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My Mother’s Story – Cardiovascular Disease: Quick Update–Right Femoral Stent Insertion

White Rose_10% In her own words two days ago, my mother, Marie Bond, said:

“I’m doing okay. My arm hurts, but I think it is the clamps and it will feel better when he takes them out Wednesday. Betty is taking me for a 10 AM appt. I did manage to do a load of laundry today, so that was good. It is all folded and away. Tomorrow I will do towels. Getting around good and sleeping well so that is all good.”

After the surgeon removes the clips from her left arm today, Mom should be “free.” It is our fond wish that she will not need any further procedures and that she can return to her volunteer work at the hospital soon. Her friend Betty–who has been ultra-kind in taking her to various medical appointments–is also a hospital volunteer.

I’ll post another update if Mom has any news after her appointment today, but all seems to be well. So no news is good news!

P.S. OK, some news is good news: Mom just called and said the doctor removed the clips from her arm. He showed her the before and after films of her leg so she could see how much the stent improved her circulation. She doesn’t have to return to see him for six weeks–and at about that same time she can return to hospital volunteering after being off since her heart attack last March. Very nice!

For background, enter “My Mother’s Story” in the Search box to read about her stent procedure on November 25, 2013. More will be coming about her long battle with heart and peripheral artery disease this past year.

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My Story – High Cholesterol: A Family History of Cardiovascular Disease

White and Blue Daisies_10% One more–and one less–thing to worry about: heart disease. Maybe.

We all need to be aware of our family history as we embark on our personal travels through the world of healthcare and health and well-being.

As discussed in the “My Mother’s Story” posts (see this morning’s update), my mother, Marie Bond, had a heart attack in March 2013 followed by cardiac bypass surgery. She didn’t even know she had heart disease, even though she had known peripheral artery disease (PAD), and her 91-year-old sister, Cecilia Braddock, has a defibrillator-pacemaker. Even more alarming, their mother, also Cecilia, died at age 42 of chronic endocarditis (inflammation of the inside lining of the heart chambers and heart valves) and acute dilatation (enlargement) of the heart. My aunt remembers my biological grandmother, but my mother does not. They had a wonderful stepmother, and Madeline Braddock is the nana I grew up with. I’ll be talking more about my mother’s medical history at a later date.

My mother was put on Plavix (clopidogrel) and baby aspirin (both are anticoagulants, or blood thinners) after her heart attack and also on a statin drug, Lipitor (atorvastatin) 20 mg, as a precaution because her total cholesterol level was a little high at 200 mg/dL (it should be 199 or less). The drug and a low-fat diet brought it down to 137, which is very good. My father was on a statin drug for high cholesterol some years ago. He had a diet rich in fat, which my mother does not–but he refused to change his habits. Also, I recall his saying that he stopped taking the statin because of acute muscle pain, which is a known side effect in some people. (My father died in 2008, but not of heart disease. He also had colon cancer at a younger age, which was cured with surgery alone. It was COPD–chronic obstructive pulmonary disease that caused his death.)

When I went for my pre-D&C blood work in October, my total cholesterol level was 263–dangerously high–and my LDL (low-density lipoprotein, “bad” cholesterol) level was 161–also dangerously high (it should be 99 or less). The only good news was that my HDL (high-density lipoprotein, “good” cholesterol) level was 78, which is high and good (it should be 39 or more in men and 49 or more in women according to the American Heart Association). My doctor warned me that I was at high risk for heart disease and advised me to go on a statin, which I didn’t want to do. She had tried putting me on the non-statin cholesterol drug Zetia (ezetimibe) some months ago, but I had gastrointestinal side effects and lightheadedness and stopped taking it. I told her I’d been on a statin in 2007 and had associated muscle pain, but she said this wasn’t in my records (!). Fortunately, I keep my own records; but by the time I’d looked them up and found that I had been on Zocor (simvastatin) six years ago, which I believed caused my muscle pain, she had already ordered Lipitor 10 mg. So I decided to try it because she said Lipitor is a more effective and safer drug than Zocor. So I started taking it on October 29, 2013.

Earlier this week when I had my pre-hysterectomy blood work done, my doctor also tested my lipids. This was two weeks earlier than she had intended, but I was fasting (needlessly, as it turns out, for the pre-op tests), so she decided to save me a trip (I’ll be otherwise occupied in two weeks anyway). When she called with the results, we were both very surprised—and pleased—to learn that my total cholesterol had dropped from 263 to 178, and my LDL had dropped from 161 to 90; my HDL is still good. And this happened in just under four weeks of therapy and on a very low dose.

