Recent Cardio Experience

[PSA680]

Hi Guys - 2 weeks ago I experienced a minor heart attack (NSTEMI) - though it didn’t seem minor on way to A&E! I ended up having 3 stents inserted in my Right Coronary Artery and am now feeling good and on my rehab.

During my 3 day stay in the Cardiology unit the Cardiology Consultants googled Enzalutamide and asked me to stop taking due to the cardio side effects. I was happy to do so for a couple of days. They then tried to persuade me to stop taking Enzalutamide completely. I wasn’t happy with this - my PSA is responding very well & CT scans looking good & bearable SEs. Despite my RCA being furred up (>70%) my overall heart function was good.

I explained that my family has a history of heart disease, I am on medication for high blood pressure, my cholesterol has gone high since increasing dairy post dx to ensure I get enough calcium, I’ve been taking Enzalutamide since May 20 & I’ve been a stress head all my life. Zeroing in on Enzalutamide didn’t seem very scientific/logical. I refused to make any decisions until i had spoken to my oncologist.

Thankfully my oncologist concurred & we have decided to continue with the Enzalutamide. He has significant experience of dispensing Enzalutamide and recognises it can affect cardio health.

Understandably cardiologists are concerned with heart health. However, I’ve got to take a more holistic, albeit risk based, view. I believe I’ve done the right thing but you never know what’s going to get you first.

Thought I’d share this experience especially with those with the APCa & heart disease combo.

Kind Regards

Darren

[Tall_Allen]

Sorry to hear about your scare. Best dietary sources of calcium are bony fish, like sardines, herring, anchovies, and canned salmon.

[PSA680 in reply to Tall_Allen]

Thanks Tall Allen

[epfj3333 in reply to Tall_Allen]

Is it OK to take calcium in capsule form? I take two 600mg capsules every morning on the advice of my MO.

[Tall_Allen in reply to epfj3333]

Pills may be necessary if your blood levels are low, or if you are taking Zometa or Xgeva. Supplementing calcium does nothing for bone mineral density. Otherwise, it's best to let your body decide what it needs by pulling calcium from the foods you eat. There is evidence that calcium supplements may may be bad for prostate cancer, heart disease, and cause kidney stones. Check with your cardiologist!

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[epfj3333 in reply to Tall_Allen]

Thank you TA!

[Kaliber]

Hi Darren …. I’m kinda in the same boat and have made the same choices . I’ve been on Lupron xtandi ( enzalutamide ) for the last 38 months and the last 24 months my cardiac QRS train has looked like scrambled eggs yayahahahaya ( normal before adt ) We bought one of those Kardia home ekg devices that work to your smartphone , to keep an eye on my wife’s sometimes iffy heart ( which looks amazingly textbook perfect ) and I started using it too and wished I hadn’t. My GP is alarmed somewhat but realizes that it’s related to the drugs that are literally keeping me alive , and defers to my oncologist because of my deep palliative circumstances. For me , as well, it’s not a hard choice …… flirt with a heart attack , or let my cancer grow hog wild and kill me off rather quickly ( my psa 1400-1600 when DXed ) . It’s danged if you do and danged if you don’t…?

Just like you , I’ve opted towards the side of cancer care …. And in your case you’ve had some reinforcing cardiac work done as well….. to help you make that choice. This stuff is tricky business isn’t it …

Just my own experience and affirming perspective…. For the 2 cents that’s worth ( IMHO ) Seems like no matter what PCa boat you are in here in the group, there are plenty of others in the same boat … as well.

Best wishes brother ❤️❤️❤️

[PSA680 in reply to Kaliber]

Hi Kaliber - I can’t agree with your response more. This forum does make you realise there’s always someone worse off than you - just in case you start to feel sorry for yourself. Keep up the good fight my brother - never give up never give in ❤️

[Don_1213 in reply to PSA680]

That is something men should be reminded of.. stents are hands down easy. I had stents (3 heart, 2 legs) installed and had roto-rooter and stent done to one leg artery. Piece of cake.

