Stents: The Short Form

Since I can’t seem to get written the lengthy version of the post, including on medical adventures more generally this year, I thought I’d put up something brief.

Early in the summer I admitted chest pain and associated symptoms to my doctor. He got me to cardiology for an exercise stress test, even though to him an EKG looked OK. Cardiologist on duty balked at putting me on a treadmill, despite that I essentially work out for a living, introducing a delay while wrangling approval for the medically induced version of the same thing. Due to a suspicious tech, I ended up having a treadmill test anyway, since nobody could figure out why the original cardiologist ever objected. Getting my heart rate up to 140-odd on the treadmill was actually harder work than most anything I’d ever do at work, and it provoked mild chest pain on cue.

The cardiologist, no longer one that happened to be on duty, but my assigned one, grilled me at the followup, poker-faced, before telling me the pictures from the stress test showed that I looked clear. She was uncomfortable with that, due to family history (which I have since learned was worse than I knew) and an oddness in my EKG. First I’d heard of the EKG being off. She wanted me to go for a cardiac catheterization, so they could get a more definite look, even though it was probably fine. An EKG can, after all, just have an inexplicable oddity. He casualness about it was belied by the fact that she’d have had me in the hospital for it the very next day, had I been able.

So I arranged a Friday and Saturday off from work at the best near-future time for them, which turned out to be the week of Labor Day, when I already had Tuesday off for the holiday, and vacation days Wednesday and Thursday for the first days of school for the kids. Funny way to get the whole week off.

Went in that Friday and about noon was finally getting probed, through an artery in my wrist. Had expected they’d have to use the groin, since I am used to blood being hard to draw through my arms, but I guess there’s no comparison.

When they were done, I had two stents and a room being lined up for the night for observation and recovery.

Turns out my two major coronary arteries that everyone has are absolutely clear. That would explain what the stress test pictures saw. I have an extra artery, which was not, and when it branches smaller, it’s worse. There was a spot that was especially clogged that was too small for a stent or bypass, which can be expected to create its own bypass. One of the stents is apparently quite long.

The cardiologist who did the procedure was mystified. I have never come close to being diabetic, despite that family history in places. My blood sugar tests even better than my cholesterol, and reliably so. The pattern of blockage is typical of what a diabetic might have. He was pretty low key, happy I’d already maintained a 65 lb weight loss for a few years, OK with losing as few as 20 more. Apparently he was shocked when I told him of my grandfather’s first heart attack at 55, but then he lived to months shy of 90. Turns out he had another at 60, then had no more heart attacks or strokes until the end. My grandmother on the other side dropped dead of a massive heart attack at 65. What I didn’t know was that she’d been taking nitroglycerin for years before that, when it was all they could do for angina.

Anyway, stayed a night. Great nurses and a cool roommate. Felt fine after the procedure, but they kept me until 7 PM Saturday, suspicious of levels of an enzyme that could mean they’d caused an MI by putting in the stents. I wasn’t supposed to drive or lift more than 10 lbs through Monday. Between that, 3 AM Tuesday being so close to the cutoff, and dizziness from the new suite of drugs, I called the guy in charge of the place on Monday to arrange Tuesday and, if I’d needed it, Wednesday off from work.

It has made a difference. The day before I went in, walking the girls to school gave me chest pain. It no longer does.

The financial impact of the procedure is less bad than it might have been, since I was included as part of a study, no charge, and things done at the hospital are covered by Health Safety Net, so that’ll take care of the way too much my pathetic insurance won’t cover. Since my last medical bill was up over $1000, before the stress test or hospital, that’s good. The prescriptions we bad, big copays, but one was nitro, which won’t be filled routinely. I’m sad to have to be on beta blockers indefinitely, since they fry my brain. Perhaps with oxygen in my blood now, that won’t be as bad. There’s blood thinner and precautionary statins. Oh well.

Followup with my primary tomorrow. That could be interesting.

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  1. Pingback: Stents and Blood Pressure Followup | Accidental Verbosity