Trans-oesophageal echo (TOE) Question

[Ged1975]

Hi, my twin brother is having a trans-oesophageal echo this week. Like me is very nervous and I told him I'd post a question on VR.com for him. The TOE is to investigate his bicuspid valve (just like mine).

He went for this procedure a few months ago but backed out last minute because he felt a panic attack coming on just as they were about to sedate him.

This time the cardiologist said they will sedate him before they bring him into the Cath Lab.

He is very nervous about the IV sedation because he's afraid he'll panick while they are inserting the IV line. He is quite tolerant to diazepam as he takes it alot for anxiety so he is afraid that the sedation will not be strong enough.

Also he was wondering if it'd okay for him to take some diazepam before going to the hospital just to relax his nerves.

If anybody has any feedback on the trans-oesophageal echo procedure I'd very much appreciate it.

Many thanks

Gerard

 

[Ross]

Gerard have him tell them of this apprehensiveness and they'll load him up on something before they ever start on I.V.s

There are always ways for this stuff to be dealt with.

They won't be giving him diazepam. Versed and Demoral or fentynal most likely. He won't remember a thing.

 

[BigOwl]

They will numb the area before they insert the IV anyway, so he shouldn't even feel anything but the slight sting of the anaesthetic. I was awake and calm when I was wheeled into the room for the TEE (as we call it on this side of the pond), and sent to happy land after that. Since it was preliminary to my AVR, the next thing I knew I was waking up in ICU.

 

[Ged1975]

Gerard have him tell them of this apprehensiveness and they'll load him up on something before they ever start on I.V.s

Thanks for the swift reply Ross.

The problem is that last time he told them he was nervous they said they couldn't give him anything on top of the sedation he was about to receive, which seems a bit strange.

When he specifically told them he was nervous about the IV they said don't worry it will sedate you. That seemed a bit contradictory to me because it was the insertion of the IV which comes before sedation which was worrying him.

I guess sometimes you need to be assertive in hospitals and even demand a tablet to calm you, would you agree?

 

[Ged1975]

They will numb the area before they insert the IV anyway, so he shouldn't even feel anything but the slight sting of the anaesthetic. I was awake and calm when I was wheeled into the room for the TEE (as we call it on this side of the pond), and sent to happy land after that. Since it was preliminary to my AVR, the next thing I knew I was waking up in ICU.

Hi BigOwl, great to see you back online! Congrats on your successful op and may your recovery continue well!

I admire the fact that you were calm. I wish I had your strength. My twin brother who was recently diagnosed as having the same condition as me (leaking bicuspid aortic valve) is by nature an anxious person, just like me

 

[Jkm7]

His cardiologist clearly now understands the extent of his anxiety. Surely it is in his record he had to leave just prior to beginning his TEE. Hopefully he and his cardiologist have discussed this and the doctor has made plans to see to it he is calmed. The test is important and must be done and every doctor I know would do what is necessary in order to enable this to happen.

Please send your brother our best wishes he is able to go forward with the test and gets the best possible report.

Let us know how it goes, please.

 

[Ged1975]

His cardiologist clearly now understands the extent of his anxiety. Surely it is in his record he had to leave just prior to beginning his TEE. Hopefully he and his cardiologist have discussed this and the doctor has made plans to see to it he is calmed. The test is important and must be done and every doctor I know would do what is necessary in order to enable this to happen.

Please send your brother our best wishes he is able to go forward with the test and gets the best possible report.

Let us know how it goes, please.

I will let you know how he gets on, please God the results will be positive. Thanks!

 

[kschul]

I understand you are talking about the TEE (the ultrasound) I can't imagine they would have it done in the cath-lab this should usually be done in a standard exam room with a nurse, cardiologist, and ultrasound tech so the environment should be a lot less intimidating. If he is afraid of the I.V. ask to have the skin numbed up ahead of time with a gel so he shouldn't even feel the I.V. going in and they should be able to give him something fairly soon after that if they plan ahead for it. I work in medical imaging where sedating patients is an everyday occurence. Since this is I.V. sedation he should not have any problems, when monitored the staff will be able to recognize if he is getting a little light on sedation and provide more before he is even aware of it. When I had my TEE I remember nothing and felt perfectly fine afterwards. Then I was served lunch while I just hung around for a short time. I have to say it was easier than going for a filling at the dentist. I know these exams can be intimidating but just communicate with the staff, they want to get him through this comfortably also.

Kris

 

[tobagotwo]

Sometimes they give a pill a half-hour to an hour beforehand that really takes the edge off, such as they did for my LASIK eye surgery. While they never did put an IV in me for that procedure, I had my eye LASERed without any real concern during the procedure, and I'm normally very touchy about anything that has to do with the eyes.

Maybe they can relax him with an oral medication before the IV is placed.

