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| Author |
Message |
Bill
medicine forum Guru
Joined: 06 May 2005
Posts: 849
|
 Posted: Tue May 03, 2005 2:30 pm Post subject:
I've been stented
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Just thought I'd let you know that I received two stents yesterday. (The last
time I had anything like this done was an angioplasty 10 years ago.) The Dr.
found a 90% blockage in the upper third of the LAD. He wanted to use a Taxus
stent, but I suggested Cypher because I had a read a study that it was better
for diabetics. We went ahead with the Cypher because he was really
indifferent. (I learned later that the Cypher sales rep. was in the next room
watching. He must have been surprised - this is not like Viagra.)
Once he opened up the 90% blockage, a blockage further down the LAD (about
half way) made itself more apparent. It was more than 70% but probably less
than 90%. He tried to stent that. But it was too hard and the balloon would
not inflate sufficiently. He had to pull the whole apparatus out and that
stent became unusable. (No charge, says the Cypher guy.)
The Dr. used a balloon to open up the second blockage and then stented it
without incident.
Everything went pretty much as I thought it would, except I was surprised at
two blockages and how high up and significant the first one was. My symptoms
were not that significant - just a very slight amount of chest pain when my HR
got up to 110 or so on the treadmill. I'm guessing I have good collaterals.
One (pleasant) surprise to me was that they have a new device which closes off
the leg artery much better. It used to be that you would have to keep a clamp
on your leg for 30 minutes and then not move it for 8 hours after that. Now
the time period is much shorter - 2 to 3 hours. It's sort of a plug that they
put in which slowly dissolves over a 90 day period. The downside of this is
that if you just get an angiogram, you do not even get a room anymore. It is
treated like a simple out-patient procedure. You go into a prep area, have the
angiogram done, and then go back to the same area to stay for 2 - 3 hours and
then you leave. (For an angioplasty, they still keep you overnight.)
My biggest risk seemed to be to my fingers and toes. While waiting for the
procedure in a wheelchair with one of those hospital gowns (I know it is
efficient but I think they like to let patients know they are on the lowest
rung) the patient in front of me backed up and squished my toes. Then on the
angioplasty table, which moves around by itself, at the very end one of my
left fingers got squished. No damage in either case. But watch your fingers
and toes if you go for an angioplasty!
Now I have to watch out for restenosis over the next few months. It may be a
little difficult to spot since, as I said above, I suspect I may have good
collaterals. I get some arthritis pains and I don't think I would have spotted
this except it occurred consistently on the treadmill at around the same
speed.
Just thought I would share my experience.
Bill |
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William Wagner
medicine forum Guru
Joined: 29 Apr 2005
Posts: 809
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| Posted: Tue May 03, 2005 3:15 pm Post subject:
Re: I've been stented
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|
In article <3HNde.1089$Jz2.976@newssvr19.news.prodigy.com>,
"Bill" <xxx@yy.zz> wrote:
| Quote: | Just thought I'd let you know that I received two stents yesterday. (The last
time I had anything like this done was an angioplasty 10 years ago.) The Dr.
found a 90% blockage in the upper third of the LAD. He wanted to use a Taxus
stent, but I suggested Cypher because I had a read a study that it was better
for diabetics. We went ahead with the Cypher because he was really
indifferent. (I learned later that the Cypher sales rep. was in the next room
watching. He must have been surprised - this is not like Viagra.)
Once he opened up the 90% blockage, a blockage further down the LAD (about
half way) made itself more apparent. It was more than 70% but probably less
than 90%. He tried to stent that. But it was too hard and the balloon would
not inflate sufficiently. He had to pull the whole apparatus out and that
stent became unusable. (No charge, says the Cypher guy.)
The Dr. used a balloon to open up the second blockage and then stented it
without incident.
Everything went pretty much as I thought it would, except I was surprised at
two blockages and how high up and significant the first one was. My symptoms
were not that significant - just a very slight amount of chest pain when my
HR
got up to 110 or so on the treadmill. I'm guessing I have good collaterals.
One (pleasant) surprise to me was that they have a new device which closes
off
the leg artery much better. It used to be that you would have to keep a clamp
on your leg for 30 minutes and then not move it for 8 hours after that. Now
the time period is much shorter - 2 to 3 hours. It's sort of a plug that they
put in which slowly dissolves over a 90 day period. The downside of this is
that if you just get an angiogram, you do not even get a room anymore. It is
treated like a simple out-patient procedure. You go into a prep area, have
the
angiogram done, and then go back to the same area to stay for 2 - 3 hours and
then you leave. (For an angioplasty, they still keep you overnight.)
