Tagged: Heart Cath, no sedation, PH, with sedation
- This topic has 35 replies, 11 voices, and was last updated 3 weeks, 5 days ago by Brenda Denzler.
June 28, 2020 at 1:58 pm #25956
Some PH centers prefer to do right heart caths while patients are under sedation. Others prefer no sedation. I have experienced both depending on which PH center was ordering the heart cath. Most of mine have been done without any type of sedation.
What about you? Have you had heart caths with or without sedation? Which do you prefer? Why? Let’s talk about this.
June 28, 2020 at 8:45 pm #25962
@jenc, My first two right side caths were done through my arm (one at the wrist, one at the bend in my arm), with just enough sedation that I was awake but didn’t care what they were doing to me! The most recent one I had last October was the first one I had at Johns Hopkins, and they did it through the neck with no sedation at all. I was very nervous about having it done through the neck, but had no issues at all with it. I think I prefer it going in through the neck. It was so ‘easy’, and the doctor and entire team was wonderful. The only ‘iffy’ thing for me, no matter how it’s done, is dealing with the warfarin tapering off & re-starting. Always a nervous issue for me because of my history of embolisms/dvt.
June 29, 2020 at 9:42 am #25971
Hi @dawnt, thanks for sharing your heart cath experiences. I have never had one through the wrist or arm, although I have heard from others who have. Mine has been through the neck or the groin. I prefer the neck. The only one that I have had in 15 years with sedation was the first one, which was both the right and left heart cath. I find it interesting as to which place some like to have their caths. My veins are tiny, so last time, they said they might need to start using the groin again.
Although I am no longer on blood thinners, I can see how this would be stressful as you are prone to blood clots. Do you stop it for 3 days before? Or how long do they have you off of it? This must bring on quite a bit of anxiety. Do you take something to help with this anxiety before the cath?
June 29, 2020 at 4:50 pm #25978
Hi @jenc. They usually start to change the warfarin 5-7 days before the procedure. As the procedure gets closer they’ll take me off the warfarin and have me use lovenox shots. I don’t take anything for anxiety, it just makes me very careful to watch for any signs of any issues. So far I’ve had no issues, so I remind myself of that each time I have one coming up. My dr at Hopkins told me in March that he’d like me to have a pulmonary function test, imagining and a rt side cath each year.
June 29, 2020 at 5:15 pm #25980
@jenc and @dawnt thank you for sharing your experiences. Funny, I was going to post a similar topic.
Cullen has always received sedation for heart cath’s. When his PH progressed severely they just stopped doing them and relied on ECHO’s and EKG’s – but by then he was listed for transplant anyway. He had a few through the neck but most of the time through the groin area. Like you Jen, he has small, flat veins which don’t make things easy.
He has had cath’s post-transplant. Mainly because he has been under pediatric care they continued to be done under sedation. He just transitioned to adult and due to an emergency this weekend he had a biopsy of his heart and an angiogram. It was his first time for both without sedation and he did great!
They went in the neck for the biopsy and through the arm for the angiogram. He said he barely felt a thing except when the surgeon went to pull out his arm it started painfully convulsing. It surprised everyone because I guess that doesn’t happen often. He was very dehydrated which is why they think it happened. Has that ever happened to anyone else?
June 29, 2020 at 9:08 pm #25985
@colleensteele, I hope it turned out to be nothing too serious with your son. You & he are in my thoughts, and sending out a prayer.
June 30, 2020 at 11:48 am #25996
Hi @dawnt, it sounds like you are already the expert with weaning off warfarin and onto the Lovenox shots. I hated those shots as the nurses said I did not have enough fat. It is all skin, lol. I could find planet fat on my belly-hehe.
I also usually have a right heart cath at least each year. Most often, it happens more than once. We typically do an Echo at least every 6 months. Do you also have an Echo in between?
I am grateful that you know your body, the signs to look out for, and that so far you have been successful without issues. That is a great way to keep the anxiety levels down.
June 30, 2020 at 11:53 am #25997
Hi @colleensteele, oh no, Cullen was convulsing after the angiogram. I have not heard of that. I would have thought it hit a never or several to cause that reaction. I am grateful that it was short-lived, and it all ended well.
Wow, that is a transition to adulthood quickly, no sedation, and the convulsing. How was he after and now at home? It sounds like he held up like the trooper he is and no big deals with not having sedation.
I am hopeful that you and him both are resting better now that y’all are at home. Please keep us posted.
