Angiogram/Angioplasty- My personal experience

I underwent an angiogram followed by an angioplasty 2 days back.

This blog is a record of my experience so far:

What was the trigger?

What were the actions I took?

How did I feel before and after?

How am I feeling now? Etc

I am sharing this mainlyto dispel fears and take readers through my journey.

Disclaimer: This blog is primarily my experience. Some of these may be at variance with medical facts.The reader is therefore advised to exercise caution.

Any matter related to the heart ( romantic or medical) is serious and therefore I am writing this blog with all the seriousness that the subject deserves. However, there may be occasions where my sense of humour surfaces and I beg the indulgence of readers.

Background information:

I am 69 years old, retired for 5 years and still play badminton regularly. I swim when the occasion permits and play tennis when I visit US. Vegetarian and an occasional drinker. I climbed the Tiger Nest Monastery in Bhutan last year. This is just to show that I was and continue to be physically active.

Over the last 6 months, I found that I wasn’t enjoying my food and ate perfunctionarily. Also, I used to get a reflux action when I started eating and had to gulp water to wash my food down.

I was a known hypertensive and took BP medicine for the last 28 years including slow acting aspirin.

How it all started

On Wed ( 29th Jul), I got up at 4.30 PM from my usual afternoon nap and found that I had a persistent pain in my chest. I dismissed it as due to gas, but the pain persisted for an hour.These are the times when people get doubts. To go to the doctor or not? Why inconvenience others? Could be a false alarm. Etc etc. Trust me, I had the same doubts on earlier occasions But there comes a time when your gut tells you that you have to get up and act. This was that moment for me when the pain didn´t  go away even after an hour.Sudha had gone to her mom’s place. I told her to come back immdly and we went to my family doctor. He suggested that I get a Troponin-I test and an ECG done.

I got the tests done and went back to him next day morning ( Thu 30th Jul). By then, the pain had gone away and I was feeling absolutely fine. No breathlessness, no nothing. My pulse oxymeter reading was 95 or so regularly.

The Troponin-I test is just a blood test. My troponin-I level was 13.35 against a max of 12 for gents. ( For ladies, the max is 9). I asked him what this meant. The doctor said that the heart generates an enzyme called Troponin-I when it is not getting enough oxygen from the blood.

So, the fact that my Troponin-I level was higher than normal was an indicator that my heart 

wasn´t getting enough blood. 

The ECG report had a lot of the usual medical mumbo-jumbo that I couldn´t understand at all.

Anyway, my family doctor told me to undergo an Echo Cardiogram followed by a Treadmill Test ( TMT).

On  Thu 30th Jul evening, I went back to the same lab and got both the tests. 

The EEG was negative ( all normal), but the TMT test was positive.The Treadmill test is done at different speeds in 4 stages ( starting from slow to every fast). You are expected to walk the treadmill till your target heart rate is reached , which is 220 minus your age. In my case, the target heart rate was 220-69=151. I reached up to 127 beats per minute at the 9th minute ( end of 3rd stage) and gave up due to exhaustion.

At the end of the test, the cardiologist who did the test told me that the TMT was conclusive proof that I had some blockages in my blood vessel(s) and that I should get an angiogram done immediately, followed by an angioplasty if the result so warranted.

He was also attached to a leading private hospital and advised me to get the procedure done if possible on Saturday 1st Aug itself. I had gone alone for the test and told him that I needed to discuss with my wife. I also told him that I needed to get a second opinion and he was fine with that.

Next day, I rang up my cousin Shashi and he fixed up an appointment for me with Dr. V.K Srinivas, Chief Cardiologist at Mallya Hospital, Bangalore for 6 PM on Sat 1st Aug at his Jayanagar Clinic.

How was I feeling? Absolutely fine. I could have played a game of badminton if I had wanted to.

On Sat 1st Aug, Sudha and I met the doctor. By this time, both of us were reconciled to the fact that I had some blockage ( though how many and what was the extent was not known to us).Our main purpose in meeting him was to check whether we could postpone the procedure till the COVID pandemic went away since we didn´t want to risk going to a hospital at this time.

Dr. Srinivas took one look at all the reports and told me that I had approx 90% blockage in one artery and possibly no blockages in other arteries , though that would be known only when the angiogram was done. On the question of postponement, he said that it was risky and there was no point in waiting for an emergency to happen ( like a complete blockage, leading to a heart attack). This way, we could choose the time, the hospital, make all preparations etc. He also showed some pictures of other patients and a video stating how exactly the procedure is done.

He stressed the fact that this was only a procedure, not a surgery, and the whole process would not take more than 30 to 40 minutes max. We were worried about COVID and he assured us that Mallya Hospital is a non-COVID hospital.

I must mention here that we derived a lot of comfort from the way Dr. Srinivas talked to us and finally agreed to get the procedure on Mon 3rd Aug.

What were my feelings at this time?

I am being truthful. I had no worries at all. Yes, there was a slim possibility that I might croak on the operating table, but I knew that enough angioplasties had been done . I did have some fleeting thoughts about things going wrong during the procedure, but I dismissed them instantly.

