Had a coronary bypass? Might want to read this. (Interesting, not negative..)

I had mine in '03, a quintuple, after several doctors had assured me my heart and circulation were OK. I had 2 heart attacks that I thought were pneumonia, wife drove me to the ER.

I'm here, fine, retired now and finally emotionally able to investigate how the surgery was done. I didn't want to know at the time, told the doctor that if he would do his job, I'd do mine when he was finished. I guess we both did a good job.

I found a very informative articls on Wiki, and wanted to share it. Link:
http://en.wikipedia.org/wiki/Coronary_artery_bypass_surgery

I am still pissed at the stupid doctor who told me my neck and arm pain was carpal tunnel, and the other doctor who told me my heart was fine after a stress test 1 1/2 years before my heart attacks, but I am in awe of the docs and nurses and others who did my surgery, and I'm grateful they were so good.

FWIW, if you are going to have this surgery, maybe you should read this afterwards....and good luck to all you survivors-you have won the only lottery that really matters.

mark

but everyone needs to understand that in most cases this surgery does NOT help you live longer. I have seen people without symptoms talked into it - guess what, they live longer! Because they survived surgery they did not need.
You sound like someone who probably needed it.

I had alomst no circulation to my heart. I was talking aspirin and vitamin E for several years, got a lot of exercise and had satopped smoking and drinking about 15 years before. If not for all that, I'd be long gone.

mark

Dr said my daughter had pneumonia
Died few days later of leukemia

Mom--"May die during night(congestion) must operate first thing tomorrow".I requested second opinion. Sr doc at UNC said "no congestion". what the xxxx.

Employee--X-ray shows big spot. Scared him to panic . Second X-ray showed clear.
A blot on first X-ray.

Pal--small growth under thigh-examined. come back two weeks--come back one week-radiation for fifteen days--leg swollen into two legs. died one week after radiation.

Could have removed small blotch next day after discovery and no problem.

Back pain-"Oh! That is Osteoporosis and very expensive to treat". Did nothing.
Went to second and he said "lets first try Tylenol Arthritis pill for few days.

Two pills pain gone.

I trust no one. No one.

cswinney2@triad.rr.com

then the next day have a plaque rupture or a clot form in your coronary artery and be dead as a doornail. I don't think that doctor was necessarily to blame for not finding your future MI's on one stress test 1 1/2 years beforehand.

when he saw the stress test angiogram - it was the same hospital - and the doc who misread it also saw it and said," Who the hell read this." Then he saw his own signature, and quietly left.

You obviously don't have to be smart to be a doctor-just be able to memorize well. I have very good doctors now, but I had lousy ones then, and I'm not apologizing for my statements.

The doctor who told me I had carpal tunnel syndrome-for several years-was lucky I survived. My wife told me she would hve killed him if he had killed me, and I have no reason to doubt her. She probably would even have gone free - her dad was a Philadelphia Lawyer.

mark

I recently had abdominal surgery, and my surgeon was YOUNG and fresh out of residency. Medicine can be such a leap of faith--and mistakes happen, everywhere, daily.

I'm glad that you're doing OK. This is a little long winded, but it serves as a warning to other people that it isn't a good idea not to be a part of your own care and decision making.

I was always active doing things like 200 miles a week on my bicycle, hikes of 8 to 12 miles after or instead of cycling, eating right... etc.
In 2003 & 2004 I started noticing a loss of energy and strength that were combined with crushing chest pain while riding. I shook it off as referred pain from a spinal cord injury in my neck and my neurologist agreed. Finally, while at my PCP in Dec. of 2004 I mentioned my symptoms and the high cholesterol and he insisted that I have a stress test done ASAP. I knew that it wasn't my heart but agreed since I was questioning my diagnosis. Well, they found that there was a blockage somewhere on the left side of the heart and said that I should think about having a catheterization as a precautionary move.

What they found was partial blockages at 5 locations with one being severe enough that I had a stent put in on New Years Eve 2004. They said that with my lifestyle and eating habits that would probably be all that I would ever need.

