Having Kidney Stone surgery with Variant Angina and SCAD

• By TamraB
• Reply 3337990
• August 31, 2012 at 11:10 pm
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I just had my gallbladder removed and the anesthetist was prepared for any possibilities. He said the op was uneventful!
However my 1-2 weeks post-op was another story!!!

My heart went loopy the next day and stayed that way. Very irregular beat, ectopics, elevated heart rate ... feeling not happy.
My GP (who did and ECG) said my heart did not like me being in pain and we needed to get my pain under control. So I took Omeprazole for 1 week (as the hospital morphine meds had given me gastritis) and told me off for not writing down my pain relief and taking it regular enough. And she also reminded me hat my cardiologist told me to increase my nitrate (Imdur) on "big" days. Instead of living with the nitro-lingual in my hand!
so in increased my daily dose from 60mg to 90mg. Today (2 weeks post-op) I went back to 60mg and so far so good.
Most of this is settling now ...

Is your op Laproscopy or open?

Good Luck
Smiles
Tamara

• By Iloveliving
• Reply 3338308
• September 1, 2012 at 5:23 am
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Hi Karin,

I hope that you have a letter from your cardiologist explaining your condition.

I had surgery 5 days ago and the surgeon would not proceed without one. In that letter he warned that it is only safe to go ahead if your symptoms are not active. He also cautioned the anaesthetist to avoid vasoconstricting medications during surgery if at all possible.

So what are the risks? I am not sure. I expect they would need to be outweighed by your need to have the kidney stones removed.

My anaesthetist said that she would not give me a general anaesthetic because it was too dangerous. I had a spinal block with a mild sedation to keep me asleep. The latter was my choice but I could have stayed awake if I had so desired.

The real risks are many I suppose but in particular for those of us with Varaint Angina/CAS it is the chance of having a heart attack or some other cardiac event.

I think the best thing you can do, if you haven't already done it, is to organise a letter outlining your cardiac history and perhaps some advice on how to treat you should you develop chest pain.

Once you have some documentation take a couple of copies with you to the hospital and have one copy put into your file. Call the anaesthetist directly and tell him/her about your cardiac history or try to arrange some kind of preadmission appointment with him/her. Your anaesthetist is the one who looks after you during and immediately following surgery. He/she takes care of your pain management and any other issues such as chest pain that might arise.

One important thing for you will be whether or not your CAS/Variant Angina is causing you problems at the moment. eg. Does it wake you at night on a regular basis. Do you get angina at any particular time of the day. Is it provoked by anything in particular such as stressful situations or emotionally 'busy' times.

Our condition is rare and my experience is that doctors pretend(or wrongly believe) they know all about it. The reality is that they don't!!! Mostly they just read whatever the previous doctor wrote in your notes and rarely look past the first page of any letters that you have so carefully prepared for your history/file.

In this last time I had bad angina as I came out of surgery so the anaesthetist gave me a couple of puffs of my nitro spray. The pain went down in intensity but didn't go away so she put a patch on me. The pain still didn't go away so I told them I wanted a nitro drip. They rang my local cardio(who does not have expertise in CAS or MVD) who said to give me the drip but she must have told them that this was my normal presentation. This was interpreted as meaning 'nothing important' or 'normal'. So I am reasonably sure that on my notes I got a sentence saying that unprovoked and long episodes of angina were 'normal' for me!!!

My point is that you can try very hard to get the message across that you have a potentially dangerous condition - after all we did get heart attacks from it!! but your attending doctors are not likely to listen to you. They are far more likely to listen to the regular messages in their own heads which equates to - younger women don't have heart disease and certainly nothing dangerous. And if, like me, the first thing they read is that this chest pain is 'normal' and you do have something resaonably unpleasant happen, you can find yourself in a very difficult situation.

If you are lucky you will not have any trouble and if you be so unfortunate as to get some angina then I hope you will get doctors who will look after you well.

Also - will you be stopping plavix?

I hope this helps and I really hope the surgery goes well for you.

Iloveliving

• By KarinC
• Reply 3338334
• September 1, 2012 at 6:20 am
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Thank you both for your posts...it is very helpful. My cardiologist has talked to the surgeon. He does not want me going off of my blood thinners so instead of using sonogram to break up the stone, they are going to have to go in through the ureter. I really appreciate your feedback and will take your advice with me to the hospital.

• By Iloveliving
• Reply 3338511 · In reply to 3338334 by KarinC
• September 1, 2012 at 8:25 am
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I'm glad you have found it helpful.
Tamara I think I might do a similar thing if my pain comes back at all.

• By Chris66
• Reply 3339541
• September 1, 2012 at 3:05 pm
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Hi I just went thru having a kidney stone. Two days after I found out I had the stone I had to have surgery to put a stent in . Two weeks later they did surgery to remove the stone and stent . The day of surgery I as in alot of pain after the surgery. ( back pain ) . I started throwing up when i got home . They thought it was the meds from being put out . The next day I had really bad pain called the dr and he said if the pain got worse or I threw up to call him . Right after I called him I got sick called the dr and told to go to the er. They found out I had a bleed on my kidney had to stay in the hosptial overnite. I too was of my plavix but still on asprin. They are not sure why this happened