My biggest risk seemed to be to my fingers and toes. While waiting for the
procedure in a wheelchair with one of those hospital gowns (I know it is
efficient but I think they like to let patients know they are on the lowest
rung) the patient in front of me backed up and squished my toes. Then on the
angioplasty table, which moves around by itself, at the very end one of my
left fingers got squished. No damage in either case. But watch your fingers
and toes if you go for an angioplasty!
Now I have to watch out for restenosis over the next few months. It may be a
little difficult to spot since, as I said above, I suspect I may have good
collaterals. I get some arthritis pains and I don't think I would have
spotted
this except it occurred consistently on the treadmill at around the same
speed.
Just thought I would share my experience.
Bill
|
Haiku poet Matsuo Basho (1644-1694) celebrated the beauty he found on
his pilgrimage to Nikko:
Ah, how glorious!
Green leaves, young leaves
Glittering in the sunlight.
To appreciate the beauty of a place one has to have experienced hardship
to get there.
Basho travelled on foot with his load on his back, as he writes in his
journal:
Most of the things I had brought for my journey turned out to be
impediments, and I had thrown them away. However, I still carried my
paper robe, my straw raincoat, inkstone, brush, paper, lunch box, and
other things on my back - quite a load for me. More and more my legs
grew weaker and my body lost strength. Making wretched progress, with
knees trembling, I carried on as best as I could, but I was utterly
weary.
Zen master Yamada Koun:
Pain in the legs is the taste of Zen.
From here http://www.heureka.clara.net/art/snyder.htm
.........................
Hope you and yours are OK
Bill Wagner
Cleaned pond filter hours ago.
Already fish look for food.
A good sign!
--
Zone 5 S Jersey USA Shade garden in a Jungle Japanese manner
Vision problems? http://www.ocutech.com/ we own two.
"oeuf tôt pique " Lover 39.615557 N, 75.04088 W |
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outrider
medicine forum Guru
Joined: 28 Apr 2005
Posts: 1155
|
| Posted: Tue May 03, 2005 3:38 pm Post subject:
Re: I've been stented
|
|
|
Bill wrote:
| Quote: | Just thought I'd let you know that I received two stents yesterday.
(The last
time I had anything like this done was an angioplasty 10 years ago.)
The Dr.
found a 90% blockage in the upper third of the LAD. He wanted to use
a Taxus
stent, but I suggested Cypher because I had a read a study that it
was better
for diabetics. We went ahead with the Cypher because he was really
indifferent. (I learned later that the Cypher sales rep. was in the
next room
watching. He must have been surprised - this is not like Viagra.)
Once he opened up the 90% blockage, a blockage further down the LAD
(about
half way) made itself more apparent. It was more than 70% but
probably less
than 90%. He tried to stent that. But it was too hard and the balloon
would
not inflate sufficiently. He had to pull the whole apparatus out and
that
stent became unusable. (No charge, says the Cypher guy.)
The Dr. used a balloon to open up the second blockage and then
stented it
without incident.
Everything went pretty much as I thought it would, except I was
surprised at
two blockages and how high up and significant the first one was. My
symptoms
were not that significant - just a very slight amount of chest pain
when my HR
got up to 110 or so on the treadmill. I'm guessing I have good
collaterals.
One (pleasant) surprise to me was that they have a new device which
closes off
the leg artery much better. It used to be that you would have to keep
a clamp
on your leg for 30 minutes and then not move it for 8 hours after
that. Now
the time period is much shorter - 2 to 3 hours. It's sort of a plug
that they
put in which slowly dissolves over a 90 day period. The downside of
this is
that if you just get an angiogram, you do not even get a room
anymore. It is
treated like a simple out-patient procedure. You go into a prep area,
have the
angiogram done, and then go back to the same area to stay for 2 - 3
hours and
then you leave. (For an angioplasty, they still keep you overnight.)
My biggest risk seemed to be to my fingers and toes. While waiting
for the
procedure in a wheelchair with one of those hospital gowns (I know it
is
efficient but I think they like to let patients know they are on the
lowest
rung) the patient in front of me backed up and squished my toes. Then
on the
angioplasty table, which moves around by itself, at the very end one
of my
left fingers got squished. No damage in either case. But watch your
fingers
and toes if you go for an angioplasty!
