Back Pain in the Cath/EP Lab: My Experience

Daniel P. Dindy, RCIS

Daniel P. Dindy, RCIS

At first, it was just a general soreness in my lower back at the end of the day. However, I was young and did not think it was anything to be concerned about. Back then, I thought my new job in the cath lab was the best thing that had ever happened to me. I envisioned a long and exciting career in a field that I loved. As it turned out, that career was much briefer than I could have imagined. As a former Emergency Medical Technician, I was drawn to the cath lab by the fast pace and excitement that it offered. In 1991, my career started at Boston Children's Hospital as a cath lab technician. Anyone who has worked in a pediatric cath lab can attest that it is among one the most exciting and fast-paced environments in interventional cardiology. Back then, the lead aprons that we wore were a bit heavier than they are now, and were not ergonomically designed. The pediatric cath lab procedures would often times last many hours. A simple hemodynamic case could last two to four hours. An interventional procedure could easily go on for eight hours, with fluoro times exceeding 90 minutes. It was not unusual in fact, it was quite common to see the cath lab techs running up the hall with arms full of angioplasty balloons, film canisters that needed to be changed and reloaded (yes, back in those days, for our younger readers, we used cine film) or whatever stock we did not have readily available in the lab. As with most cath labs, we would spend up to 12 hours or more a day on our feet, wearing lead aprons. Therefore, it is not surprising to me that so many cath lab professionals suffer from neck, back, and knee pain. Over the years, many of my coworkers have suffered from these work-related injuries. Some required surgery, while others have had their careers cut short. It was three or four years into the job that I started suffering significant back and neck pain. If the pain became severe, a few Advil would usually get me through the day. We all just shrugged off the discomfort as part of the job. As with all other cath lab professionals, you just go on and endure the pain. It was expected and accepted. After six years at Children's Hospital, I was enticed to a community hospital cath lab. Cath procedures on adults tended to be considerably shorter. The prospect of the easier commute and briefer procedure times and hopefully less time in lead was enough for me to give up life at a world-renowned teaching hospital. While the procedures were indeed shorter, we were also responsible for scrubbing in and sheath pulling after the procedure. Over the course of the seven years at this local hospital, the back pain I suffered became more frequent and more severe. In addition to back and neck pain, I acquired carpal tunnel syndrome from the many hundreds of sheaths that I pulled over the years. Although clamps were at my disposal, I have always favored holding the site manually. I never liked the clamp, since once you put it on, you have a tendency to walk away. You are less likely to have complications if your hands and full attention are on your patient at all times. Closure devices were not available to us at the time because they were considered too expensive. It was not until the last couple of years in this lab that closure patches were made available, making holding time much shorter. During my time both in Boston and the community hospital, I became interested in learning and ultimately in participating in electrophysiology procedures. You want to talk about long procedures welcome to EP! At our local hospital we were not blessed with fellows, so during an EP procedure the tech would usually jump from the C-Arm, to the stimulator, to the radiofrequency generator back to the C-arm while the physician manipulated the catheters. These procedures sparked my interested in pacemakers, but proved to be the final straw in a long battle with back pain. During my last year at this local hospital I pretty much lived in pain, both from my carpal tunnel and my back. My right thigh became numb and getting up in the morning was proving to be more difficult by the day. During the last year in the cath lab, I was able to pursue my interest in pacemakers. My experience with pacemakers won me a part-time job in a local doctor's office doing transtelephonic pacemaker monitoring. This skill, in part, led to an exciting new job opportunity at Massachusetts General Hospital. It was with mixed emotions that I finally left the cath and EP labs. Since changing jobs, my back pain has lessened somewhat, and exercise helps considerably. I have opted not to have surgery to correct my carpal tunnel, though I may need to revisit that decision later. If someone told me that a career in the cath lab would offer long hours where you missed time with friends and family, working in the dark, exposed to radiation wearing 20 lbs. of lead, ultimately suffering back and wrist injuries would I have chosen this path? Probably not. However, my relatively brief tenure in the cath and EP labs left me with a wealth of knowledge and experience that could never have been acquired in a classroom. I look back fondly and gratefully on my 16 years in the cath and EP labs, and I have no regrets.