Doctor, Heal Thyself First

Well, I am home now. I have been grounded by my cardiologist. I have to stay off work for two weeks and then get back to normal activities slowly.

If you read my column last week, you will recall that I was suddenly taken ill and admitted to the intensive care unit of the Medicine Hat Regional Hospital (MHRH). I went there on a Tuesday. I was diagnosed with unstable angina. On Thursday, I was flown by air ambulance to Foothills Hospital (FHH) in Calgary.

Unstable angina is a condition in which chest pain occurs at rest or minimal activity because coronary vessels are narrow and the blood supply to the heart muscle is compromised. But the heart muscle is not damaged as it would have happened if I had a heart attack.

Within an hour or two of arriving at FHH, I underwent coronary angiography. This is an imaging technique in which X-ray pictures are taken to visualize the inner opening of blood filled structures, including arteries, veins and the heart chambers. My angiogram showed two areas of narrowing in the right coronary artery. Immediate angioplasties and insertion of two stents were carried out to keep the blood flow to the heart.

Angioplasty is carried out by inserting a balloon-tipped catheter (thin tube) in the diseased narrowed blood vessel. The balloon stretches the blood vessel improving blood flow through it. A stent is a mesh of thin metal which helps keep the blood vessel open.

On Thursday night I was kept on Unit 103B of the FHH for close observation to monitor for any complications like chest pain or bleeding from the groin where the catheter was inserted. My stay was uneventful. Next day I was transferred to Unit 4W substation at the MHRH for more observation and blood tests. I was discharged on Saturday.

I was lucky that I did not have a heart attack or a stroke. I was fortunate to have everything done in five days. In Calgary, within 24 hours, I was seen and taken care of by four cardiologists. The staff in the angiogram room, Unit 103B (FHH) and 4W substation (MHRH) and paramedics in Medicine Hat and Calgary took excellent care of me. I am grateful to them and other health care workers who do an excellent job under difficult circumstances.

What do I have to worry about now?

It is important to remember that coronary angioplasty and insertion of a stent is not a cure for coronary artery disease (CAD). Research shows that narrowing in the coronary artery will recur within six months in one out of five people who have had coronary angioplasty. My aim will be to prevent this from happening.

How can I do that?

I should try and control the process called atherosclerosis. Athero in Greek means paste and sclerosis means hardening. In atherosclerosis, there is a deposit of fatty substances, cholesterol and other substances to form a plaque which makes the blood vessel narrow. It is usually a slow, complex disease that typically starts in childhood and often progresses when people grow older. Like arthritis, it is a progressive disease.

The underlying risk factors for atherosclerosis are: family history of heart disease, high bad cholesterol (LDL), exposure to tobacco smoke, high blood pressure, diabetes mellitus, obesity and physical inactivity. The only risk factor I have is bad genes. I cannot change that. My LDL is within normal range but my cardiologist wants me to reduce it further. This can only be done with pills. I am not obese but I can afford to lose some weight. Otherwise, I don’t have other risk factors.

It is hard to predict the future. I am getting back to normal slowly. I have received many messages of good wishes and that has helped in the recovery process. Staying at home means I have more quality time with my family. I am enjoying that. See you in couple of weeks.

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