Friday, January 26, 2007

A Day At The Hospital

Yesterday I had to be at West Penn hospital between 6 - 6:30 am to get prepped for the TEE and heart catherizations tests. Tom drove and Mrs. Hyde sat in the backseat. She came along for moral support, so she claims. The TEE was scheduled for 9 am and we didn't understand why we had to be there nearly 3 hours early. Now, I do understand, it's a long process with paperwork and bloodwork.

My veins are small and very deep. I was prodded 3 times without success before the nurses ( I had 2, one on each arm) called the ' IV Team '. I was expecting a minimum of 4 IV experts to come in, but there was only one. She managed to get the IV in my hand on the first try. Not only did she use a rubber tourniquet, but she also wrapped the blood pressure cuff on me, and tightened it. She was good. There's a little trick to not feeling the needle go in - and that's to take in a deep breath right as the needle is inserted, and then to let it out slowly. You barely knew it was there. It's probably a good thing she did it so fast, Mrs. H was getting a little annoyed at the needle prodding and I'd hate to think what she would do if we had to be jabbed once again.
I was given a saline solution because I was a little dehydrated which is not good for a person with Hypertrophic Cardiomyopathy.

Our friend Teddie, who is the head nurse on the 9th floor came down to see me before she went up to her office. She and her husband John, who works with Tom , go to Atlantic City with us every Valentine's week. This will be our fourth year. Yes, Mrs. Hyde also makes this trip, she'd be very upset with me if I left her behind. You'd think she would feel like a fifth wheel, but somehow she doesn't.

At 8:30 I was wheeled in a gurney to the floor where the TEE ( transesophagul echo) is done. More questions were asked, & I had to sign papers for both the TEE and the cath, since I would be moved to that room immediately after the TEE. The cardiac doctor who was performing the TEE was Dr. Raman. I liked her very much. She took the time to explain to me exactly what they were going to do and what to expect. There was another doctor in with her assisting, and one to actually run the echo machine and yet another person to administer the meds that would make me 'comfortable'. I thought that I would be put to sleep, but that wasn't the case. I needed to be fully awake so that I could help 'swallow' the tube and whenever the doctor asked me to bear down and hold, and to breathe deep, hold and breathe again, I was coherent enough to comply. I was given something to relax me. The techie said it was equal to about a glass of wine. LOL little did she know that it takes a full bottle to relax me and Mrs. H.

Before the actual TEE, I was given a regular echocardiogram. Now all of a sudden, there are eight people in the room, most of them cardiologists who have never actually seen a real live Hypertrophic Cardiomyopathy patient. Oh, they've read about us in their medical journals but they've never heard the actual sound of our heart, which is a very loud 'echo' and they took turns listening. You see, HOCM (hypertrophic Obstructive Cardiomyopathy is considered ' rare '. Less than 200,000 people in the US have it. I think Mrs. H. liked that extra attention, it made her feel like a celebrity. Myself, I just wanted to get the test over and done with.
The assisting doctor then told me he was going to spray a numbing anesthetic into my throat. I was to let it sit back there for a count of 10 and then slowly swallow it. It would make inserting the tube easier so they wouldn't have to push it down. Anything to make it easier! Easier said than done. The spray was nasty and as soon as it hit the back of my throat, I gagged and very nearly threw it all up. I swallowed it immediately. Gross. Big mistake, because now, they had to spray me about 4 more times. After the first spray, Mrs. H. took a hike.

Now I'm good and numb and it's time for the tube to be inserted. I'm expecting a tube about the size of an IV tube. Imagine my surprise when this tube turns out to be the size of a freaking garden hose. Mrs. H. was laughing her arse off.

I don't feel the tube, thank God but I'm awake, I hear the doctors talking and see them pointing at my heart on the monitor. They weren't agreeing with each other on some point of the MR ( which later I found out meant mitral regurgitation). Yes, there it is right there, no I don't think that's it, yes it is............... My heart rate must have went up a notch or two because one of the male docs turns to me and says 'don't mind us, this is all just medical jargon, relax now'.

I had to fast from midnight the night before for these tests and when I don't eat, I fill up with gas. Weird I know, but true. I could feel my stomach was bloated and it was hurting. I certainly couldn't belch. I damn well wasn't going to expel it the other way either. I would just suffer in silence.

