Coronary Artery Disease
In 2005, I found myself shoveling snow in an RV park in Quincy CA. I got a strange sensation in my chest akin to someone sitting on me. I did not tell anyone about it because I did not want to go home and I did not want to go to the doctor. Down deep I knew what was happening. I first saw coronary artery disease when my father was about 50 years old. He had suffered a heart attack from he really never completely recovered. It seems that when you have a heart attack, the blood flow is completely cut off to parts of your heart and those parts of your heart die. With my Father, he had several by-pass surgeries, but he had to live a pretty sedate life until his death at about 75. I do know that he enjoyed his life after his heart attack.
Back to 2005. After returning home from Quincy, I fessed up to the fact that I had been having chest pains that subsided when I suspended the activity. Evidently that is pretty clear evidence of coronary artery disease at work in your body. I was admitted to the hospital and fitted with a stint in one of the coronary arteries on the back side of my heart. The surgery was seen as a success and I recovered well from it. During the angioplasty, the surgeon noted the the other coronary arteries on my heart were clear of any obstruction
Fast forward to about 2010. Twice a year visits to my cardiologist were keeping everything going in the right direction, but my doctor always said there would be "more fireworks" I began to have minor chest pains again with exertion. Dr. Chin began to refer to my condition as a "stable pattern of Angina" I began to take Nitrostat once in a while when I over-did. Over the next 6 or 7 years, the condition did slowly worsen. Your mind and body begin to recognize the things that hurt and does what it can to keep it from happening again. In essence you are slowly becoming an invalid.
On Oct 30, of 2017, I went to my shop as I do every morning. This morning to prepare 4 golf carts for a rental at the local fairgrounds. I had coffee with my friend Charlie Vigiani who operates a body and paint shop in the same building. After coffee, I went out to my shop to get my day started. I moved a couple of golf carts to the driveway to wash them and set up the pressure washer. I began to feel the same pressure in my chest that I had seen for several years, so I took a Nitrostat. Unlike every time before, it did nothing. I took 3 more over the next 15 minutes with no relief. This was different. I also began to sweat profusely. I knew what it meant to pull the trigger on this. It meant an ambulance ride to the hospital, tests, and downtime! About 15b minutes after the onset, I called 911 and waited. We all know what that drill looks like, so I am going to fast forward to the ER, Once in the ER they already had an EKG strip rin in the ambulance. The hospital Cardiologist said the strip was mostly normal, but there was an elevated enzyme in my blood that appears after a heart infarction. A very low level, but nevertheless it was there. After discussing my episode with my cardiologist, the doctor said that I had gone from a "stable pattern of angina" to an "unstable pattern of angina" evidently that is a big deal in the world of coronary artery disease. The doctor made a pitch for me to be kept at the hospital and undergo an Angiogram to see what was going on in my heart. By this time, I was feeling back to normal and I put up some resistance. I said I would leave, contact my own cardiologist, research the options and get back to him. He suggested I call Dr. Chin right now and talk to him. It was lunchtime and while I was trying to locate Dr. Chin, the hospital doctor walked in with a portable phone and said I have him for you. Dr. Chin reiterated the position that something had happened and I was at risk for a heart attack which would make things much more difficult going forward. After some contemplation, I decided to have the test. I was not sure enough to walk out without the tests.
The tests began with a chest x-ray at the ER bedside and a Ultra sound study of my heart at the ER bedside. Both of these tests looked good. No lung problems and no noticeable heart muscle damage. The elevated heart enzyme was the most troubling symptom to them. Because it was the first test, I could have been a slightly elevated background reading and not evidence of a cardiac infarction. They began to take hourly tests for the enzyme and the level went down. This lead them to assert that I had in fact had a very mild heart attack that morning.
I was moved to a room and prepared for an angiogram Thursday morning. Since my last angiogram/angioplasty in 2005 things have changed a little. They no longer have to use the major arteries in your groin to access your heart. They can use an artery in your wrist. They call this a "radial". Although the plan is to enter through the wrist, they have to prepare both wrist and both groin arteries for possible use if plan A in the RH wrist is not possible. So here comes the nurse with the shaver drawing a bead on my junk.
Next was a trip to the "Cath Lab" for the angiogram, The hospital cardiologist is an "Intervention Cardiologist" meaning he actually does procedures in the hospital. The procedure began by putting me on a table and immobilizing my right arm. I was administered some medicine, but I was fully awake and knew what was going on. The best possible outcome of this procedure would have been to find no blockages in any of my coronary arteries. I did not have much hope that was going to happen. The next best outcome would have been the finding of blockage or blockages that could have been opened up with a "stint". My worst fear was that he would find blockages that were too severe or in the wrong place for angioplasty. During the procedure, it became clear to me that he was not doing stints. I could see the monitor and I could see the dye being shot thorough my coronary arteries. I could not see in any detail what he was seeing, but I was sure he was not installing stints.
The doctor began to withdraw the catheters out of y wrist a talk to me. He said there were several severe blockages in my heart and at least 2 of them could not be repaired by a stint. It seems a couple of them could have been repaired by a stint, but because they were below the ones that could not, it made no sense to do it. The doctor said I was going to need 4-way coronary bypass surgery immediately. The discussion continued but I did not understand all of it. It seems that the arteries that are referred to as the 'widow maker" were 95% and 100% blocked. This condition mandated that the surgery be performed as soon as it was possible.
The next meeting was with the Cardiac Surgeon. He explained it to me, and I left with a feeling this was my only good option. Rumor was that the surgery would be as early as Friday, the next morning. That was the best possible situation for me as I am not good caged up like a cat when I feel relatively normal.
Bad news came later Thursday when the surgeon said he would not be able to get my surgery into the schedule until Monday morning. This was very bad news for the caged cat! What would I do for 3 days in a hospital room waiting for surgery. At this point, I began to be a bit non-compliant with the nursing staff. In my mind, I was just waiting there for the surgery and I saw no need for all their poking and probing until there was actually a reason for it. I got in a little trouble with the Charge Nurse that afternoon. Better news arrived Friday when the Surgeon arrived and said he was making a slot for me on Saturday morning at 8 AM. That was much better!
At this point it became all hands on deck! There was additional shaving, multiple showers, and more to prepared this body to go into a sterile operating room.
It was somewhere in here that the surgeon came in and explained what he wanted to do. He was going to bypass 3 or 4 coronary arteries. The actual count depended on the condition of the target arteries when the actually got in there and could see them. The "widow maker" section would be attached to the mammary artery in my chest that would be liberated from whatever it was doing, and connected to my arteries to improve blood flow. The final count was the mammary artery hook-up and 3 bypasses using veins harvested from my right leg.
The trip down to the operating room was uneventful and I was moved from my gurney to the operation table. Somebody said something about "medicine" and I do not remember anything until I awoke with a tube down my throat choking me to death. I understand I became a bit "non compliant" again at that point.
Once in ICU the surgeon came in and told me that everything had gone very well and that, believe it or not, I would be sitting on the edge of my bed tomorrow morning eating breakfast. I was skeptical! The stay in ICU was fairly comfortable, as I was being administered pretty strong drugs for the pain. Morning came and I was indeed sitting on my bedside eating a sorry excuse for a heart healthy breakfast.
really recovered. really recovered. recovered