Comments on: What should I ask the radiologist before my cerebral angiogram?

Question: What should I ask the radiologist before my cerebral angiogram?

cgg — Tue, 24 Apr 2007 09:41:31 -0800

What should I ask the radiologist before my cerebral angiogram?

Long story short, my neurologist has recommend that I have a cerebral angiogram done. It's scheduled for this Thursday. Thanks to the nurses handling my pre-admission, I think I have a good handle on the procedure and what it entails, what to expect, and why it's necessary. Conveniently enough, my neuro's on vacation, so pestering him is out unless it's an emergency (and even then, it would involve calling the guy covering his patients.) I guess what I'm asking is that considering I'm only going to have a very limited time to talk to the radiologist doing the angiogram (who I've never met) before the procedure starts, and other than asking him about the risks and signing the consent form, I want to make sure I make the most out of the time while I'm still lucid enough to care. (The procedure is done under a local, but apparently i'm getting a good dose of sedatives). But what else am I missing, if anything?

By: ikkyu2

ikkyu2 — Tue, 24 Apr 2007 09:59:13 -0800

Ask him what the plan is in the event of either: dissection of an artery or an iodine contrast reaction, and how likely either of these things are. (Less than 1% for each, but not less than 0.1%.) Also ask him about postoperative bleeding from the groin and how it will be dealt with if it occurs.

You should feel comfortable with his ability to deal with these common complications before you undergo the procedure.

By: damn dirty ape

damn dirty ape — Tue, 24 Apr 2007 10:02:45 -0800

"Hello, have you tested me to see if I am allergic to the contrast medium?"

By: killermac

killermac — Tue, 24 Apr 2007 10:26:01 -0800

Second damn dirty ape with a healthy dose of personal experience. My heart stopped for 11 minutes because of an allergic reaction to contrast.
And make sure they have a defbrillator attached beforehand.

By: adipocere

adipocere — Tue, 24 Apr 2007 10:29:07 -0800

Welcome to "sunset groin." Plan on being a variety of colors, starting with purple, from hipbone to hipbone, for about a month. That, and they'll want you to use a bedpan for a while, due to the size and location of the clot formed. Because you will have extra fluid in you, you will want to use that bedpan. I made myself wait, because I'm stubborn, but I am not sure it was worth it.

You will be, ah, shaved. The sides of your neck will hurt a bit afterwards.

By: j-dawg

j-dawg — Tue, 24 Apr 2007 11:42:12 -0800

I would ask your doctor if a less invasive QMRA is sufficient. (Of course, you have to also find a hospital set up to do one; it's pretty new technology.)

By: orthogonality

orthogonality — Tue, 24 Apr 2007 16:16:20 -0800

Ask if you'll get a cow collagen plug for the incision. It'll still hurt like hell when the intern spends 15 minutes pressing a twenty pound bag of sand on it post-procedure, but the plug will make the healing go much more smoothly (I guess). I don't have as much as a scar, can't find any evidence of the incision. The sunset groin? Not so much in my case (and I had a triple lumen on the other side, for aesthetic balance); I was walking around and lugging my luggage two days post-procedure (and four days post-MI). Yeah, the incision remains a bit tender for several weeks.

I forget how long the dressing was on the incision, but I vaguely recall missing out on some showering. Oh, and dogs can smell the dressing or the blood or the lack of showers, so if you'll be around dogs, be ready to shove away friendly furry snouts intent on investigating your lap.

As to the procedure itself, if they tell you you'll be awake, that may be technically true, but the sedatives put me out; your mileage may vary. I remember being wheeled in, looking at the monitor, thinking "this'll be fascinating" and then blur-blur-blur. Will they take the opportunity to do anything else (stent you?) if the doc sees the need? Find out.

Good luck and take it easy.