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I flunked my stress test
Wednesday I went in for the stress test my cardiologist had me schedule. I flunked and had to be sent to the hospital. (Somebody said I should have studied more.) While on the treadmill, I began to feel some angina pain. It wasn't too bad--similar to what I had been experiencing frequently over the past four months--like a one on a scale of 1-10. But the tech was watching the EKG I was hooked up to, and stopped the test, had me step off and sit down. Then he informed me he was sending me to the hospital via ambulance immediately. Someone gave me a spray of nitro glycerine (under the tongue), which eliminated the angina pain within a minute or two. They took me out of the room on a stretcher pushed by EMTs. This was the first time in my 65 years I have ever been transported in an ambulance. The ambulance had a police escourt in front and in back. (Actually, I think that was because it had been storming, and there was a power outage that left traffic lights out on the route we had to take to the hospital, across some major thoroughfares--Woodward Ave. at 13 Mile Rd.) I told the EMTs that I felt funny having all this fuss when I felt perfectly fine. It hardly seemed like an emergency to me. But, one of the EMTs said that the stress lab tech had seen something that seemed like I was a heart attack waiting to happen. And he said that if something were to happen, it would be best to be in the hospital when it did.

When I got to the hospital, the cardiologist eventually came and gave me a catheterization. They had to go in through the femoral artery, in the groin. They found two places in one of my coronary arteries that were very constricted (they showed me before and after pictures later), and immediately put in two stints. (That must have done the trick, since afterwards I have not had any more angina pain.)

One of the nurses in that department goes to my church, so it was nice to see a familiar face.

A complication developed a little later. The artery where they had put in the catheter was bleeding subcutaneously, and producing a hematoma. They tell me this is common. Unteated, such a hematoma can become as big as a football. A male nurse discovered it, and immediately began pressing down hard on the area, leaning with most of his weight, to keep the hematoma from getting any bigger while waiting for the bleeding to stop. It must have been exhausting. He kept it up for an hour! Then a doctor--an intern, I think, came in and did it for another half hour. I give them credit for doing a lot of hard work. Finally they were both convinced the subcutaneous bleeding was stopped. Since they were both going off shift soon, and only two other nurses were on duty in that department through the night, they decided to move me to the cardiac care unit, where a lot more staff were around. Obviously they had to keep me all night, to make sure the bleeding did not resume.

I was not able to get any sleep that night. I had to lie flat on my back, not move my right leg (they put the catheter in on the right side), and they even told me not to lift up my head, lest that increase blood pressure on my femoral artery. After a short time, the small of my back began to feel fatigue. Fortunately they gave me some dilaudid, which relaxed me and gave me relative comfort. One of the hard parts was trying to urinate while lying flat on my back. It is possible, using a hand-held plastic urinal, but it was next to impossible to completely empty my bladder. Worse, I was on an IV drip with saline solution all night long, so I had to go every two hours or so.

They let me go home the next day, Thursday. They told me I was not to lift any more than 25 pounds for a while, and was not to drive my car for three days. My brother Bill and his wife went and got my car and drove it home from the office where I had the stress test.

There is still a bruised feeling, and an area about the size of a dinner plate on my groin and part of my leg is dark purple. But there is only a very slight swelling, because the male nurse and the intern were so quick to start treating the developing hematoma.

I think all of the big hospital bills will be covered by Medicare Part A. But the stress test might come under Part B, for which Medicare only pays 80%--the rest is my co-pay. I'll find out how much Medicare covered when I get the bill.

At least the prescription medicines did not cost too much. I receive "Extra Help" for Medicare part D. So the four new prescriptions I had to have filled only cost $2.60 each. Also I was able to get a blood pressure / pulse meter (which I need to use regularly before I take certain medications, to make sure my bp/pulse rate do not get too low) for only $30 or so. My sister had a discount card issued by the pharmacy, or it would have cost $10 more. My doctor thought Medicare would pay for the meter, and did not require a prescription, but the pharmacy did not seem to think so. That is odd, because Medicare did cover 80% of the cost of my blood sugar meter about four months ago.

It is nice to be free of angina pain.
Several years ago a friend ignored his doctor's advice to keep it easy for a while, this caused the stent in his coronary artery to move and he quickly died. So listen to you doctor, I hope you get well quickly.
'It's not who votes that matters, it's who counts the votes'  |  György Schwartz, Budapest, Hungary
Thanks Warbicycle.

The head nurse who went over the prescription medications with me said that one of them had to be taken every day without fail from now on, or I could have an immediate heart attack. She said something about blood platelets and the metalic stents. They are an alloy, made of titanium and (if I remember right) cobalt. Yes, it would be bad if they moved. But after insertion they were spread, so they should be wedged in there pretty well. I think the reason why my condition was not worse despite the constrictions in my RCA artery was the collateral circulation that is usually pretty well developed in people when they get into their sixties. Even if the main coronary arteries are blocked, the additional circulation that has grown up can keep the heart supplied with enough blood to prevent death of tissue. This is one of the few benefits of getting old.

By the way, a few corrections of typos. OK, I used to be an editor, so I should proof-read my work better.

"Stints" is actually spelled "stents."

My "did" actually should have been my "dad."

"Unteated" of course should have been "Untreated."

The verb for the male nurse should have been "was," not "were." I originally started to speak of the male nurse and the intern together, then decided to differentiate, and forgot to change the verb.

