One step closer...

[alpage]

Well I had my angiogram last week. I would have posted sooner, but the cable company inadvertently wiped out my cable modem connection doing 'routine' maintenance and it took a few days to get it sorted out.

Anyway, nothing went quite as planned, though it all turned out okay in the end. I showed up at 6:30 in the morning, expecting to have the angigram at 8:00 am, but due to various delays and schedule changes I didn't get on the table until 2 pm! I wasn't too bothered by all the poking around with the tubing and even watched some of the procedure on the monitor. At one point the cardiologist warned me that I might have some irregular heart beats, and I did. That was quite an interesting sensation! Then unexpectedly my pulse fell from the mid 80's to the low 40's. I started feeling quite weak, but still conscious. But the cardiologist was quick to order some medication pumped into the line and my pulse rate recovered fairly quickly. I've never had this happen before, so I guess he must have tickled a nerve somewhere in my heart muscle. No harm done, anyway.

Unfortunately since everything was running late I will have to wait for a later appointment to discuss the full results. He did reassure me that my coronary arteries have no blockage and that he didn't find any unusual or unexpected results. I don't have any family history of coronary disease or symptoms, but it's still a relief to confirm that I won't be needing bypass surgery on top of everything else. I had no bleeding and hardly any bruising from the puncture site, and was back to work in a couple of days.

So I'm going to see my cardiologist in his office in a couple of weeks (he really is rather busy) and then things will proceed to the next phase, which should be a surgical consult.

 

[sylviayasgur]

well al,
you're on your way..... glad to hear that there were no coronary artery issues. that makes it a lot easier!
please keep us posted as to what the dr says.
good luck and be well,
sylvia

 

[Perrster]

Hey you Techie!

Hey you Techie!

Good to hear things went ok with your angiogram. What kind of music did the technicians have on during your procedure? Van Halen was in concert for mine.

Interesting technology as us techies like this kind of stuff. I was impressed by it all, and while I didn't understand much, it made the time go VERY fast. Seems like it took longer to get prepped and then released due to the arterial "plug" than the whole darn procedure.

Anyway, good to hear it went well and hang tough. Keep us posted further.

 

[JBriau]

Alpage

Glad to hear everything else looks good! Its quite
a relief when it is all over! I had an angiogram done in Sept.
They found that I too only have a leaky valve no blocked
arteries.
Best wishes



Judy

 

[alpage]

Actually Judy, I have more stenosis than leakage. In my research on the two conditions, there seem to be many symptoms in common, but in my case it seems that I have pretty low tolerance for strenuous activity, but I can still walk for long distances as long as I keep to a moderate pace. It's as if the stenosis will allow enough blood flow for a certain level of activity but if I try to run up steps or other sudden bursts of energy I run out of steam very quickly. Not that I feel any urge to test my limits - I'd rather stick with the long walks. During the week I try to conserve energy so I won't be tired at work, but on the weekend it's not unusual for me to walk several kilometers (a mile or more, for our U.S. members).

Perry, no music, just the sound of the heart monitor. Though I think some music would have relaxed me a lot more than the subligual tablet that didn't have much effect at all!

Alan

 

[Zazzy]

Alan,
No tunes???? Too bad!!! I listened to Cream's "Sunshine of Your Love" I think it relaxed not only me but my cardio! lol

Take care,
Zazzy

 

[hensylee]

Did they play music? Gosh, I don't remember that! Must've been sleeping! They put me right out!.. alpage, so glad you don't have blockages. Makes the procedure a bit safer, probably. Keep us posted. God bless

 

[alpage]

Next step...

Next step...

I saw the cardiologist today and he is arranging the consult with Dr. Tirone David. I am told that Dr. David's office will be contacting me shortly. Unfortunately the waiting list for surgery is likely to be up to six months, but I hope I can manage that.

We did have a brief talk about valve choice. It's interesting that two years ago he was of the opinion that a mechanical valve was the only reasonable option. Now he mentioned that some of the newer biological valves are lasting for longer periods. But he suggested that Dr. David would offer the best advice in that area.

I did get a few more details I didn't know about before. My valve is down to 0.7 cm. sq. It was 0.9 about 8 months ago and over 1 cm. sq. a year before that. It helps to know what questions to ask! I certainly notice a lack of exercise tolerance, but I seem to have adapted so that fatigue is not too much of a problem.

I don't know how precise the measurements are, but 0.7 does seem a bit on the small side. I thought 'normal' was at least 2.0. What is the normal range?

Alan

P.S. Check out some of my panoramic photography at http://members.rogers.com/alpage/

 

[Peter Easton]

I believe anything below 1 cm. squared is considered real/major aortic stenosis. This said, I was down to 0.6 cm2 before my own operation and having noticeable but very manageable symptoms.

Peter

 

[Jean]

pics

pics

Alan,

Is Riverdale Farm your place? That bridge is so neat...we have a small bridge over the County drain ditch. I would like to make something more picturesque over it...something to do in the future.

