Tag Archives: heart catheterization

Matters of the Heart, Part 13

Posted on by
Reply

At the end of our last installment we were arriving at the hospital at an early hour to check Ben in for his heart catheterization procedure. It wasn’t his first one, or second, or even third. I think I’ve lost count by now.

But each time I’m nervous. Something about this particular test just makes me a bit antsy. The idea of running a tiny catheter into an artery up into the heart unnerves me, to say the least. I know it’s done all the time, and the doctor doing this one is an expert with it, but still, it’s one of the procedures that just scares me if I think about it.

(After all, I’m the one who almost fainted when I watched our four year old daughter have blood drawn before her tonsillectomy. Didn’t bother her, but it sure did me! And I still can’t watch the nurses start an IV or draw blood! And if it’s on me…..you don’t want to know!)

But I did get to stay back in the prep area with him, and yes, I looked away when the needles appeared. He was calm, and hungry, since he couldn’t eat before the procedure, and just wanted it done and over with!

We hadn’t yet met the doctor who would be doing the cath, and eventually the valve replacement itself, but when he came in to talk to us before the procedure, he instantly gave us a lot of peace, and certainly put my mind at ease, or as much as possible. Dr. T had a wonderful bedside manner, a great personality, and explained everything they were going to do, and why, and the next steps that were involved in getting the valve taken care of.

As long as this procedure showed no blockages of the arteries or other problems, they would need an ultrasound of the carotid arteries, a pulmonary function test to check his lung capacity, a CT scan of his chest and abdomen, and a specialized set of dental X-rays to be sure there was no infection in the mouth or teeth. Fortunately two of those next tests could possibly be done that day, and as long as the cath results were good, he would try to have them scheduled to be done before we left the hospital, which was encouraging. The other two would have to be scheduled probably the following week or so.

After he had reviewed all the results, there would then be a consultation with all of the surgical team that would be involved at the Heart Hospital where the operation would take place. There would be 3-4 surgeons from two different cardiology practices involved, as well as the anesthesiologists, the pulmonologists, nurses, etc. It was enough to make our heads spin… And we would be there as well listening to all this and asking questions as they decided how to best operate on my husband!

Questions?

Yes, a lot of them. But where to start. The biggest one, however, was when this could be done and why we had to go through all of this when everyone knew the valve had to be replaced?!

Quite simply, they have to make sure to determine the best and safest way to do this, especially since he’s had two open heart surgeries before. And you can’t just take him in, open him up, and say “ok, how are we going to do this?”

That makes sense, except when your husband is the one going through it all.

The cath procedure was actually quicker than I anticipated. In fact, we were called back to talk with the doctor probably about 45 minutes after they took him to have it done. Which sort of worried me, especially when we waited in the consultation room for about 15 minutes before the doctor came in. Of course that had something to do with having to wait so long for news from the ablation surgery when we later discovered they’d had trouble stopping the bleeding….

Fortunately that wasn’t the case this time. In fact, as Dr. T told us, the procedure went very well, and from what he saw, Ben was a candidate for the valve replacement by going through the arteries in the groin! Good news!

Because our daughter had arrived after the doctor had talked to us before the procedure, he went through the same basic scenario he’d told Ben and me earlier, except that he was now putting in orders for two of the tests to be done that day if possible, while we were still at the hospital, since Ben would have to be there until at least 1:00. (Catheterization patients are required to stay flat on their backs for 4 hours after the procedure so that the collagen plug used to close the point of entry will stay secure and no bleeding will start.)

Of course he asked if there were any questions, and Ashley being Ashley, she had one very important point to make. “We know he needs the surgery, so you need to get it scheduled as soon as possible. I’m having this baby May 1, so his operation needs to be done now, and he needs to be able to be there that day so he can hold Ryleigh!”

Dr. T just smiled and assured her they’d do what they could to make that happen. but they all wanted the best for her dad, so they’d see what they could do….

And by the way, she wasn’t kidding! Not at all!

Fortunately they were able to do the carotid artery ultrasound shortly thereafter. Since our pregnant daughter was still there they were joking around about checking to see if there was a baby in there, and if it was twins! At least he was still maintaining his sense of humor.

Which continued when he had his pulmonary function test, as he and the technician discussed which wines they liked and what Italian food they wanted for dinner. That test, however, wore him out because of the effort it took for him to take deep breaths and then blow them out quickly. I couldn’t help but wonder how bad those test results were going to be.

Finally, after spending over ten hours at the hospital, we were on our way home. Ben was exhausted, and I was tired as well as stressed. Although we had some hopeful news, we still had to wait for the other two tests, as well as for the doctors to get together and decide what to do and when to do it.

