The Fabulous Migraine Underworld
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Post  Porsche Fan Wed 16 May 2012, 12:06 am

Long story short. about 12 days ago, I saw my cardiologist and went through my stuff--we decided on a new cardiac cath (#13). Had a cath last wednesday.

Went through the radial artery in the right arm. Had complications. The stent in my right coronary artery had only 20% flow with fractional flow reserve of zip. That means that with any type of blockage, i had no blood flow to the right side of my heart. The stent had to be re-stented.....that's how it sounds--the cardio had to insert a new stent into the blocked stent and replace it. It was a long procedure. Lost blood. My heart went out of rhythm, full A/V block. Luckily I didn't need to be defibrillated...my pacemaker kicked in. I was in the lab for about 1.5 hours. I had a ton of pain meds and they had to give me epi.

Doc was cool, but knew there was a problem. I was awake through the whole procedure, but pretty bombed. I did say he could have my car if he would put a new stent in.

Stayed overnight in the hospital. Doing ok since then, but we're trying some different cholesterol meds.

Docs and staff were awesome. Had a bazillion meds in me as putting the sheaths into my radial artery was not pleasant. I lost quite a bit of blood but luckily no transfusions. Troponin levels increased showing a blood flow problem to the heart long enough but hopefully no lasting damage.

Not a walk in the park. So, with the new stent I have more blood flowing on the right side of my heart. Scary part is that it went from 30% occlusion last january to 80% now....that's huge, and not good. The mechanisms of why that happens are not quite good. The rest of the coronary system had blockages, but none of them need to be stented.

Had warning signs. Talked to my cardiologist and got scheduled right away. Had 2 diferent types of stress tests in the past 3 months--none of them showed blockages in the right system. I felt myself progressively getting more tired. I started to accumulate water weight and needed to take nitro more often for chest pain. Neither myself nor my doc expected this blockage to be so severe, so it was a surprise.

We're going to try to increase Crestor, but we'll see. I'm probably going to see a lipid specialist in Philly next. Hospital and staff treated me well. I took my own meds and didn't have to take subsitutions--which was nice.

Going through the radial artery in the arm is a bit nicer than the femoral in the groin--you can get up a lot faster, however I had a lot of bruising and swelling. Just part of the process.

I had some considerable lipid fluctations due to some meds over the past 5 months, but we are unsure why the stent blocked up so fast. We do know if this happens again in this spot, it will require by-pass surgery. The new stent is platinum-chromium that's treated to prevent overgrowth of lining.

Bit tired, got a boat load of radiation. Unfortunaetly all this radiation is cumulative.

Take care!
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Post  Cluelesskitty Thu 17 May 2012, 7:10 pm

This is very serious stuff, Marc not too mention - scary. I am so glad the blockage was caught in time.
whew, is all I can manage at this moment Shocked ....

Marc I love you

Risa
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Post  milo Thu 17 May 2012, 8:07 pm

You are in my thoughts friend. I hope it all helps you feel a bit better in the end. I had a chuckle about offering up your car. lol
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Post  30yrsofheadache Fri 18 May 2012, 4:37 am

Mad Wow, that is really frightening! I hope your trip to the new Dr. will shed some light on your problem.
Hugs,
Cindy

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Post  Porsche Fan Fri 18 May 2012, 6:02 pm

Thanks guys, I'm doing ok. The new stent seems to be doing its job. Did some hiking lugging around my camera gear last night and I had no chest pain. 2 weeks before doing the same thing I did.

Healing well--the incision in my wrist is almost gone. We're going to try and up Crestor to 10mg and see if I can tollerate it. There's nothing new that is out there to treat the lipid issue. All reall it would be is another opinion. There are no fixes except meds and surgery.

Only thing really they could do, and this would be extreme, would be to give me a liver transplant. That is rather risky. I think I'd rather let my own system do its thing rather than that type of risk. Other thing they can do is apheresis--filtering the lipids out of my blood. There's no one local that does that and the long term feasibility of that is of question.

Life throws bowling balls at us!
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Post  Ruth Sat 19 May 2012, 9:36 pm

Gosh Mark, I'm so sorry to hear about all this, you've gone through so much over the years. I don't come here too often (I usually forget my password!) but I do often think about you and wonder how you're doing. Take care and all the best, sounds like the docs. are doing all they can to help you.

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Post  Porsche Fan Sun 27 May 2012, 12:50 am

I'm still alive, and that's all that counts.

I have very good relationships with my cardiologists. The recent stent implantation was very serious. They had to place a new stent inside a stent that had clogged up. If it does again, I will need bypass surgery.

