Heart Disease :: Treatment Options Stent With Meds Or CABG?


Feb 20, 2016

70 year old male in good shape been exercising 6 days a week cardio and weights for the past 5 years or so.Last couple of weeks or started to feel discomfort in my neck and jaw while exercising, it would go away when I stopped. Went to to non interventional cardiologist who ordered up an angiogram which I had 4 days ago. Results were Right artery 99%  blocked, LAD 70 % and two other arteries on the left also 70% blocked. Interventional Cardiologist recommended CABG surgery because of multiple artery involvement and that the left arteries were not good candidates for stenting due to the position of the blockage.

My non interventional cardio after conferring with the interventional cardio said that I had options other than CABG. Both doctors agreed that my angina was most likely coming from the 99% right block.

Option is stenting the 99% blocked right and the OMT for the rest. A surgeon was also called in for consultation and neither he  or the two other Cardios would predict outcomes or give an opinion as to which course of treatment I should follow. Regardless something had to be done sooner rather than later for the  right artery. I sent the pics to  another interventional Cardio  who validated the position of my non interventional cardio that I do have choices other than CABG and that the which ever decision I would make I would probably have a good outcome. So next week I'm going to have the right artery stented and then medically treat the rest of my disease and see where it goes from there.

I also plan to make major changes in my diet to hopefully control the progression of the disease or even possible improve my condition

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Anyway, I was at uni and going through a bad time in my life, whenever I get stressed my guts go into turmoil. As a result I was off uni for a week with severe rectal pain and feeling lower than a snake's belly. I booked an appointment with my GP as I had experienced similar symptoms before.

My GP recognised the symptoms immediately, I thought I had piles, she said I was too young so had a look. The digital examination wasn't fun, in fact she said she had never seen anyway change colour so quickly but it was worth it because I was referred to a colorectal surgeon.

I took my sick note back into my tutor and as I was doing a clinical degree, he said straight away that fissures were worsened and sometimes caused by stress. The penny dropped.

As I said I was going through a very very bad time in my life which necessitated me going on antidepressants (Cipralex) for my emotional state. When this was added to wall climbing agony due to fissures I was near breaking point. I remember after one bowel movement almost fainting with the pain, I was lying at the top of the stairs at my mum's house and clawing at the wallpaper with my fingernails - I have had a broken leg and in terms of pain that fissure was far worse, trust me.

I went to see the colo-rectal surgeon a few weeks later, I was terrified, but he was a lovely man, very very considerate. He told me that I had a large fissure that could be helped with an ointment. I told him my background so he talked a bit more openly and said that fissures are an incredibly debilitating condition. He once had a 16 stone rugby player openly weeping on his consulting couch with the pain - I can understand why.

I was prescribed GTN ointment and started using it as directed. I had a slight headache which I could live with, but this was far better than the agony of the fissure and this headache was pretty much gone after the first week. After a week of use the pain from the fissure had also subsided to nothing. After six weeks I went back to the surgeon and I was healed.

I wish that was the end of the story but it isn't, I have probably had four or five bad flare ups since and dozens of other twinges, spasms, bleeds and itches since but I am nowhere near as bad as the first time - I can live with this now. I have seen the surgeon twice since and he has offered surgery but my frame of mind precluded me from that, I was simply terrified.

My GP is very understanding and I can get GTN on prescription whenever I need it. I was prescribed Anoheal by the surgeon as well but this didn't work as well as GTN for me, but I have seen cases in work where this has been incredibly effective.

As I said earlier, I was doing a clinical degree, which I have now passed, so I feel that I am pretty well qualified to offer a bit of advice, so here it is.

1. Go and see your GP. Don't be embarrassed, your doctor has seen dozens of these - they are very very common. If you get fobbed off or feel that you haven't got anywhere, go back and tell him/her that you are not happy and you will go elsewhere i.e. change your GP. Changing your GP hits their bank balance, and as GPs are notoriously greedy, they will do something. Nobody should have to suffer with this.

2. Take something for the pain but NOT codeine. Ibuprofen worked best for me.

3. Drink plenty of fluids and lay off the alcohol while you are healing.

4. Eat lots of fibre and fresh fruit and veg, switch to brown bread and have something like Weetabix for breakfast. This softens stools and makes them easier to pass - less pain and less damage to existing fissures.

5. Use a stool softener, one Movicol sachet daily really really helped me. You can buy these over the counter from your local Pharmacist but tell them what it is for. Alternatively get them on prescription from your GP.

6. Lay off the red meat, there is some science to this as meat increases the residence time in the gut and predisposes to harder stools. This really helped me and I have seen a few accounts here where sufferers also say that.

7. Try to relax, easier said than done, but try simple things like having a hot bath instead of a shower. If anything helps you, no matter how crazy or off the wall it may sound, carry on doing it. Going out for a drive helped me. Staying active also helps constipation and makes you feel better. Don't stay in and stew - stay positive.

