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Posted: 6/17/2009 9:56:07 AM EST
[Last Edit: 6/17/2009 11:37:54 AM EST by Bowman1]
I am the youngest of five kids by about 16 years. The next youngest is my Brother Bob, a guy who is my hero. My father died when I was very young, so he wasalways a role model for me. Later on, when his wife suffered a tragic accident and became virtually paralyzed from the neck down (on a good day, she can eat french fries on her own), he became my hero. Instead of crawling into a bottle or feeling sorry for himself, he picked himself up and carried on. He found the best physical therapy in the country for his wife, and started the process of designing and building a new handicapped accessible place for them to move into. He sold his house, boat, Jeep Cherokee, and Corvette on his own, and was his own building subcontractor to boot. All while working 40 hours a week and keeping the other household up and running. When I asked him about it one time, he just said, "I guess you just do what you gotta do sometimes."

I just got a call from my oldest Sister Becky telling me that Bob was in the hospital with a heart attack. They put a couple of stints in, but I don't know any other details besides that. It's kind of hard to go visit him either, since he is back in Iowa and I live in Maryland. I sometimes think that a thousand miles between me and my family is a good thing. There are times like this though when it really sucks ass.

Man, this is not good...
Link Posted: 6/17/2009 10:09:30 AM EST
He'll be O.K.. My oldest brother had 5 way bypass at 39+ yrs. Since then stints and defibulator. So 16 or 17 yrs later he's on a list for heart and does not have alot of time with out transplant. Enjoy each day as your last, some how.
Link Posted: 6/17/2009 10:12:45 AM EST
Hope he's ok.
Link Posted: 6/17/2009 10:13:32 AM EST
i'm sorry to hear that.

heart attacks have been the cause of death for all of the men in my family that have died in the last 25 years. my dad died of one when he was 52. get your cholesterol checked and have them do an HS-CRP test too to check for inflammation in the body...
Link Posted: 6/17/2009 10:28:13 AM EST
He'll make it just fine. My pa had three, but that's not what put him under (diabetes). I'll pray for the bugger.
Link Posted: 6/17/2009 10:36:05 AM EST
Sorry to hear that. I hope he will be on the mend soon.
Link Posted: 6/17/2009 11:34:08 AM EST
Update: I just talked to my Sister Janine, who went in to see him this afternoon. When I asked her how he was doing, she said, "not good." Apparently he's had multiple heart attacks since they brought him into the hospital, and he's received three stints so far. They're keeping the tube in him for now in case one collapses and they need to give him more. She also said something about a bulge somewhere around his groin (no, not THAT one, another one where it isn't supposed to be.) I don't know what it is, but it doesn't sound good. Anyone have any ideas wtf would be bulging in his leg like that?
Link Posted: 6/17/2009 11:48:43 AM EST
Just a side question:

Does the guy smoke? Overweight? Drink? Exercise?

Link Posted: 6/17/2009 11:52:29 AM EST
Originally Posted By Bowman1:
Update: I just talked to my Sister Janine, who went in to see him this afternoon. When I asked her how he was doing, she said, "not good." Apparently he's had multiple heart attacks since they brought him into the hospital, and he's received three stints so far. They're keeping the tube in him for now in case one collapses and they need to give him more. She also said something about a bulge somewhere around his groin (no, not THAT one, another one where it isn't supposed to be.) I don't know what it is, but it doesn't sound good. Anyone have any ideas wtf would be bulging in his leg like that?


Hematoma or pseudoaneurysm.,

A hematoma is exactly that... a big clot of blood that leaked out of the artery that they catheterized him through. That's no big deal... it'll reabsorb eventually and go away.

The peudoaneurysm is a slightly bigger deal, and they may consult a vascular guy to repair that. You'll know it's a pseudoaneurysm if it throbs with the person's pulse.

Could also be an arterio-venous fistula, but that's a little less likely.
Link Posted: 6/17/2009 11:54:14 AM EST
My family and I will be praying..
Link Posted: 6/17/2009 12:01:40 PM EST
Dude it's a stent, not a stint. It's essentially a small coiled piece of steel that they insert in the arteries to keep them open.

I'm not an MD or a medical device guy so I may be wrong on some of the details, but that's the essence of it.