Best wishes,

 

[ALCapshaw2]

Getting Numbed BEFORE an IV?

WOW! I've never heard of such a thing.
Maybe vampires are in charge at my hospital???

Sure would have helped with a couple of Nurses I still recall!

 

[Ross]

Thanks for the swift reply Ross.

The problem is that last time he told them he was nervous they said they couldn't give him anything on top of the sedation he was about to receive, which seems a bit strange.

When he specifically told them he was nervous about the IV they said don't worry it will sedate you. That seemed a bit contradictory to me because it was the insertion of the IV which comes before sedation which was worrying him.

I guess sometimes you need to be assertive in hospitals and even demand a tablet to calm you, would you agree?

Yes sometimes you do! There isn't any reason they can't give him the injection BigOwl is talking about. A tiny sting is all you feel and then it's so numb that inserting the IV is painless.

 

[Ross]

Sometimes they give a pill a half-hour to an hour beforehand that really takes the edge off, such as they did for my LASIK eye surgery. While they never did put an IV in me for that procedure, I had my eye LASERed without any real concern during the procedure, and I'm normally very touchy about anything that has to do with the eyes.

Maybe they can relax him with an oral medication before the IV is placed.

Best wishes,

Glad you brought this up. I have a feeling I'm developing cataracts and I can't even imagine letting them close to my eyeball with a needle.

 

[Johnny Stephens]

I've had the TEE done twice since my surgery - right before my first 2 cardioversions. Versed was given, and next thing you know, you hear them putting the equipment away and the doctor is already gone. I was distantly aware of the probe in my throat, but there was no choking or panic reaction at all for me. In fact I didn't even remember this part of it until later.

YMMV

 

[fabyan64]

Ross,

Before my surgery last month I had issues with the cath because all previous caths I had been given demerol. However, they told me in Houston, demerol is on its way out, and many thought it should be banned - not sure why, but I am definitely not a fan of demerol .

Regards,
Roderick

 

[Eva]

I was put to sleep before my TEE as it was done just before surgery...so, I do not remember anything which is great.

But before my cath, I took 1/4 mg of xanax before going to hospital and I told the nurse about it.

 

[Ged1975]

Hi all,

My brother had his Trans-oesophageal echo (TEE) today on his leaking bicuspid aortic valve. I'm so proud of him as he was very nervous but still went ahead with it. I know to many of you it seems like a small procedure but for us it was a big deal.

He only needed 10mil of valium to get the procedure done, he wasn't fully sedated. His throat was sprayed and he was asked to swallow the camera, he gagged a bit but got through it.

We didn't get any results afterwards, he was told to attend his cardiologist in 6 weeks or his cardiologist will ring him before that.

I hope the results are good and that no surgery is necessary.

Can you tell me if a TEE gives a good picture of the heart i.e. is it conclusive?

Thanks for all your supportive posts.

Gerard

 

[escargome]

Gerard,
Tell your brother congratulations on getting the TOE done. It is a good step forward. Since I am not a doctor I can only say that this procedure does give a pretty good picture of the heart and valves. So now I would suppose it is a wait and see what the cardiologist has to say.

So on another note, how are YOU doing? I hope you are well and coming to terms with your own medical situation. I pray and think of you each day

 

[Ged1975]

Gerard,
Tell your brother congratulations on getting the TOE done. It is a good step forward. Since I am not a doctor I can only say that this procedure does give a pretty good picture of the heart and valves. So now I would suppose it is a wait and see what the cardiologist has to say.

So on another note, how are YOU doing? I hope you are well and coming to terms with your own medical situation. I pray and think of you each day

Chris,

I've never felt better, physically I feel great, emotionally I'm good too. Maybe the pressure is gone because I'm now "off the surgeon's list" and have been told to go back to my GP. I will be getting an independent echo in about 6 weeks just to see how my heart is. I no longer feel consumed by my heart problem. Having said all that, if I was to go to hospital tomorrow I would be terrified . I guess I currently have my head in the sand, which kind of suits me, but in the long term it's probably a foolish thing to do.

You are so kind to think about me, you have no idea how good inside that makes me feel and thanks for sending best wished to my brother too.

Kind regards

Gerard

 

[Ross]

TEE or TOE as you call it, gives the next best results to a catheterization. Don't get much more accurate then that.

 

[Ged1975]

TEE or TOE as you call it, gives the next best results to a catheterization. Don't get much more accurate then that.

That is very reassuring Ross. I hope the results show he won't need a valve replacement but being my twin brother I'm afraid he might have to.

Incidentially the cardiologist last month said he had never come across bicuspid aortic valves in identical twins, not once in his whole career. He is a top cardiologist in Ireland. I was surprised when I heard this, I assumed that identical twins would naturally have similar physical defects.