Thursday, September 16, 2010

Down the rabbit hole...again.

So here's how Tuesday went: at the hospital at 6:15. It is, in my opinion, unnatural to leave your house when it's still dark unless there's cows to be milked, wheat to be thrashed, or roosters crowing in the nearby vicinity.  Since I was feeling slightly antsy, I only said that thought out loud once.

Regular hospital blah-di-blah ensued - imagine these events in a quick edit style, ala Scott Pilgrim or Shaun of the Dead:
  • changed into gown
  • placement of acti-tred non-slip socks
  • IV set up (after only two sticks...  yes!)
  • checked and marked for pulses in both feet
  • leads for EKG thingamabobs stuck on
  • blood pressure cuff velcroed
  • heart rate monitor positioned on left pointer finger
The nurse asked me the same ol' questions about medications, allergies, etcetera and before I knew it: 7:30.  Another nurse came over and said, "Are you almost finished?  They want her on the table as close to 7:30 as possible."  Booyah.  Let's make this happen!

Off we went.  I couldn't believe it was happening again, so soon.  Then again I really had no idea back in June what to expect 3 weeks post, much less 3 months.  I just knew I wanted to be fixed.  So there I was, back in the ever-capable hands of my fantastic doctor ready to go for round two.

There was still more prep to be done but the best part was when they gave me fresh oxygen.  That little cannula is an annoying thing to stick in your nose but there's nothing like breathing pure air.  The nurse said my heart rate was up (surprise surprise: neurotic girl in a cath lab) so she pumped in a little sedative before we got started.  Dr. X came in and apologized for not having any access to good music at this hospital.  It was the least of my worries, but I (as always) appreciated the thought.  Once they got a lil more sedative in my blood, the details get a little foggy.  The next thing I remember him saying was, "little pinch..." when he numbed the tiny spot for the incision and before I knew it, it was Innerspace, minus the whole Dennis Quaid flying a spaceship inside my body.  So not really Innerspace.  But you get the point, right?

Just like before, the little pinch was all I felt of the catheter going into my femoral vein...

...and for the most part it was the same game, different day.  For the most part.  Remember how I mentioned before that he saw a blockage in my sigmoid sinus, just inside my skull, in my MRV in July?  Well, there's a reason they call venograms "the gold standard", because once he got inside my head and took a good look:  nothing.  I'm thankful for that.  Mainly because I could feel the catheter up inside my noggin and it was not a good feeling.  If he'd seen something that needed to be fixed, of course I would have wanted them to fix it.  I say "them" because I vaguely remember meeting Dr. Y (the neurointerventional radiologist) in the cath lab too.  It's not like we could shake hands or anything - I was swaddled in blankets and sterile cloths.  So I gave him a head nod and as his services were no longer required (sigh of relief) he went on about his day.

What did he find in my silver veins?  No restenosis - so none of the areas he treated in June had closed back up, even a little bit.  He did find three new areas to treat: "incompletely treated stenosis now completely treated" as he put it.  Both valves at the bases of my right and left jugulars were stenosed/malformed and he found a web in my azygous vein - all ballooned; no stents required.

The balloons were a bit bigger than what he used the first time- almost twice as big.  It was uncomfortable the first time - just a build up of pressure.  This time?  From what I can recall during my dopey state of mind... it hurt. So much so that even in the state I was in I tried my best to communicate it.  But I couldn't even get an "ow" out.  It was like a sad, gutteral grunt - something like, "urggghhh...".  I guess I got my point across because they dialed up the Fentanyl with a quickness and I settled back in to la la land in no time.

I remember asking him how it went and if he checked my iliac vein for May-Thurner's.  He said yes he did and it looked normal.  Then I remember him saying something about my azygous and "significant improvement".  But let's remember: those drugs were dancing through my body and to say my recall is vague would be an understatement.  I kinda wish I was a bit tougher and could've been more awake - and this report wouldn't be so hazy.  Chalk it up to Chicken Little (yes, that would be me).  No, the sky wasn't falling; but there were 18 mm balloons inflated inside my jugular veins.  Ouchie.  Cut me some freaking slack.

