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ASD

Heart Defect Update – Transesophageal Echo

Disclaimer: This post includes an account of events that I experienced while medically stoned, so take it with a grain of salt.

Transesophageal Echocardiogram from Wikipedia (Creative Commons License)

Transesophageal Echocardiogram from Wikipedia (Creative Commons License)

In my last update about my heart defect, I shared that my new cardiologist confirmed that I have at least one hole in my heart but he wasn’t sure if I have an atrial septal defect (ASD) or a patent foramen ovale (PFO). So he ordered a transesophageal echocardiogram (TEE) to get a closer look which would get help determine my diagnosis and a plan of action.

A few days ago I went to the Scottsdale Healthcare Shea Medical Center for my procedure. The staff at this hospital is outstanding. A kind volunteer walked me from the information desk to the admitting area, and another volunteer escorted me from admitting to the department where I would actually have the procedure done. My nurse, Alison, was awesome. I traded my T-shirt for a gown and she covered me with a warm blanket that felt like it was fresh from the dryer, put the IV in my arm, and stuck 4 very sticky electrodes to my chest. We think we know each other from somewhere but we couldn’t figure it out.

They told me to be at the hospital by 1pm even though my procedure wasn’t scheduled until 3pm. Alison texted my doctor, ordered the machine to be brought in, and moved things along. When the Tech brought the machine in, I saw the scope they would be using – holy crap that thing is long! I knew they only had to slide it down my throat until it was parallel with my heart but geeze! I didn’t need to see that.

My doctor who did the procedure – Dr. Robert Burke – was awesome. He was very reassuring and put me at ease from the start. He made sure I understood the procedure before shifting me onto my side and he asked Alison, whom he referred to as “my bartender” to inject my IV with versed and fentanyl. I was a little nervous as I waited for the drugs to take effect but I was unconscious in less than a minute.

During the procedure they injected my IV with saline and watch to travel through my heart. All saline has bubbles in it, so they could watch to see how many bubbles went through the defect. According to Alison, when Dr. Burke first tried to slide the scope down my throat, I started hitting my thigh with my hand. (I have no memory of this.) He ordered a dose of propofol to further put me out.

I regained consciousness about 2 hours later. My aunt was there to pick me up and she said I looked very peaceful while I slept. By then, the IV was out of my arm and Alison came into remove the electrodes from my chest. Those things were super sticky. I feel sorry for anybody with a hairy chest who gets those.

I was very medically stoned. If memory serves, Alison said the doctor saw a PFO and that bubbles were going across the defect during the test. She offered me a wheelchair but I opted to walk – though I definitely couldn’t walk in a straight line, which I found pretty amusing. I slept very soundly that night.

So that’s what I know for now. I need to follow up with my other cardiologist who specializes in repairing heart defects to determine what the next step will be, but I suspect he will recommend sealing the hole.

Typical Night with Night Sweats

This is my night shirt after a night of night sweats. I took this photo 6 hours after I took this shirt off and it was still drenched!

This is my night shirt after a night of night sweats. I took this photo 6 hours after I took this shirt off and it was still drenched!

Unless you’ve experienced it yourself, you can’t understand what it’s like to have night sweats. I’ve had them almost every night at least since early December. We don’t know what’s causing them or how to stop them. I started seeing another cardiologist last week; I hope he’ll know what to do.

Here’s what a typical night is like for me:

Getting ready for bed: Put on t-shirt and shorts. Lay out two more t-shirts at the foot of my bed along with my sleep sack for the morning.

Sometime between 11:30pm and 1:30am: Wake up cold, clammy, and drenched in sweat – I mean drenched: my shirt, shorts, skin, sheets, and pillow. Take off shirt #1. Put on shirt #2. Flip over pillow. Go back to sleep.

Alarm goes off at 5:15am: Wake up cold and wet again. Turn off alarm. Exchange shirt #2 for shirt #3. Pull on sleep sack and step into slippers. Pad to kitchen to make coffee. (By the way – shirt #1 is still drenched despite air drying for the last four hours.)

And that’s just about what happens every night for me. It’s so gross to have my skin and sheets covered in human salt. I don’t know how people who have medical conditions that cause this every night deal with it. I’m pretty sure there isn’t a way to sweat through the night gracefully.

I saw my new cardiologist last week who did a second ultrasound. He’s not convinced that I has atrial septal defect (ASD). He said it might be a patent foramen ovale (PFO). Either way, I have at least one hole in my heart that I’ve had since birth.

This week we’re going to do a transesophageal echocardiogram to get a clearer picture of what’s going on and then we’ll formulate an action plan from there. The heart is right next to the esophagus so they’re going to knock me out and slide a camera down my throat and look at my heart. They’ll have a lot less to go through compared to an ultrasound that has to decipher what’s going on through muscles, bones, and my lungs. Hopefully this means I’ll have answers soon.

Of course, being a recovering addict, the first thing I asked when my doctor said I needed this procedure was, “Do I get propofol with that?”