Yesterday afternoon I finally had my cardiac catheterisation (angiogram), which had been put off the day before because there was no time. As a result, on both Monday and Tuesday I was deprived of my lunch!
I was told that the procedure was a lot less invasive and unpleasant than a colonoscopy (which I have to have every two years because of my ulcerative colitis) but my own experience belied this statement. The whole procedure was unpleasant in the extreme – although I hasten to add, for the reassurance of anyone reading this who might be facing the same procedure – that it is not the same for everyone, and for most people it is fairly routine and not too uncomfortable.
Even with a sedative I was fully aware of what was happening and the insertion of the sheath into my right radial artery was painful and unpleasant, despite the previous administration of a local anaesthetic. The passage of the catheter through the artery to my heart was not unpleasant, but when the contrast medium was injected, I felt the expected flushing sensation, and the feeling that one was passing water, which was very peculiar. This X-ray-opaque dye reveals the blood vessels surrounding the heart, and any narrowing or blockage is visible, and where it is present, it is expanded by a small balloon, possibly with the addition of a stent, which is a small rigid mesh tube to keep the artery open (angioplasty). I had a bit of a reaction to the contrast medium and developed a severe headache, and the outer quadrant of my left thigh, in which I have suffered intermittent tingling and numbness since the onset of my M.E., became very painful with a burning sensation and extreme pins and needles, which took several hours to pass off.
Coming out from the procedure, I felt very poorly indeed, and I think this is probably as a result of having M.E., which makes me feel generally unwell anyway, and having all this laid on top just made it all feel a lot worse! As the effects of the sedative and contrast medium gradually wore off, I started to feel a lot better.
Unlike the atmosphere in the room where I had my colonoscopy, the room where this procedure took place was hardly conducive to calmness – there were lots of people bustling around, calling out instructions to each other, equipment being moved, hard surfaces reflecting a lot of noise, etc. Even though I was not at that time worried about what was happening, it did nothing to help me to remain calm!
My right wrist was extremely painful where the sheath was inserted. After it was removed, they attached a clever clear plastic cuff to my wrist with an expandable chamber filled with air which compressed the artery at the sight of the wound to prevent bleeding, and over the next hour or so, they gradually removed a couple of ml of this air by means of a syringe, reducing the pressure until it was safe to remove the cuff completely. It now has a dressing on it, with a tight self-adhesive bandage around it, which I am told I can remove today, but for the next week I have to be very careful with this arm, and not get the site wet, or too hot – so no washing up, and no bathing, and no heavy lifting, until the wound has had a chance to heal. I have to keep an eye on it to make sure that no haematoma or infection develops, and I must return to the hospital or go to my GP’s surgery straight away if this should occur.
The angiogram revealed no abnormalities in my cardiac vessels, and no permanent damage from the attack, so I was taken off the clopidogrel and told that I could go home. I have been issued with a glyceryl trinitrate spray to use under my tongue should the pain recur, and if this does not work, I am to call an ambulance and return to hospital immediately. Because of an abnormal blood result (raised cardiac troponins – enzymes in the bloodstream which can indicate damage as a result of myocardial infarction), it is clear that I have had some kind of cardiac event, and the chest pain was not a result of reflux or other gastro-intestinal cause, but the fact that there is no permanent damage to the heart, or narrowing of the surrounding blood vessels, is good news.
When the nurse on the ward was giving me my discharge documents and instructions for the next few days, I suddenly became very weepy and felt extremely vulnerable and fragile, which was a bit of a shock, because this is quite unlike me – the news is good, and I was going home. I think it is just a reaction to everything that has happened over the past few days, during which I have remained strong, cheerful and optimistic, but a combination of the event itself, the change of routine, lack of sleep, odd meal times, the injections, insertion of the cannula, taking of blood, ECGs, blood pressure monitoring, and finally the most unpleasant experience of the cardiac catheterisation, have all taken their toll and it all swept over me in a flood.
This feeling continued all evening, and I am still feeling the same this morning. I am quite sure that in the next couple of days I shall be myself again, but in the meantime I am going to rest quietly and try to recover myself.