A little worrisome episode

[Traveler]

About a week ago I had my angiogram in preparation for OHS on 2/9. As I earlier reported all the new was good - no blockages! What I didn't talk about was what happpened afterward because I wanted to work through it a bit in my head, but thinking about it hasn't really made me feel better about it. So I thought I'd see if anyone else had had a similar experience.

The day was pretty straight forward. Blood work at 7 am, chest x-ray at 7:30, exam and dicussion at 8 am and then waiting in line for the angiogram. I was out of the procedure at 11:15 am and in a recovery room at 12:30 pm. Nothing extraordinary happened. Joked with the doctor a bit, remember most of the procedure up to the point where he asked me to quit talking. (I'm a good talker when nervous.)

I should mention that I often pass out when having blood drawn, when I bleed (falling off a bike, etc), in enclosed spaces -- and I have done this since I was a child. Often the passing out occurs 15 minutes or so after the event. I once started my car and then passed out following a blood draw. As a result my wife always drives me home.

Returning to the procedure -- upon arrival at the recovery room, I am joined by my wife, use the restroom (walking without assistance), order lunch, eat lunch, tell jokes, everything is great! The nurse leaves to get the discharge orders. Then I start feeling very strange and I'm thinking about pushing the emergency button and the next thing I know there are several people in the room reporting various numbers (100% oxygen, gotta pulse, no blood pressure, strong pulse ... etc) and an IV is being inserted. (My wife says the no blood pressure was that there weren't able to measure it yet, not that I didn't blood pressure). Now having passed out a lot in my life my first thought was that I had passed out. But this was a lot different I couldn't talk and could barely breath, I also found I really couldn't move. Usually when I pass out I'm back up in minutes and a little embarrassed so I move fast to prove that I'm ok. I was told my lips were white to light blue and that I was very pale. As my color started to return my wife was able to get close to me and she was looking worried and so I was trying to touch her to comfort her but my hand wouldn't barely move, I could move it very slowly bit by bit. But it required a lot of concentration and energy and I still couldn't really breath. The episode lasted about 15-20 minutes, thats when breathing became easier and talking was possible. When I noted that I had passed out, I was told no that I had had an "episode" with some authority but I wasn't quick enough in my thinking to get an explanation. I was told that during the episode my eyes were open, pupils dilated, and that before I became consious that I had tighted my hands into fists and was thrashing around a bit. I had a similar but shorter and less exciting experience following a hernia operation in March 2006.

I had dinner with a doctor friend this last weekend and questioned him about it and he said, oh yes you just had a pycho motor episode, no big deal. When try to pursue pycho motor episode on the web there are too many things to be able to run it down clearly.

But as my wife mentioned, this seems very worrisome looking at open heart surgery - so has anyone had an experience like or understand it better?

Thanks

Mark

 

[JimL]

It might help to check out what they did during your angiogram. It might be that your heart didn't particularly like all that poking around, and there was a bit of a reaction to that. I very vaguely recall some rather unusual things during mine when I was in that half-awake state they put me in. I have a much better memory of how good food tasted afterwards.

 

[briansmom]

That must have been very scary for you.

My son has a heart pump that pumps for his left ventricle. 4 days after he got out of the hospital he managed to unplug himself, which stopped the pump. He didn't actually pass out, his eyes were open, but he told me later that he couldn't move, but he remembered what we were doing (trying to plug him back in). We managed to restart the pump and 15-20 minutes later he felt fine. I have also had episodes of very low blood pressure and it feels like I can't breathe. The thrashing about part though is different from anything I have ever experienced.

Question the docs so that you can feel more comfortable about this.

 

[marky]

Your episode sounds very similar to that of mine and 2 of my dchildren.
We have Prolong QT syndrom and certain surges of adrenaline cause us to 'black out'
Actually what happens is that the QT elongates and we lose consciousness.
I was a kid that 'blacked out' whenever I got sick, or scared.. of course now I am grateful to have survived those moments.

I had to have a defibrillator implanted b/c I went into VTac which is deadly.
My oldest dd has a pacemaker b/c her heart rate dropped too low.

She always had 'episodes' associated with pain
Mine are always associated with sudden startles, usually at night (phone ringing, sick child)
or if I am overly anxious..(like when my ds came home after his first mission trip)..and then it is a bit delayed too. or at times if I am sick.


I can't say that is what you have, but it sure sounds like what I have with the QT issue.
Hope you can find out what is going on soon.

 

[Susan BAV]

That certainly would have worried me if it had happened to me. After my last angiogram I went into really severe shakes and chills and teeth chattering in the recovery room and couldn't get enough blankets on me but the medical people didn't react in anyway other than a totally mundane response -- my experience must have been just a normal occurence. Nothing like what you described.