I've also had where they go in and just look around, all over the body.. coronary angiography, amazing where they can thread the probe to... (they went in via my wrist, and ended up at my big toe on the opposite side. Go figure out that route..)

My suggestion to anyone doing PCa treatments - get to a cardiologist and have a good workup done before the heart-attack. It was never too clear if I'd experienced a heart-attack before the stents were done, there may have been a very minor one years before the PCa diagnosis, but knowing where you are in cardio health, and then tracking it as you're treated is an excellent thing to do. There are non-invasive tests that can be done that will indicate if invasive tests (coronary angiography) are indicated. The invasive tests typically are a day visit to the hospital. The roto-rooter/stent deal is an overnight stay.

BTW - most of these are done semi-sedated. You know it's going on, but you feel nothing much and you really don't care. The MD's will usually share the screen with you so you can watch what's going on. I find it fascinating, some people are evidently a bit squeamish.

Oh - I asked how they thread the probes and tools around. They have a slight bend at the end of them, as they move them through the arteries they spin them until the bend is heading in the direction they want it to go, and then they move it into the new path.

[PSA680 in reply to Don_1213]

Hi Don_1213 - thanks for your response - you’ve had a lot more experience than me with stents - very informative & good advice re cardio health - good luck my friend

[PSA680 in reply to Kaliber]

Ps forgot to say that if you do need stents in the future the procedure is painless & was all over in 1hour 20mins for 3 stents & out of hospital 6hours later 👌

[Kaliber in reply to PSA680]

Thank you buddy … there’s been a little chit chat of stinting a right bundle block or two …. But they’re talking about “ yield “ vs risk and risk stressing me. The consensus being to leave it alone for now and keep an eye on things. I’m not aware of that cardiac issue outwardly , physically speaking , I’ve already got my plate full with PCa and adt , I’m REAL good with “ keeping an eye on it “ too yayahahahaya. I suspect that in the scheme of things , that adt induced cardiac thing is low on my list of issues. I’m doing pretty good lately, real good actually …I’ve learned to deal with the cancer issues and adt SEs and I feel pretty upbeat and optimistic. I’m really looking forward to the explosion of flowering spring AG trees and plants that happens here … the white bloom trees in neighborhood yards already happening. The rest will start in a week or two .. it’ll be glorious and go for several months. I’ll be up to my armpits in it too yayahahahaya yayahahahaya. I love the fragrances and visual see-scapes. It’s wonderful ….

I’ve had a few bumps on the road for sure but I definitely don’t feel sorry for myself … in fact just the opposite. Part of that comes as a result of the great guys such as yourself and the great support that comes from this group. Some of it from knowledge that I’m still here “ plugging “ ..when so many great guys on the group have heart wrenchingly lost their battle recently. You realize how lucky you really are ….

Thanks again brother ❤️❤️❤️

Almond bloom

[maley2711 in reply to Kaliber]

QRS train?

[Kaliber in reply to maley2711]

Qrs train describes a sequence of electrical impulses that control the heart contractions and valve action. QRS is the spike in the center of the train and an entire one cycle is the train, p q r s t . This beginning with P and ending with the T wave , the final bump off baseline of the sequence…. The QRS train. See diagram below …

❤️❤️❤️

Cardiac qrs train

[j-o-h-n in reply to Kaliber]

Geez If that doesn't look like a picture of me the way I used to look in the old days when I was lying down naked.....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/27/2022 6:26 PM EST

[Kaliber in reply to j-o-h-n]

Oh ….. for a minute I thought you meant that hump in the dirt between the row of trees in the orchard picture.

Lying down naked ? Interesting what people see in a Rorschach test , isn’t it. I see …. the p wave bump as the forehead or eyeballs .. the qrs spike as Pinocchio’s nose , the s to t wave baseline as a mouth and finally the t wave bump as the chin. Like a Peter Max poster in abstract. yayahahahaya.

