My father had a TEE on a Tuesday and then an Ablation on Thursday via the neck for afib. I believe the Dr went in through a vein not an artery. He is still in the ICU on a ventilator as of the following Monday eve because of massive bleeding and swelling in the neck; they say they want to keep his airway open and are afraid the swelling would close it. They have added and removed a drain in the neck as the bleeding slowed and performed a cat scan on Saturday. Each day after is something new over the holiday weekend like that he was bumped out of line for a cat scan for emergencys and so we couldn't take the ventilator out. or they want a full team available, etc...His neck remains swollen but not quite as much - I'm very concerned that the ventilator is still in and the neck isn't decreasing much in size.
- any ideas what could cause this to happen and how to "cure" it?
- I have read about possible puncture in thyroid causing swelling but what I read said it cleared up in 4 hours- and I wondered, wouldn't this show on cat?
- could an issue like sratch or puncture of something during the Tuesday TEE have built up and caused trouble during ablation on Thursday?
any other ideas on what to ask or how we might get this moving? the Dr's have not been able to describe why this is happening in manner that I "get it". basically what I was told was, they think he may have had a reaction to meds and because his vein was small had to poke 3 times to get it started and the incision area is what bled.
I am so so sorry that your dad is going thru this. In itself the TEE has no issues with this because it is inserted thru the mouth and the risk factors for anything happening are extremely low because of the procedure itself. When i had to make the decision on my ablation i was to choose either entry thru the neck or the groin area and yes now they go straight thru the veins and not the arteries because there is less risk. I too almost chose the neck because it was in closer proximity to the heart but my heart doc talked me out of it explaining that the risk factors were so much higher. A normal allergic reaction would definately cause very fast swelling of the airway especially if it is left untreated for any length of time but there are also other symtoms (symptoms) that we look out for....swelling being one, a rash or flushing of the skins or hives as another, itching, difficulty swallowing, tongue swelling, etc. Generally when someone goes into what is called true anaphylaxis or an allergic reaction the patients are given a steroid and benedryl type of medication to flush the symtoms (symptoms) thru and keep the airways open and swelling down to prevent the extreme need for a ventillator. So from what you are saying they are actually telling you two things...one is that the swelling is from the site of the catheter insertion and two a reaction to the medications...so my question would be if it were my dad which one is it then? At this stage of the game i don't think the allergic reaction enters into it because too much time as passed and i am sure they treated the reaction so that leaves you with one possiblity which to me would be what happened during the procedure that they are not telling you? If the swelling is going down and the blood is absorbing back into his system then it sounds like he is on the mend and it should be a matter of days before the vent. comes out as long as he shows progress that is a definate positive and remember when he does come off of it he will have trouble speaking for a couple of days so don't be alarmed....if it were me i would call the docs on the carpet so to speak and demand to know REALLY what is going on...sounds like they may be alittle worried about liablity here and the possiblity of a lawsuit so they are keeping you in the dark. Personally i would call in another doc that you are sure are not affliliated w. the doc that did the procedure and get a second opinion because this is your dad after all. They cannot remove the ventillator until all of the swelling is gone because it may be very different on the inside of his neck than what you see on the outside because the interior of our bodies tend to swell much more because of the heat of our temps being confined. I would get pro active and ask them what the game plan is and that "we'll just have to wait and see" just doesn't do it for you....tell them you want answers and the treatment plan .....good luck this one is a sticky one.........
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