Diabetes and Angioplasty
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Current Postings (29): Bruce, Take it from someone who had a Stent
Thrombosis, its better to wait than end up like me with both. I do
understand the Arthritis, Because I too suffer every day, No only Rheumatoid,
but gout, caused by having too take so much Flurosomide because of
the heart damage. I understand taking pain killers are no fun, but
its better than the alternative. Wait out At least the 12 months suggested
by the FDA and more if possible. You see, I cannot have the surgery
for two reasons, the damage done to my heart by the ST and the fact
I will have
to take Plavix the rest of my life. Good Luck. I just wanted to follow up from my earlier post [March 9, 2007] regarding my angioplasty in March. All is well. No chest pain, no problems with my surgical site. Full work schedule, I own and/or manage 4 construction type businesses working about 80-90 hrs/wk and planning a trip to Disney with my daughter in 2 weeks. My issue remains my severe arthritis. I spoke to my Cardiologist about going off plavix for this. He discussed this with me, the ramifications, etc. I discussed the ramifications of not doing the surgery soon, mainly pain management and quality of life. Pain management means become addicted to narcotics, quality of life means not doing the things I enjoy, such as the Disney trip which will happen along with a big bottle of pain killers! Final decision rests in my lap. Should I decide that in balance, the risk is worth it he will support my decision and allow me to go off plavix for the surgery. The orthopedic surgeon is willing to do the surgery with a possible modification as yet undetermined to my plavix regimen. Also of note, this surgeon would have put me on plavix after surgery to prevent blood clots afterwards regardless. My diabetes is under good control, in part to feeling better since surgery. I have 4 months to wait to the six month point that my Cardiologist would like to see happen before stopping the plavix for a few days. At this point I plan to wait that long, even if I should become narcotic dependant. I am grateful for the support of my physicians, the dedication to supporting my pain control needs regardless, and the trust they place in me to make decisions on my own based on all the facts presented to me to evaluate. I think this is truly a situation where the patient and doctors are working as a team toward one common goal. I am grateful to them for their pragmatic and valuable information, and the trust they place in me to weigh the facts against the quality of life issues and support my decisions. From my cardiologist's point of view I am doing really great, he couldn't
be more pleased, and neither can I because when arthritis doesn't slow
me down, I can do the most strenuous things (I can run up 20 flights
of steps without stopping and feel great at the top) with no symptoms
whatsoever. Nita from kansas, i had three stents placed in both artery and vein back
in 2004, as the stents where placed i had chest pain which i was told would go
away within twenty mins, this i took at face value, i now know different the
chest pain stayed for three years 24/, it was heartburn, chest wall infection,
indigestion, virus you name it i had it.after a lot of pestering i had another
stent placed and at long last i am now pain free, listen to your body the doctors
can only guess what you are feeling if your doctors are anything like the english
ones most of them have hearing problems i wish all of you better health good
luck with the
rest
off your
lives. A Note
to the Forum Editor: I had my follow
up with the interventional Cardiologist that treated me in the hospital-
the one that installed the stents. All went well. My regular MD helped
me make arrangements with the Pharmaceutical company that makes Plavix,
and I was given a three months supply..and, come to find out, my medical
card does cover the generic, and I also later found out that the ambulance
bill was covered in addition to! ( I've yet to see a bill!) In terms
of medication and my heart, I'm doing well, and have even gone on several
long walks- that is when the weather has permitted it... I DO have
one question,though, is it normal for my chest to still be a little
sore? Admittedly, this only happens when my dog wants in my lap, and
gets up against my chest to snuggle. (She's an adult dog, and weighs
in at 45 lbs. Not exactly a lap dog..but, she's still convinced that
she's still as tiny as when she came home five years ago!) Bruce -- thanks so much for your detailed
post. We're glad you found value in this Forum and, as for your motivation
to post a positive story, we also thank you. As we have noted in other
topics, any online Forum such as this can become a "complaint department" and
that's not a bad thing. It's a way of surfacing concerns and very real
problems. For example, our Forum on allergic
reactions to DES is one of the only places on the net
where this potential adverse reaction has
been publicly raised -- and it caught the attention of researchers
who are now enrolling patients from that Forum into a study to
find a test and treatment). But it's very important to balance postings
of complications, etc. with positive outcomes -- which, by the way,
represents the majority of
patients. Your advice to others is also excellent. Stay well and stay
in touch! Just had a Cordis Cypher DE Stent placed on 3/7/2007. I'm home and couldn't feel better. I am 50, a type 1 diabetic using an insulin pump, and overweight. I take Lyrica for neuropathy, Mobic for arthritis, Humalog in my insulin pump, Toprolol to slow my heart rate. The Toprolol contributes significantly to my hypoglycemic unawareness. I wanted to post to thank all that have posted for their comments, all of them were of great value to me and contributed significantly to my awareness and knowledge. Up to the day of the angiogram I had no idea I had a problem. In fact I felt I did not have a problem. I did not feel limited in my physical activity. I generally felt fine, my only symptom was a general awareness that something was wrong. Now I can see that was not the case. Symptoms had crept into my life without me being aware. I didn't recognize my discomfort as chest pain. I didn't recognize my slightly swollen ankles each evening as a problem. I thought it was due to coexisting severe arthritis. I didn't notice I was reducing footsteps because I couldn't handle the exertion. I thought it was caused by my arthritis. The few times I wondered that it might be chest pain, I discarded that notion because not always did I have chest pain when I exerted myself. In fact I shoveled snow without chest pain but didn't notice it wiped me out for the remainder of the day. I visit
my endocrinologist regularly and did not feel my diabetic issues
were
the cause. So often others blamed them as the cause of unwellness.
