Rapid Lysis By Any Other Name

This morning as I arrived at the hospital, I passed Kerry leaving.  He’d popped in to see his father before heading out to work.  Jeff looked pretty good.  He hadn’t slept well between the busy nurses’ station outside his door and the noisily-breathing octogenarian in the next bed.  The foam earplugs he’d requested did not help all that much.  Nurse Mina said he was scheduled for a procedure at 11 a.m.  I asked if he was to have surgery.

“No, no.  It is procedure.  No surgery,” Mina said.

“What is the name of the procedure?” I asked.

“It is called Blood Clot Removal Procedure,” she told me.

Of course, we were curious to learn a little bit more about this Procedure.  At this point we had only our own WebMD education to help us guess what was about to happen.  Dr. Sanchez, Intervention Radiologist, came to the room to thoroughly discuss what he might find when he goes into Jeff’s vein through the back of his knee, and what he might do about it once in there: stents, filters, breaking up a clot with TPA (Tissue Plasminogen Activator), sucking out pieces of clot, etc.  He said because Jeff had acute symptoms, he could probably clean it up easier than if he was a patient with long-term issues.  Dr. Sanchez hadn’t yet seen Jeff’s imaging from yesterday so he couldn’t say for certain which of his tricks he would try.  I handed him the CD of Jeff’s ultrasound and he excused himself to go have a look.  Within minutes Nurse Mina was back in the room to announce they would take Jeff for his Procedure in ten minutes (much earlier than scheduled).   

Jeff was wheeled away by a friendly Transport Guy who referred to me as Jeff’s “daughter.”  I went to get a bite to eat and a nurse from radiology called to say they were taking Jeff in to begin The Procedure and she told me where to wait for him.  When I arrived at the Cath Lab I stopped at the desk to introduce myself and to ask again, “What is this procedure called?”

“Arteriogram,” I was told. 

I settled down to wait.  And wait.  Just when it was beginning to seem unbearable (and I reminded myself many times I was only the one waiting, not the one being poked and prodded), my sister, Judy texted.  She sensed I needed her.  She came to wait with me and provided a good distraction and comfort.  Still, I grew more and more concerned and finally asked at the desk for an update.  I learned that they’d been looking for me and “couldn’t find” me though I had been waiting in the brightly-lit and nearly empty waiting room where I had been instructed to wait.  There had been two people who recognized me as I sat in the waiting area.  Each of them spoke with me for a few minutes – a woman from our church and a co-worker.  Is it possible that the nurse saw me talking to someone and thought I was there for some other purpose?  The hospital staff weren’t calling out names, they were coming out into the waiting room to find family members.  There were never more than three people in the waiting room so it should not have been hard to figure out where I was, who I was.

Meanwhile, Jeff kept telling the nurses, “My wife is going to be mad if you don’t find her.  You better page her.” 

Dr. Sanchez told Jeff that The Procedure went well.  Two catheters were placed in the back of his leg to be left overnight with TPA pumping in.  First thing tomorrow morning they’ll check to see whether the large clot disintegrated enough to be sucked out.  This can take up to 48 hours.   

I was reunited with my honey in the ICU (because of risk of bleeding) where I found him eating pasta in a spacious, private room.  I read him some greetings from Facebook, Instagram, emails and texts.  He snoozed for a while and I took the time to update friends and family.  Nurse Mike was in and out of the room tending to Jeff.  I drew his attention to a change I noticed in Jeff’s face.  It was turning bright, bright red. 

“Is this something we should be concerned about?” I asked Mike.

Mike looked Jeff over and decided, “He doesn’t look bad to me.  I just started his antibiotic.  We’ll keep an eye on him but I’m not concerned.”

Jeff said it was his “been-in-the-islands” look.  I cursed my hyper-focus on the changes in Jeff’s skin.  I am constantly looking for evidence of Graft vs. Host Disease and chastised myself for my over-vigilance.  Still, Jeff’s face looked very, very stressed to me.  I left the room to get a drink.

When I returned, Jeff informed me that Nurse Mike thought I might be right, that the red face was a reaction to the antibiotic Cefazolin (Ancef) even though such reactions usually begin on the back.  Mike called Dr. Sanchez and Benadryl was ordered; the second dose of Cefazolin was canceled. 

Late in the day, Dr. Sanchez sent his Physician’s Assistant to discuss The Procedure with us.  By this time I had read an article about “Rapid Lysis” that Jeff’s brother, Paul, found:  http://www.mainlinehealth.org/diw/Content.asp?PageID=DIW008879

The P.A. told us what we might expect for Part Two of The Procedure, scheduled for first thing tomorrow morning.  She also confirmed that The Procedure is known as “Rapid Lysis.”

Jeff kept asking me, “What is Dr. Sanchez?  An Unconventional Radiologist?” 

“Interventional Radiologist,” I’d answer.

After a few repetitions of this over a few hours, Jeff asked again with a twinkle in his eye.

“I don’t remember, was it Inconvenient Radiologist?” I asked.

An evening visit from Dan and Jennifer was very welcome, indeed, as were the many well wishes from friends and family.