Angioplasty surgery / stenting..

[kantuckid]

I sincerely hope that my experience, described above with stent insertion catheter removal episode didn't kill this thread? 
Simple fact is that stents keep many, many of us alive and that's a good thing! 

[mike_belben]

you will probably get that feeling back in time.  the nerve over my passenger side eyebrow was severed by a tire iron maybe around 2015 or so which caused me to lose feeling on the surface of my scalp for several years. i could feel pressure in my skull but if i grazed finger tips all over my head from left to right the sensation was very strange and different on the damaged side.  it was odd shaving my head for years.  


all sensation is back now.  i have to look for the scar to remember which side it happened on, cant feel any difference. 

[doctorb]

I disagree that you will get feeling back.  The numbness sensation may change over time, and the area of numbness may shrink around the edges, but there is not much overlap of the cutaneous nerves of the thigh.  This nerve was surgically cut to access the bleeding artery.  Nerves, if severed, don't magically re-grow or connect up as part of the healing process.  They need to be lined up (approximated is the term).  Now, is it possible after being severed that the two ends lined up?  Yes, it's possible, but not likely.

Nerves that are injured, but not anatomically cut, often get return of function over time.  They don't need reapproximation as they are anatomically intact. Nerves "regenerate" (repair) at a rate of about 1mm/day, or about an inch per month, so it takes some time for sensation to return a distance from the injury site. The Ophthalmic nerve has a bunch of branches, (that's the nerve, or branches of that nerve, that got smacked above Mike's eye) and it supplies a pretty good sized area from the eyelid to the scalp on the crown of the skull. It was undoubtedly bruised badly but not disrupted, and his sensation returned over time.  I am sorry to say that is probably not what happened to kantuckid.  We have seen the difference between these two scenarios many times.  Blunt injury (tire iron) may not disrupt a nerve.  Sharp objects, like knives, cut them often, and different outcomes ensue. 

[kantuckid]

The inner thigh area adjacent to my catheter removal event has never regained any feeling-it remains nerve dead numb. OTOH, it's not an issue at all given that it doesn't effect anything that matters except touching the skin surface. 
As I might have mentioned, the surgeon who was doing my 6 month arterial heal up checkout said "it happens all the time when we cut nerves". 
 
From more recent readings, I've noticed that many stents are now done via the neck entry, not groin. 

 One finger which I tried to remove the tip of-it's been numb for maybe 15-20 years but has some feeling and I never really notice it. Another that I mashed flat as a pancake ~ 1.5 yrs ago-it's lost feeling too and has a dogleg but works ok and got a nice new nail. 

 Prior to CTS release surgery, my hands would both become deadened and I was forced to stop riding motorcycles until I got "the fix". I had every CTS symptom known, including being awakened at night. 
Not so far away from my nerve dead inner thigh area is my right and left, anterior insertion, hip joint wounds. Neither have a dead nerve area as they use the crease in your thigh to avoid muscles, nerves and large vessels. 
I have a few other body areas I wish would go dead feeling wise :D Lumbar for starters, neck, knees and shoulders as well...

I got hit by a hatchet (standing behind another kid for the backswing) when I was around 7-8 yrs old-scar's on my right eyebrow and affected my brain me thinks cause I disliked algebra? :  

[realzed]

I sincerely hope that my experience, described above with stent insertion catheter removal episode didn't kill this thread?
Simple fact is that stents keep many, many of us alive and that's a good thing!

