In the continuing saga of what to do after the mastectomies, one form of reconstruction appeals in particular. It is called a diep flap, and it involves moving fat and skin from the abdomen to the chest. It is different from the more common tram flap because it doesn't remove muscle, which means abdominal weakness is far less likely. However, in order to do the surgery the Plastic Surgeon needs to make sure there is adequate vasculature. To accomplish that she ordered a CT scan with iodine contrast.
Today was the big day. I got to the hospital at 9:55 for my 10:00 check-in (Even after circling in the parking garage) and knitted after filling out ten minute's worth of paperwork. I finished several rows before they called me back. I'm impressed with the tech; she found a vein and got it in one try for the IV. The scan itself was going decently. They took several pictures before introducing the iodine, for which I had to hold my breath, though I managed to do so the whole time every time.
They warned me that when they started the iodine that there would probably be a sensation akin to a hot flash, and that often people have another sensation which makes them feel as if they've wet their pants. The saline solution beforehand would be cold. All went as predicted; the saline flush was nice and cool, and then I felt very hot in my neck area, and indeed had the "Did I wet my pants?" reaction. And then I started throwing up, which completely made me forget about the other parts.
The techs were there immediately and gave me a bucket, plus towels. They were very concerned that it might be an allergic reaction and were looking for hives or to see if I was breathing without problems. They were rather concerned because my neck went from burning to itching, but no hives appeared. Once it seemed like I was over the vomiting they sat me up, gave me a hospital robe in place of my shirt, and had me sit in a room for long enough to ascertain that Benadryl (TM) would not be necessary. That's when I pulled out my iPad and posted to Facebook.
After a while they gave me a second hospital robe and sent me home. I'm not supposed to take Metformin (TM) for the next two days due to the effect of iodine on kidneys. I'm also going to play it safe and not use Victoza (TM) either, since I was off of both of those after the kidney crisis in September. Andy suggested I take a nice long shower, and I took his advice.
One thing I thought of on the way home is that they gave me a saline IV before the iodine. When I was in the hospital in September I was also throwing up a lot, and I thought I saw a pattern emerging wherein every time saline was administered I vomited. The nurses were dubious but started giving me the saline more slowly, and that seemed to help. I remembered that when I was doing my PICC line injections and went very slowly with the saline flushes before and after the antibiotics, but I had forgotten about it today.
The tech said that the reaction sometimes happens when people have eaten fewer than two hours before the infusion, but I had been dutifully fasting for four. She also said that some people just have that reaction, and that I should mention it if I ever had an iodine infusion again. Apparently it is not as likely to happen if the injection happens slowly, but unfortunately it's vital in the type I was having that it was administered quickly.
And then there's my allergy to shellfish -- I throw up if I eat them. Maybe that is related. Anyway, the feeling afterward in my throat was the same one I had at the hospital in September; sort of a rough feeling and a hint of something, not exactly trouble, but some sort of oddness, when swallowing. It's mostly gone now.
They were able to get all but the last picture, which was supposed to happen 70 seconds after the iodine was administered. Since it's crucial for the infusion to be fast we won't be trying it again. Hopefully the Plastic Surgeon will get the information she needs from what they already got.