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Update (12/11/99): Well, its been three and a half weeks since Dad's bypass surgery and he is doing really well. (I think this stage will be harder for him because as he starts feeling better he's going to want to do more physically. Char and I got them an iMac as an early Christmas present so maybe he can toy with that.)
Anyway, I finally scanned the pictures he got from his cardiac catheterization. This first image shows four views of his heart vessels:
He had two major blockages but the most obvious can be seen in the lower right image. Here's that fourth image enlarged:
I've circled the blockage with the light red circle. In order to read this picture you have to know that where the image is dark blood is flowing and where the image is light there is no blood. So, you can see that the thick artery feeding Dad's heart was almost entirely shut off.
Now you might ask why the cardiologist didn't recommend angioplasty (you might be more familiar with the term "balloon") or use of a stent. For this vessel either of those might have been a possibility. However, the other blockage that Dad had was located on a ninety degree turn on a vessel. (I can't see it in the pictures above, but the cardiologist did show me the blockage on the monitors in the cath lab). Because of the angle there just isn't a way to put a stent in (at least not yet).
First Report (week of 11/14/99)
You probably won't believe it but my Dad had a triple heart bypass just this past Tuesday (November 16). Here's an email I sent out to some people which described some of what happened.
As some of you know (and others are learning for the first time) my Dad was admitted to the hospital from the emergency room on Sunday for chest pains.
Char and I were at the hospital Sunday afternoon to see my sister and her new baby boy (Brendan Daniel, 9lbs5oz, 22"). Both are doing really well. He's a cutie, but long. He's got really big monkey/prehensile toes. :)
Over dinner at the hospital cafeteria my Mom told me that my Dad had been having pains for 3 weeks--episodes where he would become very hot, strip off his shirt and lay on the kitchen floor for half an hour. At dinner he confessed to having 2 episodes a day for 3 weeks straight. After a half hour of coaxing we got him down to the emergency room. Everyone is telling me that I'm the only he listened to but I think it had more to do with being at the hospital and that he was in the middle of an episode at the time.
He was bumped right up the line in the ER. They examined him for about an hour, asked a lot of questions and then admitted him. I was surprised. The worst I expected would be that they would keep overnight for observation. Instead the doctor was immediately talking about a cardiac catheterization and possibly a stent (a spring-like Chinese finger puzzle like device which keeps blood vessels open). I was very surprised they would talk about this that early.
His EKG and blood work showed no sign of heart attack though the blood did have anomalous qualities.
I drove Char home Sunday night and returned Monday morning. At 11am on Monday Dad had his cath. They wouldn't let me observe even though I told them I was in medical imaging. The cardiologist (Dr. McNamara, really nice guy) expected to find smoething and expected to install a stent. After 40 minutes they were done with the procedure. My mom said they must not have found anything because it was too quick. I told her that maybe it was worse than they thought (I said it thinking that wasn't it).
Sure enough they said that the blockages were so bad that they couldn't do an angioplasty or stent. The doc tried to show my 4 video captured images on a sheet of paper but I asked him if he still had the loop running. He was mildly surprised then took me and my mom into the back and showed us the multiple loops they had taken. He then showed my the two major blockages that Dad had and that he'd need three bypasses since one of the blockages led to a branch as well.
We were stunned. I had no idea how Dad would take this since I've seen him tear doctors apart before.
Dad surprised me. He took everything far better than I would have. Monday afternoon the surgeon showed up to talk with us (Dr. Shabahang--another nice guy). He said they had rearranged their schedules at the urging of Dr. McNamara and they would get Dad in for the second surgery on Tuesday.
He told Dad that he (the doc) was required to give him all the options but in this case there were none. Because of the severity of the blockages (one over 90%) and the nature (one along a right angle--impossible to stent) his only option was a bypass. He told Dad though that the prognosis was excellent: Dad's only 53, no damage to the heart, and in fact his heart was in excellent shape.
Tuesday, of course, was horrible with all of the waiting. They finally came to get him around 2:15. By 3pm we were in the surgery holding area and Dad was nicely doped up. During this time my sister came down to wait with us and see Dad again. My mom, brother-in-law and I were there talking, waiting with Dad. He was in and out and getting really groggy. After 10 minutes of snoring we thought he was quite out but then his eyes popped open, he lifted his head and turned it side-to-side several times. His eyes were unfocused and his face had no expression. My mom said, "Ken are you teasing us?" several times. For the first 3 seconds I thought he was but he didn't respond to us at all. I began to get really worried and thought I'd have to jump on him to keep him in bed. After 2 more seconds (5 seconds is a really long time) I put his head back down, closed his eyes and said "I'm just teasing." Holy cow! What a maroon. I don't think even I could have done that. We'll see if he remembers it. Sheesh.
At 3:45 they took him into surgery and our wait began. They told us it would take 4-6 hours.
After two hours they called us from surgery and said that all the prep work went well. He went to sleep, they harvested one of his mammary arteries and two segments of vein from his leg, and put him on bypass. (They were to take an artery from his arm--everyone has two in each arm--but the backup arteries were no good in his arms. Nothing really to be alarmed about but we were told never to let anyone take an atery from his arms.) All of this went very well.
After another hour or so they called us to tell us they were closing and that the surgeon would be in soon.
Around 7:30 Dr. Shabahang came in to tell us that everything had gone smoothly. The grafts were in and Dad went off bypass just fine. He'd be going up to ICU for 24 hours then to a normal room and he'd be home Friday or Saturday. Dr. S said that Dad would be on a baby aspirin (81mg) daily and that we all should do that. I asked who he meant by all. He said everyone in that room. He looked at me and said that anyone with a family history of problems and he said "I'm talking to you." He said he takes aspirin, that there are no adverse effects, that it greatly reduces the risk of severe heart attack and stroke, he takes one and everyone should take one.
It's now Wed morning. Dad's still in ICU and I should be able to go see him again in a few minutes. He looked really good last night after surgery considering his condition. He should be off the ventilator by now and they should have already had him sitting up to prevent pneumonia.
I'll try to keep everyone informed, but I think the really scary parts are over for now.
Thanks for the notes,
go back home