My concern for general unwellness tempted me to visit my cardiologist
that over the years I visit every few years or so. He has never
felt I had any problems. This time to be sure he ordered tests including
an EKG, Stress EKG, Echocardiogram, and a Thallium scan. All normal
except of a hint of a possible problem on the Thallium scan. At
the
suggestion of the Cardiologist, I had an angiogram Wednesday that
demonstrated a near total blockage of my LAD just below the point
where it begins
from the left main. I wanted to contribute a post for everyone
that was positive and showed excellent results as one of my concerns
of
this forum was there was so much posted about results that in many
cases were poor that it at first tended to skew my thoughts on
such an important matter it began to make me question my own judgment
about the necessity of the procedure when balancing the serious problems
some of us had had. I reviewed statistics from other sites and
spoke
to the physician in detail prior to the procedure. Ultimately I
had the procedure on schedule and am glad I did. I don't know what
the
future holds for me, nobody does, but I am happy, feel great, and
have
a very positive outlook and plan to push forward with life, with
modifications in lifestyle to afford better and healthier living
and do the things
important to me and my family in life. Hopefully this post will
be of benefit to someone and help in awareness that not always are
the
symptoms always obvious, and if not recognized in time the results
could be catastrophic. Read all the available posts and be concerned,
ask the physicians questions to ease your mind, and move forward
with a plan that works for you. Mona -- there are so many variables in what
the best course of treatment should be. Among them are the size of
the blockage, which artery and where in the artery, numbers of blockages,
other factors, such as diabetes. The biggest problem in diabetics
is the high rate of restenosis (reblockage) that's been seen. Some
studies
of drug-eluting stents show significant reduction in this restenosis
rate, specifically in diabetics. But these are questions to ask and
have answered by your sister's cardiologist (maybe you could accompany
her to the appointment). There are risks and benefits from all procedures,
so it's best to get as much information about these as possible. My sister is 64 years old and has coronary
blockage. She also suffers from diabetes type 2 and high blood pressure.
Question is: Is angioplasty recommendable
for her? Thank you. I have no idea what system was used. Some
kind of pump was used for suction . I was told that thrombo suction
is used. The suction machine was used 4-5 times. It was a difficult
procedure but I was lucky that the Dr who performed is one of expert
in India in the field. This forum is great as I am getting lot of information. M. Bhargava -- We wonder if your cardiologist
was using a device that was just approved in the U.S. for vacuuming
out clots, called the AngioJet,
made by Possis? As for medications, you really need to discuss these
matters with your doctor because adjustments to meds are different
for each individual. You are taking perindopril, an ACE inhibitor,
and metoprolo, a beta-blocker. Both lower blood pressure -- in your
case, it's too low, but again, don't change your dosages without consulting
with your MD. Let the Forum know how things work out with BP. Yes have prescribed Clopidogrel 75 mg twice
daily along with other drugs. RCA was 100% blocked due to clot which
was 15 mm long. The clot was before the stent. Complete clot was
removed by suction. The problem now is that my BP have gone low 100/70
while
lying and 90/70 after standing as such I am unable to do any physical
work. I am advised that it is due to medicine (perindopril erbumile,
metoprolol succinate) and will reduce as the drugs are reduced. I
am on diet control.