I must fully admit - that after so many major surgeries over the past 10 years that I am very touchy about what I read when it comes to - or closes in on, yet another procedure I may have to undergo..
I know - I know - why did I start this thread then? - well.. probably mainly in the hope of hearing nothing but Unicorn stories and getting 'mental pictures' of things all covered in Pixie Dust and making me feel somewhat better about things ahead, from what I can tell..
Unfortunately all I got from my last cardiology visit a month or more back now was an expected date of May24th (which has now been bumped up the May 15th or so just very lately) to have an angiogram procedure done.
Doc - says "you may have significant issues - but we won't know until we take a look inside and see what needs to be done at that point. If it is requiring stenting or... then we'll address it at that point then.  In the meantime take these Nitro patches and wear them daily, take this blood thinner daily, and keep taking the water pills - until we meet again..
If you have significant issues I have included a prescription for Nitro spray, administer it while either going to the local emergency or call 911!"
So here I wait - so far in reasonably stable shape - watching the days slide by - Slooowly..
It has given me lots or time to try and 'clean up' when I am able, some issues I did have on my plate and get other stuff arranged for but..
In all fairness though after that last visit, I didn't need to hear and fret over any complications of the procedure (but I should have expected and been able to take them in the way they were offered - in the sense of being helpful) but I couldn't read much past the first line of your initial post and then quit, knowing I was just going to hear about stuff I would end up making 'larger than life' over the next 2 + months at that point, so in a sense it did kill my interest in this thread somewhat..
Sorry - it's not your contribution - but instead my 'chicken mind' that has turned me off or wanted it blanked out somewhat.
As I said - too many surgeries in too little time and I am literally sick about any more coming to be quite honest - but Thanks for your contribution.
Before I had knee replacement(s) for example, I didn't want to know much more than just my appointment dates - then afterwards I could look at videos of a procedure being done - not before, but after, as well as give descriptive sagas to anyone who might wish to hear details - and I now better understand why few did, or the ones that did often looked fairly pale when I was doing so..
If I do manage to gather up the gumption of go back and read more at a later point I do know where I can find it!
Thanks - Randy  

[B.C.C. Lapp]

I sincerely hope that my experience, described above with stent insertion catheter removal episode didn't kill this thread?
Simple fact is that stents keep many, many of us alive and that's a good thing!

I must fully admit - that after so many major surgeries over the past 10 years that I am very touchy about what I read when it comes to - or closes in on, yet another procedure I may have to undergo..
I know - I know - why did I start this thread then? - well.. probably mainly in the hope of hearing nothing but Unicorn stories and getting 'mental pictures' of things all covered in Pixie Dust and making me feel somewhat better about things ahead, from what I can tell..
Unfortunately all I got from my last cardiology visit a month or more back now was an expected date of May24th (which has now been bumped up the May 15th or so just very lately) to have an angiogram procedure done.
Doc - says "you may have significant issues - but we won't know until we take a look inside and see what needs to be done at that point. If it is requiring stenting or... then we'll address it at that point then.  In the meantime take these Nitro patches and wear them daily, take this blood thinner daily, and keep taking the water pills - until we meet again..
If you have significant issues I have included a prescription for Nitro spray, administer it while either going to the local emergency or call 911!"
So here I wait - so far in reasonably stable shape - watching the days slide by - Slooowly..
It has given me lots or time to try and 'clean up' when I am able, some issues I did have on my plate and get other stuff arranged for but..
In all fairness though after that last visit, I didn't need to hear and fret over any complications of the procedure (but I should have expected and been able to take them in the way they were offered - in the sense of being helpful) but I couldn't read much past the first line of your initial post and then quit, knowing I was just going to hear about stuff I would end up making 'larger than life' over the next 2 + months at that point, so in a sense it did kill my interest in this thread somewhat..
Sorry - it's not your contribution - but instead my 'chicken mind' that has turned me off or wanted it blanked out somewhat.
As I said - too many surgeries in too little time and I am literally sick about any more coming to be quite honest - but Thanks for your contribution.
Before I had knee replacement(s) for example, I didn't want to know much more than just my appointment dates - then afterwards I could look at videos of a procedure being done - not before, but after, as well as give descriptive sagas to anyone who might wish to hear details - and I now better understand why few did, or the ones that did often looked fairly pale when I was doing so..
If I do manage to gather up the gumption of go back and read more at a later point I do know where I can find it!
Thanks - Randy  

Wow.   I can see why you feel like you do Randy.  But you may well be on the path to more energy and a quick recovery when they finally get you figured out and squared away. As Magic man said they do wonders with cardio problems every day.  So, as hard as I know it must be, keep a good thought.  
When it feels like your never gonna be yourself again and your lower than low, take it to the Lord.   His will is going to be done one way or the other.    But he will hear you and prayer can move mountains.   I do not mean to preach, but its what I got.  Your on my list.  