8. Stick to the doctor's directions of any drugs you are given. If you are told to apply a cream for 6 weeks into the anus, then make sure it goes into the anus for 6 weeks. And into the anus means into the hole - not nice, but a lot nicer than the agony from an untreated fissure.

Remember you are not alone, these things can be cured. You will feel terrible and you will feel like nobody else understands what you are going through but believe me, these things are very very common.

And if all the above doesn't help there is a simple operation that can be done on a day case basis that has a 95% chance of curing it for good.

If you are reading this you are no doubt feeling horrible but believe me, there is light at the end of the tunnel.

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After a while of feeling odd and stuff, I began to have trouble breathing and chest pains (I can't remember which started first), it kind of felt like they coincided, but I still would get very minor and infrequent pain without breathing, it felt like I couldn't take a full breath of air, and when I did the chest pain would kick in (more), it felt like a tightening pain. My left arm soon became somewhat numb and tingly, not numb like when you accidentally sleep on it, but just a little numbing that felt like it stretched down my arm through a single vein, the numbness was generally more intense under my armpit and bicep area, and would intensify when I rubbed certain areas. I had a very sore/stiff neck, especially around the area between my shoulder blades and neck, it wasn't on one side, it was mostly in the middle (my neck and back are still sore after this experience, as well as the tingling sensation in my arm but its not at all that bad, and it comes and goes). I had anxiety during this event, and I felt like when people would talk to me I wasn't truly comprehending what they would say, but yet I still was able to reply to them, I just didn't say much or think about what I was saying, I only could pay attention to what was happening to me. I felt like things were kind of slowed down and I was very fatigued and zoned out. I felt as if I was slowly meeting my demise. I believe I got cold sweats a couple times, but not much. I had some heart burn later that night, and the next but its gone.

It came across to me that maybe this was a panic attack but the pain lasted 2-3 hours, after that it wasn't horrible, but it was still somewhat there, and the mental aspect of a panic attack wasn't that intense. I also do think that my left arm may just have "mouse arm" (cant remember medical term), cause I use a computer a lot, a part of my muscle/tendon in my hand has been sore for a while, and it is somewhat acting up now as I type. I really am not sure if a lot of this is me overreacting, or just a placebo effect (I hope so). I've had minor chest pains since I was 13 (I just turned 18), and every time I went in to get my heart checked out, they said I was fine, and that I had a slight irregular heart beat but it was nothing to worry about and a lot of people have it but don't know.

I also have this weird problem with my thought process either that started the night of the incident, or I haven't noticed before. The only way I can explain it is as if my brain buffers for a moment when I go back and forth between two thoughts, it's like I over excite the neurons responsible for those thoughts and I end up overriding my brain for a brief second with confusion, then it's fine. I do have some chest pains now, but it isn't very often, and honestly happens mostly when I think about it or worry about it (same with the left arm), which is why I think I could be conning my self about this entire incident, because I've had panic attacks before but they weren't as bad and were more mental than physical.

It's dumb of me but I never went into the doctors cause 1. I was too paranoid to go in, and 2. I don't want to worry my mom or waste her money just so the doc's (possibly) find nothing. I haven't lately because all I've been doing is researching about this stuff, off and on I think I'm fine and then I don't. So I came here to settle it once and for all, I have a doctors appt. next week anyways so if you guys don't think its serious (I don't, but it could be denial) I'll just wait until then, if it is then I'll go now. I know everybody says "If its your heart then don't risk it", but every time I go in for my heart, it's always nothing.

My family nor myself have a history of heart disease, diabetes, or just flat out obesity. I'm very fit, just oddly muscular for my age, but I don't work out as often as I should now-a-days. I also smoke cigarettes, and my heart pains/arm numbness do come back a bit when I have a cig, but then again it could just be my head. The last time I had any form of a heart test was probably about a year or two ago, it was an EKG and I believe a blood test, but my memory is a bit foggy in that area. My heart rate is normal, I don't know about my blood pressure, but I believe I got a test for it lying somewhere around my house. My last dose of amphetamines was today, yes I know its stupid, but it's literally my last dose (I weaned myself off).

Oh and I did have sex last night, being in the moment I may have over did it (I usually get this feeling just without the numbing), my heart pounded like hell, I got heart burn during it, my left arm and leg became pretty numb, I was kind of tremor-ish, and that's it. Once I orgasmed the numbing went away (except for under my armpit area), and my heart was fine, but beating pretty fast (110bpm).

So do you think I likely had a heart attack? Or do you think it's something else? Or a combination of things? Or simply nothing but a placebo affect or panic attack? And by the way how long does numbing of the left-arm and chest pains last after having a heart attack?

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