There are a couple of accounts of AVS out there on the web – here and here – and once mine is in the past, I’ll be adding mine too. Meanwhile, here is what the interventional radiologist told me to expect.
Preparation for the procedure begins the night before, with the usual no food or water after midnight. The next morning I’ll arrive at the hospital and will be sedated. The drugs used will likely be versed, morphine, and fentanyl. After the sedation, they will insert a Foley catheter (warning, NSFW link!) – I’m told that for women this is far less of a big deal than it is for men, but still, it doesn’t sound any too pleasant.
I will be given a local anesthetic and a catheter will be inserted into both the left and right femoral veins, and the procedure begins. General anesthesia is not an option, as they need to ask the patient to do things (hold your breath, etc.) throughout the procedure.
After the procedure, they will keep me in a hospital room for about two hours, where I will be expected to lie still while they monitor a bunch of things. Once everything is satisfactory, I’ll be able to leave, but will not be able to drive. Theoretically I should be able to drive and go back to work the next day, but I’m planning to take a couple of days off, because I don’t think sitting at a desk will be very comfortable!
Because of a number of complicated things, it takes about 7-10 days for the results to come back – apparently samples get sent out to various labs for different reasons.
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I’ve only had one surgery in my life, and I was still a kid so I don’t remember much. It’s the only time I’ve ever had any kind of anesthesia except for the dental variety. Because I’m allergic to penicillin (and a ton of other antibiotics, but nothing else that I know of) I’m at higher risk for having an allergic reaction to one of the drugs or contrast media during the AVS, but they routinely take precautions for this and have someone standing by to deal with it if it happens. This, the IR thinks, is the biggest risk of the procedure for my particular case.
The other routine risks associated with AVS are bruising, and inability to access the right adrenal. There is discussion elsewhere on the web and in the medical literature of risk of the adrenal vein rupturing. My interventional radiologist tells me she has never seen this happen, and if it does happen the cause is usually administering the contrast media too quickly, which usually comes from inexperience.