Has anyone had an Angioplasty.....if so was it painful having it done ..Thanks for any info.

Hi maple:

I have had 3 catherizations last year; 2 of which required angioplasty/stents. They are relatively painless because you are heavily sedated--albeit awake usually. Provided all goes well, the only hurdle is usually keeping your head down during the few hours recovery after they stitch the artery.

ubernier

Thanks for the info.

I too, had 3 stents put in about 5 weeks ago.
I found it very painful at the begining and the end of the procedure.I am living in fear now of having to have it done again.

I noticed you spoke about stiching the artery. I had a plug put into the artery, I wonder if that was the difference.
You also said you were heavily sedated, I didn't appear to be , they put a tiny pill under my tongue,to relax me. Was that what you had?

You mentioned having it done three times,how did they know you needed it done again? by doing an angiogram or were you not feeling well?

The Cardiologist booked me for a "stress test" I canceled it as I have a bad hip joint, is it important I have it done? does it show what going on with the heart.

As you can see I'm a bit paranoid about the whole thing. Hope you can answer some of my questions.

Thanks again.

Hi Mapletree:

The first catherization followed my heart attack (March 15, 2002); I had my RCA 99% blocked and it required angioplasty and stent placement. I was given two valium orally about 45 min before surgery. This was my least sedated trip. (March 18, 2002). The stitch was relatively painless.

The second catherization came on July 11, 2002, after I had been trying to jog as part of my exercise for a few weeks. I noticed that my left arm became numb about 15 sec after starting to run, and I could reproduce this over and over by speeding up and slowing down. So, recognizing that this was exertional angina (and rather than wait for it to get worse) in I went again. This time they went in on the right side again. They sedated me through the IV this time. It was about the same strength as the first, but after the second stent was placed (in my LAD this time), the stitching was painful. The pain stayed with me for days after leaving the hospital this time.

A week later, I became concerned over a discomfort in my chest which I had not felt before. In I went again, and this time they went up the artery via my left leg. This time, I was so sedated that I don't remember the procedure at all, its a blank except for being wheeled in to the cold room and being wheeled out. Net result: Everything was fine, I was just suffereing from anxiety coupled with heartburn from cheap red wine.

Finally, I went in again one last time in October, again confused, again feeling what I thought was angina. This time, they decided to just do a stress test. I saw the images on my way out, and all looked great. Needless to say, that ended my period of being paranoid about every little pain.

Since then, I still worry every once in a while, but I remember what angina felt like. I know that if I am not experiencing it now while running every morning, then I am much safer than before.

I would say yes thats its important to have a routine stress test done now (based on the CHD ...). The test can give false positives and false negatives; however, in cases it can alert your cardiologist to a problem that you or I may not be able to detect yet. I am 36 now but I expect (and plan on) having a stress test conducted yearly, every November from here on.

Ulrich

Be very careful! Many cardiac patients have colapsed...permanently while jogging or swimming!.
Good luck...

Granted, but that can happen in healthy individuals as well as those of us with CHD. I gradually built up my exercise routine to the speed which I now run. (I didn't do this without all of my physicians' knowledge--I agree with you that someone with CHD should not just exercise without physician consent).

However, the benefits of exercise to my lipid profile are astronomical. I spent months as a cardiac cripple; I was afraid to run so I would simply walk. My HDL barely squeaked out 44 mg/HDL with niacin. Without niacin and with running, my last HDL was 70 mg/dL (my LDL was 67 mg/dL).

How I got into this mess as a 35 year old was partly genetics, partly diet and partly zero exercise/sedentary lifestyle.

I can't fix the first on the list, but the latter two I have corrected. I would encourage other CHD patients not to fear heavy cardio exercise because of the benefit to the lipid profile, more rapid development of the collateral arterial network surrounding the heart, and finally, there is a chance that exertional angina will be detected during exercise, giving an early indication that one should seek out additional treatment.

Hi Urich

Thanks for all your info,it sure helps to read that.

Can you tell me what RCA....LAD....and CHD means please.

When you said they went in the right side , where was that?
I had it done in the groin, didn't know they could go in any other place.

Is catherization and angioplasty the same thing?

I do feel better now ,I will ask for more sedation, if I have to go through it again.

Sorry for all the questions, but you seem like a wealth of information.

Thanks again.

Hi Maple

Sorry about all the abbreviations. The RCA is right coronary artery and the LAD is the left anterior descending (front of the heart left side). The left coronary splits into the LAD and the circumflex (the circumflex runs towards the back left of the heart).

I use CHD/CAD often (coronary heart disease/coronary artery disease).

My catherizations were performed, as yours were, through the femoral artery (the groin). I tend to call the three of them catherizations because technically, I had angioplasty (balloon inflation) and stent placements the first two times. The third time resulted from my paranoid fears that my first stent may have been occluded-- I thought this because there was some chest discomfort I had been experiencing.



[This message has been edited by ubernier (edited 07-07-2003).]

Thanks Ulrich, you have been a wealth of information.

I wish you the best of health in the future.