June 30, 2020 at 4:02 pm #26005RayettaParticipant
I didn’t even realize that you could have a heart cath without sedation. My first heart cath was when I was first admitted into the hospital and diagnosed with PH. (February 2018) For that one I also had a pericardiocentesis. I was put completely out for that one. In November of that same year I had another one, although I had sedation I was aware of what was going on and could even communicate with the hospital staff. Mine caths have always been done in my right wrist. I haven’t had one in the groin or neck.
June 30, 2020 at 5:13 pm #26010Alfred GronroosParticipant
My one and only rt/lt cathe was in my groin on the right leg. They gave me a bit of sedation but I was excited to watch the procedure on this huge screen placed for easy viewing. The surgeon came in and as she started to insert my leg started twitching. I could not stop it. The anesthesiologist opened up the tube on my arm and I did not get to watch anything more. I was out. I enjoy watching all the needles etc. I can make the nurses nervous.
July 1, 2020 at 9:53 am #26051
Hi @alfredjohn, thanks for sharing your experience. I love watching it as they go through with the cath. I usually start shaking and trembling from it being so cold, and they add the heaters to my bed, which almost put me to sleep. Have you used those yet?
June 30, 2020 at 7:27 pm #26020Carol VolckmannParticipant
Wow, Colleen what you and Collen must have gone through – it had to be very scary. So sorry Collen went through that.
My first RH cath was in the groin in order to confirm I had. PAH. The second one was done through the neck artery under excercise. I was on my back woth my feet up on bicycle peddles and was asked to go as fast as I could then stop then repeat. No sedation for either just numbing the area prior. It was a bit weird.
Currently I have echos every year.
June 30, 2020 at 7:36 pm #26022
@dawnt thank you. He was taken by ambulance on Friday night with chest pains and shortness of breath. There was concern that his heart was experiencing rejection and/or he developed an infection. The results came back with great news. His heart and lungs are doing very well. His kidney disease is worsening and he was severely dehydrated. That is what caused the episode. He is feeling much better now and is at home.
June 30, 2020 at 7:43 pm #26023
@jenc and @cdvol3gmail-com actually, I was quite amazed at how well Cullen handled it. He didn’t seem nervous about having it without sedation.
Jen, it was just his arm that spasmed but I guess it was pretty intense. I don’t think this commonly happens. We were told the doctor who did the angiogram is one of the best in the nation. Cullen said he seemed really upset that happened to Cullen. I told Cullen, “Way to go, he WAS the best in the nation but you just ruined his streak”! LOL!
They said it was because he was dehydrated even after receiving IV fluids. Cullen wasn’t in any pain after except his arm was a bit sore. Nothing he couldn’t handle.
June 30, 2020 at 10:16 pm #26035
@colleensteele, so glad everything is good with Cullen! I liked the ‘nothing he couldn’t handle’. I’ve found great perspective in many areas of my life when compared to dealing with all my health issues! Sounds like Cullen has too.
@jenc, I’ve had an echo each year since my diagnosis & that is one of the things my dr at Hopkins wants done yearly as well. Unfortunately, I have far more fat available for the lovenox shots than I’ll ever need! The first dvt/pulmonary emboli I had my inr was .9 and they wouldn’t let me go home until it got to 2.0 or better. It was moving up .1 per day, and some days not at all. When it got to 1.8/1.9 they agreed to let me go home with the lovenox. My mother was a long time diabetic, and although she had passed before I knew I had any of these issues, I was used to helping her with getting her needles ready and giving her shots. They had me show them I could give myself a shot, let me go home, and it was only 2 shots later that I was to therapeutic level on my inr. I get so homesick when I’m in the hospital it’s almost like torture! Makes me feel like such a little kid, but that’s just how it is.
July 1, 2020 at 12:20 am #26038Ohio CathyParticipant
I had a right heart catheterization last January. I was advised to find a doctor who has performed many of these procedures as the result will be more accurate. I actually went to one of the accredited Pulmonary Hypertension centers and have had the best of care. The heart cath was done thru my neck and no sedation. I believe they do give you something to relax, but it was minimal. The procedure was painless and easy to tolerate. So best of luck to anyone preparing for this procedure.
July 1, 2020 at 9:50 am #26050
Wow, @colleensteele, the best in the nation! I am impressed already, well until Cullen came through, hehe. JK, I am grateful that he was OK, and nothing came from that spasm. I love that Cullen has that attitude, nothing he couldn’t handle! My late Pawpaw always said, “ain’t no biggie,” and I still think of that and him when I am going through something that I may feel overwhelmed by, love it!