Fortunately, I have not experienced muscle pain with Lipitor. My only reaction has been some relatively minor gastrointestinal changes, although I’m under a lot of stress because of the upcoming surgery—a significant contributing factor. My gastroenterologist also said that uterine cancer can cause GI symptoms. (We’ll know whether I have any new GI problems after my colonoscopy and esophagogastroduodenoscopy [EGD] on December 11–two days before my hysterectomy.) My family doctor had advised me to take the supplement CoQ10 (coenzyme Q10), a natural substance similar to a vitamin, to reduce the risk of muscle pain, and I have been taking it.

So although I’ll need to stay on Lipitor indefinitely–I’ll have my cholesterol checked again in three months and then at six-month intervals after that–at least something about me is “normal.” Although I had resisted taking cholesterol medicine, at the moment I’d say it’s very much worth it.

Oh—and I am modifying my diet. But not tomorrow. Thanksgiving is, after all, my favorite holiday.

My Mother’s Story – Cardiovascular Disease: Right Femoral Stent Insertion Monday

White and Blue Daisies_10% In yesterday’s post, I gave a brief summary of the stent procedure that my mother, Marie Bond, had on Monday for arterial disease. Here’s an update.

Last night, she was transferred from ICU to Telemetry. She had had to go to ICU after the surgery Monday because she takes Plavix (clopidogrel) and baby aspirin, both blood thinners (anticoagulants) used after a heart attack, which caused a hematoma (pooling of blood) in the wound area of her arm where the stent had been inserted and then routed to her right leg.

I called her this morning, and she sounds fine. She was sitting up in a chair waiting for the surgeon to come in, which he did while I was on the phone, so I heard the conversation. He said she was doing very well. As soon as Physical Therapy comes in to make sure she’s stable enough to walk on her own, she will be discharged to home. She has to return to see him next Wednesday to have the clips (staples) removed from her arm, which is still very sore but seems to be healing well.

So all seems to be well with Mom at 8:00 AM.

And she can go to Thanksgiving dinner with us tomorrow.

Thanks for your concern on her behalf!

My Mother’s Story – Cardiovascular Disease: Right Femoral Stent Insertion Yesterday

White and Blue Daisies_10% In yesterday’s post, I gave a brief summary of the medical challenges my mother, Marie Bond, has faced this year and described a procedure she was having yesterday for arterial disease. Here’s an update.

Yesterday, my mother had a right femoral angiogram, angioplasty, and insertion of a stent to increase the blood flow to her right leg. Access was by way of her left brachial artery, through the aorta, and down to the right femoral artery–a long way around from the left arm to the right leg.

The procedure was done fairly late in the day, but went well. Last night, she had to go back in the OR because of a hematoma at the insertion point in her arm, mid way between the elbow and shoulder on the inside. She takes Plavix (clopidogrel) and baby aspirin, both blood thinners (anticoagulants) used after a heart attack, and evidently hematoma formation (pooling of blood) is a common problem because blood pools in the wound area. The procedure to clear it up also went well, although they transferred her to the ICU instead of to a regular room. The original plan was to send her home today, but we’re still waiting to hear.

I just talked to my mother on the phone, and she sounds a big groggy from the two twilight anesthesias yesterday. Otherwise, she sounded good and said she felt fine except for her left arm, which is swollen and sore. The doctor checked her pulses and said they sounded great–in both legs. Apparently improving blood flow in one also has benefit in the other.

My mother is in a suburban Pennsylvania hospital that we’ve all been pretty impressed with, and she seems to have found a very good vascular surgeon.

So we do have things to be grateful for, even though we don’t quite know what our Thanksgiving will look like on Thursday. . . .

My Current Story, Update: Medical Monday for Me–and Also for Mom

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My Current Story, Continued – da Vinci Hysterectomy Scheduled for Friday, December 13

As I mentioned in the November 22, 2013 post, which really wasn’t much about me and was mainly about healthcare delivery and reform (it has important links–take a look), I need to go for my medical clearance visit with my family doctor today to prepare for the hysterectomy in 18 days (see the My Current Story” posts and updates). Last week, I received three phone calls from her office about today’s visit after getting conflicting instructions about whether I had to fast for the blood work–I was given alternating yes and no answers, depending on whom I spoke with. I decided not to take chances and started fasting after breakfast this morning–you need to stop eating and drinking everything but water for 8 hours to be considered fasting, so I should be OK for the 4:00 PM appointment.

