Procedure Specific questions

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Procedure Specific questions

Postby CureOrBust » Thu Aug 19, 2010 4:56 am

I am booked for a procedure in the coming days (<7), Due to the way things have fell into place, I will not get a chance to speak to the surgeon before the procedure itself. So I am left with a few small questions which I haven't had a chance to get answered. Some are just an "out of interest" that would be good to know before-hand, and all of them actually make no difference to me getting the procedure done.

1. The entry point has been described as being in the groin area, yet on someone's video (Curious), they show the entry point being what I would describe as the front of the leg, at the level of your groin. Where exactly is the entry point? Is it within the pubic area or in the leg? Will I be sporting a new "haircut"?

2. How many stitches are used on the entry point?

3. I understand that my surgeon will simply be using a local. How much pain should be expected? Please note, I have a very low threshold.

ahhh... I actually thought I had more, but they have slipped my mind right now.

Thanks in advance.
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Re: Procedure Specific questions

Postby BooBear » Thu Aug 19, 2010 5:08 am

CureOrBust wrote:1. The entry point has been described as being in the groin area, yet on someone's video (Curious), they show the entry point being what I would describe as the front of the leg, at the level of your groin. Where exactly is the entry point? Is it within the pubic area or in the leg? Will I be sporting a new "haircut"?


You should expect a trim. :) The entry point is precisely where CureIous's video depicts. Mine was on the left side, just north of the leg, just west of the pubic area, pretty much in the "crease" of the leg, if you will.

2. How many stitches are used on the entry point?


In my case, none. The incision is actually quite small- I was surprised at how small it was, actually. Looks more like a scratch when you are done. The dressing stayed on overnight, replaced by a band aid the next day, and nothing the day after that.

3. I understand that my surgeon will simply be using a local. How much pain should be expected? Please note, I have a very low threshold.


In my case, the sedatives did help. My two hour procedure felt like 15 minutes. I can only speak to my personal experience, but the angioplasty on my left IJV hurt a lot. I actually thought something had gone wrong. But, before you get too scared, the angio on my right IJV and my azygous did not hurt at all. And once my left IJV was popped, the pain went away completely. I did not get any painkillers during the procedure, and as I am allergic to morphine and all deratives, I did not get the optimal sedative, either. Trust me that if you do have some pain, it should be very short lived.

[/quote]
Three veins angioplastied.  One renewed life.  
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Postby CureIous » Thu Aug 19, 2010 1:34 pm

Echo boobear. Right about where your hip socket is, expect a clip on BOTH sides (getting down to the nitty gritty here) though that may not happen, my guess is if they are unable to obtain access on one side the other is ready to go. This all happens before you even get close to the OR and is fairly discreet and efficient, they do it ALL the time. Expect it in pre-op with the curtain closed of course.

Nitty gritty aside, no stitches, local anaesthetic (for the incision site) and they were "in" before I even knew it. Nice little square bandaid was the extent of the coverage post-op, expect to be flat for around 2 hours minimum post-op so the incision can close up on it's own. My first time it was a bit longer as there was an overnight stay so wasn't on my feet for quite awhile, but that was stents too. 2nd run was angio only, but this time they gave me pill form of anticoagulants on the op table if I recall correctly, not thinners just Plavix, stayed flat for 2 hours under a watchful eye, but that turned out to be a bit sooner than what was needed for the site to fully close up, as evidenced on a trip to the bathroom in post-op. Oops, back to lying flat for another 2 hours then was no problem, on my feet and out of there. You'll have a hard time finding the scar after 3 months let's put it that way. Good luck and keep us posted!

Mark
RRMS Dx'd 2007, first episode 2004. Bilateral stent placement, 3 on left, 1 stent on right, at Stanford August 2009. Watch my operation video: http://www.youtube.com/watch?v=cwc6QlLVtko, Virtually symptom free since, no relap
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Postby elyse_peace » Thu Aug 19, 2010 2:17 pm

BooBear -
thanks for the info. love your new sign-off! :lol:
elyse
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Postby sgriff » Thu Aug 19, 2010 8:13 pm

CureOrBust -

Are you sure that is all he will be using? I guess all docs are different, but my husband was given light sedation to keep him in a twilight state as you have to be awake enough to perform certain tasks such as hold your breath, etc. He was also given pain medicine and was told that if he felt pain to let them know and they would give more. He remembers waking and feeling a pain in his neck and informing them. They would give more pain killer and he would kind of be out again. He thinks that happened about 3 times.

Yes, that catheter is very small - tiny entry point. He did have an ugly bruise all around it though!

I wish you the very best. Please be realistic about your expectations. Everyone wants the WOW experience, but if you don't get that, know that you will probably see results within days or weeks and MOST importantly possibly stop progression of your disease.
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Postby CureOrBust » Fri Aug 20, 2010 7:33 am

sgriff wrote:Are you sure that is all he will be using? I guess all docs are different, but my husband was given light sedation to keep him in a twilight state
No, I am not certain, as I have not spoken to the Dr performing the procedure directly. I was referred by one dr who was the diagnostician, and then booked in for the procedure.

I have however spoken to another dr that i originally had a booking with, but he was halted from performing any procedures outside of a formalised trial; which he is now setting up. This dr told me that all he would be using was a local. Ironic thing is the last time I saw him, he informed me for the trial to be blinded, they will be medicating the patients so that they will lose reference of time, and forget what happened during the procedure. All will have a venography, where half will simply be checked for issues, while the other half will have their issues actually treated. Then 2 months later both groups will undergo a second venography with ALL the patients being treated.

sgriff wrote:I wish you the very best.
thanks.
sgriff wrote:Please be realistic about your expectations.
At this stage, I simply hope they find something to treat! They did find some things during the doppler investigations, but neither the doppler nor 3 MRV's I have had performed have identified any specific stenosis in my Jugulars (unlike many before me). So the Azygous seems like the big culprit, though they did infer they may of seen some stenosis around the valves in this doppler, and a doppler I had done a few months after Zamboni's first paper found reflux in my IJV.

One question which I held back on (and please do not be afraid to respond to it as I will definitely be asking the Dr performing my procedure, and following their directives) is: Has anyone been told how long after the procedure they can take steroids? (ie prednisone or such) I plan on taking a pulse of oral prednisone as soon after the procedure as is safe. After a pulse of prednisone, I usually have some improvements, which slowly fade. I am hoping after the procedure, any improvements gained, will hang about a little longer. I have been on a monthly pulse cycle for a number of months.
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