I am happy that he is at home and doing well. I hope that YOU are finally starting to rest a bit more, too. Dehydration is horrible. I have been admitted numerous times with severe dehydration. Crazy, how it comes on so fast, especially once my kidneys were damaged.
July 1, 2020 at 9:56 am #26052
Thank you for sharing your RHC experience, @cathyhayes. Going to an accredited PH center where the doctors are trained to know what they are looking for is always the best option if that is available. I am happy to hear that you had your heart cath there without issues. Do you know when you will have another one?
July 2, 2020 at 3:40 pm #26093Margie NovakParticipant
Hello all… I never even knew you could be sedated for a right heart cath. I had two of them both awake They went through my neck for both of them and it was fine. The team at UPMC has it down to a science The only thing I always ask is that they tell me what step we are on (i.e. when they start; when they are half done; and when it is finished) I don’t need to know anything else even though I can hear them. The only thing I kind of mind is that they cover you with this sheet and your face is covered.. that is weird. Hate enclosed spaces. Otherwise, no problems. It takes longer for them to set you up for it than the procedure itself!! Stay safe fellow PHers!! Be strong!
July 2, 2020 at 4:48 pm #26098Jimi McintoshParticipant
Only got sedation during a double cath, because the cardiologist was having difficulty in feeding the probe after his 4th attempt. I prefer to be cognizant, to watch their faces for aniexty and to ask questions.
July 2, 2020 at 4:54 pm #26100
@margie-novak I believe that they normally prefer to do this procedure without sedation on adults. It’s usually with pediatric patients that they sedate. I don’t think a child could get through it without sedation because they would be too frightened. Overall I think it’s a fairly common procedure and most hospitals have doctors with lots of experience performing caths. I hope that makes anyone having to go through one for the first time feel a little more at ease.
July 2, 2020 at 4:56 pm #26101
@jimi unless it something that might be painful I think my son has reached a point where he prefers to be awake for procedures such as this. If anything, he finds it interesting.
July 2, 2020 at 5:59 pm #26106Jimi McintoshParticipant
I just had eye surgery and was awake for the procedure, because sedation could have been risky for me. Pain is different for everyone. I have a high pain tolerance. I think sometimes that I am afraid of being put to sleep. The pain is manageable most of the time. Your son has had so many procedures that he does not experience the pain and/or it is a control thing. I had had trouble with sedation, being bought back, cause too
Much was given to put me undet
July 6, 2020 at 3:39 pm #26130
@jimi thanks for sharing. I hope the eye surgery went well and was worth it. How is the recovery going?
When my son had PH sedation was scary but post-transplant the concern isn’t as intense. Still, I think it’s best if he has procedures without sedation if he can tolerate it. He’s been through so much since he was 6 years old that just like you, at this point he has a high tolerance for pain. That being said, he claims he really didn’t feel much to be concerned about during the biopsy and angiogram, at least not until they pulled out of his arm and it started convulsing. Even then, he said he wasn’t scared, just a bit sore.
April 27, 2023 at 2:25 pm #38147
Hi @brendad53, I don’t know if you’ve read through this topic about sedation with caths, but I want to tag you. You may find some helpful information by reading about others’ experiences.
My first right and left cath was done with sedation; the doctor was clueless. I have noticed that it’s dependent on many factors. Of course, each person’s medical history wishes, and the hospital or doctor’s protocols.
April 27, 2023 at 2:56 pm #38150
Jen, this has been very useful to read through! I don’t know why I never remember to consult the archives and do a word search. Thankfully your brain works better than mine! 🙂
I found out yesterday that the doctor wants to do an echo on me, too. I think they’re wanting to delve deeper into whether or not I really have PH. But I don’t know for sure.
When Jimi said he thinks he prefers not to be sedated because he can watch the doctors’ faces for signs of stress, I had to chuckle. Me, too. And to be awake to hear them say, “Oops!” If they’re gonna “oops” something, I want to be awake and aware to hear about it!
April 28, 2023 at 12:29 pm #38156
Hi @brendad53, I doubt my brain works any better than yours. I also am guilty of forgetting to search older topics if it is related to our discussion. But I appreciate that kindness.
It sounds positive that this doctor wants to be extremely thorough with everything they discuss with you. Do they plan to do it all, or Echo first, then decide? I hope he will follow through with the right and left heart catheters. I feel that by doing both, he will have so much more data and info needed to figure things out better.
Are you still feeling pretty optimistic about this connection with him? I imagine emotions wax and wane.