Now I have to watch out for restenosis over the next few months. It
may be a
little difficult to spot since, as I said above, I suspect I may have
good
collaterals. I get some arthritis pains and I don't think I would
have spotted
this except it occurred consistently on the treadmill at around the
same
speed.
Just thought I would share my experience.
Bill
|
May 4, 2005 JAMA on drug releasing stents. Available later today:
http://groups-beta.google.com/group/sci.med.cardiology/browse_frm/thread/4be35d092c66e3f3 |
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liaM
medicine forum addict
Joined: 03 May 2005
Posts: 81
|
| Posted: Tue May 03, 2005 4:35 pm Post subject:
Re: I've been stented
|
|
|
Thanks for writing this story of yours, fascinating, and funny..
This is part of the best there is on the usenet.
liaM |
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outrider
medicine forum Guru
Joined: 28 Apr 2005
Posts: 1155
|
| Posted: Tue May 03, 2005 4:55 pm Post subject:
Re: I've been stented
|
|
|
Bill wrote:
| Quote: | Just thought I'd let you know that I received two stents yesterday.
(The last
time I had anything like this done was an angioplasty 10 years ago.)
The Dr.
found a 90% blockage in the upper third of the LAD. He wanted to use
a Taxus
stent, but I suggested Cypher because I had a read a study that it
was better
for diabetics. We went ahead with the Cypher because he was really
indifferent. (I learned later that the Cypher sales rep. was in the
next room
watching. He must have been surprised - this is not like Viagra.)
Once he opened up the 90% blockage, a blockage further down the LAD
(about
half way) made itself more apparent. It was more than 70% but
probably less
than 90%. He tried to stent that. But it was too hard and the balloon
would
not inflate sufficiently. He had to pull the whole apparatus out and
that
stent became unusable. (No charge, says the Cypher guy.)
The Dr. used a balloon to open up the second blockage and then
stented it
without incident.
Everything went pretty much as I thought it would, except I was
surprised at
two blockages and how high up and significant the first one was. My
symptoms
were not that significant - just a very slight amount of chest pain
when my HR
got up to 110 or so on the treadmill. I'm guessing I have good
collaterals.
One (pleasant) surprise to me was that they have a new device which
closes off
the leg artery much better. It used to be that you would have to keep
a clamp
on your leg for 30 minutes and then not move it for 8 hours after
that. Now
the time period is much shorter - 2 to 3 hours. It's sort of a plug
that they
put in which slowly dissolves over a 90 day period. The downside of
this is
that if you just get an angiogram, you do not even get a room
anymore. It is
treated like a simple out-patient procedure. You go into a prep area,
have the
angiogram done, and then go back to the same area to stay for 2 - 3
hours and
then you leave. (For an angioplasty, they still keep you overnight.)
My biggest risk seemed to be to my fingers and toes. While waiting
for the
procedure in a wheelchair with one of those hospital gowns (I know it
is
efficient but I think they like to let patients know they are on the
lowest
rung) the patient in front of me backed up and squished my toes. Then
on the
angioplasty table, which moves around by itself, at the very end one
of my
left fingers got squished. No damage in either case. But watch your
fingers
and toes if you go for an angioplasty!
Now I have to watch out for restenosis over the next few months. It
may be a
little difficult to spot since, as I said above, I suspect I may have
good
collaterals. I get some arthritis pains and I don't think I would
have spotted
this except it occurred consistently on the treadmill at around the
same
speed.
Just thought I would share my experience.
Bill
|
I wish you well Bill and a speedy return to your treadmill.
I must comment on something in your experience. I find it very
disturbing that:
....a SALES REPRESENTATIVE was allowed to watch your procedure
....without your knowledge or prior permission
This is a grave trangression of patient rights and
phamaceutical/physician boundaries.
Whether or not you view it differently than I, your doctor, the
pharmaceutical company, and the sales representative didn't think they
needed to hear.
Zee |
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George
medicine forum Guru Wannabe
Joined: 02 May 2005
Posts: 102
|
| Posted: Tue May 03, 2005 6:52 pm Post subject:
Re: I've been stented
|
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|
Bill thanks for the post on your experience and best of luck. Keep us
posted.
