Did you know??

[Boz]

In 1929, Werner Theodor Otto Forssmann, a surgical resident at Eberswald Surgical Clinic outside Berlin, inserted a long thin tube into a vein in his own arm and threaded it nearly 2 feet to the right auricle of his own heart. He then climbed two flights of stairs to have an X-ray taken thus proving what he had done.

He was immediately fired from his position and the paper he published was rejected as a "circus stunt."

27 years later – 1956 Forssmann along with two American researchers received the Nobel Prize for their joints efforts in developing what is known today as cardiac catheterization.

[Reenie]

Re: Did you know??

Wow! Nope, didn't know that. Thanks for the info.

Reenie

[Burton Borrok]

Re: Did you know??

Hey Boz,
I had my first angioplasty (Cardiac Catheterization) in May 1985. At that time it was only being practiced in the hospitals for about five years. While it was being performed I let another doctor attended also, just to learn how it was done – but no touch.

It was a big deal in those days. Immediately next to the cath lab was a fully staffed surgery all scrubbed and set to do an open heart in the event the artery collapsed. In retrospect some of the precautions were extraordinary.

You know that reddish liquid disinfecting soap they use that turns your skin yellow? Well, before the procedure I had to take a shower and use an entire bottle of the stuff. I got out and asked, “What’s next?” What was next was I had to take another shower with another bottle of that soap, but this time I was not to dry myself. I got out of the shower and onto a gurney, and a male and female nurse both began to shave my entire body. The only hair I had left was on my head and a few hairs on my big toes. Everything between was shaved clean. (They said it was in the event they had to invade my legs for a vein to do a bypass.)

With me lying there nude the two of them were discussing everything but what they were doing (and I was getting lots of nicks.) Finally I said, “You’re making me into an Oriental, staining my skin yellow and shaving off all my hair.” I might have been talking a different language for all the reaction I got. It was bad enough to be going in for a then relatively new procedure – they could have been nice and laughed at my joke. Oh well.
Burt

[Boz]

Re: Did you know??

When I had my first catheterization (1995) I remember the procedure was done by a guy they called “Twister”. Apparently there is quite a knack required to get the tiny tip headed down the intended path; this guy must be especially good at it. I keep thinking about the hassles I’ve had trying to snake telephone cable through the walls at home.

Anyway - In the recovery area, the medical assistant charged with applying pressure to my wound told me the story of Werner Forssmann, but took the opportunity to put a plug in for Brigham and Women’s Hospital. He claimed it was actually a young physician at the Brigham that invented the Heart Cath.

Over the week-end I dug up the TRUE story.

Incidentally – my second cath was done this past May – again at the Brigham and by the same guy they call “Twister”. They now perform 40 Heart Cath’s a day there!

[Ronnie]

Re: Did you know??

That's good info! I'll share that with the staff in the Cath Lab, next month

[Burton Borrok]

Re: Did you know??

Yeah Boz,
The tube they use is long and semi-flexible, with an easy curve at the end. As they work there way in, they inject a little x-ray/fluoroscope opaque dye through the tube. They can then ‘see’ the artery with the fluoroscope, and by twisting the tube they can direct the bent tip through any branch in the artery they select.

Once the tube is in the right place, and the blockage is seen, they pass a thinner tube through the first one, with a deflated balloon on the end. They insert the balloon into the blockage and inflate it up to a pressure of seven atmospheres. This widens the artery at that point, and little tiny stretch marks or tears appear in the artery wall. At the same time, the plaque is pushed into the expanded area leaving the artery as open as if there was never a blockage there.

The little tears heal over a period of time, but originally the weakened artery wall would sometimes collapse, completely shutting off the flow of blood. That was why they were always ready to do an immediate bypass surgery. Somewhere along the way somebody got the idea of putting a spring like devise over the balloon – kind of like those Chinese finger tubes that held your fingers when you stuck them in and couldn’t get them out. Only this works in reverse. It is narrow when it is put over the balloon, but expands when the balloon is inflated, and remains expanded to continue to hold the artery open when the balloon is deflated and withdrawn. These handy- dandy little gadgets are called stents, and they make the procedure much safer.

