Sunday, November 21, 2010

Stenting for fun and profit

Back on the 4th of November my plain old primary care physician, Dr Silva in Littleton took my EKG in the course of a routine office visit. His sharp eye noticed something unusual in the EKG. He followed up with a stress test and a gamma camera scan. I had not complained of anything, this was a straight check of standard tests. The stress test and the gamma camera pictures convinced Dr. Silva to refer me to cardiologists. Some days later I was scheduled for an angiogram down state at Dartmouth Hitchcock down in Hanover.
I double checked the appointment time a day or two in advance and was told that my 8AM appointment has slipped to 10AM. We showed up on time and learned that emergencies had slowed things down. It was 4 PM before they got me into the Cath Lab for the angiogram. Results were confusing. The angiogram showed six places that might need s stent. The angiogram was not unpleasant, they started off with a big Valium and followed it up with a lot of happy juice fed in thru an IV. Didn't hurt a bit, and I was VERY mellow thru out a two hour procedure.
There was some discussion as to the proper treatment, either a coronary bypass operation or a LOT of stents. They didn't feel it was fair to ask my opinion while I was still zonked out on happy juice. So I got admitted for over night. Next morning the cardiac surgeon (nice guy) pitched the cardiac bypass (open heart surgery) and the the stent guy pitched stents. I picked stents, 'cause the coronary bypass surgery involved sawing my breast bone in half and pulling up my ribs to access the heart. Whereas stents go in in a matter of hours and you can walk out of the hospital in a day. An hour or two later Dr. Kagan told me he had access to the OR that afternoon and could stent me if I was ready. I was ready, he slipped three stents into my heart that afternoon. They popped me back in a room on the heart surgery wing after the stenting and all looked OK.
Except my blood pressure cycled from 210/106 (scary high) to 140/70 (not too bad) over a period of hours. They were reluctant to let me out of the hospital with the 205/106 reading lest I keel over with a heart attack on the way to the elevator, which would reflect poorly on Dartmouth Hitchcock.
After two days of pills and blood pressure tests they found a blood pressure medication that worked and managed to release me this afternoon with a raft of new prescriptions.
I have to complement the Dartmouth Hitchcock people. They worked very hard to get me well, and they managed to make my stay pleasant. Nurse and doctors were patient oriented and did a good job. Much better than Mass General which was my last hospital stay some 30 odd years ago.

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