 

[sylviayasgur]

hi alan!
great photos!
it must be a relative thing as to when your dr. thinks you are due for the surgery... my husband joey's measurement was at 0.4 when he had his surgery done (even the surgeon was amazed that he was walking around and not passing out!) his dr/cardio had told him, when he was at 1.0, that he considered the cut off to be 0.5. he felt that that was when surgery _symptoms or not_ was necessary. unfortunately, it was joey's stenosis, not his insufficiency, that made the surgery necessary. he was at 1.0 about 3-4 years ago, then went to 0.9 the following year, to 0.7 the next year and this year went from 0.7 right down to 0.45 within 7 months! that's when we decided to dr.-shop.
his aperture was so narrow that the cardio doing the cath told us he might not be able to get through there to see into the heart! he did though and all went well.
i feel so badly that you may have to wait to have your surgery, al. please let us know what dr. david says/suggests in terms of valve options. i wish you the best of luck.be well and God bless,
sylvia

 

[alpage]

It's very interesting to hear about the various valve sizes and how some people have very few symptoms even with quite narrow valves. My cardiologist takes valve size as one factor, but presence of symptoms is equally important. Certainly when it hit 0.9 he felt that more frequent checkups were warranted.

I could have surgery sooner if I really wanted to, but I might have to be a lot less picky about which surgeon to see.

Riverdale Farm is not very far from downtown Toronto. It has a very long history and is currently run by the city. It has a fairly full complement of farm animals - chickens, cows, ducks, horses, sheep and pigs. It is a wonderful place to visit, especially for urban school children. The bridge and pond photos are of the new duck ponds that are being created on some low lying land.

Houses near the farm (and associated parkland) are quite expensive and I am not fortunate enough to live in that neigbourhood. Many of the houses are over 100 years old.

Alan

 

[Peter Easton]

Trade-offs

Trade-offs

Alan,

As I mentioned, I had relatively mild symptoms, despite being down to 0.6 cm2 at my last echocardiogram (two months before my operation) and down to nearly nothing, according to the surgeon, when the valve was finally swapped out. My cardiologist had always said, "No need to do anything till symptoms crop up" -- which they did last summer at the top of Vernal Falls (Yosemite), a nice place for it to happen. Given their mild nature, though, he was at home with my waiting a month or two before the actual operation, which gave me time to get ready, to study up on the condition/operation, and to make a choice among valves and surgeons.

That was definitely a benefit. On the other hand, I came out with some questions. Was it best to wait that long? Did the extra effort required of my heart to pump blood (and maintain, I guess, my relatively symptom-free state) through a nearly completely obstructed valve put strain on the organ and cause undue thickening of the heart muscle?

Well, all I have is questions. I don't know. But the experience put a smidget of doubt in me about the universal validity of "wait till there are pronounced symptoms" principle.

Peter

PS. Come to think of it, here's the historic picture itself = Family atop Vernal Falls at precise moment when fabled AS struck! -- or at any rate became much more noticeable. (After which we climbed a little higher, then circled back down.)

 

[alpage]

I am fortunate that my cardiologist has followed me closely for about five years. So he has a pretty good idea about how quickly or slowly the valve is changing. Nevertheless, I think that now I am having symptoms I would be happy to have surgery sooner rather than later. But I don't think that's going to happen, so I will have to take it easy until it's time.

From my reading it appears that the heart can recover from the muscle thickening (hypertrophy) though there may be a point where the heart truly starts to fail, which my cardiologist believes is not too much of a risk for me at present.

I don't see the photo - here's a test of my own.

Alan

 

[Peter Easton]

Strange. Both your photo and mine appear on my screen. But I can describe the photo you're missing briefly: this incredibly handsome if slightly grey-haired fellow standing behind his two kids and (granted, lovely) wife in this idyllic streamside mountain setting. He's mentally counting his pulse.

I think you're right about the heart muscle thickening. Sounds like you're on a good track. Best of luck! We're rooting loud and clear.

Peter

 

[alpage]

Pulse rate

Pulse rate

I've been checking my pulse fairly often. Fortunately I don't seem to have any arrhythmias, but on a few occasions I have had my pulse sit at 100 to 110 for several hours at a time. I've just been sitting on the couch at home, or at a party. After a few hours it goes back to normal, which seems to be in the low 80's most of the time. I do drink a lot of coffee, but it doesn't raise my pulse like that. I've sometimes thought it must be red wine, or food, but it's not consistent enough. I've had red wine with no effect at all.

My cardiologist just shrugs as I guess it's not fast enough or irregular or associated with any other symptoms. I wonder if I'm sensitive to something in certain foods and drinks and only occasionally hit the right combination?

Not to suggest that I'm obsessed about my heart rate. I'm not sitting there panicked about my increased pulse rate, just curious about what might be causing it.

Alan

P.S. I think the IMG has to reference a file uploaded to a web site, yours just references your local hard drive, which nobody else can 'see'.