What normally should have take 15 minutes turned out to be an hour and 15 minutes or so. Stenting a stent is tricky and takes skill. So far, it's working. I feel better.

The only way for my problem is to keep on the docs, have tons of bloodwork, and let them know if I'm not feeling good. I was pretty close to a dangerous heart attack.

I had two different stress tests leading up to it. Both showed some problems, but not to the degree that the cardiologist found. Caught him off-guard and he earned his pay that day. My dad knew something was amiss--a normal cath you're in and out in 15 minutes...and the doc comes out to talk to family. This time, it took at least like I said above 1:15-1:30 hours to do this. Doc wasn't shaken, but knew I just went through some real stuff. Thank god for my pacemaker...kept rhythm somewhat normal to deploy the stent. I got zapped with lots of epi--that's a sure sign that the electical system of the heart isn't working well.

It's a game changer--sorry, hate that phrase.

When I meet with him again, I'm going to ask him what vascular surgeon he'd like me to see--time to develop a contingency plan.

Nutty stuff.....but I'm feeling better and will continue as long as I take all my meds. Since stress tests aren't reliable for me, I think caths will be done on at lest a yearly basis. my right coronary artery was only 10% away from meeting criteria for stenting. So that may need to be done next spring.

I firmly belive there's a brain/heart/HA relationship. Servere HA has gone down since I got my stent.

Could very well be anecdotal.

Later! Take care.
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Post  Ruth Sun 27 May 2012, 7:28 am

You may be right there Mark saying they're all related.

It sounds like you have a good cardiologist which is great, and good luck in the future with all these tests and procedures, it tires me out just thinking about them all!

I still hope to be able to see a cardiologist one day, I told you a while back my doctor tried to refer me because of my irregular heart beat, which I still have by the way, it's no different, but because I have worn the holter monitor twice (with no skipped beats while wearing it - typical) and I had had a stress test which was fine, the cardio. wouldn't see me. My husband said I should go to the hospital when it's really bad, so maybe one day I will.

Take care. Smile

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Post  Porsche Fan Sun 27 May 2012, 10:45 pm

Ruth, that makes me sad.

You have enough to be reviewed by a cardiologist, yet an electrophysiolist. If you don't feel good make sure you let someone know.

I've been living this battle with my own disease and my mother's years before that. Little has changed. However I have learned much from her care and it take a lot of courage and knowledge to press forward. One goal is to keep pressing and asking questions. Make the doctor uncomfortable. I do this at every visit. This only works if you are a persistant educated patient. And this does not happen over night........................

I wish your doc would do some more testing, and you're right. Get in if you don't feel good. Unforuneately event monitors, holters, ekgs, stress tests, and EP studies can miss things. Often times the only way to see what's going on is to do a cath.

I had two different stress tests, and both were wrong.

What can you do? Best wishes!
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Post  Ruth Thu 31 May 2012, 9:02 pm

Mark, I went to my doctor today because I'm feeling very tired a lot lately and I also mentioned about the skipped beats that seem to be gettting more frequent, just about every day now, and I said I feel really unwell when they happen, so he's ordering another holter monitor for me to wear and I have to have a bunch of blood tests done in the morning. I told him I still want to see a cardiologist. He said the one declined to see me because I had the stress test 2 or 3 years ago and it was fine, and I didn't have the skipped beats while wearing the monitor.

I shall be soooo mad if the irregular beats don't happen the third time I wear one, not sure when it will be.

Hope you are doing ok. Just wanted to let you know Smile

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Post  Porsche Fan Fri 01 Jun 2012, 11:18 pm

Ruth,

Oh this is so frustrating--for you! Data from 2 or 3 years ago is worthless when you are having symptoms.

I had 2 different types of stress tests that were both off (within a 2 month period), and the only way to see what was going on was a heart cath. I'm not trying to worry you, but any doc that sites that as a reason why not to do new testing is a failure (and i'm not banging on the CA healthcare system).

You have new symptoms, and plus plainly state to the doc "i don't feel good!"

Holters are not tools that can used as rock solid evidence to rule in/out problems. They are part of diagnostic testing to come to point to do more testing or not.

Keep hammering on them!

I am doing ok. I got the formal report of my procedure today. Wasn't easy and it had complications. I know the doc told me, but after I read it I have 1 40% lesion in the LAD, and in another diagonal branch I have 2 50% blocks. Not bad enough to stenth, but getting darned near to.

This healthcare stuff is nuts. I know you guys have to pay out the nose in taxes for "free healthcare" while here we have to pay out the snout if you have your own health plan. Just makes your head spin.

But by all means if you need help, go to the ER.

Best wishes,
PF.
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