Going it alone following adrenal vein sampling (AVS).
April 25, 2011 12:25 PM Subscribe
Once my ride home from the hospital drops me off, what should I expect to be unable to do by myself after my adrenal vein sampling procedure?
Based on the lack of reponses to my last question posted regarding my adrenal adenoma, I don't expect there are many here who are experienced with this, but - here goes.
I'm having adrenal vein sampling done Friday. A dear friend is taking me to the hospital at the ungodly hour of 6am, then spending the day waiting while I undergo the procedure, then taking me home.
After that, I'm on my own. I live alone, in a tiny apartment, and do not want anyone staying with me, nor do I want to stay in a home that is not my own. I'm going to feel like crap and I'd rather not have an audience.
That being said, if anybody here has *had* the procedure, or any medical types have *done* the procedure, what types of things should I be aware that I may not be able to do solo afterward?
Or maybe a better way to phrase this would be - for anybody who lives alone, what do you wish you had thought of and prepared for beforehand, after you have had an invasive outpatient procedure done?
I'm a complete noob when it comes to anything surgical - so, I appreciate any ideas you all have. Thanks much!
Based on the lack of reponses to my last question posted regarding my adrenal adenoma, I don't expect there are many here who are experienced with this, but - here goes.
I'm having adrenal vein sampling done Friday. A dear friend is taking me to the hospital at the ungodly hour of 6am, then spending the day waiting while I undergo the procedure, then taking me home.
After that, I'm on my own. I live alone, in a tiny apartment, and do not want anyone staying with me, nor do I want to stay in a home that is not my own. I'm going to feel like crap and I'd rather not have an audience.
That being said, if anybody here has *had* the procedure, or any medical types have *done* the procedure, what types of things should I be aware that I may not be able to do solo afterward?
Or maybe a better way to phrase this would be - for anybody who lives alone, what do you wish you had thought of and prepared for beforehand, after you have had an invasive outpatient procedure done?
I'm a complete noob when it comes to anything surgical - so, I appreciate any ideas you all have. Thanks much!
Response by poster: JohnnyGunn, thanks for the reply. That's so funny about the laundry and bathroom - I just did the same thing in preparation :)
And I've already asked my friends to call me and not worry about waking me up. Because, you know, my biggest fear, as someone who has never had anesthesia before, is *not* waking up!
posted by chez shoes at 1:02 PM on April 25, 2011
And I've already asked my friends to call me and not worry about waking me up. Because, you know, my biggest fear, as someone who has never had anesthesia before, is *not* waking up!
posted by chez shoes at 1:02 PM on April 25, 2011
Took a quick look and this seemed to summarize recovery time and activity. Hope all goes well.
posted by rmhsinc at 1:53 PM on April 25, 2011
posted by rmhsinc at 1:53 PM on April 25, 2011
Response by poster: Thanks for the well-wishes rmhsinc! I should have mentioned that I've already read every existing blog and forum on the topic out there, and been in touch with many of the authors as well - not that there are very many :) By posting here, I was hoping to get feedback from a broader cross-section of people.
posted by chez shoes at 2:16 PM on April 25, 2011
posted by chez shoes at 2:16 PM on April 25, 2011
I know exactly how you feel in that I wanted to be in my own home, my own bed without anybody around to constantly ask me questions; I wanted to be alone, yet I did not want being alone to be an issue in that no one was there to check on me if there was an issue. Having your friend call is a good idea. Tell that friend not to take it personally if you just say, "Thanks for calling. I am doing ok. Leave me alone but call back in 4 hours."
I also had stents put in my heart via the artery in my leg and there was definitely soreness down where they went in for a few days. Bruising was significant, but as it said in that blog linked by rmhsinc, not an issue if it is not hard. I was a little freaked that I was going to roll over in my sleep and pop the closure or clot and bleed to death in my bed without anyone knowing. In hindsight, that was a totally irrational fear not because it did not happen, but because of the way they close you up and because they check you out before letting you leave.
