Friday, August 1, 2014

A Few Things About Cardiac Catheterization I Learned This Week

My mother called last week to say that she had been having some odd back and elbow pains and decided to go to a cardiac doctor to have it checked out. They did a series of tests and the doctor said she had a blockage. He wanted to do a cardiac catheterization aka heart cath to clear it out, and said she would wear a nitro glycerin patch.

When she called to tell me about it, she said it wasn't going to be a big deal and wouldn't take more than a half hour. She didn't want me to drive up there just to drive her home from it, so she had arranged for my cousin to drive her there and back. I didn't really know what a heart cath was and asked some online nurse friends how serious it was and if I should go anyway - although I really didn't need to be away from home just then. They told me to go and I'm glad I did. What I realized after it was all over is that I also should have asked exactly what a heart cath is. Turns out, it wasn't just a procedure to clear the blockage.

It's possible the doctor explained it thoroughly to mom and she only heard "not a problem" and "will clear the blockage" which shows why it is important to have someone with you at the doctor's office, or at least have a tape recorder. It's hard to remember a lot of information, complicated information, especially when the news causes some anxiety.

What I have learned since then is that a heart catheterization, a tube inserted into a blood vessel in the arm or leg and pushed through to the heart, is generally used to show the exact location and amount of plaque in the blockage and to determine the type treatment needed. Most of the time, the cath tube is used again immediately afterward to perform an a balloon angioplasty or stent. If the doctor mentioned that part to mom, she didn't hear it. What she does remember him saying is that if a stent was needed, they would do it in a month because he wasn't licensed to perform stents and his partner, who was licensed, was out of town at the moment, but the stent wasn't necessary because her doctor was going to treat her blockage with a patch.

So bright and early Monday morning, or actually dark and early Monday morning, we drove to her local hospital where they prepped her and left her for a couple of hours before the procedure. When they finally took her in around 7:45, I left the hospital to grab some breakfast. Since she wasn't able to eat breakfast, I skipped it too, although I had taken my morning pills which were now beginning to feel like they were burning a hole in my stomach. Twenty minutes later I was headed back to the hospital when they called and said the doctor wanted to talk to me. Turns out, he found two small blockages, and had given mom the choice of doing the cath over again in a month to put in stents, or send her to Amarillo in an ambulance and do it that day.

By then she just wanted it over, and didn't want to make me come back in a month, so she decided to go to Amarillo. The doctor said they would do it as soon as she got there. Turns out, that part wasn't quite right. They managed to work her in at 7:30 that evening. In the meantime, she had to lay flat on her back, without moving the leg with the catheter in it, and without food or water. By 7:30, her back hurt, she was thirsty, and she was hungry. Another cousin, who lives in Amarillo, came to wait with me. The doctor had said it would take about an hour but it took two hours because one artery was twisted.

After she was back in her room in the CCU, she drank all the water she wanted and my cousin left to get her some scrambled eggs and a cola. With the kind of stent she had, she had to stay flat on her back for only three hours instead of six and then she could sit up. Unfortunately, the food and drink on top of the local anesthesia made her queasy and they wouldn't let her raise her head to throw up. So to add to her misery, her back hurt, she was queasy, and she had vomit down her neck and on the sheets. However, after she was finally allowed to sit up at 12:30 a.m., the nurse changed her clothes, sheets, and gave her a sponge bath.  And then we both finally got to sleep, or doze between nurse visits and beeping machines.

So here are your tips before you or your loved one has a heart cath:
1) Take someone with you to the office visit and write down everything
2) Ask what he will do during the heart cath
3) Ask what he will do if he finds a blockage, and if he doesn't plan on doing something then, find another doctor
4) Ask how long after the heart cath he will do the next procedure so you know how long you have to wait flat on your back
5) Drink sparingly after the procedure, especially if it has been a long time since your last drink, and save the caffeinated beverages for later
6) Eat sparingly also, something mild like a few crackers

But mainly, eat healthy now and avoid this procedure. That said, you want to know what mom wanted to eat immediately after we got back home? A milkshake and hamburger. Ay yi yi.

7 comments:

  1. Wow - so many comments racing through my head! I am just glad it all turned out OK - finally. I would say older (who in the world would I dare call older???) people don't really want to hear all the details. At least I think that is typical of so many folks. Yes - you really should have someone with you at appointments! But then I don't believe she really thought it would be so involved.

    Anyway - prayers to you both,.

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    1. No, she didn't think it would be so involved. I think the brain can only absorb so much when it's under stress and she maxed out somewhere after he said something about angina.

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  2. Glad to hear that your mother's ordeal is over and that she will soon be feeling better.

    Not all heart caths are to find and place stents. I've had four done to determine pulmonary artery pressures. Since the cath is done through an artery (not a vein) is is necessary to lie still to allow the blood to clot. When the procedure has been started and delayed it makes it even more difficult, and my guess is that your Mother has quite a bruise in the pelvis area. Best wishes to your Mom; she is one tough lady!

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    1. You're right, she does! Oh yes, I should have mentioned that heart caths are not just for placing stents; the point I was trying to make is that they are not actually used by themselves to clear blockages as mom believed. Of course, since I don't know any more than I read in 5 minutes on the internet, I shouldn't even have tried to explain it. lol

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  3. I'm glad you could be there for your Mom! And I hope she feels better very soon.

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  4. Frustrating and scary all in one. Hopefully she's feeling much better now.

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  5. It's so good that you went after all ! My goodness what a nightmare for her :(

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