UPDATE on seeing the surgeon

[Jako999]

Hi all,

Well I saw the surgeon yesterday in fact there were two of them and my appointment lasted 35minutes😳. It didn’t go as I wanted, but I did get some answer’s, they were very good and explained everything. They showed me my angiogram and my CTC results and explained all the flow patterns. My two veins have totally collapsed, there could be many reasons we will never know why. However the two arterial bypasses are really good.

As you all know I really wanted them to redo the the two collapsed bypasses and I still do. To me it seems the best thing to do to get the best results for now and the future. We all know what a mental struggle all this is and this is just adding to it. Basically they will not operate at this point and will only do it as a last resort, this has really not helped me😩.

They explained to me that the two good bypasses will be damaged by the surgery due to the trauma and the fact my heart will be on bypass again. Basically I could loose what I now have.

So this is what’s happening next. I’ve been put on yet another med Ranolazine 375mg, this is basically a slow release gtn that lasts all day, then they are organising an MRI with contrasting. The hope is they will be able to find bits of flow in my old original pipe work, then the idea is to stent what they can and see how I get on.

It’s not what I want but I have to listen to them and do what they want first, if it goes pear shaped and doesn’t work then they will look again and consider surgery. It’s just all such a waiting game that’s not really helping me but as I’ve said before I’m alive and I shouldn’t be and I’d like to stay alive. There are lots of people worse off then me, so I should be thankful.

Sorry it’s a bit long winded, I’ll keep you updated as I go on my next journey.

Thanks for reading.

[Heyjude31]

HiJako999, not what you wanted to hear I know. We have to trust them to know what is best. I sincerely hope the meds help and you start to feel better and less anxious.

As thatwasunexpected said there are positives and if they need to stent much less trauma and naturally you don’t want to risk the other two going pear shaped. Take good care, Judi

[Sodp]

Yes totally what I realized as well if more than 2 they opt for a bypass surgery rather than doing stents. bypass considering the age and fitness of the patient. I was suggested for bypass but one of three arteries cannot be bypassed due to size etc. They won't have hybrid version went with stents eventually. So if they have decided to go with stents that's probably a best option for now. Good luck with your surgery

[Hidden]

So sorry you feel that this is not the best news for your continued health plan.

Your heart team sees many cases like yours and I can only assume that they base their findings on those that have gone before you.

Sometimes in life we have to place our hands into others that are experts in their field even if it is not as we wish.

It sounds like they are trying to do the best that they can for you, there is of course always the second opinion route, and if you still have doubts, who could blame you taking that?

I hope for the best outcome for you

Take care.

[devonian186 in reply to Hidden]

Yes a second opinion might be good but on the other hand there were 2 doctors present so in a way that is a second opinion. Wonder if they were the original surgeons?

[devonian186]

So sorry that its not the result you wanted and it seems to be a matter of wait and see, but that you have two really good arterial bypasses is very positive.

Which leads to the general question as to whether the existing veins/arteries , some of which will have still been producing a flow, are entirely bypassed by the original surgery or do they ADD to what is then carried out?

In other words, do you get a cumulative effect of say 80% from the new work and 20% still coming from the old veins/arteries?

Or are we totally reliant only on the new bypasses?

[Chappychap in reply to devonian186]

The original arteries are left in place and continue to function (or not function) exactly as before. Bypass surgery only ever adds to the supply of oxygenated blood to the heart, it never detracts.

[devonian186 in reply to Chappychap]

So in other words if I had an original 30% remaining and the bypasses gave me 80% more then I am supercharged at 110%!

Which might explain our friend 'That was unexpected' who clearly has an unfair advantage over his competitors who struggle along at less than 100% whilst he seems to have 150%. Think they ought to take away his medals!

Seriously, that is interesting, it would be useful to know, a year on from my operation, as to what input is coming from the various sources.

[Chappychap in reply to devonian186]

There's a further twist that's even more interesting, because the arteries of the heart have a totally unique property.

If there's a blockage then heart arteries are capable of developing a network of tiny capillaries that work around the blockage, it's almost like the body is performing it's own bypass surgery!

Now some people will have this response more than others, but at its optimum these tiny capillaries (too small in fact to be seen with even the best angiogram) can supply enough oxygenated blood to meet the heart's needs for when the person is at rest. So, not enough oxygenated blood to allow the heart to pump enough for vigorous exercise, but enough for when the person is sitting or walking slowly. This is why some people can survive with extremely high levels of arterial stenosis. They may not be able to run or carry heavy weights, but their heart can still function at tick-over for many, many years.

The more I discover about our biology the more astonishing it becomes!

[devonian186 in reply to Chappychap]

Very interesting. So in the absence of any other factors I can believe I am supercharged!

[Chappychap in reply to devonian186]

You're just being modest...you've always known that!

[Sljp0000]

All my bypasses failed within 2 weeks of surgery last September (Do you remember me?) I replied to your last post but not sure if you read it. I had 4 stents in February, I wouldn't be alive without them. My LAD was completely blocked and they managed to do it. Have faith, they will do what's best for you. X

[devonian186 in reply to Sljp0000]

That's encouraging. Hope Jako reads this as he must be feeling down.

[Jako999 in reply to Sljp0000]

Yes I remember you well. So glad thing are going in the right direction for you now, I’m sure they will sort me out but things just keep going round and round in my head. What I don’t want is to keep having tests that lead to even more meds, in my head just replace what’s failed and all will be fixed.

Thanks

[Sljp0000 in reply to Jako999]

The only med I'm on extra to what I was after my bypass is Clopidogrel and that's just for one year. Remember I had major blood clots so maybe something to do with that? I'm off aspirin now too which is good cos I don't think it does my tummy much good.I read an article yesterday saying that most failed vein bypasses are caused by the body producing a chemical which thickens the lining of veins and causes blockages. A sort of defence system from being moved. Remember if that's what caused yours to block no amount of times would stop it happening.

Be happy you arterial bypasses are working well! Yayyy! And get those stents done. They could last you forever without anymore fears?

Keep us informed. Believe me, I really know how your feeling but you can do this!

Susie x

[Gumbie_Cat]

I really understand how you feel. It’s as if you want to be proactive and getting something done, and then find that isn’t an option.

It’s good that there will be further investigations to see if they can do those stents though, and also great news on the really good bypasses.

On a much lesser scale, I am taking a while to come to terms with the consultant telling me that no further ablations will be considered for my A Fib. I had gone in thinking that a second one was the usual thing, but they had found too much fibrosis in the atria. So it’s rate control now. I veer between acceptance and railing against it, and I think part of it is to do with feeling a bit helpless and wanting action. Though I guess the ball is in my court, to keep as healthy as possible despite the A Fib, and just to get on with life.

[Chappychap]

I understand your disappointment, but you’re still in the game and there’s a lot of play remaining . So hang on in there Jako, life is still beautiful.

Good luck!

[1961J]

Waiting for answers is quite a struggle I sympathise with you and I have only just been diagnosed, all the best for the future

[Dunandjam]

I feel for you too!