Paul's Heart

Life As A Dad, And A Survivor

Archive for the month “January, 2020”

“LIMA” Update

Every now and then, I have a post that validates why I began writing “Paul’s Heart” years ago.  My blog is about helping and advocating for several causes that have personally impacted me over the years, from cancer to survivorship, adoption, and divorce issues (in particular parent rights).

The other day I wrote about a procedure called “LIMA”, known as the Left Internal Mammary Artery, often used during heart bypasses, as was in my case.  Over a decade later, a symptom that I have had since my bypass, and occasionally and spontaneously pops up, and undiagnosable, had finally been explained to me as a very likely possibility, as a “LIMA attack” or as my cardiac nurse also described it, a “lightning strike.”

It turns out, I am not the only one who has not only gone through a LIMA bypass, but also has these attacks, and they, also not able to have these attacks explained to them.  I had more than a dozen readers/survivors who experience these same issues.

Having this “new” knowledge, I will be having a discussion with my cardiologist, as well as primary care doctor, for their input on these attacks, and what they feel if and how it could affect me.  Please know, as I always do, I will share that discussion with you when it happens.

My Arteries Were Not The Only Thing Opened Up

Of all the side effects that I had to deal with following my double heart bypass, caused by damage from radiation therapy for my Hodgkin’s Lymphoma, extreme pain, weakness, the one that really caught me off guard, crying.

Those closest to me, know that I am a fairly tightly wrapped emotionally restrained individual.  You will have no problem seeing when I am happy, annoyed, sometimes bored.  But if there is one thing that no one witnesses, it is crying.  Well, at least it used to be that way.

There was a time that I attended multiple funerals over several days, or had other reasons to be sad, and nothing, not one tear.

During my recovery at the hospital, as I regained strength, and my body began to heal, I had not other reason to be concerned about anything else.  Everything was going as it should.  I even got to sneak in a hockey game, something the nurses were not happy about, and could tell I was watching the game, by the reaction on the monitors they were watching.  I thought I was being sneaky when I heard them coming toward my room and would change the channel quickly.  I fooled no one.

I was not expecting what happened once I returned home.

My second wife was fond of watching daytime soap operas.  And I will never forget the title, nor the character that changed my life forever.

I had just arrived home earlier that morning.  And my wife was settling in herself after having gotten me all settled in my nesting spot for the next several days.  She was ready to resume her life, and that meant watching her soap operas.  A favorite of hers, was the Young and The Restless.  I had seen it before, and as far as I was concerned, it was not different than all of the other soaps on all the channels.  That is, until…

The Y&R story line was taking a dramatic twist with one of its characters, Victoria Newman.  Like I said, I remember this only because of what happened, as I do not, and have not, watched these dramas ever again.  Newman’s story had her undergoing open heart surgery.  The first shot of her “recovering from the ICU, I burst into tears.

What the Hell?

I have watched plenty of other things involving surgeries and blood and stuff and I had never reacted that way before.  I was literally bawling.  I could not even remember the last tear I shed or why.  And I have been through enough to have had reasons to, and did not.  Why now?

My wife turned to me.  I know for sure she had never seen me like this before and lightheartedly asked, “what’s wrong with you?”

Me:  I don’t know.  I have never felt this before.

And then it hit me.  That was me less than a week ago.  I could see what was happening to her, was me just the prior week.  I came home with a copy of the surgical report, and pulled it out to read.  I will do a post about that another time, but there it was, step by step, how doctors saved my life.  The reality set in, I was going to die.  Seeing this played out on television was as they say “too fresh” for me.  That said, I still cannot get through any scene involving the heart or cancer.

I still have no idea what caused me to lose control of my tear ducts, and it continues to be a problem for me, though normally now only while watching movies about dogs.  “The Art Of Racing In The Rain” destroyed me, because the movie made me wonder the perspective my own dog may have had as I fought for my life.

The other times my eyes will flood, any thoughts of, or events with, my daughters.  The thoughts of how close I was to losing them forever, now cherishing every new milestone, I am proud of the tears I shed for them.

