Saturday, March 1, 2008

I've Been Ablated!

(Technological wizard that I am I couldn't figure out how to get
this photo from my phone to the computer.
Bonus points to those who figure out how I did it.)

I have been ablated! All went well. I want to thank everyone for their thoughts and prayers! Thank you, thank you! Before my procedure I searched the web for accounts of other people’s experience but didn’t find much. So, I thought I’d recount my experience here.

The night before I had a hard time sleeping and spent a good portion of it tossing and turning; dreaming about cardiac catheters, pace-makers and a sore groin. In retrospect I should have taken a sleep aid. Ah, what I didn’t know. Now I know better.

Anyway, my son had to leave for school early so I got up at 6:30 am to say goodbye. He gave me a big hug and I hassled him about the length of his hair. I didn’t want to worry the kids and was trying to keep things light. My husband took him to school. We got the girls up next and dropped middle daughter off with the promise she could visit me after school. Then off to the hospital for a 9:00 am check-in.

Mine was the second ablation of the day; the first person had to check in at 6:00 am. The hubbie took the four-year-old to the hospital coffee shop while I started paperwork. My insurance was approved at the last minute negating the need for a financial waiver (this is not an inexpensive procedure - I’m expecting the total bill to run around $20,000.00 pre-insurance). After checking in the nurse and I walked to the emergency department with a side trip through the lobby to retrieve the hubbie and daughter. Apparently the ER was close to the catheter lab and they had available gurneys. I got to strip down to nothing but socks and don a lovely hospital gown; and who doesn’t want to walk around the emergency department with no underwear and an open gown? All the better to gawk at you my dear. Fortunately the ER was quiet.

An IV catheter was placed in my arm and my pulses were located on my feet and marked with an ink pen- my daughter got to help with this. They let me keep on my wedding band. Then I answered a series of questions including whether or not I had an advanced directive and if I had a living will - questions which brought tears to my eyes but that I tried to hide for my daughter’s sake. And no, I didn’t have an advanced directive. Thanks to Terry Schiavo this is big hospital talk. But that’s not how I’d like to get my fifteen minutes - pull the plug already! Apparently I should have this in writing.

I also had the privilege of explaining when my last menses was, when the last time was that I had sex and no, I was not pregnant. They asked if I wanted a pregnancy test. No, I said, I was not pregnant. OK - will you sign a waiver? Yes, I’ll sign a waiver. So, you’ll sign this waiver stating you are not pregnant. Yes, I’ll sign the waiver. Okay.

We watched kid shows on public television until the doctor finished with his first procedure. Then it was my turn. At 10:30 am they wheeled me past the main lobby and into the catheter lab. Heeeellllooo every one in the lobby! Do you like my gown? Yes, yes it is quite fetching isn’t it? My family got to spend their remaining wait time with the others in the lobby discussing the fashion choices of the patients or something along those lines.

In the catheter lab I was transfered to another gurney. And who doesn’t want to sit in a room full of people adorned in an open threadbare gown? It’s something akin to dreams of being naked in public only this is real life. The room was cold, really cold. Thank God for the socks. Two large sticky pads (for defibrillation should it be necessary) were placed on my back. A lead mat was placed on the gurney under my abdomen since I was still of childbearing age. No, I was not pregnant. And yes, I did sign a waiver. My gown was pulled up and pulled down leaving a small strip over my belly. Did I mention it was cold? They also taped a small towel (think washcloth) folded into thirds between my legs to provide a modicum of privacy. Um yeah, I’m pretty much already humiliated here. I appreciate the effort but really, at this point who are we kidding? My groin was shaved and scrubbed (my legs are still stained blue). A third large rectangular sticky pad was placed on my chest between my breasts. As the nurse put it, “women have more bumps, this pad doesn’t want to stick.” Finally she managed to adhere it to my chest. Twelve ecg leads were stuck all over my front; on my shoulders, under my boobs, on my belly. Then they pulled out the restraints. My arms were tied at the wrists to the table, as they explained, for my own good. I was not to worry; the restraints were to be removed as soon as I was awake. Although naked and tied to a table in a room full of people I was glad for the restraints. I did not want to be responsible for my sedated self.

And, speaking of sedation, it was finally time for happy drugs. I was given fentanyl and another drug (the name of which I have already forgotten). The doctor came in and the crew started talking about New Belgium Brewing Company. My overnight bag was from New Belgium and had traveled with me to the catheter lab thus sparking the discussion (when your husband is a brewer you come with brewing paraphenalia - even to the hospital).

I became acutely aware of the ceiling. It was a dropped acoustic tile with metal bands. The metal bands were moving. Only there was a spot on one of the bands. Every time the movement got to the spot it stopped. Clearly the sedation was taking effect. I’m grateful I didn’t see babies crawling overhead (can anyone say Trainspotting?). The procedure took nearly three hours yet I only have flashes of memory. I remember the nurse giving me additional sedation. I remember staring at an x-ray picture of my heart with the catheters in it. I remember staring at my ecg. And, I remember the doctor asking, “is she awake?” Then saying, “I think we got it.” They pulled the catheters embedded in the right and left side of my groin which caused some mild discomfort. Then I piped in, “my favorite New Belgium Beer is their 1554 dark ale.” Brilliant. Did I ask about my heart? No. Did I ask about my family? No. I decided to discuss beer. All righty then. They took off the restraints because clearly I was lucent, transferred me to another gurney via a backboard and wheeled me off to the cardiac ward.