Anyway, forget all the negatives and focus on the positives!! You will get answers from the test and be on your way!! Good luck.
posted by JohnnyGunn at 7:53 PM on April 25, 2011
I also had stents put in my heart via the artery in my leg and there was definitely soreness down where they went in for a few days. Bruising was significant, but as it said in that blog linked by rmhsinc, not an issue if it is not hard. I was a little freaked that I was going to roll over in my sleep and pop the closure or clot and bleed to death in my bed without anyone knowing. In hindsight, that was a totally irrational fear not because it did not happen, but because of the way they close you up and because they check you out before letting you leave.
Anyway, forget all the negatives and focus on the positives!! You will get answers from the test and be on your way!! Good luck.
posted by JohnnyGunn at 7:53 PM on April 25, 2011
Response by poster: Thanks again JohnnyGunn! The catheter part is similar to a lot of procedures for heart problems, if I understand correctly. I've had the same fears, irrational or not, that you mentioned, but from what I've been told that's why they will be keeping me for a few hours after the procedure, so none of those things happen.
posted by chez shoes at 10:57 PM on April 25, 2011
posted by chez shoes at 10:57 PM on April 25, 2011
Best answer: You evidently saw one of my posts on anesthesia, so I won't go into detail about how safe it is in this day and age. Although we don't do much adrenal vein sampling at my institution (at least that I am involved with; I am about to go do a case with an invasive radiologist and will ask him about it) it looks pretty straightforward. Your idea that it is similar to a cardiac catheterization is a good one, with the main difference being that they will not need to go into your femoral artery. That is important because the artery has much higher blood pressure than the vein (think 120/80 mmHg arterial versus less than 10 mmHg in the vein). THis means that the risk of bleeding complications is lower, although it is quite possible to hit the femoral artery by mistake while trying for the vein. Even if that happens they would pick up on it before inserting the big dilator and catheter used for the sampling, so there would only be a small hole to worry about. The one thing you might want to ask them is how long you should lie flat afterwards; if you are unable to get out of bed then having some help is important. I am guessing that you will be able to sit up by the time you are sent home, but don't know that for sure. That's all I can think of for now, but if I fin out more from the radiologist I will let you know.
posted by TedW at 8:23 AM on April 28, 2011
posted by TedW at 8:23 AM on April 28, 2011
Response by poster: TedW, thanks for weighing in. I found you from reading other questions about anesthesia in general, and surgery when one lives alone (pending results of the AVS, my next procedure will likely be laparoscopic adrenalectomy).
After AVS they make the patient lie flat for a minimum of two hours before even considering sending them home, that much I know already. The team doing the procedure is fully aware of my situation and my lack of comfort in relying on others - outside of a 24-hour restriction on climbing stairs, driving, or taking a bath, they do not foresee anything coming up that would make me require anybody's help. Of course, this is all said with the caveat that "everyone is different."
If you are able to learn anything more from the IR that you are working with, please let me know. Thanks much!
posted by chez shoes at 10:13 AM on April 28, 2011
After AVS they make the patient lie flat for a minimum of two hours before even considering sending them home, that much I know already. The team doing the procedure is fully aware of my situation and my lack of comfort in relying on others - outside of a 24-hour restriction on climbing stairs, driving, or taking a bath, they do not foresee anything coming up that would make me require anybody's help. Of course, this is all said with the caveat that "everyone is different."
If you are able to learn anything more from the IR that you are working with, please let me know. Thanks much!
posted by chez shoes at 10:13 AM on April 28, 2011
Best answer: I talked to the radiologist and we do indeed do adrenal vein sampling in our hospital. He confirmed my speculation that since it is a venous stick there is little in the way of bleeding risk. At our hospital they are typically done under mild sedation with some local anesthetic where the stick the vein, and we too keep the patient for about 2 hours afterward; a cardiac cath patient will often stay overnight by way of comparison. He said that the procedure can be tedious and time-consuming (which is why they are typically scheduled first case of the day). The adrenal veins can sometimes be hard to find and get a catheter in, and then they have to send blood samples to the lab and wait for the results to insure they got a good sample before moving on. The whole thing can take several hours in the special procedures room. But there is usually minimal risk or discomfort for the patient and it sounds like your biggest problem may be boredom.
