I remember years ago watching an impressionist "doing" Steve Irwin and he was approaching a large animal and said something like " now this fella is very dangerous and he gets really angry if disturbed, so let's get a big stick and poke im!"
More of that in another post but for now a few things I learned.
Royal Brompton Hospital is a centre of excellence for cardiac care so maybe not everything I mention is carried over into every other centre but I thought worth mentioning.
Whilst waiting for the lab staff to "set me up" I was chatting to the anaesthetist and I jokingly asked him to make sure I was properly out as I had heard stores of people being aware of goings on but unable to move or call out. He said that this was extemely rare but assured me it would not happen to me. " We use a strip of electrodes on your forehead to monitor brain activity and if we see any we stop and deepen the anaesthesia". Modern technology at its best.
Radial Arterial Lines.
We had a discussion about these a while back and my impression had been that they were rare and only used with certain types of patients so when they put my canula in (Ouch) I asked why. It is apparently for instantaneous blood pressure monitoring. He demonstrated connecting it up to his machine and the probe measure BP actually in the artery at all times during the procedure. (It had gone when I woke up .)
Post procedural echocardiogram. (approx 24 hours later)
This was something new to me as I had not been given such before so natually I asked why. What they are checking for is any increase in pressure in the right atrium which may result from the transeptal puncture. In some ways I was lucky it was a young houseman doing the Echo under the guidance of a senior registrar so I was able to evesdrop the tutorial. She explained to him that this usually healed in about three to four weeks which ties in with the migraine aura timings. (yep got them in spades if I am still allowed to use such word.)
INR and anti-arrhythmic drugs.
I was aware that propafanone increased INR but not used flecainide much so had no experience but for reasons explained in my next post I was given, to use my EPs words, "a shed load of IV flecianide". Result was a rocket from 2.6 to 4.5 overnight!. I am unable to quantify "a shed load" but it was a fair sized bag they pumped in.
More another day but right now I'm off to bed. Not slept much what with groaning patients , rich kids blasting round Chelsea in their ferraris and lambos all night and drunks peeing in St Lukes church yard (Beautiful Wren building if you are interested.) Down yere in Devon the nosiest thing we have is owls!
B
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Bob, you are amazing. Even during your recovery you remain committed to educating us. Thank you for all that you do. Rest well. Looking forward to learning more and I do hope the migraines are soon gone.
I agree, you ARE amazing! This is so interesting - and helpful - thank you 😊 Looking forward to hearing more, but no hurry ... rest up! Hope the migraine auras pass quickly. And that the owls let you sleep better than the residents of London x
Glad to hear you’re on the mend Bob. I’ve had arterial lines for BP during my ablations. They lines were put in the inside of my wrist. Was yours the same? One time with drips and IV drugs and infusions, I had 5 cannulas so ended up with lots of bruises on my arms and hands. 😃
Good to see you are on the mend Bob. All very interesting info as ever. Be better soon and be kind to yourself and rest!
Blue x
The radial artery thing for bp gave me the biggest bruise! Way bigger than the catheter insertion sites.
As for noise in Devon, we are in our tin tent near Newton Abbot, and there is one idiot with a 'zorst and a dump valve that wakes us at 6:30 am speeding down the country lane. ,👺
From now on I am asking for forehead electrodes during any GA! Thanks Bob. I bet you were composing that post in your head until you could get to a keyboard.
Glad your home Bob, sounds like all went well, I hope your feeling better after your sleep. If you need advise there is a chap on here called BobD, I think he may be able to help you 😂😂. Hope you recover quickly and by the way I have had an echocardiogram after all 3 ablations at Harefield, didn’t realise it wasn’t standard practice. Best wishes.
Every time I had an ablation I was kept in overnight. I would have been so much better at home as like you I hardly slept a wink. It is all the heart monitors, regularly blood pressure checks and others snoring. Not really conducive to giving the patient rest, rest & more rest.
I had a sleep study in January because of suspected Sleep Apnea and I think the diagnosis was insomnia. I was still wide awake at 3:00am. At 11:00 on the evening I started the study they did the washing up in the kitchen right opposite the private ward I was in. It was hot and unnatural added to which I was wired up and had a shared toilet with adjoining doors. They couldn't have made it more difficult to sleep if they had tried.
Last week I had another study at home using a new piece of kit which is similar to an Apple watch and then wired to an oxyometer on my finger. Only one electrode on my chest.
Hope you feel a lot better soon there is no doubt there is no place like home!
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I'm new to Warfarin and AF, I am just in the initial assessment stage.
I have changed my gp
changing to a NOAC