Too funny; I’m with you and @jimi; I also like to be aware of what is happening. Yep, and if I hear any “oops” or “oh crap,” I may jump off the table, LOL.
My hubby always has to be knocked out for any procedure. He pays extra for “laughing gas” at the dentist. I joke with him that he was a wimp! Hehe.
I’m grateful that this information has helped you. The laughs from Jimi were probably needed., too.
Have a wonderful weekend! Please keep us posted as you learn more about these scheduled tests.
April 28, 2023 at 1:49 pm #38161
Have the double catheterization on May 8th. Stomach in knots.
Got the bloodwork results from my ER visit. PT time is a little over the reference range. INR was 1.2. I’m having some difficulty getting the significance of these numbers to stick in my head. Is 1.2 OK?
May 1, 2023 at 12:52 pm #38167
Hi @brendad53, wow, they scheduled the caths quickly. I’m impressed! One week, at least you don’t have months to overthink things and stress about the caths.
I can imagine the knots, but I’m extremely hopeful with this cardiologist and the team for being so efficient and quick to schedule these tests. I’m sending you extra gentle hugs and lots of love as you go through this week.
Do you have any positive thoughts about this one you didn’t have before? Or will your medical PTSD not allow you to embrace feelings?
Concerning your INR, I think 1.2 falls within or near the normal range, which assesses blood viscosity. It’s been years since I last needed that test, so my memory is a bit hazy. I’ll check this information; perhaps someone on Coumadin can provide their insights.
May 1, 2023 at 1:09 pm #38169
Actually, Jen, I’m feeling more and more anxious as the days roll by and I look up constrictive pericarditis. Eating lots of ice cream.
But I am noting that at the moment, I’m terrified of the diagnosis more so than of the people. I’m also terrified of the treatment, because I fall into a group that tends not to have a good outcome with that treatment. In fact, I might die on the table. Lots and lots of ice cream!
May 1, 2023 at 1:25 pm #38171
Oh no, @brendad53! I understand that researching our concerns can rapidly heighten anxiety. I attempt to stay informed without overdoing it, especially before visiting doctors. However, I occasionally exacerbate my stress by reading about others’ positive and negative experiences.
Hopefully, you bought a few extra gallons of your favorite ice cream this week. What are your favorite flavors?
Are you more apprehensive about the diagnosis and the surgical treatment? Is it a pericardiectomy or another procedure?
Do you know if the cardiologist will conduct the catheterizations and converse with you afterward? Or would you need a follow-up appointment to discuss the findings?
May 2, 2023 at 5:28 pm #38182Terese TuoheyParticipant
I don’t know if my reply went through. I’m retyping it.
Brenda, if you are taking Coumadin, the usual therapeutic range is between 2 and 3. 1.2 seems very low to me. If you are not taking this medication, just check with your doctor to be sure he thinks you are OK. Usually, before a procedure, you are asked to stop taking Coumadin for 2-3 days beforehand, and then resume it again immediately once the test is over. Hope this helps.
May 3, 2023 at 1:45 pm #38199
Hi @tervo, thanks for your response to Brenda. Since you’re on Coumadin, I’m incredibly grateful you could share better insights with her.
You’re right; they say to hold blood thinners several days before a procedure. Years ago, I knew this was the case. Do you still do this with dental appointments?
I hope you and your hubby are doing well and enjoying each other and life, as always!
May 4, 2023 at 8:06 pm #38231
Hey, Terese. I’m taking Eliquis. 5mg. Twice a day.
Holding it starting Saturday for a Monday morning cath.
May 3, 2023 at 3:30 pm #38207Terese TuoheyParticipant
I don’t have to stop Coumadin for regular dental checkups. My Hematologist told me not to stop it for a colonoscopy either. He said it was safer to keep the Coumadin up at a therapeutic level for that procedure than not – at least for me. I did have a colonoscopy, did not stop the Coumadin, and had no problems.
Generally, the fear is that since the Coumadin thins out your blood, if there is any cutting to be done in a procedure, you might not stop the bleeding as quickly as you could without the Coumadin in your bloodstream.
May 4, 2023 at 1:12 pm #38217
Hi @tervo, thanks for sharing your experiences with Coumadin and other procedures. I’m grateful that you had the colonoscopy without any problems. Because I do know that is often on the list of things to hold a day or two before mine. However, I haven’t been on it in years. I was only on blood thinners early in my diagnosis.
I’m anemic, so it was not helping me much, and my hematologist took me off after speaking with my PH team.
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