I
want to know lowering of BP and weakness is normal in case like mine. M. Bhargava -- all you can do is reduce your
risk factors -- take the meds prescribed by your doctor, who knows
your situation better than anyone. Did he/she prescribe clopidogrel
or any antiplatelet drugs? Also watch your diet, keep active, obviously
no smoking, etc. Was the artery blocked by a blood clot? or was it
a reblockage (called restenosis) caused by regrowth of tissue inside
the stent? Hello, I had angiography performed last Monday. My RCA was 100% blocked
due to blood clot. Fortunately my doctor could remove all the clot and now artery
is clear and no new stent implanted. Homocystein level was 19.3 Doc recommend
folic acid. I am diabetic too. How to avoid recurrence of such event. thanks for your prompt reply. Bio divsyl
3.5 x 13 mm direct stenting of RCA was performed at AIIMS, New Delhi.
Our appointment is on Monday with the
same
Doctor. M. Bhargava -- was the original stent in 2000
a bare metal stent? It is certainly possible that the stent may have
restenosed (reblocked) -- if so there are several methods for reopening
it -- a recent study shows that inserting a drug-eluting stent inside
of the reblocked stent is the best method -- this is not currently
approved in the U.S. ("on label") but is commonly performed as an "off
label" use and, as the recent study showed, has resulted in better
outcomes than either plain balloon angioplasty or brachytherapy (radiation).
Let us know how you fare. I am 47 years old. I had MI in 2000 and there
after one stent was implanted. On 28th I had severe chest pain and
was admitted in local cardiac ICU. There is no change in ECG but
the blood test indicate possibility of MI. During test it is found
that
I am diabetic. I would like to know what treatment is there if blockage
reoccurred exactly where stent was placed? I have been relieved from
local hospital and going to larger hospital for consultation. Through
this forum I would like to know of other if any who have gone through
the same problem as
me. Nita -- we wish you luck, but you already
had some good luck. You were at a hospital where
angioplasty/stenting was
done immediately during/after your MI! (This is not always the case.)
Angioplasty is the preferred
therapy for MI right now and probably
saved your heart
muscle
so that
you can
make an excellent recovery. Interestingly enough, your cardiologist
implanted bare metal stents, not the drug-eluting type. This means
you need to take Plavix and aspirin for a shorter period of time --
about 6 weeks. But take them! Aspirin is inexpensive so that shouldn't
be a problem. Check with your doctor/hospital. There may be some drug
plan for people who cannot afford Plavix ($4/day). Bristol-Myer/Sanofi-Aventis
who make Plavix refer people who cannot afford their meds to another
website, the Partnership
for Prescription Assistance, for possible
help. Let the Forum know if this is any benefit to you. As for other
costs, like the ambulance, uninsured patients can sometimes negotiate with
the hospitals, etc. for a lower fee, often 50%. Good luck and let us
know. But please, make sure to take your meds -- they are very important
to a healthy recovery. I am a type 2 Diabetic, diagnosed Jan 2004...Had
a heart attack just this last week. Went to ER, and was almost immediately
taken to the Heart Cath Lab, and had an Angioplasty, in which the
attending Cardiologist implanted two Multi-Link Vision Cobalt Chromium
Stents
in my Right Coronary Artery. I spent a day and a half in CCU, after
which, I was transferred to a regular hospital room. I was up and
around that same evening! I was released a day and a half later. All
and all
I feel far better than I did prior to the Angioplasty, however, I
have TWO huge concerns- the cost of the Ambulance bill, and how I'm
going
to obtain the Plavix I was prescribed. (Meaning my insurance/ Medical
Card doesn't cover for
that particular medication.) Wish me luck!! Sultana, there are certainly those who might
opt for medical therapy (pills) only -- but if your father refuses
to stop smoking, any therapy is really not optimized. The number
one risk factor for coronary artery disease is smoking. The best thing
your father could do is to stop. As
for angioplasty, has an angiogram been done so the physicians can
see
the extent of his disease and decide whether angioplasty
or bypass surgery may help? my father is a 67y old, diabetic (takes tablets),
He has severe angina pain, can only walk a short distance before
his chest and leg pain start. He has been told to undergo the angioplasty
surgery. He is very scared and persistently believes this will make
