More organ recital

I had my one-year right heart catheterization last Wednesday. I don't have all the results, but the doc told me while still in the lab that my systolic pressure was down from 120 last year to 70 this year, which puts me from the "severe" category into the "moderate" category, which is certainly good to hear. I wonder what it takes to be in the "zero" category?

The cath lab, for those of you who have never had the privilege, is kept very cold so they don't have to worry so much about infections. An acquaintance who is a cardiac nurse said at her hospital they call the cath lab "Antarctica," because it is freezing and it is "somewhere down there." The one at my hospital has giant botanical slides on the ceiling for you to look at while they drill you up. This week's was pink, cherry or peach blossoms. Last year's was yellow, I think tababuia trees.

For a left heart catheterization, like the ones you get for a balloon angioplasty or a stent, they open an artery in your groin and snake the probe up to the portion of your heart that needs treating. This constitutes about 95% of the caths done. They make you lie flat for several hours afterward to make sure that the artery in your groin doesn't suddenly start spurting when you stand up, sit up or sneeze. This is probably a good thing, says Martha S.

For a right heart cath, they open a vein either in the groin or in the neck. They use something called a Swan-Ganz catheter, which works like a spinnaker on a sailboat (which makes me love it even more). It has several tiny ports in it, with pressure-sensing transducers. What that means is that it has a small balloon at the end that acts like a sail and lets the bloodflow pull it through where it should go, which is all the way through the heart and into the pulmonary artery. The little transducers are measuring the pressures all the way across, but only a few of the pressure readings are important. One of those is wedge pressure, which is kind of interesting. It basically measures how your heart valves are working. They put the catheter into a fork of the pulmonary artery and block off one branch for about ten seconds and measure the pressure in the other fork. This pressure tells them what your aortic valves, your mitral valves and tricuspid valves are doing (I think... I am not a cardiologist. Yet.).

Another thing it measures is the pulmonary artery pressure itself, which is Very Important To Me. If mine is down nearly 60 percent in a year, that is Very Good. If I can keep bringing it down, that would be Very Very Good.

They don't do very many right heart caths, as I mentioned before. I had one little nursey (they look so young.... or do I look so old...) who kept insisting that I not move because they opened my artery. I told her if they did they'd made a mistake. She looked very confused and called her supervisor/colleague/older looking nurse and she verified that, yes, I had had a vein opened so that while I did have to lie flat, I could wiggle if I liked. She also wanted to know if I was having a biopsy on my heart transplant. I told her no. I certainly hoped not.