I had full confidence in the doctor. Tips for readers---- if you do have to get a serious operation done, try to go to doctors whom you have heard about by word of mouth.

Sun 2nd Aug was spent in gathering my insurance papers, packing my kit and clothes, my charger ( very important!!).

Mon 3rd Aug, we reached Mallya Hospital at 9 AM. After the admission process and various preparations, I was wheeled into the OT around 11 AM. At this point, your dignity goes for a toss. Your robe is removed and a narrow strip of cloth is placed down your middle. I felt like King Tut being prepared for mummification except that my hands were by my side and not folded across my chest. Various people will come, lift the cloth and shake their head--- in wonder? envy? pity? I couldn´t guess because their faces were inscrutable behind their masks.

The doctor comes and explains exactly how the procedure is going to be done. It will be done under local anasthesia. There were 3 screens on my upper left side and he advised me to look at the middle screen.

Then he gave a local anasthesia near my inner thigh followed by insertion of the catheter into my femoral artery. This is painful ( inspite of the local anasthesia) and lasts for about 10 seconds.

Then the catheter is inserted and moves towards the heart. 

How many people can say that they have looked deep into their own heart? Well, I did.

Periodically, a dye is injected and the contrast can be seen on the screen. If the dye stops moving forward, or moves forward very slowly, it indicates a block. Such a block was found in my Left Anterior Descending ( LAD) Artery. The doctor showed the block to me and said it appeared to be about 90%. He then took a picture of the screen. This was the ¨before"pic.

He then went out to tell my wife that they had found the block and that they were now going to remove it.

He then moved around the catheter to remove the block and told me that a stent was being inserted to hold up the artery so that it doesn collapse. I could see a rush of some black fluid which was my blood. He then took another picture which was the ¨after¨ picture. Both the pictures were then displayed on two separate screens so that I could see the arteries before and after the procedure. ( Ultimately, it was shown that the block was around 80%).There did seem to be an increase in diameter of the LAD artery after the procedure, but itś not as if it is like a BWSSB pipeline.The change is miniscule but perceptible.But then, that is the difference between life and death.For good measure, he also told me that the entire video would be loaded into a CD and gifted to me.

Did I feel anything in my heart during the entire procedure?  The answer is No.

Did I feel a rush of blood when the block was removed and did I feel a sudden burst of energy flowing through me? The answer is No.

Was there any pain?  No

Was I awake and conscious the whole time? Yes

That is the whole point and that is why heart disease is called a silent killer. In my case, the persistent pain in my chest was an alarm and I¨ḿ glad that I heeded it. Everyone gets some indication or the other. Which one to heed and which one to ignore? A big question and there are no ready answers. However, like I said before, when your gut tells you to get up and consult a doctor, do so.

The entire procedure took no more than 45 minutes . There is some mild pain when the catheter is removed. I was then shifted to another stretcher and wheeled in to the Coronary Care Unit. I was advised not to move my right leg around and , for good measure, my right leg was tied to the bed. I was then put on drips.

Sudha was allowed to see me for a few minutes. I gave her a thumbs-up and told her to go home and come back in the evening.

Now, what to do? I wonder how many of you have seen a WhatsApp video that was recently circulating. It promises to show an award winning short film and then shows just the ceiling for about 10 minutes. When the audience gets restless, the audience reminds them that if they have got restless after just 10 mins, imagine the condition of a patient on a hospital bed who sees the same sight day after day. Well, that was my condition. So I just closed my eyes and went over my working career of 43 years. I was able to recollect instances that I had thought I had forgotten.

There was a hilarious moment too. All of us had to wear a mask so speech was not very audible. I wanted to tinkle, so I asked for a can. The ward boy took more than 30 minutes and finally came in with a floor mounted fan. I had to tell him that I wanted a can , not a fan.

I had mentioned before that I had lost the taste for food over the last 6 months. Now, I felt hungry and really enjoyed my lunch. Since the operation, I find that I am enjoying whatever I am eating. I hope this is a successful after-effect of the operation.

There is not much more to add. 

I had a restful nightś sleep in the CCU and was shifted to a room on Tue 4th Aug. On Wed 5th Aug, I was discharged and came back home.

The entire stay at Mallya Hospital was very pleasant and the staff was extremely helpful and courteous.

If you have found this story boring, my purpose of writing this blog would have been served. For that is exactly what this entire angiogram/Angioplasty procedure is -- an ordinary event like getting a wound bandaged. Of course, there may be exceptions and I am not trivialising the procedure at all.

In conclusion, I must add that , because I was physically very active, the thought that I might have a major block in one of my arteries had not occurred to me at all. Of course, I knew that some blockage was expected over the course of 69 years, but not 80%. Why was only my LAD artery blocked, and why not the others? I have no answer.

I hope I have demystified the angiogram/Angioplasty procedure. I´ll be happy to answer any queries over phone or email or over any comments on this blog.

Tips:

• Get an annual medical check-up that includes an ECG and a TMT.
• If you get a persistent pain in the chest, see a cardiologist immediately.
• If you are a gent and have to undergo a procedure, shave your chest hair. Stickers to hold the sensors for ECG are attached to your chest and if you have not removed the chest hair, removing the sticker causes more pain than the procedure.
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