[kantuckid]

It might sound like I'm a guy that's really "joyous" about using medical/getting medical services-well absolutely I'm not! 
This March was like national doctor month for me, eyes, knee, shoulder, throat ER, throat ENT, allergy doc, so on. But I do what I should do in my own best interest! Thats the crux of it.  ;D
 But I do everything possible to maintain my lifestyle which includes surgery when called for. My neighbor who it took me years-maybe 5-6 of them to get him to finally get a knee cortisone shot will never go under the knife, period!!! He got a knee shot and more recently shots in both wrists for CTS symptoms and he says he's much better now. So I did my job with him as far as it will go. 
My original cardiologist, who also did my stents after a heart attack (not like I chose him) he just was the doc that came along, so to speak. Well since 2004/5 I'd been seeing him and seriously not satisfied that he was worth a crap overall. Finally last year I fired him! My new cardiologist is far more thorough and much more proactive. Without trashing the first guy he explained every change and test he called for and med change and justified them all. Once all was done, I did one follow up of having charted my BP for him to learn me better and also see the echogram results too. Now I'll see him once annually. You can bet your britches I really glad I switched! 
Doctors are humans and simply said some provide better services, even when we don't always like what we hear.
I also fired my eye doc. he was obnoxious for starters and I switched to same place my wife goes-she has glaucoma. I have 20/20 but quickly learned I needed new lenses and still have 20/20 but less likely to end up with glaucoma and the new eye docs is spot on pleasant and does what I needed.
FWIW: 
 In my own case of my heart disease: I have normal BP using a common HCTZ water pill, take no blood thinners, never have heart symptoms like whatever you can name nor do I have or ever had high cholesterol. As one with stents, I'm told that there's no such thing as low cholesterol as lower is better no matter what. 
 I also have zero heart muscle damage from my heart attack. Lucky guy I am.  I do hope you chose the best possible cardio doc.  
 

[realzed]

I meant as an additional bit of information, to mention that despite my on-going problems - my previously swollen leg has now returned to pretty much 'as good as new dimensions'..
I'm don't know whether it was from another diuretic prescription change (which I doubt - as two or three other different and previous ones had little to no effect at all) or instead can be attributed to the Anti-platelet or blood thinner pills I am presently taking now.
The change began within a few days after starting to take both until my lower leg appears as 'normal' as ever now..
I'm left thinking 'thinner blood' = better flow = better dissipation of fluids in my system and essentially less build up in my lower extremities.
Regardless, it's certainly nice not having such a cumbersome lower leg, ankle/foot, so I can now wear normal socks and ditch my 'Crocks' (which often fit tightly) for regular shoes after almost a year of not being able to do so!
Randy
    

[doctorb]

Nope.  Probably Not the blood thinners.  This is not a matter of viscosity.  The term "thinner" is easily misconstrued.  This is not comparing oil to water. Blood thinners change the ability of blood to clot.  If clots form, then flow is hindered.  They can become chronic on the venous side of the circulation, and those chronic clots are much less affected by anticoagulants.  It could be a combination of the diuretic and the anticoagulants.  We may never know.

[hacknchop]

Happy to see you feeling a little bit better Gary don't get discouraged having a good attitude will definitely help you health wise and improve your quality of life. Take good care of yourself.

[realzed]

Nope.    It could be a combination of the diuretic and the anticoagulants.  We may never know.

Whatever it is - it has worked out quite well so far and I'm at least pleased with that much of my situation..
Even if I can't walk all that far or do all that much at times - at least I feel better every time I have a look at my new/old lower leg..
I guess that counts for something - Right?

[doc henderson]

with cardiac rehab, you can build your strength and endurance, and eventually make some gains.

[doctorb]

You bet!  Happy for you!

[realzed]

Well as a follow-up (everyone likes to hear some news that finalizes a thread to some degree, I assume)..
I two days ago had my Angiogram procedure and half way through it the specialist announces very loudly to me - "Mr. D you have a very large blockage right in front of your heart that I can see here , and I'm going to fix it for you with a stent that will fix you all up.. there are a few minor other issues that we will also take care of later - but this should make you feel a lot better"..
That's it - I never heard any more about what actually was done other than that, or what will be done past the point of him telling me what he did while I was 'on the table' - but I'm sure that will come still in the days ahead..
They shot me full of dye and inserted a probe in my right wrist (which at this point is still pretty sore) and did all of this very seamlessly and I did watch some of the goings-on on the huge screen parked right beside the surgeon and I.
Didn't take very long and soon I was back in my room - for an overnight stay to be monitored for any complications that might arise, and then sent home late morning yesterday with new meds for cholesterol (Plavix - apparently all stent patients have to take it) and I am now hopeful of seeing just how much better I feel in the next 2 - 3 weeks, as they said it takes that long to often feel the full benefit of everything.
I do feel already better - but maybe that is more psychological than a physical thing at this point - but I do feel I am breathing better or at least getting more energy with less inhalation at this point..
Hope it continues - and THANKS to all who gave me encouraging words and prayerful thoughts along the way!
Randy    