Thanks Ulrich, you have been a wealth of information.

I wish you the best of health in the future.

I had 5 caths and 3 angioplasties. The first was not too bad as they had me so out of it from morphine for the MI that I really did not care (or know) if they punctured my groin or took the leg off and put it back when they were done. Most of the others I was given ativan and an antiphisimine conbined before then they added something more in the iv. One angio in particular I felt like they were killing me to the point where I was out of it enough that I tried to push them away. The one I had last March I felt them going into the groin and let them know - or I though I did but they had given me something different so I was moving my mouth and nothing was coming out. This one also I felt them working more but it is the one where I finally got a doctor who was able to put a stent in as the other one told me that my arteries were too small. I had another one in April and while they were prepping me on the table, I told them what I felt the time before and they jacked up the meds from the beginning so I was able to talk to them but did not feel anything really. Also I had received the plug for this one and I will tell you that they will never not use the plug again if I can help it. I was sitting up in bed within an hour and walking in no time. The others I had to lie on my back so long that I ended up with a week long back ache. Having had both ways I can tell you that the only difference in it is after they are done - how long will it be till you can get around again. You feel more pressure with the plug while they are putting it in but it is the way to go.

If you need another one, speak with the dr ahead of time and tell him your experience. He can adjust the meds. Also, they usually add amnesia drugs to the IV so you end up not caring after anyway and the experience is not as long lasting.

Thanks for all your information.
I think you are right, I will have to speak up next time, as it was an awful experience for me.I am living in fear now ,that it will have to be done again.
It was Ativan that I had too.One under my tongue at the beginning and another have way through the procedure. He also said at the beginning that my artery was too small, but he did manage to do it after all.
Did you have a heart attack too? and why did you need it done so many times? Would you want that plug the next time or not?
Thanks.

If given the choice I would take the plug every time. I have had 3 attacks. But the reason that they did no many is that I am not a good candidate for bypass and most of my arteries can't be stented due to size or something. I changed doctors and they were able to do one of the narrowings in the LAD. I have about 8 narrowings that are not closed enough to need intervention more than the angioplasty and they are trying to keep it that way so they have been going in about every 2 months and reopening them while they figure out what to do. Eventually I expect that I may find myself on the list for a new heart but with the artery problem I have I am not sure of that either.

Jean,

I am curious about something, if you don't mind talking about this...? Did you have an idea of your lipid profile levels prior to the discovery of CHD? Also, afterwards, have you changed anything with diet/exercise?

The reason I ask is that I changed my life significantly since I had the MI--dropping ~ 75 lbs, adding in daily exercise (running), and eating properly. My lipid profiles have mad a huge turnaround. My lipoprofile analysis of novel risk factors has showed a decrease in homocysteine and hs-CRP.

Jean

Thanks again for your info.

When I read about your problems, it makes mine seem like nothing.I should stop worrying about trivial things.

I wish you all the luck with your health in the future.

Mary.

Can someone please describe "the plug" for me?

zip:

http://www.vasoseal.com/vs/vhdregulatory.html

and

http://www.reillycomm.com/di_archive/di_ps0301.htm

[This message has been edited by ubernier (edited 07-23-2003).]

As far as my lipids goes - once again the doctors do not give you information even when you ask. They feel they above explaining things to meer mortals. However, my bad cholesteral did drop significantly - but not enough for the doctors liking. My last tests showed a total of 132 with the bad well under 100. Since I have always watched what I eat (cholesterol problems is genetic on both sides) my diet did not make a difference. I am probably the only person who can raise it by a diet of only lettuce. In fact, my brothers eat everything smothered in butter, vegi oil and cheese and theirs are all lower than mine. Anyway, my doctor wants my total under 100 and taking 80mg of Provachol will not even do it. ( I have tiny arteries and they close easily as a result so this is their reasoning.)

I do not see my problem as worse than others - just different. I think the pulmonary problems make it harder to treat in that finding the meds that will work and I can take is harder. I know that provachol can agravate the asthma and in such a large dose it has to be in addition to bp meds and asperin therapy but it keeps me alive and with 5 young grandchildren to watch grow up, that is the most important thing to me.

The plug - and I am trying to find the folder they gave me on it - is just that. Instead of stitching the artery and holding a lot of weight on the site for an extended period of time which means that the patient has to remain perfectly still so that the artery will not leak, they put a "plug" in the site of the incision they used for the cath to go into. This seals the artery off so there is no leaks and bleeding is not the issue that it is the other way. It is a fairly new means of closure and is proving itself extremely credible.

My first 4 caths/angios were done the other way and I found that lying for 6-8 hours flat on my back with a 10 lb. sandbag on my groin was worse than the cath. Having to go to the bathroom was out of the question as was sitting on a bedpad. The hospital made you wait this time out for anything that you could not eat lying flat on the back. You were not allowed to even move a foot on that leg. The sand bag shifts and it is a pain in the butt. I am female and always felt like this could cause serious pain for a male to have the sandbag shift the wrong way.