• By TamraB
• Reply 3339712
• September 1, 2012 at 4:40 pm
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I asked my cardiologist about going off my cute pink heart shaped aspirin before the surgery ... and she said "absolutely NOT". the new evidence is NO. There was recently a heart patient in NZ who was asked to stop the aspirin before surgery (? 5days prior) and he died the day before the surgery. Not sure if he died from a stroke or heart related ... but they did blame the cause as being off the aspirin. I asked my surgeon as well and he said no, please stay on it. Now I am not sure about other blood thinners ...
I have had two generals in the past year and two fantastic anesthetists ... and they were very confident with my cardiac history and ready for any possible issues. For my GB removal 2 weeks ago, the anesthetist put in a radial arterial line, he said this is by far the most accurate and fastest way to monitor the heart. I was a little nervous, as my right radial artery was permanently damaged last year in an angiogram ... so I was a little nervous of letting him use the left ... But I am still here ... minus my GB and my ticker is a little wonky still , but I am confident we can get it to settle again real soon.
Spiels
Tamara

• By KAKLeon
• Reply 3340918
• September 2, 2012 at 8:45 am
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Hi Karin. I didn't have kidney surgery but did have three other general anesthesia surgeries in the first few years after SCAD. They all went well, no problems. Will be thinking of you! Keep us posted.
Katherine

• By Iloveliving
• Reply 3342835 · In reply to 3339712 by TamraB
• September 2, 2012 at 11:09 pm
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Hi Tamara,
Reading your bit about the line into your left radial artery was very affirming for me. My anaesthetist did the same. I was in HDU following the surgery and the line was still in so, with a little bit of juggling, I could see the BP being monitored. It is quite some technology!

• By TamraB
• Reply 3343045
• September 3, 2012 at 1:25 am
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I must share with you all, how excited my anesthetist was to use the arterial line ... they obviously don't get the chance to do this often. As the artery is only "messed with" if absolutely necessary!
When I was in recovery, I was checking my left radial pulse and the nurse asked me what I was doing ... I said I wanted to check if it still worked ... she said "of course it does" ... so I asked her to check my right radial artery ... her eyes nearly popped out of her head ... "what happened" ... so I told her it was damaged last year in an angiogram ... she then understood why I wanted to check my left radial artery post-op!

• By trigrandma
• Reply 3343741
• September 3, 2012 at 10:20 am
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Hi Karin, sorry you have to go to surgery for that kidney stone. General anesthesia does have risks as we all know and there is a some increased risk since its only been 6 mos since your SCAD but those risks depend on many factors, such as how much damage to your heart muscle, how well its pumping and how you are doing now, if you have good activity tolerance, and if your angina is well controlled. It is good that your surgeon talked with your cardiologist but it is also important for your anesthesia provider to know what the cardio thinks re you heart status. So if your cardio thinks you are ready for anesthesia he/she should write a letter stating that, also as Iloveliving advised get copies of everything for anesthesia it will streamline preop the day of surgery. take all your meds as advised esp your betablocker if you are on one. Hopefully someone from the hospital pre admission surgery will call or have you come in to get things sorted before day of surgery. Good luck getting rid of that stone! Best wishes

• By TamraB
• Reply 3367147
• September 11, 2012 at 5:30 pm
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Karen have you had your surgery?
Please let us know how you get on ... big hug coming your way form NZ
Smiles
Tamara

• By KarinC
• Reply 3367321 · In reply to 3367147 by TamraB
• September 11, 2012 at 6:45 pm
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Hi Tamara...I am having it tomorrow! Thanks for the Down Under Hug!!

• By Neicy345
• Reply 3368996
• September 12, 2012 at 11:02 am
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Hi--I am still recovering from septic shock caused by a kidney stone blockage. I'm a little off track with your original discussion, but I'm wondering...is there also a correlation with Prinzmetal's/CAS or MVD and kidney stones? I know most of us with one of these conditions also has or have suffered from Reynaud's, migraines, and difficult veins for IV's and blood draws. Do we also have kidney stones in common?
Thanks.
Denise

• By KarinC
• Reply 3369589 · In reply to 3368996 by Neicy345
• September 12, 2012 at 2:45 pm
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Surgery went well....no complications. Neicy345, I know of no correlation between kidney stones and spasms.

• By KAKLeon
• Reply 3369678 · In reply to 3369589 by KarinC
• September 12, 2012 at 3:33 pm
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Great news! Glad to hear it Karin, rest well.
K

• By TamraB
• Reply 3371003
• September 13, 2012 at 6:06 am
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Yeah Karin !!! Well done!
How did they do the procedure?
Smiles
Tamara

• By KarinC
• Reply 3371013
• September 13, 2012 at 6:19 am
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Tamara, it was a Laproscopy.
Katherine, thank you!

• By TamraB
• Reply 3373755
• September 14, 2012 at 12:20 am
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Karin, how are you going with the CO2? I had too much trapped after my GB removal and it was squashing my diaphragm up in to my heart! I was in really bad pain the first 2 weeks. I increased my Imdur to 90mg and made a chart for me pain killers. My GP said I had to control my pain, as my heart cannot handle any pain. So my days will filled with checking it "it was time" ....
I hope you heal quickly!
Smiles
Tamara

• By KarinC
• Reply 3373986
• September 14, 2012 at 4:48 am
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Tamara, I have had no issues with CO2. I am in pain but it is managed with Percocet every four hours. No heart issues at all with this procedure.

• By TamraB
• Reply 3375446
• September 14, 2012 at 3:47 pm
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Wonderful Karin, I am really pleased. You should heal quickly
Maybe all the hugs worked?
Smiles
Tamara