This week's post is dedicated to Joanne!
I've had two ablations. So I'll explain each type of ablation and what is involved with both procedures.. This week we'll go over ablations. Next week I'll talk about open heart/ablations.
I entered the Operating room and was given some medications. They told me ahead of time I would not be asleep, so I was anticipating some pretty bad stuff! I wasn't asleep but was given enough medication to think the clouds on the ceiling tiles were moving. They weren't! They give you medications to make you forget. So I asked for 6 hours straight when I could go to the gym! I also kept telling them if they needed to aggravate me to go get my husband because no one can make me mad faster than him! Oh well, the stuff my poor docs have to listen to while I am having surgery!
The first step of a ablation is to conduct the EP study. This is the "mapping" process that is used to identify the overactive nerves inside the heart. So they put you on a table and make a tiny incision in your leg. (Usually your right leg.) You don't feel the catheter at all. It's inserted into a femoral vein.
It sounds weird to having surgery while awake and it seems pretty scary. But once you are in there it's not scary. I was more excited to get it done than scared. Because I wanted a normal life. I jokingly told the team, "Let's go play laser tag in my heart!" That's kind of what it's like. The surgeon will ask you questions in order to try to get your heart to speed up. Sometimes they try to make you mad or ask math questions. It's very hard to answer math questions when you are on loopy drugs. Since most people with Inappropriate Sinus Tachycardia speed up while standing it's hard to trigger the heart while laying down. But they need to trigger you so they can see the messed up nerves "light up" on the screen. Sometimes they have you open and close your hand and make a tight fist because that will speed up your heart if you have an electrical glitch like me. (Go ahead, try it, see if it works on you.) I'll wait.... You'll have several large TV screens above you which you will be able to see. You can see each blinky light (which is each area that needs to be abladed.) They use several technicques to visualize the area. You have a lot of equipment around.
Once they get a clear map they can decided which areas they are going to ablade. The mapping process can take a long time. Mine took several hours. About 6 hours. But they can go anywhere from 2-10 hours. When they are going to start the actually ablation they trigger some nerves. You can feel what they are hitting sometimes because you will feel a sensation in your arm or in your diaphragm. When they hit your diaphragm nerves you feel a jumping sensation in your belly. Very weird. They have to avoid hitting the phrenic nerve during the surgery because that's the nerve that moves your diaphragm so you can breathe.
You can feel when they ablade. It was intense but I didn't cry. The doc would yell "Fire" and the techs in the next room would fire the laser. I'm not exactly sure how that part works. Very important that you don't move during this part!!! I had a mixture of hot and cold ablation. But it's strange because you'll drift off and someone yells "Fire!" it's a very surreal experience. But you just stay still and it hurts for a few seconds while they burn each nerve. It's not bad. Sounds much worse than it was for me. Sometimes they have to use adrenaline to speed up your heart to see where the problem is located. They used adrenaline with me, you feel your heart pounding and it's hard to catch your breath. But it's what needs to be done in order to find the nerves causing the electrical problem in your heart.
When they used the adrenaline I could feel my heart pounding and I felt the sensation of not being able to breathe. I let my doc know and he told me he could see the problem. Then he said he was putting me to sleep. To get a better angle on the location my doc decided to go up the other leg. I had about 5 points of entry in my legs. They had found an AVNRT (AV Nodal Reentrant Tachycardia.) This was the cause of my SVT (Super Ventricular Tachycardia.) It's a nerve pathway that they say is like a dog chasing it's tail. So when you are in that pathway you can't breathe. It happens at the weirdest times like when you eat. You can just be standing there minding your own business and your heart takes off like a racehorse. It's not awesome. But over the years I learnd how to calmly say, "Excuse me I'm in SVT can someone check my pulse/ox? My doc was able to ablade the pathway. I have a 99% chance that I will never have SVT ever again.
After you get through recovery after the EP study/ablation you will be asked to lay still for several hours. This also means not getting up to pee. It's very important not to wiggle your feet after the procedure. If you are like me you'll want to move. Bad Idea. Unless you like it when you start to reopen your incisions and a large man holds compression on your vein or artery for you for 20 minutes. If you do they incision sites will open up and start to bleed. I know because it happened to me. A very large man was send in to hold compression on my crotch to stop the bleeding. It's a great time to ask lots of awkward questions! It was kinda funny. But unless you would like to reopen your wounds don't wiggle and do what the nurses tell you do!!!
You can usually go home the next day. The recovery period is strange because you will feel burning sensations. For months. Off an on. You'll feel beat up. Picking up anything over 5 pounds will make your chest hurt. That includes pushing grocery carts. So be careful what you do after surgery. The surgeons try very hard to burn as little as possible during these surgeries. You can hear them counting off while they are operating. I was very close to getting pacemaker during my ablation. The surgeons wait and if your heart clicks back on they continue. If not they stop what they are doing and put in an emergency pacemaker.
Yes, that sounds scary but trust me. You are totally safe in that OR. They have control over everything. So pick a fantastic surgeon and get on board. Anything that gets you well is okay by me!
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