him more weaker and possible decrease his life expectancy. He is
a
smoker and refuses to give up, he has recently lost his sight in
left eye due to blocked arteries, he still smokes and doctors are surprised
that he has gone on without a heart attack, my father believes he
can
go on as he has done on medications (tablets). please help i do not
know what is the best solution for him, i know there are risks to
angioplasties, how will it affect him? i have discussed it with the
heart doctors
they suggest that my father should accept the surgery and that there
are low risks. i am a bit unsure after researching on angioplasty
cases. please feedback ASAP- the hospital hAVE a booked bed this week
for
my father. Thank you. my co-father had his second attack on last
month. Now he had undergone PTCA and the echo results show that 50%
of LVEF and the LV mildy dialated. What type of angioplasty can be
suggested for this patient. He is now 50 devoid of any type of diabetic
or bP complaint.Now he is under treatment with cardiopril, atocor,
clopigrel, metolar, deriphylin I am a diabetic.I underwent angioplasty to
remove 2 blockages in my Left Circumflex Vessel, in March 04 (Single
Vessel Disease). Since then I have been having a burning sensation
on both sides of the chest and back pain, off and on. It subsides at
night but slowly builds up during the day. I have been taking Pantaprazole
from time to time but have stopped doing so after a week or so. Any
possible reasons? I have heard about diabetics who undergone
PTCA and affected coronary arteries found to be resternosed after 3
to 4 months. I TOO HAVE JUST HAD AN ANGIOPLASTY PERFORMED
- 4TH MAY 2000 - WITH A STENT PLACED IN MY RIGHT CORONORY ARTERY. I
AM ALSO DIABETIC AND ALSO VERY CONCERNED THAT THIS WAS NT THE CORRECT
TREATMENT FOR ME - BUT NO OTHER OPTIONS WERE PRESENTED AS IT WAS AN
URGENT CASE. I AM NOW USING THE WEB TO FIND AS MUCH INFORMATION AS
POSSIBLE TO ALLOW ME TO MAKE A MORE INFORMED DECISION ABOUT HOW MY
TREATMENT SHOULD PROGRESS. I WOULD WELCOME ANY INFORMATION/SUPPORT
FROM ANYONE IN A SIMILAR SITUATION. I am facing a plasty possibly with stents.
I have diabetes but it is very well controlled with sugars rarely above
110 fasting. Also I lost 65 lbs and blood pressure (with norvasc) is
excellent. After nuclear test they said I had some blockage in two
arteries but there was no evidence of heart muscle damage. Would the
caveats about having this procedure with diabetes apply to me? I'm
totally freaked about the whole idea. I was being pre-oped for some
leg surgery to free up a nerve that has been causing me incredible
pain for 22 years. Worst of all the surgeon who did that one miss set
my foot causing the problems I have now. So you can see my fear. Please
e-mail I have to have this done in 2 weeks. The persantine test was
scary enough. Scared to tears in Colorado Several years ago, studies showed that diabetics
don't fare as well with angioplasty as they do with coronary artery
bypass surgery (CABG). There are a number of factors involved, but
with the advent of stents and new technologies, treatments change,
and recommendations must constantly be re-evaluated. If you will look
at the description of the EUROCVS meeting held in The Netherlands at
the end of January on our Meetings
Page you will see that interventions in diabetic patients was a
major topic. As with all these procedures, decisions must be made on
a case-by-case basis. What might be right for someone else might not
be right for you. By all means keep doing research (use many of the
links on our site) and discuss your situation with an interventional
cardiologist. And let us know how you do. Is angioplasty safe for someone with diabetes? Hello, Penny. Allow me to suggest that you
also post these comments to the internet
newsgroups you will find listed on our site, specifically the alt.support.angioplasty
and sci.med.cardiology groups. Hello, I suffered a heart attack on
aug 11th 99 and had a cardiac cath done on Dec. 1. Now my cardiologist
wants to do an angioplasty early next year. I have since read that
this procedure is not advised for diabetics, which I am. I am obese
since childhood, used to smoke and drink. Do neither now. Living
in the Caribbean I am concerned about getting the right treatment,
even I have been told Barbados has the best Cardiology unit in the
Caribbean. I am concerned that I am getting this procedure done and
then still face the possibility of a heart attack. Having read some
comments in the forum, I would like to hear from someone that has
been through it and is in a similar position as me. Thank you so
much.
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