Date: Fri 09-Oct-1998

Publication: Bee

Author: CURT

Quick Words:

iinfo-Brand-heart-attack

Full Text:

INTERNET INFO FOR REAL PEOPLE: Heart Attack -- Part II

By Bob Brand

As reported in the last article, while I rested in bed at Yale New Haven

Hospital on Saturday morning, Dr Alan Berger sketched a rough diagram

indicating the three blockages (plaque buildup) in two arteries feeding blood

to the heart. An emergency had arisen, tying up the cardiac catheterization

laboratory (`cath lab' for short) where my balloon angioplast (a catheter

inserted through an artery starting in the leg and expanded when the blockage

area is found, forcing the buildup into the artery wall) was to be performed.

It appeared that the procedure would be postponed until Sunday.

Time crawls in the hospital. Luckily, at 2 pm I was informed that my

angioplast would be performed shortly. I was disappointed to learn that Dr

Berger, who had gained my complete confidence in a very short time with his

careful and thorough explanation of my situation, would not be performing the

procedure. He said, "Not to worry. The job will be done by my boss, Dr John

Setaro. You are in good hands." He was right. Dr Setaro, associate professor

of Internal Medicine, Cardiology at Yale University, is also the head of

Cardiology at Yale New Haven Hospital. He and Dr Habib Sanady performed the

two hour procedure. I was awake the whole time, when the catheter reached the

constricted area and the balloon expands, a milder form of angina pain was

felt again. After compressing the artery wall build up (largely cholesterol),

a small metal tube called a stent, was left behind to prevent the wall from

collapsing.

For the most part, the procedure was essentially painless, with only mild

discomfort. Watching the images on the screens positioned in several strategic

areas in the `cath lab' made time pass quickly. At the end, however, fluid

build up in the bladder from dye injection became very uncomfortable. Finally,

a catheter, inserted through the penis, (UGGHH!) relieved the pressure. A

tourniquet-like device, placed on the artery where the catheter was inserted

for the angioplast, prevented bleeding and allowed the opening to close.

The procedure was a success. Dr Sanady stated blood was flowing through the

tributary artery, the area that caused the most concern. He said that I would

be discharged in time for me to see President Clinton's statement after his

testimony to Starr's Grand Jury. By late Monday afternoon, I was home. For a

period of one week, I would be taking Ticlid (generic name: Ticlopidine to

prevent platelet aggregation) in order to prevent blood clotting around the

stents.

Presently, I take a combination of vitamins and medicines: Vitamin E, folic

acid, coated aspirin, Lipitor (generic name: Atorvastatin for lowering

cholesterol and triglycerides) and Zestril (generic name: Lisinopril for

reducing blood pressure.) In addition, I always carry a vial of nitroglycerin

tablets just in case I experience chest pains.

Follow-Up

Within a week, I visited Dr Jarrett in Brookfield. He said I should walk

daily, avoid strenuous exercise, maintain a low cholesterol (low fat), low

salt diet, and eat plenty of vegetables and fruit. I walk 1.7 miles every day

and 2.5 miles on Sunday. Blood samples taken after my second visit revealed my

cholesterol level had dropped from 187 down to about 100. Studies seem to

indicate that when low levels of cholesterol are maintained, the body will

actually reabsorb some of the build up on the artery walls. Although I will

have "heart disease" for the rest of my life, it can easily be kept in check

with proper diet and moderate exercise.

Two weeks ago I underwent a stress test. It was less stressful than I

anticipated. I felt only mild discomfort when my heart rate was elevated to

140 beats per minute. Dr Jarrett stated that the stents were performing as

advertised. He suggested a weight reduction of 15 to 20 pounds. My blood

pressure is now 120 over 80, down from the high 150s.

The Cost

The cost of high-tech medicine is not cheap. The bill exceeded $40,000.

Without insurance, this could easily have resulted in a second attack!

The first open-heart bypass surgery was broadcast (via Real Video) over the

Net on August 18, 1998 from Providence Seattle Medical Center. It is believed

that over 7,500 people watched the operation on the Net. Over 570,000 coronary

bypass operations are performed yearly in the United States alone. Perhaps a

live broadcast of an angioplast procedure will be broadcast soon. If so, I

hope it is done from Yale New Haven Hospital. Dr John Setaro knows some folks

at Microsoft, and he is at the top of his game.

URLs (Uniform Resource Locators) of interest:

http://www.ynhh.org/index.html

http://www.hsfacal.org/hrt_todo.html

http://www.grand-rounds.com/StentPlacement.html

http://www.guidant.com/vi/patient/StentGuide1.html

http://www.medfacts.com/crdiodoc/angioplast.htm

(This is the 123th of a series of elementary articles designed for surfing the

Internet. Next, The iMac is the subject on tap. Stay tuned. Until next week,

happy travels through cyberspace. Previous issues of Internet Info for Real

People (including links to sites mentioned in this article) can be found:

http://www.thebee.com. Please e-mail comments and suggestions to:

rbrand@JUNO.com or editor@thebee.com.)