I have been in Alaska for 9 months. Anchorage is an amazing city, almost as amazing as the state of Alaska. I have never seen a city with so many municipal grounds. The trails in the city are more beautiful than any I've ever seen. I can drive 50 miles to a glacier for a hike, 250 miles to Denali park, surrounding the highest peak in North America (Mt. McKinley). I have pictures of a moose in my backyard. The outdoor activities are all year long. A little snow and ice does not stop Alaskans from living the Big Wild Life.

Why did you choose to work in the invasive cardiology field?
I was in nursing school when my mother had a heart attack. I wanted to understand more. The more I learned, the more I liked the environment. The cath lab offers a more technical aspect of healthcare with the added bonus of instant gratification when an artery is opened and the patient receives quick relief.

Can you describe your role in the cath lab?
I have been in the cath lab since 1989. My role has changed many times over the
years. Currently, I am working as a technologist in a multi-disciplinary lab which includes invasive cardiology, electrophysiology, neuro radiology and interventional radiology. I enjoy the diversity, especially the exciting new venues in neuro radiology treatment options. Cerebral stenting and coiling afford treatments for non-ruptured aneurysms besides surgery. Patients who return for follow-up angiograms express their overall wellness improvement. Some had suffered cerebrovascular accidents (CVA); others, unrelenting, severe headaches. Percutaneous treatments are more desirable than brain surgery when possible.

What is the biggest challenge you see regarding your role in the cath lab?
Times have changed in healthcare. The financial support for education is not as readily available as it has been in the past; however, the technology is more advanced and our roles have broadened. The accomplishment of quality education and training requires everyone to be engaged in communicating and disseminating information, while supporting learning opportunities and adequate new hire orientation. Also, respect for each modality of allied healthcare present in the cath lab is essential. Every discipline has knowledge and expertise to be valued.

What motivates you to continue working in the cath lab?
That's the easiest question of all the PATIENTS!
The human body is a most amazing organism. The methods we practice in healthcare to correct what goes wrong with the organism are also just as amazing. Over the years, I have been fortunate to work with exceptional physicians and have been involved in many interesting cases. The research cases in the time of implantable cardiac defibrillator (ICD) investigations were always filled with firsts. The first pectoral implant was exciting. Stenting a patient's esophagus to maintain an airway until reconstructive surgery could be performed was gratifying. The first left main intervention was tense, but really brought home how far science and safety have come.

What is one of the more bizarre cases you have been involved with?
A patient with tamponade came into the emergency room. When we performed the pericardiocentesis, the fluid was neon green. The patient spent three weeks in the critical care unit with intensive antibiotic therapy.

When work gets stressful and you experience low moments (as we all do), what do you do to help keep your morale high?
1. Humor
2. Choices
Life is all about choices. Most of the time, I feel better if I remember that I have some control. On really bad days, I remember that all days must end, tomorrow is another day, and I am where I am because I choose to be. No one is forcing me to come to work every day.

Are you involved with the Society of Invasive Cardiovascular Professionals (SICP) or other cardiovascular societies?
Yes, I am a member of the SICP. I have been involved with other cardiovascular organizations over the years. Many have come and gone, but SICP has been strong and consistent over time.

Are there websites or texts that you would recommend?
I seem to run across new sites now and then. The vendor sites have new product info and are good for research articles. I have used cathlabdigest.com, eplabdigest.com, theheart.org and cathlab.com, to name a few.

Do you remember participating in your first invasive procedure?
Yes, I felt excited, tense, intrigued and fortunate. It was a percutaneous transluminal coronary angioplasty (PTCA) of the right coronary artery (RCA) with a 8 Fr Simpson balloon at the VA hospital in Gainesville, Florida. After each inflation, we waited 5 minutes and recorded the intra-arterial pressure of the RCA. I think it lasted a little over 4 hours.

If you could send a message back to yourself at the beginning of your career, what advice would you give?
Spend less time in management and more time in lead.

Where do you hope to be in your career when it is time to retire?
I hope to be the best tech I can be, providing the best care for my patients.

Has anyone in particular been helpful to you in your growth as a cardiovascular professional?
Yes, Dr. Robert Feldman, Ty Minnick, Ken Judkins, Dr. Bill Pickens, Dr. Joey Trantham, Dr. Ray Aycock, Dr. Mark Borganelli, Ty Walker, Quint Studer and Dr. Marshall Tolbert have all helped me in my career.

Where do you think the invasive cardiology field is headed in the future?
We will see better patient access and increases in both treatment options and pharmaceutical prevention options.

Cathy Pieper is currently working and living in Anchorage, Alaska. She can be reached at azuresaffron@clearwire.net.