Apparently my hubbie and daughter met me in the lobby and walked me up to my room. This I do not remember. The sedation came with a healthy dose of amnesia (in case your could not tell from the account of my procedure). My job for the next four hours was to keep my legs perfectly still. My family went home to rest and I spent the first hour reading a book of which I will have to re-read; can you say amnesia? Then I slept. Once I turned my foot. Nothing catastrophic happened. Periodically people were in and out of the room to check to my groin and vitals. I was wearing a portable cardiac monitor which was feeding info to the nurse’s station. After I woke up I found it entertaining to push the button on my monitor and watch my ecg float past. My resting heart rate was in the 80’s; improved from the 90’s on admittance. The beats appeared to have a normal rate and rhythm. Now, as I write, I am having palpitations but have yet to have another bout of tachycardia (are your fingers crossed?). Palpitations can be normal as the cardiac tissue heals. I wish I still had the monitor on so I could see what my heart was doing.

After four hours I was permitted to get up and move about the room. And what a room I had. It was huge! They could have easily fit four beds in the space. There were floor to ceiling windows with mountain views. The room was painted a soothing light yellow and standard issue nature prints adorned the walls. It felt more like a hotel than hospital. And what does one expect for $20,000.00 a night?

My groin was sore but not nearly as painful as I anticipated. My chest felt fine. On a pain scale of 1 to 10 I’d give the procedure a 2.5; childbirth is an 8.5. I hope to never experience a 10. I was given a percocet for pain but could have easily had just tylenol.

The family came to visit - the hubbie and all three kids. They drew me pictures on the dry erase board in the room, ran about and started fighting over something silly. Ah, back to normal. Finally the hubbie took them home so as not to disturb the other cardiac patients.

After being sedated most of the day and sleeping it off in the afternoon I had trouble falling asleep that night. My doctor prescribed a dose of ambien. I’d never had ambien before. I did not know what to expect. Oh lawdy! Fifteen minutes after taking it I was out; sound sound asleep. I was, however, rousable for periodic checks of my vitals and groin. I haven’t slept that well in a long long time. Hmmmm - makes one think. But I’d also rather not get caught sleep driving...

The next morning, yesterday, I got to go home. No medication needed other than tylenol. There was, is, minimal bruising of my groin. I have some mild discomfort in my chest. I find it is best not to turn upside down. I discovered this while attempting to blow dry my hair yesterday. I think I will stay upright for a few days. Overall I feel great. Yesterday I even managed a slow shuffle around CostCo. I am not supposed to lift heavy objects for 48 hours. But, that’s what husbands are for, right?

On discharge the hospital’s policy is to wheel everyone out. My volunteer wheelchair driver must have been in his eighties. He was sweet and hard of hearing. It felt very strange to have him push me out when I was capable of walking on my own.

Oh, and I didn’t mention it yet because it is hardly worth mentioning. Hospital food is, well, hospital food. Stick with the basics - milkshake, waffle, coffee. (Yup - they let me drink coffee!)

So, that was my experience with cardiac ablation. Only time will tell if it was truly successful. I am happy to answer any questions should anyone be curious.
Happy weekend to you!


Anonymous said...

Thank you! I couldn't agree more--no, there isn't enough first-hand discussion of ablation on the web, and I really appreciate yours. The pain level assessment was an especially welcome detail.
This is a very encouraging story; I hope that it will all work out totally successfully for you. I imagine that the pacemaker in your dream was an indication of your apprehension, since you were getting an ablation, but apparently not getting a pacemaker.
Hope you will find time to report your progress as time goes along.
Questions: You say only Tylenol. Did they discuss Coumadin with you? Or give you reasons for or against using it? And what about using an anti-arrhythmic (or a beta blocker to reduce the rate) if the heart significantly acts up again during the healing process--is either or both of those recommended?
Yes, time will tell--what time frame are they looking at to say that the procedure worked or didn't work?
Thanks again.

Shalet said...

Let's see. They did not discuss coumadin with me. I asked about aspirin and they said it wasn't necessary. I think blood clots are more of a risk with atrial fibrillation and/or flutter. I had AV nodal reentry tachycardia (or garden variety tachycardia as my doctor put it).

I was taking diltiazem prior to the procedure. They told me I could stop my medication. As an asthmatic I can not take beta blockers. I did read of people who continued with their anti-arrhythmics after ablation. It seemed most common with the atrial fibrillation cases.

I am supposed to have a recheck exam in one month. Of course sooner if I am having problems.

Does that help? :o)

Backpacker momma said...

So glad to hear you made it through and my thoughts are on their way to you for a full and healthy recovery. I can't imagine what you went through!

Honorary Indian said...

I am in awe of your detailed account and your ability to remember it all(well, most of it!), type it out, and add bits of humor, as well! What an unbelievable few days you've had!

I was particularly struck by the restraints (I would have gone mad...the happy drugs would have had to come waaayyy before they tied me down). As a former nurse, I'm very familiar with the revealing gowns and how patients don't like them. But, as you can guess, they make things so much easier.

I also was emotional reading about the advance directive...and having to discuss it in front of your daughter. Completely heart-wrenching.

What a great account of your life-saving experience. And, for the record, this blogging-friend in cyberspace was praying for you!!!!

Anonymous said...

Yes, you answered all my questions! Exactly what I wanted to know. Thanks again.

Deeapaulitan said...

I don't think I realized what an oredeal this was going to be, Shalet! OH MY! I'm glad you are recovering well, but what a process to have to recover from! Humiliation and pain! Not to mention the fun, prickly comfort of all the pubic hair regrowth over the next week or two! I think you just achieved hero status in my book!

I'm still praying and well-wishing from Montana...

John said...

glad to hear all went well.
I hadn't heard tell of such a thing as an ablation, and then just yesterday, on one of my shows, there was mention of an ablation. go figure.
You're such a trooper to insist on getting a photo done. Way to go.

jennifer said...

wow, having to have on defib pads... that would freak me out. so glad it went well. what happened with your follow up today????