“LIMA” Attacks

You can relax.  I am not referring to the capital of Peru.

A different world completely, I am referring to the world of cardiology, LIMA, known as “left internal mammary artery”, used in coronary artery bypasses in certain circumstances.  And in my case, my life-saving bypass procedure was done via “LIMA.”

The surgical procedure of redirecting blood flow around a blockage, using a grafted vein, is called a bypass.  A patient may need to have any number from singular to five bypasses to avoid a fatal cardiac event.  Typically, the patient’s own body will supply a vein from their own body to be harvested and used to perform this bypass.  This vein may come from the arm or the leg.  Depending on the circumstance, like my unique health background, upon removing a vein from my leg, realizing it had been compromised due to radiation therapy for my Hodgkin’s Lymphoma decades ago, my surgeon had no other choice than to use a “mammary artery.”  In fact, the mammary artery used, was actually split to bypass a second blockage, not just the major blockage of my left anterior descending artery.

There are pluses and minuses to this option.  A big minus to the LIMA is, there are no other options from my own body for any future bypasses.  The condition of my veins in my body leave them unusable.  So, if I were to need any further bypass procedure, I would guess I would either be looking at cadaver or pig veins.  But I am not going there, at least not yet.

The plus to using the mammary artery, the one end is already attached, meaning only the end on the other side of the blockage needs to be attached.  Plus, being an artery, it can handle a higher pressure than that of a vein.

That is as technical as I am going to get on this post.  Because as the title suggests, something has been getting my attention.

Prior to my bypass, I had symptoms for four months.  I ignored them, but they definitely got my attention.  My father had a major heart attack.  So I understand following my bypass, I need to listen to my body when it gives warnings.

For the first three or four years, my recovery from my bypass was flawless.  Of course I was dealing with my other late developing side effects from my treatment now making themselves known.  But in February of 2013, I developed a pain in my left breast, that left me paralyzed where I stood, afraid to move.  Afraid that one simple step towards help, might trigger a fatal cardiac event.  This pain lasted about a minute, and upon its relief, I went straight to the hospital.  Doctors all agreed that something had happened, but were unable to determine just what, and sent me home.

Fast forward to the end of the summer of 2019, I would have several of these mini episodes of that similar pain.  Knowing that it was nothing of real concern based on the last episode, I was not worried.  And again, these “attacks” subsided.  However, in September, one of these attacks came on, and it did not stop.  I was afraid, this was going to be “the real thing”.  At the half hour point, I made the decision to go to the emergency room.

Treated with nitroglycerin (not enough to explode me to pieces) to open up my circulatory system rapidly (warning… major headache was a side effect), the pain was relieved.  But once again, extensive testing revealed nothing.  Repairs that I had done previously were all in tact.  Doctors did not doubt that something was happening.  They just were not able to pinpoint what.

So, as I qualified for cardiac rehabilitation due to the stent I had placed in another major artery earlier in the year, I complied with the 3-day-a-week regimen for the last several months.  And again, being monitored, my body is acting and behaving the way it is expected to.  And then on Sunday, another one of those attacks came on, but like the older ones, minor and short in duration.

As I am prone to do, and as I have mad respect for them, I find that you can get a lot more information, and time, in talking to a nurse than your actual doctor (I am lucky that I am able to have this luxury with both doctor and nurse).  It was during a recent cardiac rehab session that I mentioned this “attack” to the cardiac nurse.  And that is when she told me about… “LIMA attacks.”

She described them perfectly as “lightning strikes.”  Now, while I have never personally been struck by lighting to explain how that feels, the description of quick and short in duration, and attention getting, fit perfectly to a lightning strike.

It turns out, these attacks are actually common for those who had LIMA bypasses.  Who knew?  She assured me that while they are uncomfortable and alarming, they do not foreshadow any pending cardiac event.  I have an upcoming appointment with my cardiologist, when I will ask and get a much more detailed explanation of this phenomenon.  I want to make sure that I explain it accurately, not just for those reading this, but for my sake as well.

Post Navigation