Delayed Surgery/heart failure

36andcounting

I was scheduled to have a left mastectomy and alnd with tissue expander placement on Wed. 1/30/19. I was in preop with iv, dressed and ready to go. A little background: I have had a cough since August 2018 and was diagnosed with a pulmonary embolism in Oct. 2018 and have continued with a cough and hoarseness since then. I had every test imaginable and was cleared by cardio and pulmonary as they could not find a reason. So day of surgery, the anethesiologist overhears me coughing and barely able to speak with nurses due to breathlessness and hoarseness. He comes in and tells me I can't have surgery as there is definitely a problem with my airway and I would likely in up on a ventilator or worse if they went through with surgery. At that moment I cried as this disease has thrown so many curveballs. So they run more tests and everything comes back normal so I go home. By Sunday I am exhausted and short of breath and unable to produce sound when speaking. I go to the Er and was admitted. After more tests, they determine I have diastolic heart failure with preserved ejection fraction(previous echo showed a normal ef which is why surgery was approved). I was discharged today on 40 mg of lasix daily. My question to the group is how long can my surgery safely be delayed? Any experiences with heart failure and Surgery? I have appts with my cardiologist and breast team but would like input from the group.

*I completed dose dense A.C and 9 of 12 taxols on 1/3/19.

bam320

I have no experience with what you are giing through but wanted to wish you the best with cardiologist appointment. I can only imagine how frustrating it was to be ready for this only to find out you must wait but sounds like it was for very good reason. Keep us posted on the results of your appointment.

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DebAL

36andcounting, I also dont have an answer to your question. As frustrating as it is I do know it was in your best interest that the anesthesiologist cancelled your case. He very well most likely saved you from a less than optimal outcome. Heart failure can come on quickly..even since you saw your cardiologist ( as you know from your ER visit) you could have ended up on the vent and sometimes it can be difficult to wean once you are on it

Cardio and pulmonary need to see you again. You didnt mention any other meds but often patients are put on ACE inhibitors/ARB's if you want to research. It's so important and that you are optimized for surgery.

Please go right back to the ER immediately if your symptoms resurface between now and your other appointments. Please update when you can. I'm so so sorry for this added stress. Your anesthesiologist made a good call

edwards750

I don’t have an answer either except to agree with your anesthesiologist that surgery be delayed. When I was prepped for my lumpectomy the anesthesiologist asked me if I had had pre-surgery screening. I did not. He then asked me when was the last time I had an EKG. It was several years before that. He called the hospital where I had it but their records were on microfiche so he wheeled the machine in and did the test. He was not happy.

When I was in the OR the nurse said she needed to get my oxygen level up. Idk what it was it usually hovers around 98 and I was a smoker. She then told meto take a deep breath. I did and she said okay everything is fine. So I know they don’t want those of us with possible issues keeling over in surgery.

I know you are disappointed and frustrated but I do think your medical team is doing their due diligence.

Hopefully you will get the green light again and move on to the surgery.

I do have a question though. They couldn’t find the cause of your coughing and hoarseness so they did nothing?

Good luck.

Diane

36andcounting

Update: surgery was completed on 03/01/19. No problems 😊. My cough and hoarseness did improve after increasing omeprazole again. From a cardiac standpoint all is well, just maintaining fluid levels. Thanks everyone

Meow13

So glad it worked out.