[doc henderson]

time will tell if this has corrected some of your issues.  glad you are ok.  hang in there with the cardiologist.  

[realzed]

I had a call yesterday and was informed that my follow-up with the cardiologist is scheduled for Sept 02nd!
The Medical Wheels here in the Great White North - do turn pretty slowly!!
Lots of time to get a good list of questions to ask when I visit, I guess.. looking, or trying to look, on the 'bright side' of things..
Now all I can hope to do is have a reasonably normal Summer and stay away from a hospital for a change!

[thecfarm]

Hope all goes well for you!!

[realzed]

Thanks!

[realzed]

The details continue to trickle in slowly after it is all said and done now..  
Apparently depending on who provides them - my Left Descending Artery LDA I believe it is referred to..  showed in my early February testing, to have a blockage of either 90 or 95% and that is obviously where a coated stent was ultimately placed a few weeks back.
My family doc remarked during a phone call last week, that a blockage in that location and of that amount often is referred to as a 'Widow maker' and allowed that he felt that I was very fortunate not to have had a heart attack during my waiting period for the procedure (or before)..
It was also noted that I still have a 30-40% blockage in another artery that is or will be addressed with medication, exercise, and dietary changes, hopefully - and as much as I now understand that blockages 50% or less aren't usually addressed with or by stenting - I sort of wish they would have done that one as well, when they were in there - but it's not like I has a choice or was given any say in it..
All in all, I feel better and have been out mowing lawns and climbing stairs a ton better than I ever could have or hoped to, prior to this being done.
I wish more info would be available - but at this point I do feel a lot more stable and somewhat more energetic than previously - for obviously good reasons I guess!
It is though, very frustrating to know that our medical system actually puts you at a great risk sometimes to the point of possibly dying or being harmed for life, while they put you in a queue awaiting procedures - but it is - what it is, I guess.
Thankfully I managed to not incur any damage (my heart efficiency rating has been measured at 65-70% - which I'm told is considered quite good for my age) especially in the 3 months I was parked awaiting this deal to get done - a situation that was totally within the realm of possibility apparently.
Thanks, once again to all who expressed their wishes for a successful resolution to my issues!
As per many of the comments previously - this type of procedure is quite amazing, as I so far can attest..  
 

[doctorb]

Realized-
Glad to hear you are doing better.  I would like to address your concerns about being put at risk....

I know it's unsettling to interpret your doc's comment the way you did, and to look at the delay after scheduling your cath and stent procedure as a failing of our system.  Emotional terms like "widow maker" are not medical terminology, and are simply hyperbole.  There are, truly, a lot of people walking around with a 90-95% occlusion of their anterior descending coronary artery.  Those patients, like you, have significant coronary disease.  But, in many of them, the blockage has developed slowly, and collateral "end run" blood flow around the clot develops in the small vessels over time, making the degree of blockage more tolerable.  In some people, the blockage occurs suddenly, and all at once, and those patients are more likely to suffer severe damage to the heart, and possibly die.

So one can't just take the fact that you had significant blockage on your angiogram, and say you were lucky to survive for the next month or so.  If your symptoms and preop work up had shown more critical ischemia to the heart, you'd have been done much more urgently.  I'm very glad it went well.  My suggestion is to focus on that, and not feel like you dodged some theoretical predictable bullet despite some miscarriage of medical care.  We really can't predict such things.  Best of luck.  You will probably improve your strength and stamina over time.  Enjoy the journey.

