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Wednesday, November 30, 2011

My Angiogram Experiences – Part 1

For those who have been followed my blog would have known that I had admitted into hospital twice in the month of September. This was due to I was having quite serious haemoptysis or coughing out blood. Moreover I was having twice for the angiogram for my lungs too or it is also known as bronchial artery embolisation. Now I would like to share with you for my 2 times of the angiogram experiences.

An angiogram is an imaging test that uses x-rays to view our body’s blood vessels. Physicians/radiologists often use this test to study narrow, blocked, enlarged, or malformed arteries or veins in many parts of the body, including the brain, heart, abdomen, and legs. The physician may recommend an angiogram to diagnose a variety of vascular conditions, including:

• Blockages of the arteries outside of the heart, called peripheral artery disease (PAD)
• Enlargements of the arteries, called aneurysms
• Kidney artery conditions, called renovascular conditions
• Problems in the arteries that branch off the aorta, called aortic arch conditions
• Malformed arteries, called vascular malformations
• Problems with the veins, such as deep venous thrombosis (DVT) or blood clots in the
   lungs called pulmonary emboli

I was having one of the problems above, i.e. bleeding from the lungs and therefore I coughed out blood seriously. The reason for bleeding from my lungs was some of the veins in my lungs had “burst” and caused the bleeding. As I was a TB patient before, my lungs already had some scars, thus those scars caused the infection of lung and eventually I was having badly cough and thus the bleeding started. :(

My first angiogram for the lung was taken on 16/9/2011 during the evening time and it only taken an hour for such procedure. However, as for my second angiogram, it took me 3 hours for the procedure and it was done on 23/9/2011 which was also done in the evening. 2 different radiologists carried the angiogram for me respectively. The first radiologist was a Malay lady and the second radiologist was a Malay guy whom I think he is a very good and experienced radiologist. Both of my angiograms were treated as the emergency cases.

Before my 1st angiogram taken, the house doctor had given me an injection as to avoid the risk for an allergic reaction on me. Then I also required to sign a consent letter for carried out the angiogram as there are risks for such procedure. The radiologist asked if I was allergies to the seafood. Allergies can increase the risk of a reaction to the contrast dye. The extra fluid associated with angiograms can sometimes cause problems for patients whose hearts have poor pumping ability, such as those with congestive heart failure. I told the radiologist that I am not allergies to the seafood, and then she said it is OK, and did not need to worry. After that, I signed on the consent letter and then I was pushed into the room for the angiogram.

Once entered the room, I saw it was a room equipped with a specialized machine with 3 monitors. I was told by the nurses to lie on a bed and then I was instructed to lower my panty due to the radiologist was required to insert the angiographic catheter into an artery in my groin. I was very nervous at that time too. I was also wearing the oxygen mask for the whole procedure. Before the insertion, the assistant of the radiologist (who was also a radiologist) cleaned my skin in the area to reduce the risk of infection. I was very embarrassing at that time due to it was a male assistant radiologist to do it. He then numbed my skin with an anaesthetic and then the main radiologist told me that they would make a tiny puncture to reach the artery with a needle. The radiologist done it in a very fast pace and once she inserted, she told me the worst part which was the most painful for the procedure had done. She told me to relax and breathe normally. FYI, I was conscious for the whole procedure.

After the radiologists inserted the catheter, I could see the monitors were showing some images. I think it was showing my lungs and I could see the heart was pumping too. Later, I found that it advances a thin wire through the needle, threads a catheter over the wire, and guided it to the desired location. The radiologist used x-rays that were projected on a video screen, a process called fluoroscopy, to see the catheter as it moved through the arteries or blood vessels.

When the radiologist had positioned the catheter properly, she injected the contrast dye as she told me that I would have a bit of warm feeling because the contrast dye entered my bloodstream. I did feel the mild warm feeling. She then started the procedure by instructing her assistant to take more x-ray images to see how the contrast was flowing through the arteries. During the procedure, I was asked by the radiologists to hold my breath for about 5 to 10 seconds as they needed to take the x-rays. I think I was told to do it for few times. The radiologists also told me to lie perfectly still to prevent sudden movements from blurring the x-ray pictures. But I did some fidgeting during the procedure for few times as I could not stop helping it.

Well, my first angiogram procedure was going smooth and it only took an hour for it. In my first angiogram, the radiologists only put 6 coirs into my lungs to patch the blood vessels to stop the bleeding. After the end of the procedure, the radiologist removed the catheter and then the assistant pressed the insertion site which was my wound for about 20 minutes to help stop bleeding and then pasted the plaster to cover my wound. Then he told me to keep my leg straight and to lie down straight for 6 hours to minimize bleeding from the puncture site. The radiologist also told me that if I felt my wound was having some hot feeling, it meant that it was bleeding and required to seek for the treatment immediately. After that, I was transferred to another bed by the nurses and then sent back to my ward. I saw my mother was there once I had been pushed out by the room and then she went together with me returned to the ward.

Since I could not sit up but just to lie flat on the bed, my mother was feeding me for some soft food and drink. I also dared not to move my lower body at that night as I was afraid that my wound would bleed. I also did not sleep well too. So, in the next day, after 6 hours, I started to move a little for my legs and few more hours later, I could leave the bed to walk. My haemoptysis also stopped after the angiogram and of course I still needed to take some antibiotics treatment and then I was discharged from the hospital on 20/9/2011. Moreover, I also did not have any side effects from the angiogram as the doctor said some people would have rashes, pain or swelling on the wound after the procedure.

So the above is my first experience of my angiogram for my lungs. I was thinking that I was recovered after such procedure but it was not and eventually I had to undergo for another time of the bronchial artery embolisation in a week later after my first angiogram and it was a totally different experience for me. I would blog about it in my next post.

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