Less than two years later I went for a bike ride even though I thought that I might be having a heart attack before I left the house. After doing 30 miles I knew that I was in trouble so I drove myself to the ER still trying to convince myself that it was from the neck injury. The ER ??Doctor?? agreed that it was probably the neck and tried to send me home even though my resting heart rate was well over 100/BPM.
Luckily, my PCP had to approve my release and said that there was no way in hell I was allowed to leave just because the blood work wasn't showing any sign of a MI.

It wasn't until the next morning that the blood test came back positive that I was indeed having a heart attack.
The local hospital is a joke so I was in there for 48 hours before they went in to see how bad it really was. They thought that the original stent had closed and that all I needed was to have it re-opened.

As it turned out, the original artery which was stented was about the only place in my heart that was open. They were shocked that it was so severe and I was still alive. I was expecting the best case scenario until they said that what I really needed was multiple by-passes but that I might not have time for that because the damage was so widespread. I almost freaked out when they asked me which I wanted; a bunch of stents or multiple by-passes. I'm sedated, but I'm still freaking out at this point so I said whatever they suggested was fine.
They were able to put two more stents in the left main artery but I still needed other arteries opened. They were unable to do those at the time because they said that they were about to lose me if they stayed in the heart any longer. That was a major panic time for me when I heard them say that.

A month later they were able to put two more stents in but there was one major artery that was too far gone to repair (left circumflex).
The worst part was that two days after leaving the hospital after the heart attack, the news reports that night were about the dangers of having the medicated stents put in instead of having CABG done.
Then I found out that the artery that I had three stents in should never be stented since it's the most crucial artery and that CABG should be the only option for that artery.

OK, I didn't mean to be so long winded but this really struck close to home.

The object of this rant is to let people know that they shouldn't always assume that their Doctor is always right and a second opinion is always a good idea.

did he put those stents in just to buy you time until surgery at some later date, or do they consider you fixed unless you develop new symptoms?

He said that the Cardiologist in P-Burgh had helped some of his other patients after heart attacks. The main reason that I went was that my local Cardiologist was telling me that I'd never be able to resume the kind of cycling that I enjoyed because of the muscle damage from the MI.
This sounds stupid, but at the time I felt that my life was over if I couldn't still ride like I used to. My local Cardiologist said that it was about 50/50 whether I'd go into CHF and that I shouldn't push myself at all. That had me a little concerned.

The Doctor that I saw in P-Burgh is the Director of the Cardiac Catheterization Laboratory at the Cardio Vascular Institute of UPMC.
The first thing that I asked him was whether I should have the main artery bypassed instead of having the three stents. He said that ideally, I should have chosen the CABG but lets just deal with what we have right now. They ran me through a nuclear stress 6 months post MI and he was pleased enough with the results that he said that there was no reason that I had to hold myself back when it came to exercising. The next time that they did a stress test was 12 months post MI and he said that I did well enough that I could ride my bike to the next appointment if I wanted. However, I really didn't feel like doing that since it was 100 miles each way but he made his point.

I still see him every year and it's now been exactly 3 years and 10 days since the MI. Everything is still stable from what they're seeing and as of June he said that I could stop taking my Plavix but that I'll be on Atenolol, Lisinopril and Aspirin the rest of my life. I still don't have as much energy or stamina as I used to, but that might be from the medications. My EF before the MI was in the 65% range and now it's only around 50-55% but that's still a lot better than right after the MI.
It might just be me, but the main thing that I've found is that the Psychological aspect is the hardest thing for me to recover from. I still get nervous when my rides hit about 50 or 60 miles but I'm alive and that's all that really matters.

after an MI (and the valves might have been affected), so it's not surprising that you may not have the same EF or activity tolerance--it just may not conduct impulses, contract, and pump the same exact way it used to. You are also on a beta blocker which slows your heart down/decreases workload, so you don't have the same cardiovascular response to really high-level muscle activity than you used to, maybe. But it sounds like you're in good care (being a little biased, as a Pitt grad) and have a positive attitude--being in good physical shape has probably also helped your recovery tremendously. Hope you never need that surgery--best of luck!