Nice to see something posted here that is actually about cardiology. |
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Andrew B. Chung, MD/PhD
medicine forum Guru
Joined: 25 Mar 2005
Posts: 8540
|
| Posted: Tue May 03, 2005 6:54 pm Post subject:
Re: I've been stented
|
|
|
Bill wrote:
| Quote: |
Just thought I'd let you know that I received two stents yesterday. (The last
time I had anything like this done was an angioplasty 10 years ago.) The Dr.
found a 90% blockage in the upper third of the LAD. He wanted to use a Taxus
stent, but I suggested Cypher because I had a read a study that it was better
for diabetics. We went ahead with the Cypher because he was really
indifferent. (I learned later that the Cypher sales rep. was in the next room
watching. He must have been surprised - this is not like Viagra.)
Once he opened up the 90% blockage, a blockage further down the LAD (about
half way) made itself more apparent. It was more than 70% but probably less
than 90%. He tried to stent that. But it was too hard and the balloon would
not inflate sufficiently. He had to pull the whole apparatus out and that
stent became unusable. (No charge, says the Cypher guy.)
The Dr. used a balloon to open up the second blockage and then stented it
without incident.
Everything went pretty much as I thought it would, except I was surprised at
two blockages and how high up and significant the first one was. My symptoms
were not that significant - just a very slight amount of chest pain when my HR
got up to 110 or so on the treadmill. I'm guessing I have good collaterals.
One (pleasant) surprise to me was that they have a new device which closes off
the leg artery much better. It used to be that you would have to keep a clamp
on your leg for 30 minutes and then not move it for 8 hours after that. Now
the time period is much shorter - 2 to 3 hours. It's sort of a plug that they
put in which slowly dissolves over a 90 day period. The downside of this is
that if you just get an angiogram, you do not even get a room anymore. It is
treated like a simple out-patient procedure. You go into a prep area, have the
angiogram done, and then go back to the same area to stay for 2 - 3 hours and
then you leave. (For an angioplasty, they still keep you overnight.)
My biggest risk seemed to be to my fingers and toes. While waiting for the
procedure in a wheelchair with one of those hospital gowns (I know it is
efficient but I think they like to let patients know they are on the lowest
rung) the patient in front of me backed up and squished my toes. Then on the
angioplasty table, which moves around by itself, at the very end one of my
left fingers got squished. No damage in either case. But watch your fingers
and toes if you go for an angioplasty!
Now I have to watch out for restenosis over the next few months. It may be a
little difficult to spot since, as I said above, I suspect I may have good
collaterals. I get some arthritis pains and I don't think I would have spotted
this except it occurred consistently on the treadmill at around the same
speed.
Just thought I would share my experience.
Bill
|
Thanks for the update, Bill 
At His service,
Andrew
--
Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
**
Suggested Reading:
(1) http://makeashorterlink.com/?L26062048
(2) http://makeashorterlink.com/?B2B851EFA
(3) http://makeashorterlink.com/?X1C62661A
(4) http://makeashorterlink.com/?U1E13130A
(5) http://makeashorterlink.com/?K6F72510A
(6) http://makeashorterlink.com/?I24E5151A
(7) http://makeashorterlink.com/?I22222129 |
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Jim Chinnis
medicine forum Guru
Joined: 30 Apr 2005
Posts: 1030
|
| Posted: Tue May 03, 2005 9:49 pm Post subject:
Re: I've been stented
|
|
|
liaM <cuddly@mindless.com> wrote in part:
| Quote: |
Thanks for writing this story of yours, fascinating, and funny..
This is part of the best there is on the usenet.
|
Well said. I agree.
A pearl.
--
Jim Chinnis Warrenton, Virginia, USA |
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Bill
medicine forum Guru
Joined: 06 May 2005
Posts: 849
|
| Posted: Wed May 04, 2005 4:32 am Post subject:
Re: I've been stented
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|
Thanks to everyone for the kind thoughts, support, and information.
A couple of things come to mind:
I went into the hospital with more junk than almost anyone. I had a portable
CD player, radio (with spare batteries for both of course), lots of crackers,
magazines, etc. But I think the most important thing was a pair of shorts (why
do they call it a pair when there is only one?) similar to the ones I wear to
the gym. Thus, after I was allowed to walk, I could walk around not feeling
very strange in those gowns - even if you put on two, back and front.