That procedure is called an angioplasty. If they go in looking for blockages but don’t need the balloon to angioplasty anything the procedure is called an angiogram. Now-a-days they usually start off with an angiogram, and if they find significant blockages it becomes an angioplasty. No need to do double work.

When you referred to running wires through you’re your walls, picture this. When the house was being built picture the contractor installing (Romex) pipes throughout the house. When you want to run a wire, you push a long metal wire (called a snake) through the appropriate pipe. When the snake is in place, you attach the wire to it, and pull it through the pipe. Then it’s just a matter of connecting the ends. Simple.
Burt

[Boz]

Re: Did you know??

Yeah Boz,
As they work there way in, they inject a little x-ray/fluoroscope opaque dye through the tube. They can then ‘see’ the artery with the fluoroscope, and by twisting the tube they can direct the bent tip through any branch in the artery they select.
Burt

During my first angiogram, the atmosphere in the cath lab became rather "excited". Reminded me of a bar room during a dart tournment. The Dr., known as "Twister", has a British accent (South African actually) and is a quick wit.

There was clapping and celebration (loud celebratory encouragement) after what must have been a very difficult maneuver. This was when they discovered a myocardial bridge (I spoke of this in an earlier post). They could't wait to rotate one of the monitors so I could look up and see the discovery for myself. Of course the details in the picture were kind of meaningless to me, but I did appreciate their efforts.

Hey Burt? Do you think we've horrified everyone preparing for one of these proceedures??

[Ronnie]

Re: Did you know??

Hey Burt,
The Title of your next book could be "Heart Attacks for Dummies". I've tried to be well read & have a sound understanding of all proceedures & surgeries I've (endured), but you put everything in such easily manageable terms-much less scary than the Web Sites! I truly feel much better about my upcoming Cath-thanks to you!

[Burton Borrok]

Re: Did you know??

Ronnie & Boz,
Hey guys, from the point of view of the patient it is a piece of cake – they don’t even make you get up. Now, how lazy is that.

The normal routine is; you check in early in the morning and they prep you. A bit later in the morning they take you into the cath lab and do the procedure. This normally takes an hour or a little less. After that, they wheel you into recovery and you lay there, and you lay there, and you lay there. After a few eternities they let you use a small pillow, and sometime after that they allow the gurney to be tilted up into a more comfortable position. After four or five hours, when they are sure everything is progressing properly, they let you sit up, and you are usually discharged in time to have a nice dinner.

In the great preponderance of cases that is the routine that is followed. The most difficult part usually is laying flat on the gurney for a couple of hours. (The padding gets to feel exceedingly thin.) The next most disturbing part is at the very beginning, and feels like they are pressing firmly at the crease of your leg. This lasts only about ten seconds and can be compared with holding a small child on your lap and having one of their shoes press into the crease of your leg – and that’s the whole big deal.

Now, remind me sometime to tell you about my fourth angioplasty / Heart Cath. It was a doozy. Suffice it to say it lasted for six hours (three hours a day for two days.) I was laid up for two and a half weeks, and didn’t fully recover for two months. Would I do it again? Six months later I had another angiogram, - but I did use a different doctor that time. (Actually I don’t believe it was his fault. I just had a bunch of underlying ‘other’ problems.)

Ronnie, I like your idea of writing another book. I’ve written two ‘How To Do It’ books already – “Forgery For Fun And Profit” and “Lynching As A Community Project.” The lynching book didn’t sell very well except in the south, but the forgery book was a real money maker.
Burt

[Ronnie]

Re: Did you know??

Burt-
I thought I recognized your name! I happen to have copies of both of your books-what are the chances of that? We'll be in Vegas in a couple of weeks, maybe you could sign them for me!
I've had 3 Caths - 2 went according to plan. The last one, resulted in me being wheeled into the OR, for 2x Bypass (in April), I'm worried that my Cath, the end of Oct will end the same way, based on my chest pains. I hope they get it RIGHT this time!
Your descriptions are perfect.

