I had an appointment at 7am today for a right heart catheterization. I have a nasty history with this procedure. Basically, what it does is measure the pressure of the pulmonary artery and whether or not the Tricuspid valve between the right atrium and right ventricle is working properly.
There are a few different ways they can do this. There's the Femoral artery (the groin), the Radial artery (the wrist/forearm), and the Aortic artery (the jugular). The forearm was out for me because my arms are so scarred up from years of pokes and PICCs. The Femoral is less ideal because I would have to be kept at the hospital lying flat for four hours after the procedure. So, that left me with my neck.
A little history: I had this procedure done in August 1999 as part of a 5-day transplant evaluation at the U of M, Minneapolis. I did not live in Mpls at the time, so I had driven myself to the cities and stayed at a hotel by myself, all while riding a shuttle to and from the hospital for tests for five days straight. They literally saved the worst thing for last. On the fifth day, the only thing I had to do was a heart cath. I had never had one of these done before, so I didn't know what I was in for.
Everyone knows I used to be a singer. My throat is VERY valuable to me at this time. Most people also know about my claustrophobia. So, I found myself on a metal table, head turned to the left, with a MASSIVE metal X-ray "disc" smashing down on my face. Then, a doctor who apparently had very little patience that day, was attempting to access my jugular with a fairly large needle. It took him FOUR punctures to get it in. Granted, the jugular is basically wrapped in fibrin and difficult to stab.
They didn't give me any sort of anesthesia, due to it dropping the blood pressure and them getting inaccurate readings. So, what they do is inject Lidocaine as a local. It may numb it a bit, but you can still feel pressure. I then start having a small panic attack and tell him that it feels like he is stabbing my throat. I asked him a few times if he was stabbing my throat. At one point, I was beginning to sob and he then proceeds to YELL at me that "it's not in your damned throat, just calm down."
At which point, I'm freaking out internally and holding my breath as much as possible, and thankfully, he had finally accessed the vein and they were getting readings.
Afterwards, I had to do some blood work. I went and they took about a pint of blood from me, gave me apple juice and graham crackers and a foot in ass out the door. I could hardly stand while waiting for the shuttle to pick me up. By the time I got back to my hotel room, I called my father and he could barely recognize my voice through the uncontrollable sobbing. It was not a very fun day. I was in a strange city, by myself, I knew NOBODY there, and my nearest family were 4 hours away.
So, back to today. I'm already freaking out in the waiting room and I haven't even seen a nurse yet. I tried to maintain composure enough to change into a gown and get an IV placed while going through my med list. Then I start getting anxious. My hands start fidgeting and my breathing gets shallow. One of the attendings came over and introduced himself as Ziggy. He was pretty nice. He tried to calm me, gave me a half milligram of Atavan (which didn't do shit), and asked me what I wanted to listen to in the procedure room. I told him Johnny Cash. :)
I had little bouts of freaking out that would come and go. Then, it was go time. They had sterilized the area around my neck and had placed a cloth over part of my right cheek. The Dr. came in and at this point, I'm back to fidgeting and shallow breathing. I think I was mostly upset because nobody was talking to me, telling me what was happening. All I got was "Okay Eyva, this is just the Lidocaine injection."
In my mind, there were quite a few steps that they had forgotten to tell me. So, it was like I'm laying there and they are setting up, and then BAM! There's a freaking needle in my neck.
The very second he started injecting that burning, stinging nightmare that is Lidocaine, I lost my shit. My heart rate jumped up about 30 beats, I was doing some sort of scream/wail combination, and my chest was heaving. When that happened, I think it kinda freaked the Dr. out because he's nervously telling me that I have to calm down and try to breathe normally and try to stop heaving. Yeah. Good luck with that.
The danger was that he still had the needle in my neck and there is a risk of puncturing the upper lobe of the lung. Since I was in a full on panic attack, there was nothing he or I could do, so he had to attempt to pull the needle out with the hopes that I wouldn't heave and shove it back in.
People came in and tried to calm me, but then I heard them say that they were cancelling the procedure altogether. Second wave of losing my shit ensues.
In my mind, I was convinced that my transplant eval was hinged on this procedure, and that if they couldn't do this, they would refuse to list me. I'm not sure if I had one long panic attack with a slight intermission, or two panic attacks where the first one was just a preview of the second disaster that was to come.
Thankfully, they were able to call the trans. doc and tell her the situation. She agreed to just let me get a contrast ECHO and they would determine from the ECHO whether they think I really need to get a heart cath. I wish they would have told me the options before. I think that my fear of this procedure was a bit underestimated.
I'm not saying that anyone was at fault, I think they just wanted to spare me from having to do more than one test, which is common sense. I just wish that there had been a dialog before hand and maybe I could have been given a choice.
Anyhow, Mark and Luna had been in the waiting room the whole time. After we left the hospital, I got to go get doughnuts. :) We were both pretty starving, but Mark was able to get something to eat at the hospital. I wasn't allowed any food since midnight, so I was STARVING by the time we got home around 12 noon.
As I have been sitting here tonight, I started emotionally processing what happened today. I began to feel ashamed that I'm no longer the "tough girl" I used to be. I remember laying there on the table and imagining my dad standing there, holding my hand and being like "it's okay baby, you can do this. You gotta suck it up and keep going." Even that didn't help. I guess I just feel like that stone wall that's been hacked at and hacked at for so long that it's finally crumbling.
I hope that the ECHO comes out okay. I hope that I don't have to go through any more nasty procedures. I just want this part to be over with so that I can just be on the list and be happily (nervously, anxiously, excitedly) waiting for my miracle.
Jesus, if I have a panic attack at a heart cath, I'll probably just pass out when I get "the call".
Until next time....