I root for Penn State, but my heart will always have a soft spot for Pittsburgh and UPMC. Wow, that pun was pretty bad.

No doubt about it, every medical person that I've dealt with in the last three years says that the cycling before the MI was what saved me.

http://www.lef.org/LEFCMS/aspx/PrintVersionMagic.aspx?CmsID=116417

Metabolic, Not Surgical

Neither plaque formation nor plaque rupture is simple or straightforward. They both occur because of complex interactions between cholesterol, free radicals, and inflammatory cells. All of these are controlled, either directly or indirectly, by our metabolic processes, which makes heart disease a metabolic disorder—a disorder caused by abnormal chemical reactions in the body that disrupt the normal process of metabolism (how we create energy from the food we eat). And metabolic disorders require metabolic solutions—not surgical ones.

But surgery, in any circumstance, is like putting on a band-aid: it doesn’t fix the problem; it just covers it up for a while.

If we want to stop heart disease, we have to address the underlying causes: cholesterol levels, free radical production, inflammation. The good news is that, because heart disease is a metabolic disorder, all of these things are, to a certain degree, within our control. No one has to die prematurely from heart disease.

Preventing heart disease is in large part a matter of simply encouraging a healthy metabolism: eating the right foods, getting plenty of exercise, and avoiding chronic stress. And you can reverse heart disease the same way. Studies have shown this again and again, including one study published by Harvard-based researchers in the New England Journal of Medicine that concluded that lifestyle changes (diet, exercise, etc.) are capable of reducing cardiovascular disease risk by more than 80 percent—a figure which trumps even statin drugs, known to reduce the relative risk of cardiovascular disease risk by 30 to 35 percent.

But if all this is the case—and I can tell you from experience that it is—why aren’t your doctors telling you this? Why does the treatment of heart disease still rely so thoroughly on surgery, which often doesn’t work?

And this?

http://www.lef.org/LEFCMS/aspx/PrintVersionMagic.aspx?CmsID=113979

A topnotch cardiologist might have figured it out but a GP wouldn't unless you also had the associated symptoms of an MI like nausea, vomiting, and cold sweat. Doctors are not infallible and go with the statistics. Sometimes they're wrong.

Your stress test could have been perfectly fine a week before an MI. Heart attacks are caused by clots that occlude the tiny vessels supplying blood to the heart, not by the slow closure of an artery by plaque. The plaque in an artery supplies both a place for a clot to break off and a narrow spot for a clot from elsewhere to lodge and cause trouble.

You were good not to look at the surgery beforehand. Watching a saw and rib spreader in action is not for the faint hearted. I also hope you didn't look at the chest tubes when they were pulled, they're beyond gross.

I'm glad you made it through. All the lifestyle things they told you in the hospital is meant to keep you from having to go through another one. There are only two to a customer since there are only two saphenous veins in the legs to harvest for the grafts. I hated seeing people who refused to quit smoking come in for a second bypass two years later. I liked seeing people outside the hospital who were twenty years out from a bypass with no problems.

I'm very happy with my new cardiologist - My former insurance made me saty with the group of docs who missed the diagnosis the first time, and, oh, yeah, got me infected with staph in '06 when I had to have a pacemaker installed.

My mess comes from genetics. My mom and 3 or her 4 brothers died before age 60 of heart disease.
My dad is still alive - will be 93 on New Years day. I figure I passed throught the bad shit, and I'm trying for at least 80, and will be seriously pissed if I don't make it.

mark

added: I am an organ donor, but when I'm done with it all, there might not be much left....

Added again: The first day in recovery room, I was afraid to sneeze - I thought all my insudes would pop out. The drugs affected my thinking for months, and I had surgical pain for about 5 years, still have nerve damage, but I am still here to complain, so I'm happy.

Everyone I know who had one was completely surprized and had to have it immediately.
To quote Johnny Rotten, "I'm a lucky bastard."

I don't think it was the doctor's fault for not finding anything on the stress test because I think stress test only shows something if you have arteries that are most of the way blocked. But you can have a heart attack from a smaller block if it ruptures.