Well – it happened. My second AVS took place yesterday and aside from a change of time (6am!) and doctors (the main IR in the practice, rather than her associate), it was pretty much exactly like the first, right down to the potassium crash.
I did find out that I was slightly misinformed (or perhaps just confused) about the sedation used the first time around (and this time as well). Typically the method used is conscious sedation, administered by a nurse rather than an anesthesiologist. I’m not sure what led to this the first time around, but after my files were reviewed before the procedure yesterday I found out that the first time, I was under general anesthesia rather than conscious sedation. All involved decided that it was in my best interest to use this same method again, which led to a last minute scramble to find an anesthesiologist (and led to me being unnecessarily worried that the whole thing would be called off!). The one they found was fabulous – she had one of the best bedside manner of any doctor I’ve ever encountered.
I’ve heard a few stories lately from others who have had AVS done and have had to deal with pain and discomfort during the procedure, and it makes me wonder why it’s not just routine to always use general anesthesia. If I understood correctly, at the hospital where I had it done, they use general in patients who have hiatal hernias (which I was born with) as a rule. For my procedure a combination of propofol, fentanyl, and versed was used. The first time I didn’t experience any side effects at all; this time around I had nausea that lasted for a good 12 hours after the procedure but nothing too terrible.
The only pain I experienced was from the potassium IV – I learned something, do not ever let them put this into the vein in the back of the hand! Only do this through the – whatever the bendy part opposite the elbow is called. It’s still uncomfortable, but tolerable. I’m not a screamer, but when that IV was in my hand I came about as close to screaming as I ever will.
Like the last time, there is no pain or bruising at the cannulation sites. Getting around is much easier than it was the first time – if it wasn’t for the 48 hour driving restriction, I could probably be out and about today, albeit a bit slowly.
Rather than the six weeks it took last time, my doctors expect to get results back in two weeks or so. Here’s hoping that the second time is a charm!