Search Lobsterland

Thursday, July 11, 2013

To Bypass or Not to Bypass?

My heart is all stopped up.

My brother in law sends me stuff via Facebook about how chelation therapy will fix me right up, just stick a big 'ol suppository up my but and problem solved. Which is a fine theory if I hadn't also heard for years that this exact same nonsense would cure my daughter's autism.

What I've been holding out hope for is stents. I have three blockages, all in that 90% range, but two are up front, the other in the back. The back one is supposedly too long to stent, but a doc friend of mine (internal med, not a cardiologist) says he's seen them 'full metal jacket' things with a series of stents. I already have one in my LAD from a heart attack 11 years ago, that LAD is part of the problem again (I've heard it's nicknamed the 'widowmaker').

But the interventionist who worked on me a week ago Monday pronounced me beyond intervention and sent me to a cardiothoracic surgeon for a triple bypass. About as invasive as surgery gets, and a long recovery period. Months before I can be back to riding my bike to and from work, tending to our two dozen garden beds, etc. Weeks out of work, not good either.

The surgeon seems capable and what he's telling me makes sense, but this still starts roughly like field dressing a deer. So while I'm scheduled to go under the knife next Tuesday, I also have a Friday afternoon appointment with an interventionist at a different cardiology group, one that's supposedly the best in the city. I don't know who ranks these things or by what criteria, but supposedly top 100 in the country.

And after reviewing a CD of my scans from the other chop shop, this interventionist thinks stenting might be possible. I'm all ears.

If there's anything innovative going on, that's probably where it's happening. Even if I still end up having the bypass surgery I might prefer to have it there. Plus the place is half way between work and home, so I will probably pursue my after care and follow up there no matter what.

The only thing I worry about here is getting someone who tells me what I want to hear (that I don't need a bypass) but it turning out that the bypass is my best option. If you are a hammer, everything looks like a nail, so I suspect an interventionist is vulnerable to a bias that stents and balloon angioplasty are awesome, and a cardiothoracic surgeon is likely just as apt to think bypass surgery is the thing. Which one is likely to see me become a senior citizen (I'm 43 now)?

No comments: