My personal thoughts about life with a disability and all other things I consider important in my life.

Monday, April 14, 2008

A Vascular Surgeons Dream

That's what Mom's surgeon calls her.

To recap the last few months, Mom has had 4 angioplasties. Actually, 1 ended up being an angioGRAM, which means the docs just looked around. But we got some great pictures!

Our local renal vascular dude couldn't, well, revascularize her kidneys. 1 is dead. DRT - Dead Right There. Her other was about 85% occluded and he couldn't get the catheter into the arteries (she has 2 to that kidney), so couldn't stent. The only option was renal bypass.

Now, when I started this blog, it was covering just ME. It was a pity party. Still is, mostly. But there are so many hidden medical problems that cause morbidity (disability) and mortality (death) that it's coming to me that I need to expand. So - I'm going 1 step out and talking about my mom.

With Mom having 3 very inquisitive children, she soon found out that there were other options besides renal bypass, the odds of success with renal bypass, the frequency with which her condition (renal artery stenosis, or RAS for those in the know) occurs, signs and symptoms of RAS, survival rates after going into renal failure with RAS, and a slew of other odds and ends. I'll write about those later.

What my sister found out is the hospital she works at has a head surgeon who actually advertises his email! Ha! So she had no clue he was the grand poo bah (her words) of surgery when she emailed him. Had she known, she probably wouldn't have, thinking it not appropriate and we wouldn't be where we are today. And where we are - is in the best dream a vascular surgeon could ever have.

He was able to stent her kidney. The first artery - which he thought would be the most difficult - went flawlessly. That stent was placed just like it had always lived there. The second artery was a bit more problematic. It took an hour just to get the catheter placed. But, then went beautifully.

Since then, she has had her right arm (subclavian artery) stented, which means she now has a pulse in that arm again and is scheduled to have her right leg (femoral) done April 24. Her right arm is now warmer than her left, which means she'll probably have to have that one done sometime in the future.

One good note - her carotid artery (the one open one in her neck) is staying at about only 60% occluded which means they won't touch it until at least next year. Since it's been at 60% occlusion for about 5 years, I'm guessing it'll hold its position. We all are since her cardiologist down at my sister's hospital says she can't handle a stent being placed and would need a full endarterectomy. We don't want her sliced open if we can avoid it.

But her right femoral artery is 80% occluded. Which brings me to another post - how pissed I am at her local docs.

For YEARS she has complained about her leg being weak, getting tired quickly, aching and feeling numb. For YEARS they stated it was NOT vascular. Even last year during her open heart surgery, the vascular surgeon stated there was no way it was a vascular condition. And here we are, hoping it can be stented since a bypass would most likely be out of the question.

So, between her RAS being totally missed and BOTCHED, her right leg is in danger as well. Smooth move exlax.

And so this year continues. 3 trips out of town so far, and at least 2 to go.

Her blood pressure is coming down. Before the kidney work, it was holding steady at 180-190 systolic. After the kidney, it was holding steady at 160-170 systolic. Since the arm was stented, it was holding in the 140's, but over the weekend crashed to 90 systolic. We reduced one of her meds by half during the time it crashes to keep it up between 140 and 160. Considering how quickly it has dropped (within a month's time) and her risk for stroke, I am not letting it get that low again. Ischemic stroke due to a shock-like BP - take your BP and then drop it by half within 30 days. See how you feel. Anyway, a stroke due to her BP crashing is not the way things should end.

We take her pressure at least 3 times a day to make sure all is on an even keel.

Slowly, she is feeling better. Each stent brings more relief, more energy and more hope.

For me, it brings no physical relief, but hope things will improve for all of us in this house.

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