Thursday, March 31, 2016

What is it like having a TEE and cardiac catheterization?

So, I’m SURE you’re just dying to know what it’s like having a transesophageal echocardiogram (TEE) and a cardiac catheterization all in the same day!

Mom and I got to the hospital at 9 a.m. and were promptly ushered to the waiting area, where the wait was maybe around five minutes. A lovely woman, Renee, was at the cath lab concierge desk (yes, that’s a thing) and was wonderful and calming. I was shipped back to a corner suite where I was informed the TEE would be taking place, and afterwards I would be hauled down the hallway to the cath lab. I changed into my always stunning green hospital gown and skid-free socks and cuddled up under warm blankets due to the frigid atmosphere of the room. Roxy the Oxygen Tank was replaced by wall oxygen, and I was fitted for my very own capnography cannula. Try talking with a spoon over your mouth and you’ll get the general idea of what that’s like.

I informed the RN that I was happy to receive an IV into my right arm, but IVs into my left arm usually didn’t turn out that great with fainting and weird results and things. She skipped off to consult with the MD that would be performing this procedure after I explained my funky anatomy to her in great depth. (It turns out that the MD had already called the MD who read my original CT angiogram to confer as to exactly what the hell was going on with me. #Mutant) So, I had an IV in each arm and an itchy nose. Naturally. I also was given Valium and Benadryl. I felt a bit mellow, but that’s about it.

The MD who was doing the TEE came in, and was full of good energy and evidently very excited to be on my case. He showed the CT video to the two nurses who were in the room. One RN hooked up a double syringe to my right arm which held the magic meds, Fentanyl and Versed. They helped roll me onto my left side, gave me a lovely pink bite block (to protect the doc, they said) and injected me with the medications.

All I remember after that was what seemed to be a twirling black Rubik’s cube heading directly down my throat. As I write this, two days later, it still feels like my esophagus is pouting in a dark corner, and pudding and cold drinks are about all that feel okay going down that pipe.

For my ACLS folks out there, this might amuse you. When I woke up, I was smilingly informed by my nurse that I had questioned the MD at great length as to what his favorite color was, as that would be their key to know if I’d had enough Versed. (For synchronized cardioversion during heart issues, patients are usually sedated to the extent that they can’t remember an answer to a simple question.) He told me “blue,” and apparently I answered him correctly when he quizzed me later on. I have no recollection of any of this.

I was also informed that they had to give me almost double the medications needed because I just wouldn’t “go out.” That’s normal for me. Takes the pharmacy and a half to get me comfortable and allow tubes to go places without me going all velociraptor on people.

I remember waking up somewhere in the cath lab, looking at a monitor, and telling the second doc that I was doing fine. I bemusedly watched the majority of this procedure, fading in and out. I always liked watching the contrast going through vessels when I was able to participate in the cath lab in nursing school. Now it was my vessels they were scrutinizing, and I had a great view. The only time I was really uncomfortable was when they did the radial cath on my left arm which was quite painful and they seemed surprised when I cried out. I was given even more Fentanyl and was okay after that. I didn’t feel anything else. I heard the words “wedge” and “stenosis” and “holy shit” a few times. Turns out that my single left pulmonary vein is dangerously narrow, and will have to be stented no matter what.

I remember having pressure put on my arm and groin by a young man after the sheaths were removed. I remember Mom and Dad coming into the recovery area, and I asked Dad how his lunch went. I vaguely remember going up to the short stay room and engaging in enthusiastic conversation with my nurse up there. I dozed off and on, and dove into my dinner plate when it arrived since I hadn’t eaten anything in almost 24 hours. It was salty but delicious chicken stir fry and the bread with it was probably the best thing in the world. The five hours flew by that I had to remain on my back, and some back discomfort was all that I noticed. I didn’t need pain medications for that as I knew it would go away once I could stand up. Being able to walk after hours of lying down is a lovely thing.

We finally arrived back at the parents’ house at around 10:30 p.m. and I fell asleep quickly again. It has taken until today for my brain to feel clear(ish) from the medications. I slept the majority of yesterday and all of last night, and even had a nap today. I removed the dressings and was surprised at how sore the two puncture sites are but have assessed them and they appear normal.

The MD team are going to confer as to what the next steps are. There seemed to be some question as to the “bridge” that was mentioned by the cardiothoracic surgeon, meaning that nobody else saw a bridge. I’m not sure as to what the next few weeks will bring, but I was told that it would take about that much time for them to get their plans thought out. At least we’re through this part and on the path to something or other. Right?


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