If you are a candidate for adrenalectomy that is obviously a bigger procedure requiring general anesthesia, but it should still be straightforward as far as these things go. It sounds like it may even be quicker than the adrenal vein sampling.
As always, I mention these things with the caveat that any other medical conditions you have as well as the standard practice at the hospital you are going to may deviate somewhat from what I have described. But you should do well and I wish you luck.
posted by TedW at 11:01 AM on April 28, 2011
If you are a candidate for adrenalectomy that is obviously a bigger procedure requiring general anesthesia, but it should still be straightforward as far as these things go. It sounds like it may even be quicker than the adrenal vein sampling.
As always, I mention these things with the caveat that any other medical conditions you have as well as the standard practice at the hospital you are going to may deviate somewhat from what I have described. But you should do well and I wish you luck.
posted by TedW at 11:01 AM on April 28, 2011
Response by poster: Thank you TedW! That all sounds exactly like what I've been told will happen. I wasn't aware that they sent samples to the lab during the process, that's good to know.
I'm still worried that my biggest problem will be nausea afterward (since just about every drug makes me nauseated, even on the best of days) and staying still for 2 hours. And yes, I've been told that the actual adrenalectomy is quicker.
One question for you, if you don't mind - I've read that before getting the sedative, I should mention my concerns about nausea. Is there a specific med I should ask for? Nausea is a huge deal for me because my adrenal tumor already causes potassium loss, so any electrolyte disturbances can be dangerous.
Thanks again!
posted by chez shoes at 12:29 PM on April 28, 2011
I'm still worried that my biggest problem will be nausea afterward (since just about every drug makes me nauseated, even on the best of days) and staying still for 2 hours. And yes, I've been told that the actual adrenalectomy is quicker.
One question for you, if you don't mind - I've read that before getting the sedative, I should mention my concerns about nausea. Is there a specific med I should ask for? Nausea is a huge deal for me because my adrenal tumor already causes potassium loss, so any electrolyte disturbances can be dangerous.
Thanks again!
posted by chez shoes at 12:29 PM on April 28, 2011
Is there a specific med I should ask for?
That is hard to say; if you are just getting mild sedation from the team doing the procedure nausea is unlikely even if you are prone to it; if an anesthesiologist or CRNA is involved the sedation will probably be deeper with more likelihood of nausea. In any event, mention your concern to whoever is doing your sedation; they will have heard this concern before and have ways to deal with it. I am reluctant to mention specific drugs because there are a number of approaches they might take.
posted by TedW at 2:47 AM on April 29, 2011
That is hard to say; if you are just getting mild sedation from the team doing the procedure nausea is unlikely even if you are prone to it; if an anesthesiologist or CRNA is involved the sedation will probably be deeper with more likelihood of nausea. In any event, mention your concern to whoever is doing your sedation; they will have heard this concern before and have ways to deal with it. I am reluctant to mention specific drugs because there are a number of approaches they might take.
posted by TedW at 2:47 AM on April 29, 2011
Response by poster: Turns out that at the last minute the hospital rescheduled my procedure for *next* Friday, giving me a whole other long week to worry about it :)
Actually, I'm feeling a little less apprehensive about it, thanks to your info - really appreciate it, thanks!
posted by chez shoes at 7:56 AM on April 29, 2011
Actually, I'm feeling a little less apprehensive about it, thanks to your info - really appreciate it, thanks!
posted by chez shoes at 7:56 AM on April 29, 2011
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For some weird reason I also thought it important to have done all my laundry in case I needed any item of clothes clean and had cleaned my bathroom as I was afraid I might be puking or spending time in there. Overkill. I was pretty much prepared for my life to run on autopilot for about 3 or 4 days in the event I was unable to do anything but sleep. I also asked my mother to call me at specific times both for company and to assure I was ok.
Oh, I also had a bunch of baby wipes so I could clean myself without taking a shower. You may need someone to help with getting a prescription filled or have the person driving you home stop on the way if possible.
posted by JohnnyGunn at 12:43 PM on April 25, 2011 [1 favorite]