I am surprised I spelled "dilaudid" correctly--I was just guessing. S1
You will be in better health once you dump your support for Romney and finally realize that the GOP is the source of all your ills.
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Yes, and you also have to do something about your eating disorder, veganism? Vegetarianism? Keep in mind that you'll be dead next time if the GOP gets its way and slaughters the public healthcare system.
"You know, Paul, Reagan proved that deficits don't matter." Dick Cheney
Actually Q, since I learned a few months ago that I do not have celiac disease and can eat all the wheat gluten I want to, I have gone back to a mostly vegetarian diet, including free use of the meat analogs (Morningstar Farms, etc.). Now I will be getting much less cholesterol in my diet.

Romney is probably the only one who can save the public healthcare system. If sanity does not prevail with the electorate, then by 2014, when the pay deducted from Social Security payments to cover Medicare more than doubles in one year, Obama will pretty much destroy the public healthcare system. Or destroy Social Security. As long as Obama is in office, I can not feel very secure.
As I have previously reported, a little over three weeks ago I had two stents implanted in my right coronary artery via catheterization that went in through the femoral artery in the right groin, and following that there was a complication as the place where the artery was entered by the catheter (which was afterwards withdrawn) began to bleed, and formed a hematoma. This was quickly noticed by a male nurse and then an intern, who spent 1 ½ hours pressing down hard to prevent the hematoma from growing bigger.

About two weeks ago, I began to feel some pain in that area. I went to my primary care physician, and he suggested that the remnant of the hematoma was pressing on a nerve. He prescribed a pain killer and recommended that I have an ultra-sound test done to rule out the possibility of an “AV (Arterio-Vascular) Fistula” (an improper direct connection between an artery and a vein).

I went to Troy Beaumont Hospital to have this done. The ultra-sound discovered that I had something called a “pseudo-aneurysm.” A regular aneurysm is when there is a bulge in an artery or vein. A pseudo-aneurysm is where blood collects outside of an artery or vein.

What this means is that the artery was still bleeding underneath the hematoma. While the pocket was surrounded by clotted blood, the pocket itself contained blood that came out of the artery and swirled around.

I was admitted to the hospital immediately on Friday afternoon. A vascular surgeon using a hypodermic needle, guided by an ultra-sound scanner, injected bovine thrombin into the pocket where the blood was pooling outside of the artery. (Bovine means it came from a cow. Glad it wasn’t porcine!) The thrombin was supposed to make the blood clot immediately. That was especially important, because I am on blood thinners (anti-coagulants) after the stents were implanted in my right coronary artery three weeks ago, to prevent clots from forming on them. I was sent to an observation room where I was checked on regularly overnight. The next day I again received an ultra-sound, and it was found that though smaller, some of the pseudo-aneurysm remained. So I had to be re-injected with more thrombin. The surgeon said he was pretty sure he got it all hardened off this time. The next day I again was checked via ultra-sound, and that confirmed that the problem had been corrected. So Sunday I was allowed to return home.

What this means was that Friday night I had to spend flat on my back for six hours, before I could get up and go to the restroom. Before then, I had to make do with a hand-held plastic urinal, which is difficult to use under those circumstances. You can never completely empty your bladder! Then again I had to do the same thing Saturday afternoon—another six hours flat on my back! Making it worse was the fact that I was connected to an I.V. drip of saline solution, which seemed to go straight to my bladder. (It connected to my arm, but you know what I mean.) It was a good thing I brought a book to read.

The doctors and nurses were very helpful and friendly, and I tried to return this pleasantness (might as well try to make things go well for everyone). When one nurse said something about how sometimes you just have to be patient, I said one of my favorite sayings is “Be patient or be a patient.” Then I added, “But wait a minute—I am a patient.” They enjoyed that. When I was finally discharged, several of them gathered around and wished me well.
I certainly hope you get better real soon Ron. Then you can spend more time here, arguing with me and others. S5

Yep. Thanks, John. I am back home now. Everything seems to be fine. Some of those nurses were really cute--but they seemed so young! How could they be old enough to be R.N.s?
(08-12-2012, 08:04 PM)Ron Lambert Wrote: Yep. Thanks, John. I am back home now. Everything seems to be fine. Some of those nurses were really cute--but they seemed so young! How could they be old enough to be R.N.s?

Its because you're an Old Fart, and everything young looks like a bunch of kids.

You old fart you. S5

Yea, those hot chicks were probably 45 years old!!!

Just messing with ya Ron. Praying for your total recovery bro.
There are two main hospitals in the Beaumont Hospital system, Troy and Royal Oak. When the vascular surgeon was about to inject thrombin into my groin to seal off the pseudo-aneurysm, he asked me where I had had the catheterization done that implanted the two stents in my right coronary artery. When I said it had been done at the Royal Oak hospital, he seemed to nod knowingly to his assistant. I suspect there may be some sibling rivalry between the two hospitals, and he was pleased to note that the cardiac surgeon at Royal Oak may not have withdrawn the catheter in a proper manner in order to prevent bleeding and hematoma, and the ultimate pseudo-aneurysm. I did not question him further; I figured he would not come out in the open and say it, lest I sue the Beaumont Hospital system. But I am not litiginous that way. As long as they got it fixed, and it is paid for, I figure that is good enough.
Beaumont Hospital wanted me to pay over $1200 more than Medicare paid. But I complained about the complications, including the second hospitalization that should not have been necessary to deal with the pseudo-aneurysm, and also I explained to them how little I get from Social Security, and gave them the information they requested to verify my "hardship" status. Finally they agreed that I did not need to pay them anything more.

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