Surgery-claustrophobia

Drape over face doesn't have to be *on* your face

by crustyg - 2020-03-08 12:16:55

Had my PM inserted under local last year, head turned to right, drape over head held up to a pole so that I could see and breathe without problems.  I could watch my ECG trace (that was about it) and talk to my surgeon when he wasn't super concentrating.

The surgical drape (one of the modern disposable, all-in-one with stick down edges around the surgical wound) wasn't close to my face, but I couldn't breathe my nasty bacteria into the wound, which was good.

Two lots of skin prep before the drape was applied, using different, disposable applicators (the more you rub skin the more the bacteria at the bottom of each hair shaft move to the upper edge and contaminate the skin, so they contaminate the applicator).  My PM should have been 45min in total but the big vein for the leads to go in wasn't full enough - spent 10min head-down to fill things up - probably a bit dehydrated from the nil-by-mouth from midnight prior (nearly 9hr), so in total took 90min.  45min is a sensible planned time from start to finish.  I have medical chums who used to insert leads+PM in about 20-30min.  Depends slightly on the ease of placement of the lead(s) into your heart.

Some EP docs like to use local + IV sedation (midazolam + fentanyl), others just local - it's a personal choice.  Some like their patients in overnight, I was in at 07:30, op at 08:30, home by 14:15 (driven by a family member).

Ask for some IV sedation - you will be conscious but incapable of forming memories (very useful side-effect of the sedation), and responsive to any command, so you won't worry about, or remember, a thing.

HTH.  Try to relax.  Yes, the thought is scary, but like most fears the fear is worse than the actual experience.

Claustrophobia

by Chapter - 2020-03-08 13:18:27

I have always been a claustrophobic and if I had known anything about what was going to happen in advance I would have been like you.  In 2017, my surgery was very quickly arranged, required an ambulance and an air-ambulance flight to get to hospital, along with worrying about my husband driving in an anxious state over 5 mountain passes in November, to get to where I was going.  They told me what was going to happen, and I would be doing it with only a local.  What was going to happen was out of my control, the draping or tenting was not discussed and the last  thing I was thinking about.  When they started the draping I turned my head to right and had a window to watch the technicians working on computers across the room.  I did have an initial stir of panic but concentrated on voices rather than thinking of tent.  I soon found that, because of insufficient pain med, I was more concerned with keeping my very painful left arm still, than being in a tight spot.

When you think of the area that they are working in, it is very close, they are right there working next to your face pretty well.

In August 2019, I had to be switched over to a CRT-Pacemaker, and was very aware of what was going to happen.  I knew that I had been able to survive through first head tent so knew I could do it again.  I explained the pain I had felt first time and was promised it would not happen again. I felt no pain at all, was able to listen to machines and voices (very close) that were a lot less frat boys (the first time) and more professional - all very interesting as I imagined each step in my mind.   
Tell them of your claustrophobia before hand and they will make it work for you.  I am sure that they get told that a lot.  I am not sure how long it took, I guess a couple of hours from ward and back recovering.  It feels like you are in there a while but that is because it is a new experience for your brain to learn.

Chapter 🌹

For me, I'm a scared cat so .....

by MartyP - 2020-03-08 13:41:58

I just told them to knock me out.  I didn't want to know or hear anything.  A little propofal (milk of amnesia) and I woke up feeling fine.  So for me it was a no brainer - Out Like A Light !!

The pole keeps the drape off yor face

by BradyJohn - 2020-03-08 15:48:40

Hey JFBUFFY,

I was almost a bit disappointed, I thought I would get to watch.  Two things, one, they 'put a little something' to help you relax in your IV.  Two, the drape is held off your face by a horizontal rod.

Congrats on getting a PM.  I'm a bit of a newbie yet, but I am completely happy with mine.

Take care, peace,

John

What do you need?

by Gotrhythm - 2020-03-08 18:01:11

I think the word "cover" in the internet quote was ill-chosen. it summons a picture of something lying on your face, blanketing your eyes and nose and in contact with skin. Wrong! Cancel that picture!

It's more like a curtain, a little fabric wall. It doesn't touch your nose. In no sense are you "trapped" by it.

But this is the second time you have asked the question. You've been told your face wouldn't be covered. You've been advised to talk openly with the anesthesiologist. You are nor his/ her first rodeo. You've been assured that they have really good drugs that will handle anything you can throw at them. 

Clearly, the previous answers didn't satisfy. That makes me think we don't really get what you're asking. So what do you want/need to hear? What would really help/ reassure you?

Surgery

by Nascarsuzi - 2020-03-12 13:29:14

I was knocked out by propofal..had dual lead pm put in under emergency conditions on Fri 3-6-2020.  Took 2-1/2 hrs to complete so I remember nothing.  They do take good care of you & explain everything before doing it.  You will be fine.

Talk to your consultant

by Beca H - 2020-03-12 20:25:16

Hello

I am going into my 3rd day of recovery following the implant of my 4th pacemaker so everything is fresh in my memory (unfortunately) at the moment! Fortunately for my first and second pacemakers (age 7 and 13) I was under general anaesthetic due to being a child so don't know anything of the operation. 

I'm a scardy cat and also suffer from claustrophobia so share your concerns. For my third and fourth pacemakers (ages 17 and 27) I had differing experiences (different hospitals). Both ops were local anaesthetic jobs. They cover the area to be operated on in iodine - this is standard practise for any operation. It washes off pretty easily though (just don't get the wound wet!). For my 3rd one, I had nothing surrounding my face during the op - good for the claustrophobia but not good for the sqemishness. I could have watched the whole procedure if I wanted but I kept my head to the right. For my fourth they put a blue sheet up just in front of my face to stop me from seeing what was happening. It doesn't drape over your face, it acts like a wall, so plenty of breathing space for claustrophobic people like us.

Personally I haven't had good experiences under local anaesthetic as I panicked and hyperventilated throughout both times. On a Tuesday they gave me three doses of seditive and it did nothing! 

My best advice is to talk to your consultant before hand if you have any concerns, as they will listen and talk you through all the small details. Luckily for me, they have decided that going forward I will be put under general anaesthetic for future pacemakers, which suits me fine.

Best of luck with your pacemaker journey! 

Pace maker install

by Boat1690 - 2020-03-19 19:14:21

I was a scared as anyone.  The put a tent like structure so you can't see.  You can see out the side. I never felt closed in.  The nurse would ask how I was doing  it lasted about an 11/2 from the time I left my room . I could hear everything and remember the doc and nurses talking.  It's really not a big deal.  The loop recorder they took out hurt like hell.  Other than that you will be good.  Believe me I was more worried than probably you.