Stents

Hi, Vinny

I'm not sure exactly what it is that you're asking.  I'm sure there are many people that have had very good results with stents.  Unfortunately, I ain't one of them.  I had 3 stents installed in 2-03.  By mid May, all 3 were blocked 90% or more, so I had triple bypass surgery.  In July and August, 2 of the 3 bypass grafts were starting to block, so they installed stents in them.  Since then, I've had no problems.  The first 3 stents were of the unmedicated kind, and the last 2 were drug eluting.  If you got the coated stents, it ups the chance for success quite a bit.  I think the restenosis rate goes from about 30% for plain stents to about 5% for the medicated ones.

All you can do is control what factors you can (diet, drugs,  exercise, smoking, etc), and hope for the best.  Gotta figure there's a pretty good chance that you'll be in the 95% with no problems.

I really don't know how representative my case is among all heart events.  I'm pretty convinced that I was not treated correctly from the get-go.  Seems to me that stenting originally probably was an overreaction.  Should have been drugs and lifestyle changes and see how it goes.  Bypass may still have been needed, but maybe not.  Even when the original 3 stents blocked, there was no attempt to clear them--just bypass surgery.  We'll never know I guess.  I just hate to use up the treatment of last resort before getting to the point of last resort.

Hope everything goes well for you.  Try to not worry too much about it.  If something does need a redo or something, you'll know it.  Symptoms should be very similar to what you had before.  Don't take chances with it though--if you think you got a problem, get help.  Don't put it off.

I guess I haven't brightened your day too much, huh??  Just don't be overly concerned about the stents.  At least not until you have something to be concerned about--you'll probably be good as new for a long, long time.

Jim

Barb,

I think my symptoms began to reappear about a month after the original stents were installed.  Started out very mild and very vague.  I couldn't be sure for a while if it was in my chest or in my head.  The cardio thought head at first, since it occurred at rest mostly.  Said if it started up under exertion, that it would be time to do something.  That started happening in mid May, which was almost 3 months after the original stents.  In fact, I was scheduled for a stress test to see if the stents fixed me, 90 days post stent.  So happened I was in the hospital on that day, so I had to cancel.           I guess I'm just a fast stenoser.  Seem to be very efficient when it comes to building scar tissue.  But, on the brighter side, it's now been a little over 17 months since I've been in the hospital, and I seem to have no limitations activity-wise and exertion-wise.  Still watching my diet and exercising every day (almost), by walking for 20 - 30 minutes, plus going about all my usual activities.  I did have the nuclear stress test back in September, and it showed no problems.

Hope everything will work out for you. 

Oh, about symptoms------the first go-round (2-03) was chest pain, achy left arm, and achy jaw.  (and achy, breakey heart) hehehe  In the May episode, I had ONLY chest pain, like someone pressing hard in the center of my chest.  Following the bypass, I had only left arm pain.  Looking back, I'm not real sure that was a symptom at all, but it did get me back to the hospital, and they found the veins closing off.

Anyhow good luck on your re-stress test.  Be sure to study!!

Jim

Thanks

Dear Barb Taylor,  Hang in there. I've been following your exchange with Barb and am simply impressed at your tremendous strength and fortitude.   Here is some good news.  I had three stents placed during October and November and thus far no problems with restenosis.  I have some heart pain once in a while, but no significant problems.  I talked with another friend to day and his two stents have been fine for the year since he had them.  When I read about your problem with bleeding yesterday, I should have mentioned the Plavix and Asprin.  I've been on them for about 4 months and bleed or bruise if anything even brushes me.  I am very lucky in that my cardiologist invented the Johnson & Johnson drug eluting stent and his partner invented the stent back in the 80's.  Both of my cardiologists are adamant about 1 thing.  STAY ON THE PLAVIX!  They have done more stents than just about anyone in the US and they think it is critical to a good safe recovery.  Here is another thing.  Sometimes the drug eluting stents reclog (restenosis).  This seems to happen pretty rapidly ( a friend of mine with type 1 diabetes had restenosis in about 6 weeks).  To fix this the cardiologist went back in and inserted a different type of drug-eluting stent into the ones that failed.  The different stent uses a different drug and reacts with the patient in a more favorable way.   In following this it seems that no one knows which will work for a given patient so they try one and if it fails they use the other.  The good news is that my friend has had no restenosis with the other type of stent. Should your stents begin to clog, talk with your cardiologist about using another type with a different anti-rejection drug.  Hang in there.  You are incredibly brave and we need more people with your courage.  Good luck to your son as well we will keep him and you in our thoughts.  John D

