Tuesday, January 29, 2008

Angina Attack

On Sunday last, I did a very foolish thing. At 8 PM, I took two pills made of "natural" supplements that were to increase my sexual prowess. I took them despite the warning label that clearly stated I should consult my physician before using it. Two weeks before I ingested two of these blue capsules and enjoyed a remarkable session of sexual activity with my significant-other. I had absolutely no bad side effects. So I decided to try the pills a second time.

By 10 PM, I began experiencing tremors far more severe than any my Parkinson's disease ever caused. I also developed a fairly significant chest pain that lasted a couple of hours and was accompanied by sweating, nausea and vomiting -- classic signs of a myocardial infarction. I stubbornly refused to go to the emergency room and by 2 AM, the symptoms had all subsided and I felt well enough to perform the activity the pills were designed to facilitate. The chest pain returned during this time.

I decided to go to the emergency room and I drove myself to the Indiana Heart Hospital. The emergency room staff swung into action the minute I arrived and emergency treatment was quickly initiated. The monitor was hooked up, an IV established, lab work drawn, oxygen provided by nasal cannula. The on call cardiologist arrived soon after this was done and he intervieiwed and examined me. It wasn't very much longer that a doctor from my own cardiologist's group arrived and I was admitted to an observation unit.

This was the first instance of angina that I experienced since completing EECP last fall. In fact, I had not used nitroglycerin and weaned myself off of Imdur specifically so I would be able to use medications like Viagra, Cialis and Levetra. I had Levetra with me, but foolishly used the natural supplement because it had giveen such excellent results a fortnight before.

Well the good news was, I had not had a heart attack. The markers were all negative and an echocardiogram apparently turned out normal. At least I was allowed to leave the hospital a little more than 12 hours after arriving. But I left with the promise to return Thursday for an angiogram. Now, readers of this blog know I am generally opposed to this invasive test and my favorite noninvasive cardiologist is no doubt spinning in his grave because I signed a consent to undergo this cardiac catheterization. But I was faced with three choices.

One, I could continue taking the prescribed medication that has served to keep me from the cardio-thoracic surgeon's blade for nearly four years and not have the angiogram. This choice is the one I wanted to take at first because Dr. Howard Wayne had little faith in this procedure.

Two, I could have the angiogram with the plan of having stents placed or angioplasty performed. Since I am adamantly opposed to stents, this choice was eliminated as the doctor presented it to me.

Three, I could have the angiogram with the plan to have a CABG done after the procedure is completed. I again said this wasn't a choice, with the caveat that if there was evidence thaat the left ventricular artery was partially occluded, I would consent to the surgery. The "Widow Maker" is a vessel not to be played with.

I did agree to undergoing cardiac catheterization day after tomorrow for one reason. I want to compare the angiogram that was performed in 2004 with this new one. It should tell me if Dr. Wayne's medical regimen and the EECP successfully allowed my body's collateral vessel system to develop around the blocked arteries. So in actuality, I am allowing this invasive procedure to be performed so the efficacy of my treatment thus far can be evaluated.

If my body did create a viable collateral vessel system that effectively supplies my heart with oxygen, I feel that will lend credence to my decision to refuse to have a quintuple bypass four years ago. I am scheduled for the cardiac catheterization on Thursday morning. As soon as I come home from it, I will report the findings on thsi blog.


Anonymous said...

Good luck, Jeff!
Just remember that many collateral vessels don't show in angiograms and that you don't have a myocardial infarction (damaged heart), but I think is a good idea to compare angiograms.

Jeff said...

Thanks for the information and encouraging words. I know one of Dr. Wayne's reasons for not getting an angiogram, aside from the fact that it is not a good diagnostic tool is because in most cases there is no baseline test to compare it to. Inn my case there is and I am curious about what it will show.

Anonymous said...

Some of those natural remedies can cause dangerous rises in blood pressure, maybe your angiana was caused by this besides of the physical activity?

I know you know this, but I want to paste this here in case some of your readers is interested:

...the main coronary arteries, the visualization of which is the main objective of coronary angiograms, contain only about 25% of the total coronary blood flow. Indeed, the vast majority of the total coronary circulation cannot even be seen on an angiogram simply because the angiographic technique is unable to visualize vessels smaller than 0.5 mm. A analogy would be looking at a large city from a high altitude. One would be able to see the major freeways but the city streets would be invisible. Thus, if the objective of coronary angiograms is visualize the amount of blood flow to different regions of the heart, it fails miserably.

I remembered how well Dr. Wayne exemplified this with a large San Diego picture :)

My best wishes for tomorrow! You'll be in my prayers.


Jeff said...

Thanks Maria. It was good to be reminded of the road map Dr. Wayne had on his wall.

Regarding the herbal pills I took to enhance my sexual performance: I am convinced the angina attack was caused solely by the pills. My significant-other (My divorce from my wife was final on the 14th of January) is an RN and she monitored my vital signs with me. At the height off the attack, my BP was 180/130 and my pulse was 145. I will not use those pills again, although I must say, two weeks earlier I used them without side effects and with amazing results. Last evening I used a prescription drug - Levitra. It didn't work nearly as well as the herbal pill, but there were no untoward side effects either.

Anonymous said...

I wish you all the best. I am happy to have you in my life. You are my mentor and always will be. Keep us posted. You are always in my thoughts and prayers. From Diane Walker