Dave Has Angiogram Procedure

 

On July 8th, I had an Angiogram procedure. This was a procedure that I had not expected or anticipated, but it was the end result of what had taken place over the last few months.

In late February, when we rode the Chilly Hilly bicycle ride (the ride around Bainbridge Island) on our tandem, I noted in the first mile that my "lungs were burning" like they were starved for oxygen. I needed to sit more upright on the bicycle seat and hold my chest to relieve the slight burning sensation. It felt like the capillaries in my lungs were crying for more air and I could not breath any deeper to satisfy their craving. Soon, however, after a few more miles, the burning sensation melted away and we completed the ride OK, even though I decided to walk a couple of the steeper hills. All of this was nothing new as I had experienced this same situation while training for the previous STP (Seattle to Portland bike ride) and the RSVP (Ride from Seattle to Vancouver BC and Party) last year. With all that bicycle riding, the only problem I had was in starting the ride and experiencing the annoying "oxygen starvation", which then gradually disappeared. Diana decided after the Chilly Hilly experience that it was time to see the family doctor to find out what the problem was. I, however, was satisfied that is was just old age settling in.

At my appointment in March, our family doctor tested my lungs and found that they had good capacity, but suggested that I do more of a warm up prior to riding to insure that my chest muscles were ready for increased exertion. After several more bike rides, I noted no improvement, and in early June I started to notice that I could no longer "ride through" the discomfort. I would need to slow the bike down before the discomfort would subside, but then it would come back as I speeded up. That is when Diana again decided it was time to revisit the family doctor. This time the doctor advised me to have an appointment with a cardiologist within the next week. He indicated that if I couldn't get an appointment scheduled, he would get one for me.

Of course, doctors are normally booked weeks if not months in advance, but when it was explained that my family doctor wanted me to have an appointment within the week, the cardiologist I had chosen was able to schedule me in.  During the appointment and after describing the symptoms that I had while bicycle riding, it was immediately decided that a treadmill test and radioisotope test was in order, and also a possible Angiogram. The treadmill and isotope tests were then scheduled for the next week with an Angiogram scheduled for the day after the other tests with the provision that the Angiogram would be cancelled if the other tests indicated it would not be necessary.

A day and a half prior to the treadmill test, I had the opportunity to talk with a friend regarding my friend's previous Angiograms. I wanted to get the scoop on what was involved. After talking with my friend, I got that "squeamish, light headed" feeling in my body, which lasted all through that evening and into the next day. Part of that feeling also involved a very slight sensation of tightness in the chest during the night. This was all alleviated the next evening when Diana gave me a glass of wine. The next day when I told the cardiologist of the previous days symptoms, it was decided that running on the treadmill was not a good idea. Instead, I was injected with some medication while lying down, and the medication affected my heart in a way that simulated running on the treadmill. This allowed an EKG to be taken while my heart was under stress and also allowed the radioisotope to be injected for the scanner test. The technician who operated the scanner indicated that he was observing a heart that appeared to be in much better shape than most that he normally sees, but he suspected that I would probably be scheduled for the Angiogram based on what he observed. And, he was right. The cardiologist requested that I show up the next day for the Angiogram procedure.

The next morning I reported to the hospital at 6am for the outpatient procedure. The nurse who prepared me for the procedure provided me with some Valium for my nervousness and I soon felt like I had just consumed a full glass of wine. My bed was then wheeled into the procedure room where my cardiologist was waiting for me along with several assistants who further prepared me for the procedure. It was not long before I began to feel a slight burning in my left arm from an injection that was made into an IV in that arm. I was told that it was from another shot of Valium. Soon, the cardiologist was asking how I was doing, and I answered, "just fine". In fact, I was amazed at how fine I was. I never felt the slightest pain or had any discomfort whatever during the rest of the procedure. But, I was totally awake and was engrossed in what was taking place while watching the television monitor.

This is an Angiogram picture showing a blockage of a heart artery where indicated by arrow

I was lying prone on my back on a comfortable bed/table in the middle of a fairly large room next to what seemed like a mechanical tree on my left that had a branch or two holding instruments. One of these instruments was a large cylindrical moveable camera, which was positioned just above my chest. The camera provided an x ray sort of view of my heart area on the television monitor positioned to my left on the mechanical tree. The doctor soon indicated to me that he was about to poke the top inner area of my right leg next to the groin where the leg makes a crease with my abdomen. This is where the catheter would be inserted into my leg artery for the work to be done. I felt absolutely nothing and was still waiting for the expected pain when I saw the catheter appear on the television screen. During the whole procedure, there must have been at least three different catheters inserted into the vein and then into the heart. Each of them were like a stiff plastic hollow tube about 3 feet long and about a 1/16 inch in diameter, and each had a different twist to their front end. It was not long before a puff of die was injected out the end of the catheter and then immediately a heart artery would spring into view on the television monitor as the dye showed its presence. After numerous injections of the dye to show off all the various heart arteries, an injection was made into one of the heart chambers to show off its capacity and the valve functioning. At one point the doctor mentioned that I might feel a slight sensation of heat in the middle of my chest, which I did (but I also felt it in my rectum which my friend had previously clued me in on). Soon, the last catheter was removed and one of the assistants was applying constant pressure to the area where they had put the opening in my leg. After several minutes of pressure, a bandage was applied and I was done.

It seemed to me that the whole process of injecting dye and looking at the heart arteries took less than half an hour, but it may have taken longer. During that time my doctor was in constant communication with another technician/doctor who was monitoring the whole process from a control room close by. It was here where the entire procedure was recorded and saved on a CD for future reference. An example picture of an angiogram and a blockage can be seen in the picture here. I had been told before hand that after some time was spent in analysis of the video recording, a decision would be made as to whether to continue with Angioplasty (the reaming out of blockages) or in placing any necessary stints if my heart required them. While waiting for completion of the analysis, I suspected that these further procedures were not going to be done, and my cardiologist soon confirmed this to me when he returned from the control room. What he did say to me, however, was something I didn't expect. He said it looked like I was a definite candidate for bypass surgery and that there was no effective way to put in stints according to the diagnosis. He indicated that he would talk to Diana and me later during my recovery process.

The recovery process from this procedure involves laying in bed for about 6 hours without moving a muscle in your body. Even lifting your head off the pillow is a not allowed. The purpose is to allow the puncture wound in the upper leg to heal properly without complications. During recovery, the cardiologist came and explained that the best way to take care of the problems that were observed with my heart was to have bypass surgery. It looked like this would probably be a six-way bypass. He said that there were several areas where blockages were found and some arteries were more than 90 percent blocked. He continued to say that he had already set me up with an appointment to see a surgeon later in the day at 3pm. I asked how soon I needed this surgery and wondered if it could be delayed for two or three months. He said that I could delay it for a while, but suggested that I not wait too long. When I asked if I could continue with bicycle riding, he said that I could, but that I must be sensitive as to my symptoms of discomfort and go slow when necessary. I then asked if this surgeon, which I had an appointment with, was the same one that once operated on him (I new that my cardiologist also had bypass surgery at one time). He said, "yes". Later that day, Diana and I talked with the heart surgeon for an extended period of time with review of the angiogram. We then scheduled an appointment for the bypass surgery, and then went home. I had a definite feeling of trepidation, but also a feeling of some confidence that I had some real experts working on my behalf.

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