After a week or so, when the pain kept coming back, even when I was taking the dogs for runs with my bike, I decided to call the doctor. So I called Dr. Kent,, who was the heart doctor I was seeing at the time. I wasn't able to get in touch with him, but I did talk to his PA (Physician's Assistant), and he ordered a Thallium Stress Test for me.
A Thallium Stress Test is a procedure that lets the doctors see pictures of your heart while you are resting and again shortly after you have exercised, or in my case, after they gave me a drug that simulates exercise by putting stress on the heart. They gave me an injection instead of having me run on a tread mill, because my heart rate is so low, that it takes too long, and I get too tired, before I can increase my heart rate to a level they need to take the test. The pictures give the doctors detailed information about how well your heart pumps blood. By comparing the pictures of the heart at rest, next to pictures of the heart during stress, they can tell how much blood flow reaches every area of the heart, and can detect any damage or dead muscle.
In a normal Thallium Stress Test, they hook you up to a dozen or more electrodes, then have you run on a tread mill to get your heart to beat at a certain rate. Once your heart reaches that rate, they give you an injection of a radio active substance. You need to keep exercising for a short period of time (3 minutes in my case). After this part of the test, they take you into a room that holds a gamma-ray camera, used to take the pictures. You lie on a table in the camera surrounds you as it takes multiple images.
Then you move to another room where you rest for a few hours. Then you repeat the process, but without the exercise. So when you are done, they have pictures of your heart during stress, and during normal activity.
The gamma-rays from the camera pick up traces of the radioactive material as it goes through the heart. By looking at these pictures, the doctors can see the healthy arteries, indicated by the radioactive traces, and the damaged parts by the lack of radioactive traces.
In my case, I am not able to run on the tread mill long enough to get my heart rate up high enough for the test. So they give me an injection to simulate heart stress. Much easier since my normal resting heart rate is so low to begin with.
So I went in for the test, which was the fifth or sixth time I have taken this test. After they take the last pictures, the techs read the test and decide if they need to call in a doctor. So when I was done tech said that I could go home and the doctors would let me know. I was almost out the door, and almost out of the building when the tech comes running out and tells me that I have to wait to have a doctor talk to me about the results. I knew right then that something was wrong.
After about an hour I was finally able to see the doctor. He said the he saw some things in the pictures that concerned him, and combined with my symptoms he recommended that I have an angiogram to determine what, if any, damage had been done to my heart.
09/2009
A couple of days later I went in for my fifth angiogram. Deanna took me to the hospital, and it was like Deja vu all over again. To my horror I had the same nurse that I had when I had my open heart bypass surgery. The reason I say horror was because she had a hard time giving me an IV. Now, let me tell you about my veins. You can see my veins from the opposite end zone on a football field. You could see the veins in my arms if you were legally blind. Whenever I am in a teaching hospital, I always get the phlebotomist students that need practice. So when a nurse has to stick me three times and still not be able to draw blood, it's a little annoying. The last time she tried, my wife took over after the first attempt. Of course she had no problem. But this time, Deanna was at work. I toyed with the idea of asking for another nurse, but I gave her one try. It wasn't pretty, but she got it in the first time.
Dr. James did the operation this time. Every time I have an operation, I tell the doctors that the anesthesia that I get always wear off fast, so make sure you give me plenty. I have woken up before in the middle of an operation, and it's not fun. Another doctor did the procedure, and I was still half awake. I told him that I could feel it and that it hurt, but he just told me that I shouldn't be feeling anything. I insisted that it was hurting, so they gave me more - enough to put me out. This time I remember going to the operating room, getting on the table, and watching them give me my happy medicine. The next thing I remember I was in the recovery room.
They moved me to a regular room later, and Deanna was there soon after. She said that when Dr. James called her at work, he told her that I had two occlusions on the new grafts that were put in place a few months earlier. She didn't hear anything after that. So when she got to the hospital, Dr. James came in and told us that while I did have a couple of occlusions, my heart was fine, and getting enough blood, and that my heart was not causing the pain in my back shoulder. He said that one of the grafts never took hold, and that the other one that was occluded never was a large one, and that while it was partially blocked, I was still getting enough blood from the other veins. He told us that he did not know why I was having the pain, but that it was not from my heart. I scheduled a follow-up appointment three weeks later, and we discussed medication. I am going to stay on my Plavix, Coumadin, and Aspirin to keep my blood thin and prevent any clotting until my next appointment in three months.
Dr. James did the operation this time. Every time I have an operation, I tell the doctors that the anesthesia that I get always wear off fast, so make sure you give me plenty. I have woken up before in the middle of an operation, and it's not fun. Another doctor did the procedure, and I was still half awake. I told him that I could feel it and that it hurt, but he just told me that I shouldn't be feeling anything. I insisted that it was hurting, so they gave me more - enough to put me out. This time I remember going to the operating room, getting on the table, and watching them give me my happy medicine. The next thing I remember I was in the recovery room.
They moved me to a regular room later, and Deanna was there soon after. She said that when Dr. James called her at work, he told her that I had two occlusions on the new grafts that were put in place a few months earlier. She didn't hear anything after that. So when she got to the hospital, Dr. James came in and told us that while I did have a couple of occlusions, my heart was fine, and getting enough blood, and that my heart was not causing the pain in my back shoulder. He said that one of the grafts never took hold, and that the other one that was occluded never was a large one, and that while it was partially blocked, I was still getting enough blood from the other veins. He told us that he did not know why I was having the pain, but that it was not from my heart. I scheduled a follow-up appointment three weeks later, and we discussed medication. I am going to stay on my Plavix, Coumadin, and Aspirin to keep my blood thin and prevent any clotting until my next appointment in three months.
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