I really did not mind the Cypher stent guy being in an ajoining room, though I
understand how others might. For one thing, I get along very well with the
cardiologist who did the procedure. I was surprised he remembered me from back
in '98 when I had an angiogram. (All he does is work in the cath. lab.) He
even remembered what my arteries looked like back then without looking at the
old pictures. (Except for the current LAD problems, he thought they looked
better now.)
Also, I really think there is some good information being passed back and
forth on techniques, problems, etc. This is not like the ditzy Pharma. reps.
you sometimes see and not some sort of show. In my case, for example, I think
they will take the stent that failed to open the second blockage back to the
lab and see if there is anything they can do to improve the design.
Again, thanks to all.
Bill |
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Jerome Ranch
medicine forum beginner
Joined: 11 May 2005
Posts: 6
|
| Posted: Wed May 11, 2005 4:36 am Post subject:
Re: I've been stented
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Drug coated stents?
Did they RX Plavix for a few months post stenting?
Jerry |
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Bill
medicine forum Guru
Joined: 06 May 2005
Posts: 849
|
| Posted: Wed May 11, 2005 7:43 am Post subject:
Re: I've been stented
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|
"Jerome Ranch" <ranchjp@mchsi.com> wrote in message
news:iov281hdf35jkijo4518lcsjmfbpmue11s@4ax.com...
| Quote: | Drug coated stents?
Did they RX Plavix for a few months post stenting?
Jerry
|
Yes the Cypher stent is drug coated and I have been on Plavix for a while and
that will continue. They added 325 mg of aspirin/day.
Thanks for asking.
Bill |
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outrider
medicine forum Guru
Joined: 28 Apr 2005
Posts: 1155
|
| Posted: Sat May 14, 2005 9:07 pm Post subject:
Re: I've been stented
|
|
|
Bill wrote:
| Quote: | "Jerome Ranch" <ranchjp@mchsi.com> wrote in message
news:iov281hdf35jkijo4518lcsjmfbpmue11s@4ax.com...
Drug coated stents?
Did they RX Plavix for a few months post stenting?
Jerry
Yes the Cypher stent is drug coated and I have been on Plavix for a
while and
that will continue. They added 325 mg of aspirin/day.
Thanks for asking.
Bill
|
I wonder why the 325 mg aspirin rather than the 81 mg. Did your
physician think the higher dose would protect more by thinning blood
more or provide more endothelial protection...or perhaps both?
Zee |
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Jerome Ranch
medicine forum beginner
Joined: 11 May 2005
Posts: 6
|
| Posted: Sun May 15, 2005 9:23 am Post subject:
Re: I've been stented
|
|
|
when I had my recent stent, the doc RX'd 325 ASA as well too
said to drop it back to the 81 after 6 months (drop the Plavix then
too)
jerry
| Quote: | Yes the Cypher stent is drug coated and I have been on Plavix for a
while and
that will continue. They added 325 mg of aspirin/day.
Thanks for asking.
Bill
I wonder why the 325 mg aspirin rather than the 81 mg. Did your
physician think the higher dose would protect more by thinning blood
more or provide more endothelial protection...or perhaps both? |
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Bill
medicine forum Guru
Joined: 06 May 2005
Posts: 849
|
| Posted: Sun May 15, 2005 6:59 pm Post subject:
Re: I've been stented
|
|
|
"Jerome Ranch" <ranchjp@mchsi.com> wrote in message
news:o6ce811c6h2o8elmvph357ln8brgll2mne@4ax.com...
| Quote: | when I had my recent stent, the doc RX'd 325 ASA as well too
said to drop it back to the 81 after 6 months (drop the Plavix then
too)
jerry
|
I think you should double check with your Dr. the recomendation to drop the
Plavix after 6 months. As I understand it - which is not all that great - the
primary controversy now is whether to stop it after 1 year or a lifetime. Here
is a portion of a talk which addresses that:
http://www.medscape.com/viewarticle/493904_14
Bill
| Quote: | Yes the Cypher stent is drug coated and I have been on Plavix for a
while and
that will continue. They added 325 mg of aspirin/day.
Thanks for asking.
Bill
I wonder why the 325 mg aspirin rather than the 81 mg. Did your
physician think the higher dose would protect more by thinning blood
more or provide more endothelial protection...or perhaps both?
|
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