I'm wondering, though, if you pass out when you have your blood drawn, how will you do if you need Coumadin checks, especially if you do your own INR checks? And I guess they did a plug in your femoral? You didn't have to lay around with a weight on your groin for multiple hours following the angiogram?

 

[Traveler]

I'm wondering, though, if you pass out when you have your blood drawn, how will you do if you need Coumadin checks, especially if you do your own INR checks? And I guess they did a plug in your femoral? You didn't have to lay around with a weight on your groin for multiple hours following the angiogram?

No I only weight on my groin for an hour. Based on everyone's notes I expected hours and I'm a little hazy on the timeline but my wife says she was told the procedure ws complete at 11:15 and I was in the recovery room walking at 12:30. Maybe they were slow to tell her when the procedure was over. I had the episode at 1:30.

Recently I've had enough blood draws that I only pass out about 50% of the time, until 2 months ago it was 90%+. I'm planning on a tissue valve so I'll avoid a lot of pricks, but it is a bit odd to be traveling, trekking, backpacking, and climbing knowing that if you get cut, or find yourself in a tight crowd you'll pass out.

The hardest part recently was having blood draws at the blood bank to support an autologous blood transfusion. After reading about blood transfusions and being told that I'd need a unit or two because I'm thin - I really wanted to use my own blood. The blood bank told me that if I passed out they wouldn't draw my blood in the future because my health was "fragile." So to avoid passing out and to get past the blood pressure check I developed a routine based on the advice of a doctor friend of mine. Drink 16 oz of cold water 1/2 hour before followed by two cups of coffee (got my blood pressure up to ~120/68 I'm usually in the 95/58 range which was too low). Give blood and head quickly to men's room in case you pass out - that way they won't know. It worked.

 

[Marguerite53]

Traveler. I believe you mentioned that you were a professor? Hm. So is it your practice to teach students things and not care whether they understand you or not? I don't think so. CALL YOUR CARDIO AND GET A THOROUGH EXPLANATION!

That said, I don't think I would worry too much about it as long as all that information is given to the anesthesiologist (who, it is my understanding, is the main guy who is keeping you in one piece as they operate).

My angiogram was done the old fashioned way and I had a clamp, not a plug. Therefore, I lay in a bed for a good 6 hours afterwards. My incision site is still somewhat wierdly tender almost a year later. Wish I'd had the plug!

My surgeon said that in our town it was such a hassle to use your own blood that he recommended that my "simple and straightforward" surgery did not require banking my own blood. He said that the benefit can be that if you become anemic due to the heart-lung machine (a normal thing...it leaches the iron as it works, unfortunately for everyone, I guess) you can get your own blood to help you along. I did end up slightly anemic, but it did not ever require any blood. I ate a lot of steaks and spinach prior and post surgery!!

Please call and let us know what you find out. Please. Otherwise we'll be forced to refer to you as our crazy psycho motor valver.

Kidding aside. Please do call. You'll feel better. Maybe it's not as unusual as it sounds.

Marguerite

 

[hensylee]

It sounds like a seizure to me. Caused by what, only your dr or a refered dr can say and you might want to pursue this further, especially since you had one before. IMHO

 

[ALCapshaw2]

IMHO, you REALLY need to get an explanation for these episodes. I would be looking at Low Blood Pressure, LOW Heart Rate, Irregular Heart Beats, etc. Please take a writen copy of your history to your CARDIOLOGIST for assessment.

Any and all of the above may suggest medication or even a pacemaker.

I hope you can get to the bottom of this and find a 'cure'.

'AL Capshaw'

 

[Traveler]

Traveler. I believe you mentioned that you were a professor? Hm. So is it your practice to teach students things and not care whether they understand you or not? I don't think so. CALL YOUR CARDIO AND GET A THOROUGH EXPLANATION!

That said, I don't think I would worry too much about it as long as all that information is given to the anesthesiologist (who, it is my understanding, is the main guy who is keeping you in one piece as they operate).

Marguerite

I'm back from traveling!

Yes - I'm an engineering professor, but I'm better about asking questions about things other than myself. for example I'm relying a bit on my wife (also a professor) to work through all the journal articles about aneurysms and bicuspid valves. Our surgeon commented at our last mtg that we must have read everything he ever written. Answer - not only everything you have written in the last 5 years. Part of the problem with trying to discuss this with my caridiologist is that I don't have a good handle on what to describe to my cardiologist, but I'll give it a try. I'll let you know if I figure anything out.

 

[carolrai]

I don't know if you were still trying to research "psycho-motor" responses, but another name for that is vasovagal response. I have had several under different circumstances, and when I was working as a floor nurse in a post -angio unit, I saw it happen alot. Sounds similar to what you had....although your cardio should have the final say on that. Hope that helps some!