Good luck to you, your brother, and your families.
Link Posted: 6/17/2009 12:05:34 PM EST
GrayMan is right. The stents are placed in the heart via a long catheter that is inserted in the femoral artery( groin). When that catheter is removed it can cause some bleeding or possibly a problem with the artery wall- pseudoaneurysm. The fact that he has had multiple infarts and is still on the ventilator is not good. Hopefully his heart will recover some function over time.
Link Posted: 6/17/2009 12:36:47 PM EST
I am an nurse/scrub in a cath lab and do this stuff all day long...sooooo

The cardiovascular system can be thought of much like the pipes in your house. Put too much gunk in there and there gonna eventually clog up. So once an artery clogs you "usually" start getting chest pain or shortness of breath. They take you to the lab and a sheath is inserted into your femoral artery. This sheath is about the diameter and length of a coffee straw and has a seal on the end that the catheters can pass through. Catheters are put up to the openings of your coronaries and all of the equipment (wires, balloons, stents) can be delivered through the catheter. A wire is passed through the clog and a balloon is inserted over the wire and inflated displacing some of the "blockage" a stent (which is mounted on a balloon) is inserted and the balloon is inflated. The stent opens and provides a scaffolding for the artery. The reason the "tube" is still in his leg is b/c of the blood thinners he had to receive so that clots did not form on the wires/balloons/catheters. He's probably oozing around the sheath due to the blood thinners causing a hematoma (not really a big deal).


Sometimes while stenting smaller arteries can become "jailed". This means that they are originating at a spot that the stent will cover. Unfortunately arteries that are jailed often close completely off causing small infactions and more chest pain. Eventually the tissue will die or the artery will fill via collateral flow and the pain will subside, right now though I'm sure he's on some pretty good pain killers and is probably a little out of it.

He should be up and around in few days. If a patient comes in and we find they have a narrowing that hasn't completely closed, we stent the area and there home the next day. Unfortunately for you brother it sounds like his completely shut down, if they opened the artery fast enough he may get some of the heart muscle function back, he'll just need a little more time to recover.

If you have any more questions feel free to ask.
Link Posted: 6/17/2009 3:59:24 PM EST
I appreciate everyone's thoughts and feedback. You've all been very helpful in my understanding of what exactly is going on back there.

One of the problems with living 1000 miles away from your family is that all medical information gets garbled in translation. In order to get the straight dope, I called the hospital tonight and talked to Bro's nurse. She told me that he came into the ER complaining of chest pains early this morning, but that his EKG was normal at that time. That's good. They put him into the monitoring ward for further observation, and it was then that he had more chest pain and began to show irregularities in his EKG. The fact that he was under observation in a hospital when it happened though probably helped to minimize a lot of the damage that could have taken place otherwise. Like she said, if there is a right place to have a heart attack, the ER is it.

The only complication he's had (besides the bulge on his groin) is some internal bleeding coming from either his colon or stomach. They think that it's probably a combination of the blood thinners, ibuprofin, and existing stomach problems, but they're going to scope him out to find out for sure. Once they get that under control, they will put him back on blood thinners. A good thing when you have three new stents in you. (Thank you for the correction by the way. I didn't know.)

Someone asked about his health. He is a former smoker who hasn't lit up in about 25 years. I would say he could lost a few pounds, but I wouldn't say he's morbidly obese either. He's just a dude in his 50s you know? He likes to drink, but he's a long ways from having a problem. All in all, he's just an average middle aged guy.
Link Posted: 6/17/2009 4:23:23 PM EST
I'm an average middle-aged guy too. My doctor wants me to loose weight, I take Vytorin and Omega-3 fish oil, and he gives me ECGs and echocardiograms to make sure I will not have a heart attack.

My father died at 63 with heart problems; first heart attack at 52. But that was decades ago. Today, your brother could and should have a complet recovery.

I will keep him and you in my thoughts and prayers.
Link Posted: 6/17/2009 4:43:02 PM EST
They're called stents and I just shot another 3 day conference of Dr's putting them in.
He probabaly had angioplasty or some kind of arthrectomy and then they put the stents in.
Think of it as a roto-rooter job in your blood vessel.
It's an alternative to bypass surgery.

The procedure will restore blood flow to his cardiac muscle and depending on whether he got a drug eluting stent or not, continue to dissolve the plaque in his arteries.
He probably got put on Plavix as well.

Go get a workup, atherosclerosis runs in the family.
One thing I've learned from these gigs is that you are never too young to have a heart attack.

Does he smoke or is he diabetic?
Both are major risk factors.
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