Sunday 29 November 2015

Claustrophobia and Bypass Surgery

One of the first things I noticed a few months after my heart attack and triple bypass surgery in July, 2007 was a problem I had going into elevators and confined spaces. It first happened a couple of months after my surgery when my wife and I travelled to Twin Towns club to see a show and we had to take the elevator from the ground floor to the sixth floor where the auditorium was located.

  
Now this was not the first time we had been to this club to see a show and certainly was not the first time we had taken the crowded elevator up to the floor where the show was taking place. However, it most definitely was the first time, as we were standing at the back of the full elevator, that a feeling of “dread” consumed me and I felt like screaming and collapsing and could feel my heart racing.

My wife could see what was happening, it was that obvious I guess.

In short, I felt like I was having a panic attack and it wasn’t nice. In fact this was the first of what was to be a series of such attacks any time I went into an elevator or found myself in a confined space like in the back of a coffee shop or even sitting between two people in the back seat of a car.

That feeling also reared its ugly head during the show itself, a Wickety Wak show from memory - we were seated in the middle of a row in a full house and that feeling of being surrounded and "cramped in" was both new and difficult to cope with.

As I soon found out, this feeling of claustrophobia/panic attack/anxiety became the norm and occurred when we went to the movies or to see a show at any venue. I learnt very quickly when booking tickets for a show to book aisle seats.

And this feeling of an impending anxiety attack still happens today when we go to the movies or to see a show eight years later!

I can distinctly remember on one occasion when I took the train from where I live on the Gold Coast up to Brisbane how I had to go through “mind control” and deep breathing exercises to overcome that terrible feeling of a panic attack coming on whilst sitting in the “confined” space of a train car.

When this first happened I did some research and asked around and even asked other people who had gone through bypass surgery if they had had similar experiences and asked them if they understood what I was talking about.

To be truthful, not everyone knew what I was referring to but there were some who did which, I guess, made me feel like I was not crazy and not the only one dealing with these issues.

I also mentioned this to my cardiologist and he confirmed that this was not knew for what people like me had been through: heart attack, multiple cardioversions and of course open-heart surgery/triple bypass.

Knowing this was helpful, dealing with it was the challenge and as I said above, I had to develop techniques to cope which included deep breathing and “concentration” exercises to help me take my mind off the problem.

In early 2011 following heart related issues my cardiologist ordered me to have a CT angiogram and I can clearly remember today, 4+ years later how I just about freaked out when they l lay me down and I started to go through the tunnel, twice they had to pull me out before I could complete the test.



And a year later in 2012 I had a similar bad experience when I needed a CT scan for lower back/spine issues to determine what was causing me severe lower back pain. This happened again earlier this year when I again needed a SPECT CT scan on my back.

My biggest challenge came three years later in October, 2010 when I had to fly interstate. The thought of this scared me and even though it was enough to just about bring on a panic attack. I took the flight. I remember I really had trouble coping and whilst it may not have been obvious to those around me on the plane, I know inside myself I was anxious and really struggling to keep it together.


Over time I thought, hoped, this would get better and I guess it did, however, three years later in January, 2013 I had to fly interstate for one of my children’s weddings. The whole process began again and the “fear of flying” became real. The flight was twice as long as the one a few years earlier and I was fearful I was going to have issues again.

This time I planned ahead. I made sure I had aisle seats so that I would not have that “cramped in” feeling sitting against the window if the flight was full. I also decided that this time I would take a valium to help calm me down. Doing this definitely helped.

Now, a few years later I am preparing for another interstate flight and part of me is dreading this. Sure, things have improved a lot since my surgery in 2007 but that fear is still there. I have booked aisle seats so this is taken care of and I will no doubt take a Valium before the flights and I am sure everything will be fine, however, best to be prepared as I was taught in the Boy Scouts.

Dealing with the after effects of a heart attack and bypass surgery is one thing, coping with these in addition to dealing with additional medical issues including diabetes, thyroid and respiratory conditions can most certainly make life challenging.


This is a link to an interesting article that deals with this question of Claustrophobia and Bypass Surgery: http://www.canada.com/story.html?id=b9cffbea-8c7f-4f9e-a2eb-0614bfd42b4d

Claustrophobia link to heart bypass: study

Canadian researchers have uncovered what seems like a bizarre side effect of a common operation, finding many heart-bypass patients experience severe claustrophobia after their surgery.

Monday 2 November 2015

Pump Head - Cognitive Impairment After Bypass Surgery

A study from Duke University, published in the New England Journal of Medicine in February, 2001, confirms what many doctors have suspected, but have been reluctant to discuss with their patients: A substantial proportion of patients after coronary artery bypass surgery experience measurable impairment in their mental capabilities.

In the surgeons’ locker room, this phenomenon (not publicized for obvious reasons) has been referred to as "pump head."

In the Duke study, 261 patients having bypass surgery were tested for their cognitive capacity (i.e. mental ability) at four different times: before surgery, six weeks, six months, and five years after bypass surgery.
Patients were deemed to have significant impairment if they had a 20% decrease in test scores.
This study had three major findings
·        * Cognitive impairment does indeed occur after bypass surgery. This study should move the existence of this phenomenon from the realm of locker room speculation to the realm of fact.
·        * The incidence of cognitive impairment was greater than most doctors would have predicted. In this study, 42% of patients had at least a 20% drop in test scores after surgery.
·        * The impairment was not temporary, as many doctors have claimed (or at least hoped).



You can read more about this study using this link: http://heartdisease.about.com/cs/bypasssurgery/a/pumphead.htm

Postperfusion syndrome, also known as "pumphead"

"Postperfusion syndrome, also known as "pumphead", is a constellation of neurocognitive impairments attributed to cardiopulmonary bypass during cardiac surgery. Symptoms of postperfusion syndrome are subtle and include defects associated with attention, concentration, short term memory, fine motor function, and speed of mental and motor responses. Studies have shown a high incidence of neurocognitive deficit soon after surgery, but the deficits are often transient with no permanent neurological impairment." http://en.wikipedia.org/wiki/Postperfusion_syndrome

This is not something to be dismissed lightly and many who have had bypass surgery comment on issues such as memory loss after surgery. Sometimes talking to others who have dealt with this problem is helpful.

Postperfusion Syndrome (pumphead) Facebook groups:

These groups may help people who have suffered memory loss after cardiac surgery and/or issues with fine motor skills and speed of mental and motor responses. Use these links to find out more about these group:

https://www.facebook.com/groups/277112179141875/
https://www.facebook.com/groups/1490829674283544/