- The second anniversary of my heart transplant
- Two different catheter procedures to check the health of my heart
- The hospital cafeteria, endowed by Williams of Williams and Sonoma
Today I had an appointment at CMPC for the procedure I was scheduled to have done a week ago, but which was derailed by some emergency in the catheter lab, as I wrote about here.
This marked the second anniversary of my heart transplant. I wrote about having the same procedure done a year ago, on the first anniversary, but see now I got some details confused.
The catheter biopsy involves sending a catheter — not a urine catheter! but a catheter that goes up a blood vessel — from an entry-point in the neck and then down over to the heart. Somehow they literally snip tiny biopsy samples of the heart tissue and pull them out for testing. They also do a test for “Blood Gas w BMP, Lactate, H&H, Venous, POC”. The result of that test is a long list of component results, from “PH, VENOUS, POC” all the way to “eGFR, Ven, POC”, and most of the results — sent to us by email almost immediately, today — are normal, a few measurements low or high being borderline.
(It’s great that modern medicine and online interaction enables results of such tests to be available almost immediately. Not like the old days where they would have to *phone* you or even send *physical mail* to tell you details of test results… if they did at all. Most times they didn’t notify you at all, unless something was wrong.)
What I erred about in my post from a year ago when I discussed this procedure, is that I conflated two different procedures. On that first anniversary of the transplant, and again on this second, I had a procedure called “LFT/RT HEART CATHETERIZATION”. This is the procedure that involves a catheter sent up from the groin, with two tiny catheters, one in a vein, one in an artery, to the various chambers on both sides of the heart to inspect … the pressures on the sides of the heart tissue, if I remember the doctors’ descriptions correctly. But it doesn’t involve taking a biopsy.
That procedure, with the catheters sent up through the groin, entailed some anesthesia (though I was never entirely asleep), and some resultant bed rest, for 2 or 3 hours, before I could go home — and had to be driven home. And that one has only happened to me twice, now.
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Today’s procedure has been more routine, done every couple months following the transplant in May 2021, reducing to every three months, then four months, now six months. If I understood the cardiologists correctly — some of the guys in the cath lab today thought they would see me again in another year — this is the last such procedure I’ll need. From now on, after two years, they will rely on blood tests, or any symptoms that might occur.
Today’s procedure was more stressful than earlier ones. The worst part of this procedure is the initial injection in the neck, where they use Lidocaine — familiar to most people through dental exams — to numb the portion of the neck where they will inject the catheter. The Lidocaine stings, mightily, but in past procedures, once it’s over, the process of pushing the catheter into my neck, and so on, has been virtually painless, unnoticeable. Not quite so this time. I was more aware this time of the doctor *pushing* against the right side of my neck to drive the catheter in. At one point I felt a sensation in my chest, just right of my sternum, as if the catheter and gone off track. Comments from the doctor suggested he was having trouble guiding the catheter around some corner in my heart; he pulled back; ordered something longer from his staff (15 centimeter!); and proceeded on. Eventually all was finished, successfully, but I was left more stressed out than from any such procedure before.
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The procedure was over about 10 minutes to noon. I had thought about doing this, and so did ask the staff in the cath lab, as we all finished up, where they go for lunch? After most of our previous visits, we’d walked across the street to have lunch at Mel’s Kitchen, where I discovered huevos rancheros.
Surprisingly, they recommended the hospital cafeteria, which I had never been to. (In the days two years ago when Y was visiting me every day in my room on the 10th floor, he would sometimes get something to eat from that cafeteria, while I got my hospital-supplied luncheon.) One of the staff mentioned that the cafeteria — remember this hospital was built only 5 or 6 years ago — was endowed by Chuck Williams, co-founder of Williams Sonoma. Well OK then.
So it was just fine, as a cafeteria, with several stations for specials of the day, a salad bar, and so on. The architects cleverly arranged the cafeteria to be on the 2nd floor, one up from street level, with huge windows looking out onto Van Ness and a side street. And it was a bit of a thrill to see so many doctors and hospital staff coming through for their lunches. I had the special chicken sandwich of the day, and Y had the Bibimbap bowl. And then we drove home, in much better traffic than we had the week before.
