The technology I'm trusting today

By the time this is posted, I will be in a hospital having a fairly routine cardiac chatheterization procedure done to determine the level of blockage in my coronary arteries.  Cardiologists do a ton of these every year, saving people from inactive lives and open heart surgery.  Unbelievable technology, but I'll get back to that later. 

No Chest Pain Symptoms!

The main reason for this post is to help people understand that symptoms for heart trouble don't have to include chest pains.  I have had a little tightness of breath while exercising over the last year and I've noticed a drop in my cardio output, but I figured that's just what comes with aging.  I've been bike riding, skiing and hiking/walking, but my pace has been slower and hill climbs on the bike have been harder. Still I can do them without experiencing symptoms that make me worry.

However, climbing stairs has become really weird over the last 4 months. I've always tended to bounce quickly up stairs for some reason, but in the last few months, this has made me feel faint.  Once during the Christmas break and again about 5 weeks ago, I thought I was going to completely pass out after climbing a couple flights of stairs. I knew this wasn't just ordinary aging crap, so shortly after the second wiggy experience I went to see my doctor who referred me to a cardiologist. 

Went there, got the stress test (wires and a treadmill) and failed. That was a few weeks ago. Today we'll be taking the next step, which is a little scary, but for the most part I can't wait to experience the whole thing.

A Very Specific Application

The other reason for this post is to help people understand what goes on and what the technology is about.  Sometimes there is nothing better than analog technology and this is one of them. 

Coronary catheterization is typically an out-patient procedure performed in a hospital. That way, if something goes drastically haywire, such as having a heart attack, you are in the best place possible to deal with it.  If, during the process, the doctor decides to insert stents in your heart to push away the blockage, they'll keep you overnight for observation - and then it becomes an in-patient experience complete with institutional cuisine!

One of the positive things is that I'll have a drip bag with a variety of meds that should keep me chilled out while there is a tiny hose poking around the inside of my heart.  I'll be prone on my back on the platform of a specialized imaging machine made just for me (and thousands of others). The doctor gives me a little local numbing balm and then punctures me near the privates and starts working the catheter up towards my heartland. Former patients say they can hardly felt anything during this process, but I imagine I'll be comparing it to a root canal, even if I actually don't feel anything.

It's a bit like a real-life video game for the doctor, who watches the catheter action on the screen of the imaging system. When when the catheter is finally in the right location, it squirts out a dye that is super visible and he watches how it moves through the arteries - all in real time. People tend to feel the dye and I'm assuming its one of the least special moments for the patient during the whole thing.  My doctor has done this thousands of times and he knows what it looks like when there is a blockage.  There are three arteries that they check out this way, and this is what it looks like: (not mine, just some guy's on YouTube).

If my cardiologist sees something that he doesn't like, he'll probably insert a stent made of surgical steel that resembles one of those chinese finger traps. The stent is collapsed when they run it into your artery and up into your heart.  When it gets positioned in the area where the blockage is occurring, they inflate the stent with a balloon of sorts (at least that's how I understand it) until it pushes the artery walls out and blood can flow more or less normally again. The stent has an inert coating that lessens the likelihood of it irritating the heart. Something I would certainly like to avoid. 

There are a number of key technologies here: first is the catheter system that enters the body, follows the artery right into the heart, delivers the dye and puts stents in place. Next is the real-time imaging system that gives instantaneous feedback to the doctor as he plays the Fix Marc game, Last is the chemical technology used for the dye and the stent coating to mix with the blood, show up clearly on the imaging system and sit in your heart like it doesn't exist. Of course, there is a lot more technology than that, but that's how I'm breaking it down today and they are the things I'll be thinking about as all this work is going on.  Amazing stuff - I'm completely impressed.

Comments

[Chris Fricke]

That all sounds really neat - a bit scary but neat nonetheless. Best of luck Marc though I'm sure you don't need it.

[marc farley]

Thanks Chris, Everything went well and I didn't need any stents. The time the catherter was inside was very short - probably less than 15 minutes. The dye injection was nothing - it felt slightly warm, but was barely noticeable.

The hardest part was about 6 hours after the procedure, the industrial strength pain killers had worn off and the place where the catheter entered my leg was pretty grouchy. But a little Ibuprofin took care of that.

All in all, not a bad experience. They brought me a breakfast after it was over, but I turned down the hospital oatmeal. It had "the look", if you know what I mean. Today's good news doesn't explain my symptoms or my stress test results. Maybe I am just too heavy for my mid-range cardio system.

[Steve]

Best wishes my friend! You ever need a break come to Boston and we'll do a SWCSOA from the Boston Harbor on the Boat!

[Chris Fricke]

It's actually probably all that time you've been spending with Greg Knieriemen!

[Tom Trainer]

Glad it all turned out well, Marc. I have moved swiftly to salads - lots of salads after installation of the new back hardware. Hope we can 'salad' sometime soon.

[Sean Clark]

It's probably all the podcasting. You're only one man, Marc. Hope you get your mid-range cardio system upgraded or find good way to reduce I/O to that bad boy. :)

[Chris Mellor]

Marc,
Best wishes and your post on the procedure above was brilliant.

[marc farley]

Thanks Chris,

I'm expecting to talk to my doctor next week, but I'm wondering if I might have something called Cardiac Syndrome X. If, so that's not a very bad thing at all. Then I could be a real X man!

[George Crump]

Marc, Awesome post and I'm glad you came through OK. I have to be honest if I was having that done my last thought would be my blog. You were either stuck for a blog idea or are truly committed. Either way I am impressed. Recover quickly. -George

[marc farley]

Thanks George, AFAIK, I'm going to be just fine. When I went looking for information online about my symptoms I didn't find much. Probably because I didn't know what to look for, but just the same I wanted to post this - thinking that it could be helpful to others in similar circumstances. Then there was the fact that I thought it was pretty amazing tech that gets used everyday.

[nate]

glad your doing well! keep up the good work!

[marc farley]

Thanks Nate.

[Dylan Locsin]

Yikes. Scary stuff, Marc. Glad to hear you're recovering well.

[marc farley]

Thanks Dylan, how are you doing anyway - long time no see. The only thing that is scary is not knowing what the situation is and now I know a lot more than I did a few days ago.

[Matt Simmons]

Can I just say, thanks for sharing this. We all need to be more cognizant of our health, and discussing things openly in a public forum like this makes others who need to talk to healthcare providers more likely. Every person who talks about their issues reduces the shame factor that someone else feels.

Great post. Thanks.