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I was in excruciating pain after the cardiac catheterization six years ago. The pain was not because of the actual procedure to my heart but because of the closure of my puncture site. My puncture site in the groin area was closed by a sheath which was removed several hours after the procedure. Little did I knew how painful it would be when the nurse told me that it would hurt and that I would have to bear with it. He offered something to place in my mouth to bite on it while he removed the sheath. I opted to hold my son's hand for support. But by the time the nurse finished removing the sheath and applying pressure I thought I died and came back the second time. Removing the sheath was one thing but the pressure applied with a sand bag was much more difficult to cope with. It took 15 to 20 minutes to hold the pressure before he removed the bag. All I could do was bite as hard and deep as I could into my son's hand which left marks. This method of closure to an incision/insertion site in the groin area is called manual compression.
I was told to keep my legs straight for several hours and could not get up from the hospital bed for two days. I was kept under observation in the cardiac intensive care unit for 24 hours before I was moved into a general room where I was held for couple more days before I was discharged. My basic necessities were taken care of by a bed pan and foley catheter during my hospital stay. It took me about a week to somewhat to get on my feet but still couldn't do too many things on my own. By the time I fully recovered and was able to carry on with my daily routine, it was almost six weeks after the procedure.
This time, when I went through catheterization it didn't take that long to recover. I was able to use the toilet in my room the same day. I was placed in not the intensive care unit but in an outpatient surgical holding area. I went home the next day, in the evening. I could move my legs as I wanted but carefully. I could walk slowly and carry out my daily routine at home. There was little bruising and pain in my groin area and some inflammation in my lower pelvic area. I was told not to still bend my leg too much or bend down to lift anything above 10 pounds. I was told to take it easy for a week. I did not see the insertion site as much. I still feel like there is something in there that is poking at me and am cautious about it. This time my insertion site was closed with something called an "angio seal" which is a vascular closure device.
Vascular closure devices, or VCDs, are the new technology that was introduced in the 90's. They are used to provide faster hemostasis of the artery and reduce complications at the access site.With the introduction of these devices patient comfort became more bearable. Most of the VCDs are made of collagen and are dissolvable. Recovery time with the use of these devices is faster and easier. Patients get back to their routines faster and usually are on their feet sooner. Hospital stays are shorter, thus costs are cut significantly. Chances of infection at the closure site are less. Contraindications usually include bruising, retroperitoneal hematoma, small vessel size, fewer trained professionals, peripheral vascular disease, higher costs, some bed rest post the closure, concerns about re-access through the femoral artery, increased chance of infection due to the time it takes for the VCDs to be absorbed, and increased bleeding. I still have to take it easy for a few weeks.
The overall experience for me with the closure device has been positive. The only complication I faced so far is a small amount of hematoma in my lower pelvic area. I am able to do most things except for bending and heavy lifting. I am not able to move as fast because I can feel the device in my groin area. Even though I was told I could start my cardiac rehab I am wary of the device that is inside me. I was told it takes around 90 days for the device to be fully dissolved and it makes me feel uncomfortable. But overall, recovery time is what made me ambulatory and close to normal in a very short period of time. Since it is a relatively new technology I urge patients who undergo catheterization, to study the benefits and contraindications of vascular closure devices and address any concerns to their cardiologists before and after the procedures. Because, OUR LIFE MATTERS.
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