June 26, 2007
My heart problems and a quick fix
On Friday June 22, I had my angiogram and subsequent angioplasty
surgery. Although the day was not without incident, the final result could
not have been better. I need about a week to recover, but I will be back to
normal very soon.
On May 31 (and again on June 2) during my workout, I encountered chest
pain (angina). At first I though it must be something else. It seemed
unbelievable that I would have heart problems when in recent weeks and
months I have been doing long bike rides without any difficulty. In any
event, when the pain started I stopped all workouts (and sat out of the
Milton Tri) until I could visit my Cardiologist.
My Cardiologist (Dr. Darcel) put me on some strong medicine to slow me
down and had me scheduled to undergo and angiogram (a catheter-based
test that provides detailed images of the heart and blood vessels). He said
he expected that I would require another heart bi-pass. It had my first heart
bi-pass surgery on October 1, 1997
It looked like my Ironman career was over for good. After 10 years, my
heart disease has caught up with me. It was disappointing to say the least.
During that first week, I battled through the emotional challenge but felt I
was now ready to accept the reality. I became focused on new objectives.
Instead of doing the Ironman in August, I would undergo heart bi-pass
surgery and recovery (probably about the same level of challenge, but
without the Gatorade and Powerbars).
When I though about it, I really should not complain. The last 10 years
have been incredible! I have done over 60 triathlons including 3 Ironman’s
and played an estimated 400+ hours of old timers hockey. I am a lucky
man! I have been really fortunate that my fitness has allowed me to do
triathlons. I was glad I did the 3 Ironman’s when my health allowed me to. I
really glad I did not allow myself to “put it off” until another time.
My Cardiologist has described my congestive heart disease as chronic. He
and several other doctors have said they believe that my fitness lifestyle
has significantly delayed the progression of my disease, but it seemed that
time has caught up to me.
Before the test on June 22, the cardiologist suspected that my 2 bypass
arteries had collapsed from age. Apparently, they often have a life
expectancy of about 10-12 years. It has been 10 years since my last
bypass. If the predictions were accurate, it would mean I would have to
undergo a repeat bypass. That operation takes a long time to recover
from. The cardiologist that did the angiogram (Dr. Stanton) told me before
the test that was what he expected to find.
When he did the actual test, he was very excited when he found that my 10
year old bypass arteries were clear and flowing generously. What he did
find was that a different artery (the right coronary artery) had 90%
blockage, which sounds very bad, but he explained that the right coronary
artery was wide open, except this one blockage. Better still, the location
and nature of the blockage was assessable for angioplasty surgery. Dr.
Stanton said, “If you have a blockage, this is the best possible scenario
that can exist. We can fix this.” I was surprised and delighted about his
optimism.
Dr. Stanton went on to say, “although we can fix this, we can’t fix it right
now, because the angioplasty surgical team has just started surgery on
someone else. So, they will bring you back in again after lunch.” That was
fine by me, I was happy it was going to get fixed the same day.
Good news seems to attract attention in the cardio centre. Word spread
that I had graduated from their medical study exercise program and bypass
surgery of 10 years ago and had done 3 Ironman’s since. They all seemed
proud of this. So, the rest of the day, was spent with lots of visits from the
cardio medical staff. Over the last 10 years, I often feared that the exercise
programs were “pushing the limits”. However, this test had revealed that it
was keeping my arteries clear (except this odd lonely blockage) and that
they described my heart muscle as extremely strong.
After lunch, they prepared me for surgery and the team all seemed
positive. The surgical cardiologist was Dr. Shy Amlani. He told me that the
"sheath introducer" (a small tube incerted into my groin in which the
cathitor would be passed through) that was used during the morning
surgury needed to be replaced, because it was no longer sterile after I had
left the surgurical room during their lunch hour. He wanted to change it.
When they introduced a new sheath, they struck a nerve and this induced
a fainting response called Vasovagal Syncope. The unfortuate part was
that this occurred during the introduction of surgurgical medications. The
medical staff had a few tense moments while they introduced alternate
recovery medicine. My blood presuure dropped to 30, which really casued
them some concern.
I became extremly illl for a few minutes and was upset because I though
that my surgical fix would be cancelled because of the complications.
Hovever, they were able to revive me, and when my blood pressure return
to 100, Dr. Shy said to me, “John, your alright now, and now we will
continue with your surgery”. I felt relief. As I looked around the room, I
could see a lot more people had appeared. Apparently, when an incident
like that occurs, they specialized staff are quickly called in from the
adjoining surgical rooms. Later I would learn that their was as many as 15
people with me during the incident. They said that they have about one of
these incidents every day. If things had gotten worse, they were prepared
to deal with it.
The angiplasty and and stent placement surgury contined. The whole
procedure only takes about 10 to 15 minutes. The preparation and
cleanup segment take about 75 minutes. The staff that do angograms and
angiplasty are specialized. This is all they do every day. They
improvements over the last 10 years are dramictic. Medications are better.
The equipment is better. The medical staff experience is better. Apparenty,
they can solve more problems now with stents than 10 years ago. Heart
bypass surgury’s are required less aften now because the stents are more
reliable.
The cardio staff at Hamilton General Hospital seemed much less
overworked and overstressed compared to 1997. They were very attentive
and pleasant.
In addtion, there are no longer the long wait lists. In 1997, I was declared
an emergeny case and hospitalized for 4 weeks before I could get an
angigram.This time, they got me an angigram in 2 weeks and I was only
hospitalized for the day.
This time, of the people who got angiograms (test) only, they were
released the same day. For those of us who also had angioplasty surgery,
we were kept over night. However, I was released at 6.10 a.m. the next day.
The surgical cardiologists both told me to go back to my regular exercise
program; they said that my exercise expands my arteries. This was great to
hear. Many times friends and family during the last 10 years have said they
though that I was overdoing it and that I was endangering my heath. Over
the years, I have discussed this with many doctors and cardiologist and
every one of them have told me to continue what I am doing, provided I
also get the rest needed.
The medical staff has instructed me to wait 7 days before I resume my
workouts. When I go back to my workouts, I will continue to listen to my
body and let it decide how much and how far I can go. That arrangement
has been successful for me for the last 10 years. I look forward to the next
10 years. I am a lucky man!
John