14th July 2007
It is so kind of both of you to reply to my post. At this time it means the world to me. I am confused and slightly emotional :) I did not expect the chest pain to come back so soon.
Nosa47, what a birthday gift you received last year! There are two ways of looking at it, it seems to me...."A bummer of a gift", or "geeze, they saved my life!" I do hope that you had, or will have a much better birthday this year. I had a heart attack for my wife's birthday in 2003.....
Was it pure luck that you ended up in a hospital so capable, or did you "search out" one? The answer to this is obvious, as your LAD collapsed...I still had to ask. Was it a prominent or very prestigious hospital? I know it was to you, lol. Anyone or any institution that saves your life and from having the nightmare CABG is very prominent and prestigious!
I have looked into the eyes of so many of these poor traditional CABG people, walking the hospital hallways. They appear pale and very frightened. I am not so courageous, in fact I am a big chicken.
I have had 9 cardiac catheterizations. The tiny scars are making it tough to deaden new entry points....You mentioned not liking the Plavix treatment... I have taken Plavix since a heart attack in June of 2003. I also had a CVA (cerebral vascular accident) with the mi. I have an extremely hard time tolerating aspirin. Did the Plavix cause you adverse side affects? Plavix is for stroke prevention for myself. I also have small vessel disease (SVD) from years of smoking. This was discovered after my first cath.
My nightmare is ending up in my small town hospital with a scar from my chin to my navel...Just for a single bypass. I think the info you guys gave me will help to prevent this from happening. Really, both of you have made me see that I really need to be proactive with this.
You don't know how much your descriptive information of your surgery means to me. Yes, now I see that I would be pre-empting a heart attack. That is the language that I will use with the medical people. Last March my "hometown hospital" wanted to do a CABG for a single bypass, after a catheterization. I asked if UAB hospital (University of Alabama) could stent it. The doc had a phone conference with UAB and they said they would try it. I rode in an ambulance for 100 miles to UAB. The did a procedure known as Rotoblational Arthectomy at the very proximal (beginning) of my LAD.
The little acorn shaped cutting head came off of the cath wire and I went totally rigid with fear, lol. I had read about this procedure and about the cutting head coming off the deal, which required emergency bypass. The "student" stepped out of the way and the Professor retrieved the cutting head. I stayed on the cath table for one hour and forty five minutes.
I could have had radiation burns...I was way too alert for most of my caths, especially this one, but I could follow there commands very easily like bear down as if to have a bm, or hold your arms up high, or take a deep breath and hold it.
Again thanks so much for your post. It is so appreciated and gives me so much hope. I need to get busy with the docs and I dread it :)
I hope you continue to have great health.
Lenin I have heard of the Barnes-Jewish hospital. A very famous hospital indeed. I think they do many valve replacements also, but the Cleveland Clinic hospital does the most valve surgeries (per a large sign at the entrance, lol) Can you believe that I flew to Cleveland, took a taxi to the CC ER and the rest is history.
I got to the ER on a Thursday night at about 6:00 pm and left the following Saturday at around 12:30 noon? I felt great....
My insurance covers any state that has bcbs, so it was like "in network". No extra out of pocket cost. I had it pre-certified over the phone before I left.
My local folks made me very mad. I went to a sinus doc whom I asked to listen to my heart. This guy is a smart doc. He said I had aortic valve leakage and to see my cardio asap. The cardio receptionist said the earliest I could be seen was about a month in the future....
Turns out = minimal aortic, tricuspid and mild mitral valve leakage, which is common for my age they say?
I am going to have trouble in having this minimally invasive or Mid-cab procedure done preemptively, I believe. Maybe not if I mention the angina, though fairly mild now, to my local cardio. Then maybe he can communicate with a CC doctor. I do have a cardio at the CC that I have seen. He was a genius, I swear.
Lenin I am taking Zetia and prescription fish oil, Omacor, lol, to lower the triglycerides (now > 800) (TC at 297). CC did not do a direct Ldl test. The Zetia makes me weak and sore, especially my feet (sore). I am also trying to lose about 20 lbs. That would put me at my normal weight. It is hard to exercise while taking all of the heart medicines that I take and now I am afraid to.
