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Tuesday, May 14, 2013

After Stent Placement Pain

It has now been five months since DH had his last stent placement.  It still freaks me out a little bit that he developed heart disease so early and so easily.  I mean, yeah, he ate the Standard American Diet from time to time, but for most days of our marriage, he has been a healthier eater than anyone else that I know, personally.  Usually he only ate fatty greasy animal foods, and desserts on Friday nights, and an occasional lunch out at work.  This is a guy that snacks on full heads of romaine lettuce or cabbage right from the bag, but washed, of course, which he has done since I met him.

 It also sorrows me, and I try not to think about it too often, that he has two pieces of metal in his heart.  Yet, twice in the last five months I have had very sobering reminders through his development and reporting of chest pain.

Since the last stent placement, he has reported to me twice (three or four days into each experience) that he has been having chest pains, similar to the ones he had but not as strong as what he had from September to December, when the CTO stent was placed.  

These two experiences, remind me that although he has been repaired, he has not been cured, and that we must be vigilant on our preventive measure to keep his stents and the rest of his arteries from closing up.  This includes monitoring his cholesterol and triglycerides carefully, and frequently, taking his prescribed medications, and being vigilant on the his low-fat plant based diet.

Adding to that protocol is exercise, and this has been an essential tool both for assessment and for feeling better.

One and half weeks ago, he reported to me that he was having chest pains again.  Of course, I wanted to take him right to the ER, but he said, "No, the pain is only at a 2, and I will know when it's time to go and when it's time to take nitroglycerine."  So, I decided to keep the report under advisement and observe him myself to see if he was showing any heart signs, i.e. dizziness, shortness of breath, and distracted looks when I'm trying to talk to him.  He showed none of these signs, so I suggested we go do something fun and distracting.

We went bowling.  He was having a good game, and so was I which makes him happy.  Halfway into the game I asked, "How the chest pain?"  and answered, "You know?  It's gone!"  We decided we could then test out his heart further with a brisk walk later in the day, and still no pain.  So, we walked again the next day, and he never showed any signs of heart disease, no shortness of breath, no dizziness, no fatigue, only a relief from the stress he has been experiencing, and finally, a relaxed and content look on his face.

Both times that DH experienced his multi-day periods of chest pain, once reported to me into the 3rd or 4th day, we tested out his heart with gentle exercise, and when the pain did not worsen, we upped the intensity with no resulting angina, and both times the exercise got rid of the chest pain.  This is why cardiac rehab is such a valuable tool, but he decided not to take advantage of it due to the lack of insurance coverage for that benefit.

Whether the chest pain is cardiac or a non-cardiac in nature, which I believe it is the latter, the first initiation of exercise has eliminated the pain.  Therefore, I believe the pain to be caused by physical inactivity, and either the build up of toxins in the body from being sedentary, thereby causing inflammation, or the stressing and tightening of the chest wall muscles from being under stress and being exhausted from lack of sleep.  During both periods of time, DH was under a lot of work and church work related stress and went for several nights without good sleep. Both times he also developed a cold.

The stress has not lifted up from work, but the daily walks we have been taking since then have helped DH to sleep well, and his outlook and stamina has also been better.  

I am hoping this article will help anyone with post stent placement pain to cautiously ease their minds as post stent placement pain is possible and there are several causes for it, without it being an impending heart attack.

It is my belief that the medications given to heart patients are protective, but if you are eating a high saturated fat diet, post angioplasty pain should wake a person up to changing the lifestyle urgently, not next week, not tomorrow, but this minute, because as Caldwell Essestlyn, M.D reported studies that it takes at least six  hours for a person to recover from a fatty meal, as opposed no recovery time needed for a low-fat plant based meal.  If you are still eating the Standard American Diet, and you develop post stent pain, it's even more imperative to report that pain to the doctor, because all it takes is one meal of saturated fat to injure the endothelial cells and cause damage, and possibly reclotting, and we now know that fragile infant clots cause heart attacks, not the existing plaque.

DH, however,  has been very careful, and he knows that moderation in diet for heart disease patients kills, so we decided to monitor his pain before calling the doctor, through increasing activity (our own little stress test in a sense) to see if exercise induced the pain, which it did not, but relieved the pain.  So we are confident that the pain is non-cardiac.

I am happy to report that DH also not only passed the BSA swim test this past Saturday, but said he could have kept going another ten laps.  Two years ago, we swam daily at the YMCA for the whole summer, and despite his daily exercise, he was fatigued after four laps, and I often noted that his face always got really red when he swam.  Not the case now!!!  So, his confidence, and my confidence in his abilities is increasing.

We do keep it under advisement, however, that this condition he has, we can't know exactly what is going on in his heart without actually taking another look through angiogram, so we are always cautious and keeping in tune with how he feels, never giving up the notion that the cardiologist phone number should always be handy, and the nitroglycerin always in the pocket, even if he hasn't felt the need for it since December.

Best wishes to all of my friends out there who are dealing with the post stent life.  I know what you are going through!