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