Unfortunately, you are in one of the highest risk groups there are for development of coronary
disease, as well as the most likely not to do well after revascularizations. This is completley due
to your having diabetes- a terrible disease that we as physicians do not have a great handle on(especially
on preventing the progression of the disease.) It has been shown in a few studies that diabetics with multiple
vessel coronary artery disease do better with bypass than with angioplasty and stenting.
When your vessels and grafts reacted so quicky with more and more stenosis following the bypass, the only
thing to do at that point was try angioplasy and stent, because actually when patients get stenosis of their
bypass grafts that quickly following surgery, it often will respond to an angioplasty alone(without stent.)
Unfortunately, you did not respond and your body continued to lay down plaque in the bypasses and coronaries
at a very brisk pace-this more than likely is related to your diabetic metabolism. Not only can we not explain
why a diabetic is more likely to do worse, we currently have no specific therapy for it, except to do as much as
you can to prevent the heart function from decreasing (i.e. damage from occuring)
We have known about "small vessel disease" for quite some time and because we simply have no therapy for such small vessels,
other than medical therapy (nitrates, cholesterol lowering drugs, and aggressive sugar management), it presents a very difficult
situation for a patient such as yourself.
The cramping in your legs could very well be secondary to decreased blood flow to your muscles(due to blockages in the arteries that feed
the legs.) This is best dealt with (evaluation and treatment) by a vascular doctor.
The Cleveland Clinic will not give second opinions so to speak until it has the patient and the records at hand, granted it may only be
one visit, however, the patient must present for a history and physical as part of the evaluation. If you are still interested, you can
call 1-800-CCF-CARE and ask for an appointment with one of the cardiologists at desk F25.
It really sounds as if the cardiologists have done as much as possible to help keep your
heart strong, however, a second opinion is always a good idea. Good luck and write back with any further questions.
I apologize if I seem very blunt, however you have a very bad disease that is progressive, making it unlikely that you will
ever feel "back to normal" so to speak. A patient in your situation needs to be his/her own advocate(which you are) and
needs to find the good in a potentially bad situation, or better said, look on the bright side and really enjoy all those days
that you are not spending in the hospital for your heart or diabetes appointments and procedures.
Information provided in the heart forum is intended for general medical informational purposes only, actual diagnosis and treatment
can only be made by your physician(s).
THANK YOU FOR READING THIS LONG LETTER. I HAVE A PROBLEM WITH GETTING
ANSWERS FROM DOCTORS AND NO EXPLANATIONS. I ALSO HAVE BEEN TOLD
TO MANY TIMES THAT I LOOK GREAT AND GO HOME AND WAIT. WELL I,M
I RECENTLY REPLIED FOR SOCIAL SECURITY AND WAS JUST TOLD THAT
I WILL RECIEVE IT, THIS HELPED ME TO ACCEPT THAT I'M SICK BUT
I HATE IT AND WANT TO WORK, DO YOU THINK THERE IS HOPE?
THANK YOU SO MUCH