Once I was all sewn up (no stitches, just more Dermabond), they wheeled me to recovery.  I slept and then I heard Keith asking me how I was feeling.  How was I feeling?  Sore.  And sleepy.  That pretty much summed it up.  Just like last time: no "on the table" miracles to report.  That's okay, though. 

Keith did show me some pictures - Dr. X printed them out before he went to talk to him (yes, my doctor is that awesome) - complete with arrows pointing to what he'd fixed, each page labeled "before" and "after".  Dr. X told Keith he felt really good about it and that he was really pleased with the results.  He warned Keith that I would have a nasty headache the next day but that he thought I should see "significant improvement" - there's that phrase again.  He also said he wanted to talk to both of us when I was a little more... with it.

So I slept.  And I slept some more.  And then, just when recovery was going smoothly, I had to pee.  They wheeled me over to the bathroom and though I got up slowly I guess it wasn't slow enough.  I've never passed out before but I'm guessing that's what it would feel like - heavy limbed but Stretch Armstrong-y at the same time.  Then I broke out into a cold sweat.  ugh.  I avoided puking (though just barely) and got a hefty dose of Zofran which made me sleepy on top of sleepy.

I was moved from a recovery bed to a recovery recliner.  We hung out for awhile and waited for my body to chill.  And I was still hoping to speak to Dr. X before we left.  I think the nurses were ready to shuffle me out and make room for another patient because at one point they just said, "Well if the doctor has already spoken to your husband I don't think you need to wait to speak to him." If I hadn't been so loopy I would've waited.  I haven't spoken to the doctor in person since I had my follow up consult in July and I wanted a full explanation of what he did.  Keith, bless his heart, relayed all the info to me but I wanted to hear it myself.  First hand.  Poo.

The nurse gave me a shot of Lovenox and an aspirin (anti blood-clot/blood thinner combo) and sent us on our way with a script for 6 shots of Lovenox and a note to take daily doses of regular aspirin for two weeks and baby aspirin for two months.  And oh yeah, a script for a follow-up ultrasound for the next day.

He's really got his protocol down - I guess he's had some time to get it right.  I mean, I was one of the first patients he treated so it makes sense that he's got more practice now.

What happened next? More sleeping.  Sore neck.  Headache (not a monster headache, more like a nagging headache).  Ultrasound was good -both jugulars were open and dumping deoxygenated blood back to my heart.  Dr. X offered to call something in for my headache - I was thinking, like, mega-dose ibuprofen or something.  Nope.  Homeboy called in some Vicodin.  My head didn't hurt that bad.  But Keith picked up the script anyway, just in case.

The thing that was nagging me: Dr. X said in an email to me that pretty much everyone he's treated that gets a bad headache the next day has significant improvement of MS symptoms.  But what's a "bad" headache?  My version of "bad" could be a pin prick to someone or a migraine to someone else.  That's a relative word.  Does that mean I won't get symptom relief? Or will it be marginal? 

Oh, God.  Please don't lock me in to this roller coaster again.  Let me be ok with whatever I get - even if it's nothing.  It is, after all, only two days post.  The marker spots for my pulse points are still on my feet and I can't get the tape residue of any parts of my body that had something stuck to it.  My neck still hurts and I'm still exhausted.  It. will. take. time.

Patience.  Tell me where to get some of that?

1 comment:

  1. Patience, my friend! Was perusing the "ccsvi didnt work for me forum" but decided I wasn't there yet. My stent still hurts like an arthritic sage, when it rains or if the moon is low, or the wind is coming from the east. Something like that. I too would like another office visit with the good doctor. I can't remember much of what he said post scraping the faulty valves. But the best news right now is your sinus is clear! I haven't felt the cath in my brain, but super close. It was a crunchy sound. I did feel him in my heart. That was extremely uncomfortable! Like he says "hopefully you will continue to see slow steady improvements and this will slow the decline". Congratulations and on we go! XO, KFB