Issues of the Heart Chapter Seven

In the fall of 2024 the symptoms of a blockage returned again. We headed to Florida to be close to Clearwater Cardiovascular Consultants so any needed procedure could be done by the same doctors as the last three had been. I went in for an appointment in late October and was immediately scheduled into the cath lab.

I went into the cath lab on November 14 to address an apparent blockage. The heart saga continued as I’ve been experiencing some of the tell tale signs that things aren’t quite right – fatigue, chest pressure, shortness of breath, dizziness and a few others.

The expectation was a blockage(s) somewhere, but for some reason my body never actually reveals any issues via the normal tests until they are actually inside looking around. Dr. Stein, who has done my last three stent placements, will be at the helm again.

Visit	Date	Location	Hospital	Procedure	Doctor	Outcome
1	Mar-90	Salt Lake City	University of Utah Medical Center	Cath Lab – Diagnostic	Freedman/Kosak	Mapped electrical short circuit but could not fix except for open heart surgery
2	May-90	Oklahoma City	Oklahoma Memorial Hospital	Cath Lab – ablation	Warren Jackman	Did initial ablation of accessory pathways
3	Jul-90	Oklahoma City	Oklahoma Memorial Hospital	Cath Lab – ablation	Warren Jackman	Ablation of additional pathways
4	Jun-91	Oklahoma City	Oklahoma Memorial Hospital	Cath Lab – ablation	Warren Jackman	Ablation of additional pathways
5	Jan-05	Omaha	Creighton University Hospital	Cath Lab – exploration	Sujimoto	Attempted to open veins – too much blockage so took no action – scheduled open heart surgery
6	Jan-05	Omaha	Creighton University Hospital	Open heart surgery	Sujimoto	Quad bypass surgery
7	Jan-20	Tampa	Tampa General Hospital	Cath Lab – blockage	Fadi Matar	Stent placement
8	Nov-22	Tampa	Clearwater Cardiovascular	Cath Lab – blockage	Bernardo Stein	Stent placement X3
9	Mar-23	Tampa	Clearwater Cardiovascular	Cath Lab – blockage	Bernardo Stein	Stent placement X2
10	Dec-23	Tampa	Clearwater Cardiovascular	Cath Lab – blockage	Bernardo Stein	Stent placement
11	Nov-24	Tampa	Clearwater Cardiovascular	Cath Lab – blockage	Bernardo Stein	Stent placement and balloon current double stent

So it’s been a pretty active relationship with the cath lab the past four years. No explanation as to why except genetics. My test numbers are very good and while the docs say ‘this shouldn’t be happening’, but it is, so they went in to fix it again.

Dr. Stein offered a few possible outcomes:

1. No blockage so just a nice exploration (this would be ideal although the symptoms indicate an issue)
2. A blockage in a new area requiring a new stent (currently have seven)
3. A blockage in an area which already has a stent requiring input of a stent into that stent
4. A blockage in the one area that already has a stent inside a stent. He cannot put another stent in that area and would need to use a new treatment of a medicated balloon unclogging the block and then a transfer of medication that will hopefully prevent it from happening again.
5. An issue with the quad bypass from 2005. We’re approaching 20 years which can become a new problem area. Dr. Sujimoto gave me a 10 year warranty after that surgery so it may be part of the new issue.
6. Any number of other things that could happen.

While he didn’t say it specifically, he spent the most time talking about #4 which would be the most difficult to deal with.

Dr. Stein found the problem areas and addressed as much as possible.

There were three areas of blockage (per the picture):

1. First area was the problem area that already has a stent within a stent. It was 70% blocked. There aren’t a lot of catheter options for that one as you can’t put further stents in so he ballooned it and got it open to 95% It will likely block again, but for now that is a great outcome.
2. Second area was a 75% blockage in a current stent so he opened it and placed a stent inside the stent getting it to 99% open.
3. Third area was 90% blocked and he was unable to do anything with that area. It is in a secondary artery and because of the location and other blockages, there was no way to maneuver to it with the catheter. The only fix for it would be a bypass with open heart surgery. The good news is that this is a secondary vessel, so while he told me to expect some angina (pressure and pain) with heavy physical activity, it should not be much more than an aggravation and at worst I might need to stop what I’m doing and rest for 5 minutes and potentially pop a Nitroglycerin pill.

I was very pleased with the outcome. Dr. Stein showed us before and after videos (isn’t technology amazing) and while he would have liked to clear all three, he got the two more important ones flowing again. I’m grateful for God’s hand on this and even though I know it’ll happen again, I’ve got a new lease on life for a while.

God is faithful, and I’ll continue to do my best to listen to the Holy Spirit and my body to address additional issues in the future.