Dear Barb,  The fact that you have pain after strenuous exercise is a question I have been asking anyone I can find who has stents.  I have such pains.  They do not come during the exercise, but about 12 hours to 24 hours after.  They can last for several days.  These are not the same pain (angina) that I had before the surgery.  I was able, during surgery when the balloon was inflated, to reexperience the angina pain under a controlled condition. (Angina is a blockage of oxygen / blood flow to the heart--this occurred naturally with blockage and under surgery when the balloon blocks the blood flow when it is inflated.)  I took great care to remember exactly where and how I felt pain.  I have asked my doctor about the exercise induced pain and have received absolutely no advice or help.  They seem to alwasy quote the fact that arteries have no nerves and therefore the stents cannot cause pain.  I beleive that the stents cause pain by being beaten against the heart and / or the pericardium.  These things are about an inch long and must be fairly ridgid.  The heart beats about 6000 to 8000 times an hour against the stent during an hour of activity.  Frankly, I think this causes something like an irritation of the cardiac area.  Good news is, it seems to happen less after a period of time and a lot of low level aerobic exercise.  I had a lot of this pain immediately after surgery (could not lie on my left side without this pain, but okay on the right.)  One month after surgery, I really over did it in an aerobics class and had pains for about 5 days.  I began a treadmill program at about 3.6mph and maintained a heart rate under 130 for the duration of the workout.  I had some pains at the start, but after about 2 weeks they went away.  I over did it again a few weeks ago, tried to go too long before I was ready, and bang, back came the pains.  I am now up to 45 minutes and no pain with the hopes of going to 60 minutes this weekend.  I will present this data to my cardiologist next week and see what he says.

Do you have these pains during exercise, but not before?  Are they similar to mine, or are they like angina?  Thanks so much for providing this information.  You are really doing well. 

P.S.  I attend a support group for heart patients called Mended Hearts.  This is a nationwide organization and may have a group in your area.  They have been very helpful to me in overcoming some of the fears associated with this disease and pointing me toward groups and people who can help.  Hang in there, John

Dear Vinnie,

Just a little infor on finding Mended Hearts in Denver, see below.  Support groups aren't for everyone, but my mother-in-law, one of the first surviving heart valve patients put me onto this and often the speakers and attendees provide me with good information.

Mended Hearts Denver, Rocky Mountain Chapter #42
www.mendedhearts.org
1522 E. Mineral Pl.
Centennial CO 80122-2911
Phone: 303-797-1466
Contact: Wayne Klish, President
Alternate Contact: Vivian Vernon, Treasurer
Alternate Phone: 303-361-9786

Support group for anyone, including family and friends, who has had open-heart surgery or any type of heart problem. Meets 1st Thursdays, 7 pm, at Presbyterian-St. Lukes in Denver. Call for details. Mended Hearts is affiliated with the American Heart Association

For Barb T, if you are anywhere near Eau Claire or Marshfield, here is the Mended Hearts data for that

Mended Hearts

For more information, call 715-838-3269.

Marshfield Mended Hearts Chapter 246
Mailing Address:  Marshfield Clinic, 1000 North Oak Avenue, Marshfield, WI 54449
Contact: Nancy Moede, RN
Phone: (H) 715-676-3669 (W) 715-387-9002

Hope this helps all,

John  D