot like the picture here, but what you don’t see is that both the scanning arm above and the table below are mobile. Also, since it’s an X-ray machine, the tech runs away while the scanning is going on. So the first thing they do is take my blood pressure (again), then they make me lie on the table and position me for three separate scans. The block under the knees in the photo is for the spinal scan. This gizmo, I’m told, measures bone density. They can also measure fat and muscle in the body. They do a full-body scan, but there are also specific scans for the legs, the hips and the spine. As I mentioned, the scans involve both the scanner arm and the table to move back, forth and from side to side. Freaky!
When the scan is done, I’m hooked up to an electrocardiogram. This takes a little doing, as my chest is hairy and one of the contacts won’t stick right. The tech says, “If this doesn’t work, I may have to tape it down. Unless you want me to just shave that spot, instead.” I tell her, “I’m thinking it’s the same net effect, either way.” But she manages to get good contact and it holds long einough to get a good reading. Those electrodes come off (ouch) and another set goes on. This is apparently an ultrasound of some kind, and they listen to the blood whizzing through my left carotid artery.
The penultimate step in the trailer is in the center room, where I meet with a nurse practitioner. She spends some time looking in my ears, mouth and nose, checking my reflexes all over, taking my blood pressure TWO MORE TIMES–once in each arm–and chastising me for eating Honey Nut Cheerios every morning per doctor’s orders. Her advice runs similar to the Atkins Diet, except it’s called the Caveman Diet or the Paleo(lithic) Diet. She concedes, briefly, that I have lost weight since starting on the Cheerios, so you can’t argue much with results, but still: Caveman Diet. Protein the size of your palm at each meal, and for god’s sake, don’t eat anything white. But I’ll tell you what, if the Honey Nut Cheerios does for me what it’s done for others, I’m not complaining much.
More poking and such, and it’s back to the first room, where I have to do some balancing acts, I have to squeeze a Hydraulic Hand Dynamometer to measure my grip in each hand, and I have to fold my hands across my chest, then stand and sit repeatedly ten times. Naturally, my blood pressure is taken yet again. But I’m done! With that part.
Escorted back into the building and I have to do a computerized survey. Since I have some background in psychology, I can see that the survey wants to know: 1) Am I a racist? 2) Am I depressed? 3) Am I obsessive-compulsive? 4) Am I a potential substance abuser? 5) Do I suffer from excessive anxiety? (answer: No, I rather enjoy my anxiety.)
Next step is to do a neuropsychological exam. This involves orientation to time and place, pattern recognition, memory tests and a few other things. I have to admit at this point that I may not have done well with one of the subtests because the examiner had some very nice cleavage going on and I was a little distracted.
Finally, there’s an interview where I’m asked to expound on some of the medical history stuff we wrote down all the way back at the beginning. Also, have I ever smoked cigarettes? How about cigars? What about marijuana? Ever drank? Done drugs? Ever had VD? Meningitis? Heartbreak of Psoriasis? Shingles?
And then, just like that, we’re done. Here’s a bag lunch, which is basically the Opposite Day version of the Caveman Diet. Of course, “just like that” ran from 8:00 AM until 2:30 PM. We’ll be getting test results in the mail in a few weeks, and we were paid a nice little stipend for our time. Perhaps I’ll take my stipend and buy the Brand Name Cheerios instead of the store brand. Laissez les bontemps rouler!