Plan B it is …

Well, I finally met with the cardiac surgeon. Once again there was a delay, so overall – we waited over two hours. The question was whether I would have bypass surgery or not. Well, it turns out not. Because of my lung disease, I have taken prednisone – on and off – for many years. That leaves me with a significantly enhanced chance of infection after surgery. And then, of course, there is the lung disease which is now being treated with remicade and methotrexate (since the disease has worsened over the years). Chances are good that I would have a long, difficult recovery. So, with all of this, and at the advice of the surgeon, I am not having bypass surgery.

On to Plan B –ADTYR6_2093488b.jpg

What is Plan B? In the next few weeks they will try putting in stents (angioplasty) again. (I already have two stents). They are pretty sure they can stent one area – and one area is a maybe. I also have narrowed arteries and a bundle block – neither of which can be fixed without bypass surgery. The stenting will not correct all of the issues but it should make it better. Chances are that I will never become a world-famous athlete because I won’t be able to do things that require a lot of exertion – but, then, I have never been a athlete in any sense of the word. And I can find plenty to do when sitting …

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So, that is the plan.

Thanks for reading! I hope you will return. 

 

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White Coats and Vascovagal … aren’t I the lucky one?

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Last week I had an angiogram – where they determine if there are any blockages of the arteries to the heart. (More about that later.) My procedure was scheduled for 11:00 am. But, as luck would have it, there were two emergencies where they needed to do angiograms on the patients. So I got bumped to the end of the line. I finally went to the procedure room about 3:45 p.m. Not a big deal, except that I have ‘white coat syndrome” – where ‘patients exhibit a blood pressure level above the normal range, in a clinical setting, that they don’t exhibit it in other settings.’ This all seems quite silly to me – that my blood pressure goes up – because I don’t feel that anxious. In fact, part of the time I was falling asleep. The ‘cure’ for white coat syndrome is to relax – so sleeping should be sufficient. But is wasn’t and it has never worked for me. During the angiogram, my systolic (upper number) blood pressure was over 200. A reading of 140 or more is considered high blood pressure. As a result, they gave me medication – twice – to get the systolic pressure down. It took until AFTER I got home late that evening to get it under 140.

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I also suffer from vasovagal syncope –

Vasovagal syncope (vay-zoh-VAY-gul SING-kuh-pee) occurs when you faint because your body overreacts to certain triggers, such as the sight of blood or extreme emotional distress. Vasovagal syncope trigger causes your heart rate and blood pressure to drop suddenly. That leads to reduced blood flow to your brain, causing you to briefly lose consciousness. (from the Mayo Clinic – online)

The last incident of this was when I had a tooth pulled. I drove home (about 20 miles), put gas in my car, and then worked at my computer for an hour or so. It was then time to change the gauze. I removed the gauze, stood up, was immediately weak and dizzy, and barely made it a few feet across the room to a chair where I collapsed, falling across the chair. I turned “ashen white” – as described by the paramedics who arrived after we called – because we had no idea what was going on. After an ambulance ride to the local hospital, I was soon home but It takes several hours to get back to normal. I asked the admitting ER doctor what I could do to avoid this – because it seems so silly and should be preventable – and he simply said: “When you figure out what to do, let me know. My wife does the same thing.” By the way, I am really good at passing out; I have it down to a science – with the most important thing being to get to the lowest level so you don’t hit something as you fall. Vasovagal syncope is usually harmless and requires no treatment. It is just a temporary annoyance.

It appears my body reacts with a ‘high’ (blood pressure) or a ‘low’ (passing out); I would be quite content with something in the middle.

Back to the angiogram – not the best news. I do have blockages – that may not be correctable with stents. (I already have two stents.) They are now considering some sort of bypass surgery. However, I also have a lung disease so they need to determine if I am a good candidate for surgery. Interestingly, the angiogram was done through my wrist – instead of through the groin – which is a big change from the last time – and a big improvement. It is amazing how many changes/improvements have been made in medical procedures and treatments. Perhaps they will have a new idea on how to address the blockages and narrowing of the arteries. I’ll learn more when I confer with the surgeons/specialists in about two weeks. — More on that later.

Thanks for reading. I hope you return.