confusion regarding cath result

[Jay4471]

I had a cath done 5 months after getting stent for cto of lad and another One month ago w/ ultrasound that said there was a 20% restenosis in stent on report. I got the disc and took to top guy to review and he said stent was wide open ie, no stenosis. How can something that would appear to be cut and dry objective observation be so differently interpreted especially since cath report is rather specific about the appearance of the lesion eg, smooth, irregular. I get so flustered that I walk out w/ more ?s than answers and it is impossible to get these people on the phone to clarify. They get most annoyed when it is they who are the problem.

[Flycaster305]

I can't remember what type of stent needed housekeeping, I've got both types, but do know the reason for the restenosis was caused by what they called tortuous (twisted) arteries, which were straightened.

I would disagree vigorously that diet is a minor cause of cholesterol issues.  Like Ed, I also manufacture too much cholesterol but changing my diet to a heart healthy intake plus taking statins really saved my life. Statins take a bad rap, in my opinion.  The fact that you are tired and have gained weight seems more in line with what all of us experienced initially when taking beta blockers.  

Like Ed, every time I refused t take a drug I paid for it.  In my opinion, part of recovery from heart problems starts with acceptance, trust and commitment.  I'd choose a heart doctor, and establish a relationship.

[ed34]

I haven't been checked for a stomach ulcer, are the symptoms correct? I wondered about an Ulcer but I would expect pains to exist with certain foods. Only the Aspirin seems to cause pains. I was prescribed Omeprozole proton pumps to see if it would help, but it seemed to make it hurt even more. I have no idea what's going on and even my Doctor seems to be scratching her head over many of the problems. I see my Cardiologist in Feb, the Doctor had it brought forward from May, so I will type a list and slap it on his desk to read. I don't know what country you are in, so have no idea if you use mmol/L or mg/dl. Anyway my total cholesterol was 9.7mmol/L before statins which is way way too high. Average is 5 and heart disease patients should be 3.8-4. If you can get down to 4 or less, then there is apparently lots of evidence to suggest much lower risk of cardiac related death. My total cholesterol on 40mg of Lipitor was 5mmol/L. Now on 80mg of Lipitor it is 3.9 mmol/L. All I know is, when I stopped medication, my conditioned got a lot worse over 12 months and another artery totally blocked.

[Jay4471]

flycaster,  where was the stent that restenosed? was it bms or des? were any a calcified total occlusion mid-lad? your on the money about my frustration in that all I want to know is what the new lesion in the stent is. scar tissue, plaque (hard or soft) a bit of context and what it means for the future of the stented area. Thats why they did the ultrasound in the first place. I blame myself to an extent for not being more focused in this consult but I was absorbing the fact that he told me I had a heart attack when the other guy said no. one thing Ive noticed w/ these interventionals is they can be quite patronizing and insulting of ones intelligence. my diet and weight have always been good but ironically since starting the stain Ive gained 15 pounds of fat around the middle, my metabolism has basically stopped and the drs have no answers. oh, also what meds are u on if u dont mind?

[Jay4471]

I too have tiredness and weakness after eating that might be a form of hypotension. usually it happens to older people but im just 42. seems there are a host of weird changes since the stent. have you been checked for a stomach ulcer? this last consult I did had a whole page w/ questions about falling asleep easily that I hadn't seen before so it is relevant. I've already had experiences w/ these people where if I wasn't proactive and aggressive they would have missed important things. The indifference and even incompetence is disturbing. I think cholesterol in food issue is minor to begin w/, as u say its the liver but beware of cognitive and emotional changes w/ 80 lipitor, I became very irritable and foggy over time. hopefully over time you can go back to 40 and ur heart will start to function a little better and reduce the tiredness.

[Flycaster305]

Jay, I understand your frustration.  I'd consider a cath the gold standard, and also understand there is soft plaque and hard plaque.  There are many other factors involved, including where the blockages are occurring in the artery walls.  Like Ed, I have had multiple stents, either 9 or 10.  I've had some of them for almost 15 years, must have had at least a dozen caths.  I've had only one incident of restenosis, which is blockage of a treated area.  Another big factor is how twisted and turned your arteries are.  

Ed gives great advice, center on reduction of stress, lose weight if you need to, control diabetes, and find a heart healthy diet that matches your lifestyle, and above all, exercise daily aerobically for at least 1/2 hour daily.

[ed34]

I stopped Aspirin because the stomach pains I got were as bad as a heart attack. I have no idea why they do this now, when I managed them for years prior. I am not too worried about the Aspirin though, I have a pack ready to take if I have another attack which the Doctor is ok with. Yes 80mg is high, but I had blood tests last week again and the results all look normal. Well I say normal, but as usual my white cell count is slightly elevated and always seems to be, has been for years. The trouble is I have hypercholesterolemia which means even if I didn't eat, my Liver works overtime shifts to over produce lipids. I seem to have one other new symptom since this latest attack. If I eat anything, no matter how much, I suddenly feel very tired. So tired that I can't fight it and fall asleep for at least an hour. I have mentioned this to the cardiologist and Doctor but neither seem concerned. I spent 48 hours in hospital with the last attack and I swear 40 of those must have been sleeping.