Medical clearance by a family doctor includes a brief physical examination; blood work (which is good for 30 days), including a complete blood count (CBC) and a complete metabolic profile (CMP–this is why I have to fast); urinalysis (UA); EKG (which I had done in October before the D&C and is good for six months, so that’s one less thing needed today); and a chest X-ray (which will be good for one year should I–heaven forbid–need another procedure). During the visit I also need to discuss when to stop taking prescription medications before the surgery.

I wish doctors would take a few minutes to educate their staffs about such simple matters as office-visit preparation, but maybe it just doesn’t occur to them (?). I’ll mention it, gently, when I see my doctor today.

Now, I have another story to tell–or at least to begin. This one is about my mother.

P.S. During my visit with the doctor this afternoon, I mentioned the confusion about fasting. She said you never have to fast for pre-op blood work and that a nurse probably told the receptionist I had to fast because glucose level is part of the testing. But the fasting was not in vain because she was also able to test my lipids (for cholesterol) so I don’t have to go back for that in two weeks, when I will be otherwise occupied. Also, I called the radiology center at 1:15 to try to get a walk-in appointment for my chest x-ray at 3:00 and did. So the appointments today went very smoothly for me. And I was grateful for that and for my family doctor, who is new to me (and young!)–she showed the right combination of professionalism and concern.

But things didn’t go quite as smoothly for my mother, as I will describe in tomorrow’s post.

My Mother’s Long Story, Ongoing – Procedure for Arterial Disease Scheduled for Today

Last March, my mother, Marie Bond, had a heart attack, for which she had cardiac bypass surgery. I will discuss heart disease and treatment in a future post–a very important topic.

But this was just the beginning of a very tough year for her. She had a major complication following surgery–not with her heart, which did fine, but with a MRSA (methicillin-resistant Staphylococcus aureus) infection in her feet that she had picked up in one of the medical facilities. This went undiagnosed for a few weeks. I will also be discussing this insidious problem in a future post.

Fast forward to June, after the MRSA had finally been identified and was being treated–but wasn’t healing, and my mother needed an urgent appointment with a vascular surgeon for poor circulation in her right leg. He found no pulses, which is why the MRSA infection wasn’t healing in that foot, and he also said she was in danger of losing her leg. She had known peripheral artery disease (PAD) that had gotten worse. I will also discuss this serious problem later.

The surgeon performed an urgent right femoral-popliteal bypass graft using a vein from the same leg and also a femoral endarterectomy to remove the plaque buildup in the artery to restore the blood flow in her legs and feet, which was successful. (Apparently, she obtained some benefit to her left leg from the surgery on her right leg.) Over the following months, she slowly got stronger. But she needed repeated visits to the Wound Care Center for an open, unhealed area in her groin and for the MRSA that was slowly disappearing from her feet.

Recently, she had an ultrasound to determine how good the blood flow to her leg was. It wasn’t. She saw the surgeon again last week, and today he is scheduled to do a right femoral angiogram, angioplasty, and insertion of a stent by way of her left brachial artery–a long way around from the left arm to the right leg, but he can’t take a chance on reopening the groin wound. The procedure should take about 1 1/2 hours. If all goes well, she will be in the hospital just overnight. Her left arm will be sore from putting the stent through it, but she should be OK to go out to Thanksgiving dinner with us on Thursday.

Thanksgiving 2013

This will be an interesting Thanksgiving. I usually have dinner here, but this year I’m giving myself a break. Next year, all the fancy linen and dishes will come out, and we’ll have a house full of people to celebrate with. And I won’t mind wrestling with the turkey at all (as long as there’s wine–I can wrestle with almost anything if there’s wine).

In the meantime, we do have things to be grateful for–including the medical interventions that are saving our lives. And my son, Matt, will be coming from Boston to join my husband, Farok, and me, along with my mother and her 91-year-old sister, Cecilia Braddock–who also has heart disease, but is doing well. It is worth noting that their mother, my maternal biological grandmother, died of heart diseas eat the age of only 42. My mother was still a baby at the time.

Look for an update on my mother soon, as well as more information about her various medical challenges–these problems affect so many people