19 April 2024

Is That a Catheter in My Heart or Do You Just Adore Me?

Hello, friends, I'm back from the other side! Just the other side of the cath lab table, that is, which I had to use a metal stool to reach. I could go on about the indignity of being a short woman, but I think they just set that sucker for the doctor's height and leave it because it's quite the assembly line of weary hearts wheeled in and out all day. 

I spent all of about 20 minutes in the lab, which was 1/18th the time I spent in waiting and recovery. All of the nurses were kind and efficient, even the youngest one, who had the delightful duty of groin prep. Even though the plan was to snake the catheter through my wrist, the team likes to prepare for uncooperative radial arteries so this lucky RN was in charge of womanscaping. Naturally, Dr. Catheterization chose the moment of peak buzzing to enter my cubbie to explain the procedure. A quick survey of the scene, along with my "Sir, really? Right now?" sent him right back through the curtain and me to a one hour delay. I guess I should have crossed my legs and just talked to him (title of my memoir)!

When the doc came back and I signed all the consent forms, I was rewarded with a trip to the icy confines of Cath Lab 6, staffed with two Joannas, a Katie, Kirsten and Monika, plus my new favorite cardiology fellow, Dr. Chris, who asked why I was there because "You seem young for this procedure. You're only in your fifties!" Yes, friends, I'm living by Dr. Chris rules now: I will be IN MY FIFTIES until December! I'm pretty sure the flattery was a distraction because one of the Joannas immediately put me on oxygen and slapped a freezing gel pack on my flank, Monika swabbed my wrist and groin with chilled betadine, BFF Dr. Chris started injecting my wrist with lidocaine, and the other Joanna pushed the good drugs into my IV.  

And then I woke up. 

I was required to spend about three hours in recovery, during which the nurses gradually let out the air in my wrist pressure bandage while I dozed and sneezed. Eventually, Dr. Catheterization came to see me and the Captain, who had balanced on a rickety chair in my cubbie from post-prep through post-op. I was a little loopy but Dr. C explained that the LAD blockage was only about 30% so I hadn't needed a stent. The stenosis in the first diagonal branch was 70% but because it was a relatively small branch he wasn't concerned and thought it would be fine with medication. Cap quickly texted the good news to all the family and I sneezed some more. 

When it was finally time for discharge, the IV nurse took me for a walk around the unit to make sure I was fit to go home. 

"How long have you been married?" she asked. 

"Thirty-four years," I answered (confidently cheating ahead by a few months). 

"Wow! Thirty-four years! You're like newlyweds," she said. "You can tell he really adores you." 

Now, it is true the Captain adores me. But I think she should have higher standards for newlyweds than a partner who scrolls instagram for kitchen hacks and chef reactions while patiently waiting to find out if their betrothed is dying from coronary artery disease. 

Okay, that's a little dramatic. I'm not dying from CAD. But I do now have a diagnosis of non-obstructive coronary artery disease, or NOCAD, which is not nearly as exciting as NORAD, the folks who track Santa (and maybe bombs). And despite the initial relief about the not-as-bad-as-we-thought blockages, I'm still concerned about that diagonal branch. I may be overreacting, but shouldn't I want oxygenated blood to flow freely to the front and lower part of my heart? A family member told me two of her friends have this diagnosis and it's really just part of getting older. Sure, but as we all know I am only IN MY FIFTIES so that can't be the reason! 

After my walk with Nurse Low Expectations I was given my discharge instructions: leave the wrist paddle on for 24 hours; don't lift anything over five pounds; don't bend or push on the wrist; if there's a hematoma call 911; if there's spurting blood after you remove the bandage call 911 (I think this should apply all the time); if your dog or children are bad call 911 (I made that one up but Barkley is still available); and follow up with your cardiologist. I thanked everyone on the floor and wheeled out of the unit, sneezing. Guys, this was the weirdest side-effect of the whole day. The sneezing and runny nose got progressively worse. I took Claritin, Benedryl and Flonase for the whole weekend and didn't stop sneezing until Monday! Naturally, I researched "sneezing after sedation" and found out I was either allergic to the medications (NOOOOO, NOT THE GOOD DRUGS!) or the nasal cannula for the oxygen. I guess we'll find out the next time!

Despite the rhinitis, I had a lovely brief recovery. The boys were attentive and caring (Two went to the florist AND Starbucks but both were closed lol) and Erin made them do all the lifting and carrying of things. The Captain captained, and friends and family reached out to check on me. I explained to all how women shouldn't ignore a NOCAD diagnosis because all the literature says it still means an increased chance of myocardial infarction! But I think folks want to hang on to the good news, and maybe I should, too. So I've stopped citing medical studies.

At least until I have the delightful Dr. Dutta trapped in a room with me, where she will be obligated by oath and Aetna to listen to all my concerns!

Stay tuned and be well!