We were still in a holding pattern, and Ben continued to get more exhausted every day, and his shortness of breath slowly increased.

I was anxious and worried, and could only imagine how he felt….

The story continues in Matters of the Heart, Part 14, to be published April 14.

Don’t miss the previous stories in this series:
Matters of the Heart, Part 1
Matters of the Heart, Part 2
Matters of the Heart, Part 3
Matters of the Heart, Part 4
Matters of the Heart, Part 5
Matters of the Heart, Part 6
Matters of the Heart, Part 7
Matters of the Heart, Part 8
Matters of the Heart, Part 9
Matters of the Heart, Part 10
Matters of the Heart, Part 11
Matters of the Heart, Part 12

Matters of the Heart, Part 10

Posted on by
1

If you’ve been following my stories in this series, by now you’re probably wondering when this saga is going to end.

Well, so are we. And I can’t answer that yet. I wish I could.

When you’re dealing with a hurting heart, a damaged heart, you just never know. And when the damage is caused by rheumatic fever at an early age, it just seems the older we get, the more problems which seem to occur.

It’s not easy by any means. It’s very difficult for the patient because they’re the ones going through the physical part, the exhaustion, the procedures, the pain, as well as the emotional stress of wondering when they’ll ever feel normal again.

For the family, it’s a different kind of stress. We worry. We’re anxious. We feel the stress in different ways. These feelings are normal. And as much as we try to hide them from our loved ones, because we don’t want to worry them any more, well, it makes things even harder. We try not to show our stress, but sometimes we just can’t help it.

Waiting to have the cath was like that for us. Surely we could wait the two and a half weeks. It’s not a long time, right? Well in this case, yes it was. We just wanted answers. And for Ben to feel better.

Then we found out those answers weren’t going to be as quick as we’d like.

Because of his history with two previous open heart surgeries, he has what is termed a “hostile chest,” because of the scar tissue and two sets of wires holding his rib cage together. This condition makes a third open heart surgery more troublesome and complicated. More risky.

Therefore, they need to go in through the femoral artery in the groin if at all possible to do the valve replacement to avoid complications, and make it easier on the doctors as well as the patient. But in Ben’s case….nothing is ever simple!

Meeting with his primary cardiologist a week before the cath was scheduled confirmed that. The procedure they were hoping to do is called TAVR, or transcatheter aortic valve replacement. Never heard of it? Neither had we.

Simply put, it involves inserting a catheter with the new valve thru the femoral artery in the groin and replacing the valve that way, without having to open up the chest cavity. In Ben’s case this would be the best way to do the surgery, but he has to be a good candidate for it. And that can only be determined by a series of tests, starting with the heart cath, which looks at not only the valve but the arteries to be sure there is only minimal plaque buildup. If there was too much blockage that would prevent him from being a candidate for the procedure unless the blockage was handled first.

If the cath results were good, he would then need four other tests to be done, all of which would be analyzed in conjunction with the cath results by a team of surgeons to determine if the TAVR would be acceptable in his case.

Four other tests??? How long would that take?

Fortunately those tests are relatively quick and non invasive, but still, there is time involved. There is a pulmonary function (breathing) test, carotid artery ultrasound, a CT scan of the chest and abdomen, and X-rays of the mouth to be sure there are no bacterial infections in his teeth which could lead to that infection going directly to the heart.

Why didn’t we know all of this before? Good question. But nothing is ever simple when dealing with cardiac issues. It seems we learn something new with every doctor visit, every procedure.

The catheterization was scheduled for President’s Day, Monday, February 18. We were so looking forward to that day, getting the results and being able to move forward quickly with the other tests, and hopefully schedule the replacement. Everything was on track. We thought.

Until Ben woke up with a horrible throbbing toothache Saturday morning before the procedure. Of course… And the dentist’s office was closed, of course, and we couldn’t find our dentist’s cell phone number, which we had somewhere. Which meant he was in pain all weekend. I made him call the cardiologist’s office to tell them, and, you guessed it! The cath was cancelled due to the risk of the infection from his abscessed tooth going to his heart. Now he was not only short of breath, and exhausted, but his tooth was throbbing, making it difficult to eat, and giving him a pounding headache.

What next? How much longer would all of this take?

You just can’t make this up, as you will read in Matters of the Heart, Part 11, to be published April 4.

Don’t miss the previous stories in this series:
Matters of the Heart, Part 1
Matters of the Heart, Part 2
Matters of the Heart, Part 3
Matters of the Heart, Part 4
Matters of the Heart, Part 5
Matters of the Heart, Part 6
Matters of the Heart, Part 7
Matters of the Heart, Part 8
Matters of the Heart, Part 9