Just say’in

❤️❤️❤️

[j-o-h-n in reply to Kaliber]

In the army testing they asked me what my perception of a blot test they showed me was.......... I said ink.........Right away they assigned me to Army intelligence.....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/27/2022 8:28 PM EST

[Kaliber in reply to j-o-h-n]

You are a gentleman and a scholar and obviously very intelligent …. thats what your ex told me you kept telling her . 😂😂😂

[PSA680 in reply to j-o-h-n]

Surely an oxymoron 😂😂😂

[j-o-h-n in reply to PSA680]

I can understand the moron part.....for marrying her......

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 01/28/2022 12:58 PM EST

[Kaliber in reply to j-o-h-n]

The “ oxy “ part is the pain meds for your brain after you married her …😂😂😂😂❤️❤️❤️

[j-o-h-n in reply to Kaliber]

This time the nail hit the hammer.............😂😂😂😂❤️❤️❤️

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 01/28/2022 5:51 PM EST

[London441]

Glad you got those stents! Modern medicine is amazing isn’t it?

TA is correct about the calcium sources, but dairy in moderation isn’t bad, it’s the saturated fat in cream, whole milk, cheese etc that you want to avoid.

I would also get serious about exercise at this point if I were you, since your heart disease isn’t going anywhere. Between your cardiac history, BP and the enzalutamide you are in a tough spot from here as you know. Still, reining in the diet and moving more will really help both your OS and QOL of course. Great luck to you!

[PSA680 in reply to London441]

Hi London441 - thanks for your reply - I’ve always been very active but since my dx I’ve become Forest Gump - walked 3,500miles in 2022 & also do light dumbbell exercises at home. Up to 5miles a day again. I’ve swapped skimmed milk for semi-skimmed, low cholesterol spread for butter & natural yoghurt for cream & now eating lots of sardines. I think walking has been my saviour since dx - it ticks so many boxes; bone health, weight control, mental health & socialising with people you meet along the way - I love it & needed something to replace my road cycling which I just lack the confidence to do with my bone mets - one accident could be very nasty. Good luck my friend

[PSA680 in reply to PSA680]

Ps cardiologist also said the walking would have delayed my heart attack & has maintained a good level of heart health which made me more resilient to the heart attack & should help with the recovery period. I just love walking 😀

[maley2711 in reply to PSA680]

Walking = boring..but since I found it helps maintain better BP, 2-3 miles/day for approx 25 years. Too bad that's not enuf to rid myself of 20-30 pounds. I've started to skip breakfast 2 days/week...know that won't be sufficient, but.......

[London441]

Too bad that eating rarely bores us! If eating less doesn’t bore you, stop eating breakfast every day.

[j-o-h-n]

It stands to reason that you had a mild heart attack.... Eating typical English fare will normally give you heart burn and sometimes a mild heart attack.... You're a young Dude who picked the wrong Mum and Dad.... but I (we) are glad you made it and will continue to post with us. God strength to you........and never give up.....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 01/27/2022 6:20 PM EST

[PSA680 in reply to j-o-h-n]

Thanks j-o-h-n - This forum provides a daily source of information & support for which I’m truly thankful - I don’t know anyone with APCa other than you guys - I have great family & friends but no one understands the issues we all face day to day. I cope pretty well emotionally but just can’t handle sympathy & you don’t get any on this forum just good, well intentioned & mostly well informed advice. Fair thee well brother

[sharoncrayn]

"Zeroing in on Enzalutamide didn’t seem very scientific/logical."

Management of Anticoagulation in Patients With Prostate Cancer

Receiving Enzalutamide

[PSA680 in reply to sharoncrayn]

Many thanks Sharoncrayn - good article - when I was in hospital they changed the anti platelets to Prasugrel due to the known interactions between other anti platelet medication & Enzalutamide. It’s great they’re aware of this. Hopefully the combination of Parsugrel, Asprin, Statins, exercise & diet will do the trick for me. Seeing my GP in a week to check for any adverse reactions.

Once again thank you my friend & good luck