Lenin, thanks for being here for myself, and all of us. You are remarkable :)
*I wish you guys had time to read this question I wrote to a cardiologist, and his answer that follows :) I won't post my reply to his answer, only because it will add to this most gigantic post in which I must apologize for writing. I must say that I feel much better after reading your replies and writing mine.
The very best to the both of you :)
********************************************************
*Question
I have 4 stents in my LAD starting at the "very proximal LAD". Dr. xxxxxx's partner inserted the last stent about 2 months ago. I also have one widely patent stent in my circumflex.
My local cardiologist here in xxx, told me that I cannot have any more blockages or restenosis in my LAD. My cholesterol is extremely high and uncontrollable due to hyperlipidemia and intolerance of statins, so I am planning for bypass within this next year.
My question is, am I a candidate for the minimally invasive surgery (just based on what info I have given you, I am 54 and in fair health otherwise)? My LAD is very diseased, per the cath report.
Also would it be possible to bypass my RCA during this kind of surgery? It is congenitally small and insignificant per the latest cath report. It supplies the bottom of my heart, but not sufficiently.
I have a left dominant heart.
Thanks so much in advance.
******************************
*Answer
I understand you are very concerned about your coronary artery disease. At this point, however, the most important thing for you is to continue with good diet and exercise and to try to bring down your cholesterol. If statins are not the answer due to side-effects you should try other classes of meds such as fibrates or niacin or zetia. You must eat well.
As far as bypass candidacy, first you have to have an indication for surgery. The most important reason to do surgery in you is if you develop chest pain limiting your quality of life. A positive stress test (exercise stress test) would be a good way to check for these symptoms if you have none with regular activity at home.
Since you had a stent in the LAD, you have to wait at least a year, maybe longer, before you can have bypass surgery because you have to stay on plavix.
Based on the info you gave me you might be a candidate for minimally invasive surgery. That really depends on your body habitus, the type of surgery and other issues that your surgeon will discuss with you. The small RCA does not need to by bypassed. There is no benefit from that. The LAD and the circumflex can be bypassed only if there is severe disease in them.
Since you are not having chest pain, there probably isn't severe disease there. Bypass surgery will not work if you do it when there isn't severe disease because the grafts will not mature well and will go down over time.
Therefore, I don't think you should be planning for any surgery now. Stay on your meds, have a good diet, exercise and relax.
Nosa47, what a birthday gift you received last year! There are two ways of looking at it, it seems to me...."A bummer of a gift", or "geeze, they saved my life!" I do hope that you had, or will have a much better birthday this year. I had a heart attack for my wife's birthday in 2003.....
Was it pure luck that you ended up in a hospital so capable, or did you "search out" one? The answer to this is obvious, as your LAD collapsed...I still had to ask. Was it a prominent or very prestigious hospital? I know it was to you, lol. Anyone or any institution that saves your life and from having the nightmare CABG is very prominent and prestigious!
I have looked into the eyes of so many of these poor traditional CABG people, walking the hospital hallways. They appear pale and very frightened. I am not so courageous, in fact I am a big chicken.
I have had 9 cardiac catheterizations. The tiny scars are making it tough to deaden new entry points....You mentioned not liking the Plavix treatment... I have taken Plavix since a heart attack in June of 2003. I also had a CVA (cerebral vascular accident) with the mi. I have an extremely hard time tolerating aspirin. Did the Plavix cause you adverse side affects? Plavix is for stroke prevention for myself. I also have small vessel disease (SVD) from years of smoking. This was discovered after my first cath.
My nightmare is ending up in my small town hospital with a scar from my chin to my navel...Just for a single bypass. I think the info you guys gave me will help to prevent this from happening. Really, both of you have made me see that I really need to be proactive with this.
You don't know how much your descriptive information of your surgery means to me. Yes, now I see that I would be pre-empting a heart attack. That is the language that I will use with the medical people. Last March my "hometown hospital" wanted to do a CABG for a single bypass, after a catheterization. I asked if UAB hospital (University of Alabama) could stent it. The doc had a phone conference with UAB and they said they would try it. I rode in an ambulance for 100 miles to UAB. The did a procedure known as Rotoblational Arthectomy at the very proximal (beginning) of my LAD.
The little acorn shaped cutting head came off of the cath wire and I went totally rigid with fear, lol. I had read about this procedure and about the cutting head coming off the deal, which required emergency bypass. The "student" stepped out of the way and the Professor retrieved the cutting head. I stayed on the cath table for one hour and forty five minutes.
