Healthy Aging

healthy aging

Role Reversal: Coronary Artery Bypass Surgery (Part One)

Please excuse the personal nature of this month's column, but there are lessons here that extend beyond the writer.  After all, coronary artery atherosclerosis is a very common problem, especially as men and women age.

I spent my entire professional life as a cardiac anesthesiologist--a medical specialist whose primary work is to anesthetize patients who require heart surgery.  On Saturday, April 28, 2012 I had the opportunity to be anesthetized for coronary artery bypass surgery.  In other words, in one day, my 40 year role of care giver was reversed to care receiver!

What follows are critical decisions and steps that all patients must be prepared to take as "consumer" of coronary heart disease care.

The first lesson in healthy aging is to stay acutely attuned to one's health.  In my case during my regular exercise routine I sensed a new burning sensation in my throat as I ran laps.  It ceased when I stopped exercise.  Over a few weeks this sensation began to occur with fewer laps--it was getting worse.  Because my father had coronary disease as did others in the family, I had actually been waiting my whole life to have these symptoms.

On Monday, April 23, I had my pain while running in the first lap.  That was it!  I knew that the next step was to contact my doctor which I did on Wednesday, April 25.  My physician, who had treated me with aspirin and statins to prevent coronary disease, listened to my story, and arranged for an exercise stress test to determine if my exercise symptoms were what we both suspected--angina pectoris or coronary artery disease.

Friday, April 27, I "failed" my test--this means the treadmill exercise reproduced my pain.  The electrocardiogram revealed heart ischemia (lack of blood) as did the simultaneous nuclear heart study.

Having proved the diagnosis of coronary disease a cardiac catheterization followed the stress test Friday afternoon.  This procedure is done while the patient is sedated and involves inserting a catheter in the coronary arteries to see which ones are involved and the extent of disease.

My angiograms revealed a 95% lesion of the left anterior descending coronary right at the first diagonal branch.  This is called the "widow maker" lesion since if the coronary were to become 100% occluded the patient usually dies from the ensuing heart attack.

Although coronary disease can be treated three ways--medicine, stents, or surgery--a severe lesion like mine is best treated by surgery, a decision I made readily upon learning of my precise diagnosis.

The next morning, Saturday, April 28, my professional colleagues and friends at MUSC devoted the morning doing the "urgent" surgery.  All went quickly and well, and I awoke in the ICU in the early afternoon.

By Sunday I had learned the first new lesson in my new role.  There was pain at the operation site and in the back and especially when coughing.  There was a lot of pain and I had always told my patients that it was not terribly painful!

Monday, April 30 was better, but I was passing blood clots in my urine that threatened to obstruct my urine flow.  This resolved in a few days and the incisional pain resolved as well.

By Wednesday, May 2, I found myself doing what about all any patient can do--watching hours of mindless TV.  As luck would have it--this was the first anniversary of bin Laden's death and I had seen repeatedly the most disturbing video of his being shot in the chest (heart.).  This was my next lesson--do not watch TV, especially with any mortal wounding portrayed--there is nothing inspirational about it.

On Thursday, May 3, I was discharged home to begin what we expected would be an uncomplicated convalescence.  Everything is better at home from the rest and diet perspective.  it is, however, a real burden on spouse and family.

So what are the lessons for healthy aging in this personal story?

  1. Always be aware of any health status change--in my case new exercise pain.
  2. Do not deny symptoms rather call or visit your doctor if you think something is wrong.
  3. When dealing with a life threatening medical problem, time is important.  You and your medical team need to act swiftly.
  4. Pain is part of surgery, no matter what you think or were told--take the pain medicine that helps you cough, walk, etc.
  5. Ambulate and work to get out of the hospital as long as it is safe, but know how to call your medical team if any complications arise.
  6. It is easier to give than receive care, but it is better to receive life preserving care.

The bottom line is that only you can alert your doctor so that he/she can see that diagnosis and treatment are readily available.

Healthy Aging

Health Information Library: Anatomy and Function of the Coronary Arteries

Video: Stress Test/ECG

Podcast: Coronary Artery Disease, What is a Heart Attack?

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