[doc henderson]

Thanks Doc Bob.  I was hesitant to comment, but glad you did.  I agree with your comments.  My friend @Cardiodoc  prob. has 100 patients he is watching.  The lesser blockages make little difference in daily life at 30%.  the risk is they could rupture and cause a clot, that makes it an acute MI.  The higher blockages cause angina, and most folks will decrease activity bases on the discomfort.  The acute "STEMI" go to cath in 20 minutes from arrival.  A stent can clog over time.  some are medicated and some require oral meds like aspirin and Plavix.  You do not change a battery or water pump when they are 30% done, you wait till it is closer to time.  A 30% blockage may never need to be stented in your lifetime.  there is always some risk to a procedure and the benefit must outweigh this.  you can rehab an open the collaterals with exercise and cardiac rehab.  also the bp meds and cholesterol meds.  

[realzed]

I have been on a low dosage Aspirin regime for years now- and I am also taking Plavix daily now and told that may continue going forward for possibly the rest of my life somewhat considering the possibility of the stents themselves being known to be magnets for plaque build up - as well as for trying to help lessen the effect or amount of the 30/40% blockage that still exists..
My take on what I have been told - is to a degree what I have been given (much almost verbatim) but I prefer not to dwell on it and look forward to increased personal productivity and capability in the months ahead.
Guess what makes (or made) it a lot harder to take hearing it all 'after the fact' was that I had absolutely no feedback from the time I entered the Cardio Lab at the end of January/Early Feb - until the procedure was done finally in mid May.
I knew at the point in Feb that I had failed the medically induced stress test miserably and said as much to those in the lab at the time, but no one - either the persons who administered the actual test, or the cardiologist who I saw a couple of weeks later, took the time to explain any of the details at all!
That is a long time to sit and stew about things and Google all sorts of situations which may or may not actually apply - and of course everyone who ever had a Angioplasty procedure done seems at that point to come out of the woodwork to pass along their own personal tales of good news or woe regarding their own situation, all of which just seems to turn up the 'worry' volume.. .
Better feedback would most certainly from the outset, have gone a long way in assisting me (or anyone else in that situation) in weathering the wait better and/or understanding possibly the reasons for the length of it or how much I may or may not have been 'at risk' during that time, most certainly!
And doctorb this wasn't 'your' system of Health Care in the USA - it was our Canadian System, which our government always assures taxpayers is the best in the World!  
Possibly much of that is to make us feel better about how much we pay in taxes for it, so we think we are getting good value for the $$'s..
I'm sure our waiting lines (sometimes in ER's are 6 - 10 hours or more just to be seen) are no bragging matter compared to those in the US, hopefully where things are better in that regard..
Our great 'Universal Health Care System' has patients stacked up in hallways on gurneys and put into cleaning staff equipment rooms often and still we are told we are so lucky!
The government here is terrified of private health care or pay as you go programs and does everything it can to shut that sort of thing down - but if any one of the politicians needs urgent care - you can bet they know exactly where they need to go and to whom - and how much it will cost them so they can jump the queue and be attended to - not so much for the little guy or gal though..  

[kantuckid]

In my healthcare world the best I can do for my heart disease other than my part, meaning diet and exercise is to have done what I did, i.e., fire a cardiologist who wasn't tending to my care. The differences were downright scary, and I don't fret over such things much really. 
 The new one immediately ordered the tests that had not been performed on a regular basis, changed my heart related meds that needed attention, and all is as well as it can be.
 
Glad your being cared for as so many people simply let such things go. From the general common sense position I operate out of, I wonder why they didn't do all that you needed?
Be willing to read what you can that relates to your condition and ask the right questions when you can. Huge amounts of information available for us to use these days and I don't mean watching TV pill ads.  :D

On the subject of following through proactively on one's care-  
I was recently in a discussion about dental care with two guys around a sawmill. One is big ole boy who played college basketball. As the talk moved along it became a fact that both these adult males, both farmers, one who owns the sawmill where I'm having a bunch of work done, have avoided much needed dental care because they cannot stand the needle used for Novocain. 
GIVE ME A BREAK! : 
Of course many people won't do anything that involves cutting on your body such as orthopedic work, but teeth, what can I say?  ;D 

[TroyC]

Tell them it ain't that bad. Had a cracked molar removed last week. Other than a space in the gum, wasn't bad at all. Better now, cracked tooth was giving me some pain.

[trapper]

When I was a kid the dentist would drill and fill my teeth without freezing them.  He told me that way he could know how he was doing when he hit the nerve.  Took a long time to go back to one as an adult.  Still nervous around them.