Angioplasty | Heart attack waiting to happen

Today, 235 days after I was discharged from hospital, I had my follow-up Cardiology Check-up. Having waited for such a long time I had mentally built it up to being a big deal, and I was apprehensive as the time of my appointment approached…

Aren’t hospitals are strange places! As I ran the gauntlet of smokers alley and approached the Main Entrance, it occurred to me how different this visit was from my last one. Are there any other buildings where the various users can have such vastly different experiences? As an individual, each visit can have such dramatically different purposes and impacts; births / deaths, delight / despair, mundane / eventful, excitement / dread, etc..

Fortunately for me, this visit was short and positive. I had an ECG on arrival, again bringing back memories of my previous visit as my chest was shaved to improve the contact points. One big difference this time, however, was that everything was a little more relaxed!

After only a few minutes, the Cardiologist was ready to see me. He reviewed my notes, took my Blood Pressure and asked a few questions:

“Everything’s Perfect!” Dr, Noman (My Cardiologist)

I took this to mean “Thing’s are as good as they could be.” Which is also pretty good!

Again, everything was more relaxed, so I had a chance to ask some questions:

Dizziness? Due to medication. There are some options, but I am on the optimal dosage and should stick to it if I can. The best approach is to take my time when getting up (See Golden Rule #1).

Sensations in my chest area? Consider them normal, as long as it doesn’t feel like I did before I was admitted last time (i.e. as long as I don’t feel like I’m having a Heart Attack!).

Exercise? To be encouraged, as long as I don’t feel pain in my chest. Make sure I eat properly to minimise the dizziness.

How hard can I safely exercise? The drugs should prevent me from going “over the top”, but keep an eye on my Heart Rate (120 is a sensible upper limit).

My sponsored cycle, 300 miles over four days? (This prompted a little more thought…) I hadn’t previously had a Physical Stress Test, so we went back to the images of my Angioplasty. [I should have realised, but the whole procedure had been recorded. Not me on the hospital bed being brave, or the attentive staff, but the business end of proceedings (i.e. my Heart).]

My Heart post insertion of Stents

Last time I saw the images, I had a lot on my mind! I’ve spent so much time thinking about what’s going on inside me since last June, it was amazing to see them again!

The conclusion was that the damage to my Heart itself was minor and the narrowing of my other arteries was not sufficient to restrict blood flow, so I’m good to go! So good in fact that there’s no need for any further follow up visits unless something happens at my end.

So, the final “thumbs up”, I can really start training rather than exercising now, as long as I obey the rules…

Golden Rule #3: Make sure I am properly fuelled before (and while) doing exercise.

Golden Rule #4: If I feel dizzy while exercising, stop and refer to Golden Rule #3.

Golden Rule #5: If I feel chest pains while exercising, STOP!

I heard about two more Heart Attack Survivors at work recently. Apart from the fact that there seem to be more cardiac emergencies around today than in the past (probably more to do with me than everyone else!), I was struck by the way they had been treated… the two gentlemen had received 8 and 12 stents respectively.

Apparently the guidelines for treatment have changed recently…

When I had my Heart Attack, the approach was to just treat the blockage that was causing the immediate problem. For me that meant fitting two stents in my Left Anterior Descending or LAD artery. During the procedure they identified that another of my arteries (Right Coronary Artery or RCA) was partially blocked, but as it wasn’t causing any distress so it was left untreated.

Apparently now the approach has been revised so that they address any blockages during the initial procedure. As a result, the patient leaves hospital safe in the knowledge that they have no blockages. I guess it maximises the value of the angioplasty procedure, and reduces the chances of having a repeat performance,

There is a point of view that stents aren’t great for you. Yes, they are helpful in an emergency situation like mine, but many people are treated with stents as a preventative measure.

The argument is that the stent treats the symptom rather than the disease, and in the process reduce the chance that any action will be taken to address the root causes themselves. In addition, they leave the patient dependent on a concoction of medication and exposed to the side-effects and potential complications (for example, risks associated with future, non-heart related medical procedures).

Personally I haven’t thought much about whether my situation would be significantly different if my other artery had been treated at the same time. Given the emergency nature of my treatment, I obviously didn’t have an opportunity to think about it in advance. There was certainly no debate or discussion as I got wheeled into the “Cath Lab” (See: The Cath Lab (FD ~02:30)). I didn’t have an opportunity to weigh up the pros and cons.

There was no cosy chat for me when I arrived at the hospital!

To be honest, it doesn’t feel like a huge deal right now, but I recognise that it could turn out to be a big deal at some point in the future. It seems strange to me that if I’d had my Heart Attack today I might have been treated in a very different way than 6 months ago.

I guess I have little option but to carry on taking my medication and stay disciplined, it’s up to me to do the work to address the underlying disease (or at least to prevent it from getting any worse). For me, watching what I eat and drink as well as exercising regularly are the key to my long term health.

I can’t rely on stents to return me to “normal”. Now it’s all about establishing a new, safer, healthier normal.