I could have had radiation burns...I was way too alert for most of my caths, especially this one, but I could follow there commands very easily like bear down as if to have a bm, or hold your arms up high, or take a deep breath and hold it.
Again thanks so much for your post. It is so appreciated and gives me so much hope. I need to get busy with the docs and I dread it :)
I hope you continue to have great health.
Lenin I have heard of the Barnes-Jewish hospital. A very famous hospital indeed. I think they do many valve replacements also, but the Cleveland Clinic hospital does the most valve surgeries (per a large sign at the entrance, lol) Can you believe that I flew to Cleveland, took a taxi to the CC ER and the rest is history.
I got to the ER on a Thursday night at about 6:00 pm and left the following Saturday at around 12:30 noon? I felt great....
My insurance covers any state that has bcbs, so it was like "in network". No extra out of pocket cost. I had it pre-certified over the phone before I left.
My local folks made me very mad. I went to a sinus doc whom I asked to listen to my heart. This guy is a smart doc. He said I had aortic valve leakage and to see my cardio asap. The cardio receptionist said the earliest I could be seen was about a month in the future....
Turns out = minimal aortic, tricuspid and mild mitral valve leakage, which is common for my age they say?
I am going to have trouble in having this minimally invasive or Mid-cab procedure done preemptively, I believe. Maybe not if I mention the angina, though fairly mild now, to my local cardio. Then maybe he can communicate with a CC doctor. I do have a cardio at the CC that I have seen. He was a genius, I swear.
Lenin I am taking Zetia and prescription fish oil, Omacor, lol, to lower the triglycerides (now > 800) (TC at 297). CC did not do a direct Ldl test. The Zetia makes me weak and sore, especially my feet (sore). I am also trying to lose about 20 lbs. That would put me at my normal weight. It is hard to exercise while taking all of the heart medicines that I take and now I am afraid to.
Lenin, thanks for being here for myself, and all of us. You are remarkable :)
*I wish you guys had time to read this question I wrote to a cardiologist, and his answer that follows :) I won't post my reply to his answer, only because it will add to this most gigantic post in which I must apologize for writing. I must say that I feel much better after reading your replies and writing mine.
The very best to the both of you :)
********************************************************
*Question
I have 4 stents in my LAD starting at the "very proximal LAD". Dr. xxxxxx's partner inserted the last stent about 2 months ago. I also have one widely patent stent in my circumflex.
My local cardiologist here in xxx, told me that I cannot have any more blockages or restenosis in my LAD. My cholesterol is extremely high and uncontrollable due to hyperlipidemia and intolerance of statins, so I am planning for bypass within this next year.
My question is, am I a candidate for the minimally invasive surgery (just based on what info I have given you, I am 54 and in fair health otherwise)? My LAD is very diseased, per the cath report.
Also would it be possible to bypass my RCA during this kind of surgery? It is congenitally small and insignificant per the latest cath report. It supplies the bottom of my heart, but not sufficiently.
I have a left dominant heart.
Thanks so much in advance.
******************************
*Answer
I understand you are very concerned about your coronary artery disease. At this point, however, the most important thing for you is to continue with good diet and exercise and to try to bring down your cholesterol. If statins are not the answer due to side-effects you should try other classes of meds such as fibrates or niacin or zetia. You must eat well.
As far as bypass candidacy, first you have to have an indication for surgery. The most important reason to do surgery in you is if you develop chest pain limiting your quality of life. A positive stress test (exercise stress test) would be a good way to check for these symptoms if you have none with regular activity at home.
Since you had a stent in the LAD, you have to wait at least a year, maybe longer, before you can have bypass surgery because you have to stay on plavix.
Based on the info you gave me you might be a candidate for minimally invasive surgery. That really depends on your body habitus, the type of surgery and other issues that your surgeon will discuss with you. The small RCA does not need to by bypassed. There is no benefit from that. The LAD and the circumflex can be bypassed only if there is severe disease in them.
Since you are not having chest pain, there probably isn't severe disease there. Bypass surgery will not work if you do it when there isn't severe disease because the grafts will not mature well and will go down over time.
Therefore, I don't think you should be planning for any surgery now. Stay on your meds, have a good diet, exercise and relax.