General Medical issues thread

[prozac]

IVIg is scheduled for tomorrow. Following up on the elevated cancer markers mentioned upthread I managed to get a booking reasonably quickly for a PET scan next Wednesday which surprised me. Very happy with timing. Not worried but I rather it did not drag on.

 

[Steamrollersam]

Rare and my vascular surgeon would disagree as he had to fix a few of these pseudoaneurysms . Ive seen a few myself. At my hospital they have stopped using AngioSeal and gone to PerClose.


Agree but i was responding to his comment that they mentioned a transeptal puncture. Any why i said it was not a big deal.


Disagree. We dont exactly know what they are going to do. As a result we can only comnent generally about risk. The treating cardiologist will be able to clarify the risk in the individual case- and this encourages the patient to ask the question.



Again same point as above. BTW ive seen one in flutter ablation. Never say never.


Which is the point that was made about the incidence of a PFO by the treating cardiologist

I surmise your vascular surgeon would mainly be dealing with complications from our cardiac interventional and structural colleagues who use arterial access —they are a completely different mob from us ( tongue in cheek). Electrophysiologists mainly use venous access, so we generally just pull sheaths out—no need for closure devices such as Perclose or Angioseal because veins are low-pressure vessels. But yes I do use Perclose for leadless pacemakers for Fr 28 femoral venous access and left-sided VT ablations if using femoral arterial access.

As I also said cardiac tamponade is very rare, I never say never, I might have my first one related to a flutter ablation next week. A big worry if it happens because patients are on blood thinners.

Our patients are provided written procedural info sheets and reliable online resources (including patient support groups) prior to their pre-procedure appointments to facilitate an informed discussion instead of turning to Dr Google.

 

[prozac]

I surmise your vascular surgeon would mainly be dealing with complications from our cardiac interventional and structural colleagues who use arterial access —they are a completely different mob from us ( tongue in cheek). Electrophysiologists mainly use venous access, so we generally just pull sheaths out—no need for closure devices such as Perclose or Angioseal because veins are low-pressure vessels. But yes I do use Perclose for leadless pacemakers for Fr 28 femoral venous access and left-sided VT ablations if using femoral arterial access.

As I also said cardiac tamponade is very rare, I never say never, I might have my first one related to a flutter ablation next week. A big worry if it happens because patients are on blood thinners.

Our patients are provided written procedural info sheets and reliable online resources (including patient support groups) prior to their pre-procedure appointments to facilitate an informed discussion instead of turning to Dr Google.

I am having a pacemaker swap next year, under 18mths left on current 2 lead PCM battery. Anything to know?
Original implant had a number if issues that took more than 6 months to sort out. PMT for 3 months, 30cm clot in axillary and branchial viens. Heart surgeon is suggesting he will do swap, but given initial issues I am thinking maybe I should use the original electro-cardiologist.

 

[prozac]

I have a PET scan appointment tomorrow at 1pm. I know I should fast for 6hrs prior per the following instructions sent when the booking was made last week.

I am writing to confirm your PET-CT appointment scheduled for Wednesday 16th October.

• FDG PET-CT Time 1pm

Please arrive at ½ Hr earlier to the appointment
I have noted that you are non-diabetic

Preparation is required as follows:

Fast 6 Hrs Prior No exercises for 12 Hrs prior Wear loose warm and comfortable clothing and if possible, avoid wearing jewellery or anything with metal.

Odd they don't mention water so to be certain I called the imaging company this morning.
"No water, definitely nil by mouth for 6hrs". I asked are you certain? "Yes, nothing at all for 6hrs"
So, HUACA. Someone else answers and I ask how they intend to get a canula into my arm if I am dehydrated. "I'll check" Runs off down the imaging labyrinth and returns 2 minutes later.
"Yes, you can drink water. Please have some at least 2hrs before coming in."

 

[Quickstatus]

Fasting is now (adults)
No food or milk 6hrs prior to procedure
Clear fluids up to 2hrs prior to procedure

Clear fluids = fluids that is transparent. No milk. Black tea/coffee, Gatorade etc OK. No fizzy. Technically that means wine is OK but thats not OK as alcohol apparently slows down gastric emptying.