Tuesday, June 16, 2015

The Procedure - One More Stent

The health care system here can move pretty quickly when it wants to. I saw the cardiologist on Wednesday, May 27th and got a call soon after telling me that I was scheduled for an angiogram in the Cath Lab at our hospital here on Monday, June 15th. I was to visit the hospital for my pre-admission interview on Friday the 12th.

The pre-admission visit went fine. A list of medications and a medical history that should have already been in the computer here were entered. I got a sheet of instructions to follow in preparation for Monday's procedure. I stressed the hernia repair I had forgotten last time around.

Yesterday (Monday), Sandy and I arrived at the admissions section by the appointed 6:30 AM time and took a number. The waiting room was full and I got a bit concerned as they called person after person by name, many of whom had arrived after I did. It turns out those were people who were scheduled for various procedures in different places. They got to the Cath Lab people further down the list.

With my hospital armband on, Sandy and I walked up to the Cath Lab waiting room where we were joined by several other people. I was the only repeat visitor. They took us into the ward area where we took off our clothes and donned the traditional hospital gown and robe. A nurse started an IV line into the back of my hand, doing a much better job than last time around. Then I returned to the waiting room where Sandy and I talked to the other folks.

People were called one by one until it was my turn. I walked into the room and climbed on the table. The nurse, a fellow whose name escapes me at the moment, remembered me from eighteen months ago because they had so much trouble getting the line in the artery in my groin. He added more than the usual amount of Versed into my line to make me extra relaxed while they checked out the arteries. Apparently they couldn't get a good pulse in either side and so I ended up with a line in the brachial artery inside my right elbow. I was so doped that I barely remember the warm flushes as they injected the radioactive dye into my heart.

Last time, this was the point at which Dr. H. told me I'd be getting one stent. Nobody told me anything this time, just that I had a 99% blockage in the same artery as the last time. They also said the previous stent looked clear. Then they wheeled me back to the recovery room. Once there, a nurse explained that the doctor had not been able to visualize the functioning of my aortic valve. It was diagnosed as calcified over a decade ago, although I've had the murmur since I was a teen. She told me that if the function was severely impaired, they wouldn't do a stent. Instead, they would open me up and replace the valve, doing a bypass at the same time.

So the next step was a side trip for an echo-cardiogram. The tech was from Poland and he and I had a rousing political discussion as he developed a sound picture of how my heart was working. Back in the recovery room, I was told that the valve impairment was only moderate and Dr. Ravi, the interventionist, would be along shortly to put in a stent.

Back to the lab and more Versed along with a large shot of Heparin. This anti-coagulant is why they keep you in overnight after a stent. The procedure was done in no time and then I was on my way up to the special ward on 8 North where all the stent people go. On my way out, they gave me the before and after pictures of my heart. Someone did comment that I had an unusually large circumflex artery. I'm not sure if that's something I can brag about.

There's the picture

I spent the night in the ward with pressure on the puncture point after Dr. Ravi removed the line. It was good to have my Kindle to read, something I didn't have last time. I had thought that an arm puncture would be preferable to the groin but you use the arm for so many things that I have changed my mind. Give me the groin any day.

This morning, Dr. Hourtovenko came by and signed me out. The nurses gave me several sheets of instructions to be followed and I was on my way. I'll see my GP in a week where he will check me to make sure I haven't developed a pseudo-aneurysm, which occurs when the arterial puncture does not heal correctly.

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