The last time I had the plug inserted and there were no problems at all like this. I had to use the toilet in the recovery room and they walked me to it. What a pleasure after having dumped the bed pan on a previous occassion. The incision did not bother me as much and I found the film much easier than the bandaid and folded gauze. Made for a much easier recovery since I did not have all the other things to contend with.

Thank you, Ulrich.

Just to update you all on my heart problem. I replaced the drs. The new ones have found that the breathing problems are pulmonary and I have a double wammy going. My heart has a 30%overall loss of function from the MI. I fired all the drs I was going to when they told me that there was nothing really wrong with my heart but I was having the breathing problems because of fear of having another MI. Gee, if that were true ya think they were very reassuring when they did 5 caths in 7 months.. Anyway the new cardi ordered a pulmonary function test right away. it came back moderate obstruction. So I got a new pulmonary guy. They sent a letter to the old drs telling them that they were the cause of any anxiety I was having because they did many useless caths with nothing in their records to back up the necessity for them. The least my complaint was water retention. I will never be 100% again but without treating the COPD there was a greater strain on my heart which would have caused worse problems.
Jean

I stopped counting catherization, PTCA, (angioplasty) and PTA after 19 entries. I had the first catherization and a PTCA done in June 1983 (this was, of course, long before stents). Three weeks later I had the 2nd PTCA because the right coronary artery failed to stay open. I have had entry into the right femoral artery, left femoral artery, brachial, right and left popliteal and I have had entry in left femoral and right popliteal at the same time. (Obviously, I have extensive arteriosclerosis which includes two heart attacks and a quad coronary by pass graft surgery). And here is what I can tell you from having had all these catherizations, PTA and PTCA procedures done by three different doctors in four different hospitals in two different states. Not all cardiologists are created equal, in terms of either knowledge or skill.

Some have far superior skills when it comes to using a catheter whether for cardiac catherization or a PTCA or PTA. I have had a couple of brutal catherization by a cowboy cardiologist who repeatedly hit the sciatic nerve. It was excruciating. Heck of a nice guy but as a cardiologist he would have made a much better plumber! The cardiologist who did my first two angioplasties back in ‘83 is now who I use exclusively even though it means going out of state to do so. And, yes, he is that good. After cardiologists said that a PTA couldn't be done on my right leg--occlusion throughout the iliac and into the upper femoral--and two failed failed femoral to femoral bypass graft surgeries in one month, he saved the leg and reopened the vessel with a balloon catheter, ( PTA). have 4 stents in the iliac. I'll repeat, not all cardiologists are equal in terms of knowledge or talent!

JeanE716,

Sorry to hear about your problems, but maybe some good will come out of all the bad.I'm glad you have found youself new Drs.It seems there are a lot of bad ones out there, and it's up to us to weed them out.I'm not too happy with my Dr. either.

Johnny_P

Thanks for giving me your experiences with angioplasties.It really helps to hear other peoples stories. It's good you have a Dr. you rely on.It's just finding the right one that is hard.

Yes there is pain involved but not unbearable. You are only slightly sedated unless you've come in unconscious or close to it. There is pain when they blow up the balloon and if a stent is inserted but again not unbearable. You must lay still while they have your leg plugged and when they remove it there is pain from the pressure they must apply to keep you from bleeding profusely. I've had angioplasty with stent and bypass and I was a 41 yr old female with very few risk factors. I would much rather have the angioplasty.

When the Dr. started, he said the artery was too small, then he said it was ok and carried on. That wasn't too painful,it was when he was putting in the plug at the end.Maybe the reason was that the artery was too small.
I fully agree the stents would be nothing compared to bypass surgery.
Do you know how long the stents can last? How long have yours been in? Thanks......

ubernier: You sound like my hubby, he had three MIs before 50, not to mention 4 angioplasty and 3 stents. I have to tell ya one thing tho, excersise doesn't always raise the HDL. When my hubby had his first MI his LDL was 120 and his HDL was 3(yes 3), he was a triathalon winner and rode his bike 25 miles everyday. Can't be in much better shape than that right? His second one was about the same only HDL was 5, the third MI almost killed him and his HDL was 3, LDL 130. so my hubby couldn't convince the Drs about HDL and excersise so he became a coach potato and just did his hobby working on wood etc. His last HDL was 55 and LDL 110, you can't get him on a bike now after 3 yrs of having a good HDL without doing anything. He'd love to ride again but is somewhat reluctant as he equates it with MI and so far he is feeling healthy and active just not riding his bike. His cardiologist finally conceded he was one of a very few who HDL is not raised with excersise but diet only.

NancyH:

I agree (absolutely). I try to qualify my statement about exercise often, typically, by saying something like "in some people...which includes me."

As you pointed out with your husband, the exercise was not doing a thing but diet was. Fortunately, in my case, I was able to figure out that exercise had the greatest impact on my lipids. I have never heard of HDL so low--that 3 is amazing. It sounds like your husband is doing better now? If so, I hope that he has continued event-free or intervention-free good health now.

[This message has been edited by ubernier (edited 08-28-2003).]