Scrotal Orchiectomy question

[Cecilia]

I interviewed a pair of surgical urologists and have made my selection as to whom will do my scrotal orchiectomy.  They asked for surgical clearance from my cardiologist;  since I do have a past history of atrial fibrillation events (since age 25).  I called my cardiologist and he wants to do a nuclear stress test.  I hate those because I always worry that pushing my heart to 165 bpm will cause a heart attack.  At my last one 2 years ago I freaked out so bad I jumped off the treadmill at 140 bpm.  Does your heart even go to 160 bpm while you are under anesthesia? I thought it just stayed at 60 bpm like a resting heart rate.

[Dev]

From the reading I've been doing today - you gave me something to research - it looks like inhalation anesthesia is known to increase the heart rate.  Anesthesia in general also looks to be commonly linked to irregular heartbeats as the body tries to regulate the changes.  You mentioned that your cardiologist wants to do a nuclear stress test.  That kind of test doesn't involve the treadmill.  Instead, they use chemicals to artificially raise your heart rate for the purpose of evaluation.

 

I'm not a doctor, mind you, but it sounds to me like there's a solid medical reason for wanting to take these steps prior to putting you under.

[VickySGV]

Just because we are under anesthesia insofar as our consciousness goes there is stress on the body as a whole, since this is a major injury that is going on, even though it is an injury for the purpose of "healing" us.  While we will not know the stress has happened in real time. it is why it can affect our heart, blood pressure, lung and kidney functions and maybe more.  As @Dev said above, the inhaled anesthetics can and do make your heart really go wild if the right one is used too. 

[Cecilia]

As soon as I complete the stress test,  I will talk to my Cardiologist about whether it's safe or not to use anesthesia.  I read somewhere that an Orchiectomy can actually be done with local or spinal anesthesia instead of general.  So after talking to the Cardiologist I will talk to the urgology MD doing the surgery. 

[Rachael]

I have had the nuclear stress test as well as the treadmill test. Both scared me so bad I changed cardiologist. different one gave me a treadmill test and it was not to bad. Try a different cardiologist if you can. Hope it works out for you. Let us know how it works out. I am considering one when I have been on hrt long enough. 

[Cecilia]

I'm happy with my cardiologist;  but he's thorough and wants to make sure I am safe for surgery.  I have had paroxysmal atrial fibrillation for 30 years now.  It only happens every blue moon - maybe once ever couple of years. At one point there was a 15 year gap between episodes.  My biggest problem is being overweight and hating exercise.  That has been my bane my whole adult life, along with carbs. I do want the Orchi, and want to live through it.  So it's tugging me both directions. I did a google search on mortality among people who have had surgery and have afib.  The article is giving me serious panic attacks.  The way I read it; every person who had surgery and has afib has a 60% chance of being dead from stroke or heart attack within 24 months.  If other folks would look at this article and let me know if I am reading it right - I would greatly appreciate it. 

https://www.webmd.com/heart-disease/atrial-fibrillation/news/20140812/common-irregular-heartbeat-may-pose-risks-for-surgery-patients

[Dev]

It looks like the added risk is something you can't discount, but it also looks from the article like there are measures they can take to reduce that risk.  This is definitely something I would bring up with both the cardiologist and the surgeon who will be performing your procedure.

[Cecilia]

Thanks Dev.   I'm doing the treadmill test Friday and will print out the WebMD article for the cardiologist, and I see my primary MD next week.  I will also bring the article with me to the surgery to show the anesthesiologist since it talked about using different drugs to put you to sleep.

 

[Charlize]

With any luck your cardiologist, surgeon and anesthesiologist will all communicate.  That is what happened for me.  I also was asked to do a stress test for clearance and i did make the required effort.  Then my cardiologist said he couldn't approve as i had shown abnormalities.  I cried, the doctors talked and it was decided to do the procedure under local which was fine with me and my surgeon. (Dr McGinn)  Turns out that the premed made me so "happy" they decided to let me sleep anyway and everything was fine.  Having a cardiac issue is one major reason i have not considered having any further surgeries.  I am enjoying life as myself and without the stress of guilt and shame about who i am i'm sure my heart is happier without any meds.

Hope it all works out well for you.  Try your best to relax and let it flow.

 

Hugs,

 

Charlize