Then Dr. Raman told me to bear down as if I was having a bowel movement. I do this all the time when I'm having an echo done and sometimes when my cardiologist is just listening to my heart through his scope. But NEVER when I was bloated with gas!!!! omg I was ready to freak out. How embarrassing would that be if 'it' happened in a room full of people. I would be humiliated, I would have to wear a bag over my face for the rest of my life!!!!! Mrs. H was laughing so hard she had tears rolling down her face. Well, I wasn't about to be mortified. I bore down and envisioned a plug holding everything in and it worked out okay. My stomach hurt so bad, that plug would have burst like a champagne cork.

Finally the procedure is finished and the garden hose is removed. My throat is pretty sore and it's hard to swallow. But I'm still alive and my pride is intact.

On to the heart cath lab. My personal cardiologist, Dr. Musselman is doing the procedure. He did my first one too, about 3-4 years ago. He tells me they aren't going to administer any more meds to relax me because the TEE folks gave me plenty. Excuse, glass of wine only whets my whistle. Where's the freaking bottle!!! I know I was 'out' for this procedure the first time, but I was fully awake for this one.

One of the nurses shaves the area in the groin and applies some kind of antiseptic. Dr. M explains that he is going to insert two lines this time.......not just one. eek.

He gives me two shots to numb the area and tells me I will feel some pressure from the line being manuevered into the vein. If I feel anything sharp to let him know and he'd give me another shot. Oh, I felt it alright and got 2 more shots. Same thing happened with the second line. Once I was totally numb though, it was a piece of cake. A few times I felt some palpitations, but he said it was normal. I really can't say that the procedure was 'painful'. Uncomfortable at first maybe, but I believe it's because I was fully awake. The hardest part was having to lie perfectly still. When you are knocked out you aren't moving.
At one point, my throat was really bothering me and I had to cough. I was so afraid if I did that the cath inside me would be jarred and might puncture some important organ, or maybe I'd bleed to death. I started clearing my throat, I could hold still for that. Dr. M asked me if I were okay, and I explained I needed to cough. He said go ahead, and nothing code blues went off. Dr. M announced that my veins were 'beautiful' meaning I had no blockages at all. :-)
One nurse applied pressure to the area after the caths were removed, it felt like she was sitting on me. After about 10 minutes, she was relieved so she could go to lunch and another nurse resumed the pressure. It was a little bit sore down there. But nothing I couldn't handle.

When the cath was finished I was wheeled back up to my room and maneuvered from the gurney onto the hospital bed. The nurses each grabbed an end of the sheet I was laying on and Tom thought they were going to toss me onto the bed, lol. Once I was rolled over a bit, they slid this long plastic 'table' under me and slid me onto the bed. I was told I would have to lie flat on my back for 6 hours, and could not move my right leg at all, nor raise my head. That was to keep the area where I had the cath's in to not bleed. You're talking main artery here.

I had to wait a total of 3 hours after the TEE before I could have anything to eat or drink. They want to make sure the gag reflex is back so the food/drink goes down the right 'pipe'.
A nurse came in with one of those huge swabs and sticks it in the back of my throat and I almost threw up again. It was all good.
She brings me a glass of cranberry juice and a turkey sandwich, applesauce and 4 vanilla wafers. The juice was chilled and felt good on my throat. Mrs. H was disappointed, she thought it was red wine and was pouting when she found out it was only juice. I think she may have a drinking problem.

Have you ever tried to drink or eat while laying flat on your back? It's tricky. Tom had to hold my juice with straw off to the side, and I'd turn my head and take a few sips. Sometimes Tom was distracted and tipped the cup too much and I ended up with a sticky cheek. I was able to eat the sandwich okay, but the tomatoes kept falling off and Tom would have to get them for me. I had some tomato stains on the sheet that was covering me. He also had to feed me the applesauce, I could not manage that on my own. He needs lessons, I got a spoonful up my nose once.