[Boz]

Re: Did you know??

Ronnie & Boz,
Hey guys, from the point of view of the patient it is a piece of cake – they don’t even make you get up. Now, how lazy is that.

I agree, the heart catheter really isn't a difficult proceedure for the patient.

..... After that, they wheel you into recovery and you lay there, and you lay there, and you lay there. After a few eternities they let you use a small pillow, and sometime after that they allow the gurney to be tilted up into a more comfortable position.

For my second angiogram (May this year), they gave me some kind of sedative. I was awake but couldn't put two words together if I tried. At the conclusion the Dr. used a vascular closure device called an Angio-Seal which was supposed to plug the hole and get you on your feet in no time. In recovery, I promptly passed out and was asleep for 4 hours.

[Burton Borrok]

Re: Did you know??

OK Boz,
So you slept through the part where you lay flat on your back until it falls out. Did you ever think you got the sedative because the doctor didn’t feel all that chatty that day?

Ronnie,
Frankly, I don’t understand how your artery could collapse with today’s use of stents to hold the artery open – and requiring OHS. There just has to be more to the story.

I’ve had four heart caths, my renal arteries cath’d, my iliac arteries cath’d, and I’ve lost count on the angiograms. My fourth heart cath was the horror story though – before the renal and iliac angioplasties. I was admitted the day before to be hydrated and medicated (to protect my kidneys). The angioplasty started by the long tube getting hung up in the artery, and when they tried to pull it out it kept stretching the artery. They were afraid to pull harder for fear of breaking the artery.

They finally did get it unhooked and the procedure continued – for a total of six hours – three hours each day for two days. In placing the stent (just beyond a 90 degree turn in the artery) they damaged the artery itself and had to place a second stent to repair the damage. By the end of the second day my kidneys almost failed, my pressure was down to 70/40, and I had pneumonia and could only croak a word or two.

I was released from the hospital – too early – twice, and when I saw the cardiologist he hit the roof that I wasn’t put on Plavix (a blood thinner). The stents were coated and without the Plavix I could get a massive coronary or stroke. He gave me a prescription and I had it filled, taking three times the normal dose to start. I did pass out on the kitchen floor, and when I tried to get up I passed out again – so I took a nap on the floor. A day later I did have a stroke (thankfully a little one) and when my PCP saw me he called the paramedics and had me taken to a different hospital, where the stroke was confirmed. After three days there I was transferred to an after-care unit for three more days before being released. That killed two and a half weeks, and it took me two months to recover enough to get my renal arteries angioplastied next.

My right femoral artery is full of deposits and no longer affords entry, so they wind up going in on the left side. They prefer the right, and they always think I’m talking threw my hat, and they give it a try. I wind up with entry wounds on both sides.

So you’re coming to Las Vegas ay? Well you’d better give me a call when you get here. Just maybe we can find a time convenient to the both of us when we can get together. I’ll send you a PM with the details.
Burt

[Art Geddes]

Re: Did you know??

My first heart cath was in 1975, went in early in the day, prepped that night, showered in mornig, several hours in cath lab, out in afternoon to my room and flat on back for 6 hours. When i finally stood up to go the bathroom, i filled a urinal, the old metal style ones, threw up, and blew the clot in my leg, geyser style. That got everybody excited. The next day the cardio wanted to keep me in another day but I wanted out, at 20 years old i loved the attention from the nurses.

My mother had a cath in the early 70,s at Stanford that just about proved fatal, they collapsed all her veins andshe arrested. They had given up and they had brouth in a death cert when she sat up and said, "I can't die, I have kids to raise." They made her lie back down and she raised her kids. Caths have come a long way since then.

Art

[Laoshur]

Re: Did you know??

Art,

Your mom was all mom, that's for sure! Glad for all of you that she made it!

Rhoda

[shirleymahoney]

Re: Did you know??

Art

If my mother had sit up like that i would have had a heart attack for sure


Art you are from my neck of the woods, i'm from Tulsa, My sister worked at the Knotty Pine BBQ resturant for years her name is Karen

Shirley