I was still a little hungry and Tom wanted some fries. He was going to go down to the cafeteria and bring some up for us to share. See, I could have fries cuz I was clear!!! woo hoo. Easy though.
When he left, the nurse came it to take my vitals. I thought it would be a good time to use the dreaded bedpan. I had to go sooooo bad and had been holding it far too long. She went and got the bedpan which looked extremely shallow to my thinking. To get it under me, I had to roll over onto my right side without moving that right leg and hold onto the bed rail. She slid the pan under me and it took a while for me to 'go'. Hard to do when someone is standing there waiting. I hated every minute of it. I could feel urine spurting up between my legs, and then the shallow pan was filling and my arse was soaked. GROSS.
She dabbed at me with a paper towel. Dabbed!!! Not wiped. Believe it or not, it does make a difference. And she used the same paper towel that she dabbed between my legs, to dab at the back side. GROSS. I know damned well too, that when I rolled over so she could remove the pan, that some spilled out on my sheet. GROSS. I vowed if I had to go again, I would just hold it until I got home. This was 1:30 pm and Tom was back without the fries, the cafeteria had closed until 4:00 pm.

At 2:00 pm I had to relieve myself again. Didn't help that I was still getting the saline through the IV and I had to keep sipping my juice. I wasn't going to ask for the pan. I wasn't. At 3:30 pm I had to go so bad I could almost taste it. GROSS. I relented and asked for the pan. This time when she got the paper towel I asked her to bring an extra and I made her wipe not dab. I think I may have p****ed her off because my sheet was wet again. Mrs. H was smirking and was glad it was me and not her.

Dr. M came up to see how I was doing, and said that Dr. Haybraun, the head cardiologist surgeon would be coming to talk to us before we left.

Shortly afterwards, he came. He was younger than what we were expecting. I don't know why, but we pictured this guy in his late 60's with white hair and glasses and a little paunch.
Dr. H wasn't bad looking, perhaps in his mid 40's and not at all paunchy. But he's a fast talker. Sounds like one of those auctioneers. You really had to strain to listen to what he was saying and we missed quite a bit. We know he said I'm going to have some valve work done. He said he would rather not replace the valve with a prosthetic because I would then need to be on a medication called coumedin for the rest of my life, and he wanted to avoid that. He was talking about repairing the valve. The valve is almost closed. It's not letting the outflow blood completely out, and it's flowing back in, called mitral regurgitation.
He mentioned myectomy which is what I thought all these tests were preparing me for. But I don't know if he was saying I would have it or I wouldn't be having it. It was confusing.
He did say that he wanted me to schedule surgery in the next few weeks. My grandbaby's baptism is on Feb. 4th, her older sister's 7th birthday is on the 9th and Tom and I are leaving for Atlantic City on the 11th, so I asked if the week of the 19th would be alright and he said yes. But he wanted me to have any dental work that I needed done, before the surgery. I guess if I would need anything done after the surgery, I would be at a very high risk for complications like infection. Anytime I've had any kind of dental work done, I needed an antibiotic first because of my heart murmur/condition. All pre-op work would need to be done no more than 2 weeks before surgery as well.
He asked if we had any questions, and both Tom and I did, but just then his beeper went off. It was an emergency and he had to leave right away. He said to call his office on Monday if we had any questions. He hadn't seen the results of the TEE yet, they weren't ready when he came in. So on Monday I'll call and explain that I would like to confirm exactly what type of surgery/ies will be done. In the meantime I'll make my dentist appt.

Teddie stopped in to see me again before she left for home at the end of her shift. She kept asking me if I wouldn't rather cancel our AC trip and have the surgery sooner. He** no!!!!! I will need that trip to relax me some.

At 5:30 a young med. asst. came down to take me for a walk down the hall to make sure I was steady on my feet. Then I was informed it was okay to get dressed and the first thing I did was go the the toilet, aaaaaahhhhh & wash and dry my behind real good. It was 6:30 pm by the time we finally were released.

Tom and I were really hungry so we went to Blinkey's for some hot wings. Tom had a beer and I had a diet Coke. No alcohol for 24 hours. Mrs. H was totally disgusted and went home to pout.
She has informed me that she will be going to Atlantic City with us, but she regrets she won't be able to go along with me to the hospital for my surgery. She is thinking about taking a cruise. I hope her ship sinks.

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