Coronary Artery Disease (CAD)
Millie knew something was wrong with her one weekend in 1990 when she went to Iowa to visit her daughter. She just didn't realise how serious her condition was. She had a crushing feeling in her chest as well as shortness of breath. "I just felt lousy," Milllie recalls. Milllie, who lives in suburban Minneapolis, says she didn't tell any family members how she was feeling, but at the end of her visit she drove straight home without her usual stop for lunch. She saw her doctor the next morning.
The doctor examined the then 65-year-old Millie and said, "Lady, you're in trouble." He explained that Millie had coronary artery disease – narrowing of the arteries in her heart. Millie was devastated. The doctor asked Millie about her lifestyle and risk factors. She was a fairly active nonsmoker. She enjoyed golf, bowling, cooking, playing cards, and family activities.
Unfortunately for Millie, she had a family history of heart disease. Her father had had a heart attack and her mother had congestive heart failure. "That's why I tell my kids, 'You'd better be careful!'" says Millie.
The doctor scheduled tests for Millie to determine her heart's ability to function and which vessels were blocked. He then performed an angioplasty – a procedure to help open the narrowed vessels. The doctor also prescribed two heart medications for Millie – diltiazem HCl (commonly known as Cardizem®) and nifedipine (commonly known as Procardia®) – to maintain proper blood pressure and flow.
Millie says she felt better after the angioplasty, and she heeded her doctor's warnings about changing her diet and getting even more exercise. "I became quite a label-reader," says Millie. Her family was greatly concerned about her health. "They watched me like a hawk. If I reached for the butter at dinner, I'd get a slap on the hand!" she joked.
"GG [Millie's nickname] has always been stubborn when it comes to admitting she's feeling under the weather, but this time it was different," says grandson Kirk. "Even though she always hid it well, we could really tell she was having a hard time with even everyday tasks. While out on a walk, my young daughters would ask, 'Why does GG need to take so many rests?' We knew something needed to be done; she just wasn't herself."
At the end of 1997, Millie again experienced a crushing feeling in her chest and shortness of breath. She went straight to the emergency room. Once again, doctors performed tests on Millie's heart and determined that she needed another angioplasty procedure. This time, her doctor also placed a stent in one of Millie's heart vessels. A stent is a tiny device that supports a vessel and helps it remain open for adequate blood flow.
More than 2 years passed, and the familiar feelings of fatigue and shortness of breath became more and more prevalent. "GG would experience these ‘spells' – like mini heart attacks," says her daughter Jan. "That in itself was a constant cloud over her head, worrying that she could die."
Millie entered the hospital in September 2000 for yet another round of tests. At first, she assumed that she was headed for another angioplasty procedure, but her cardiologist was concerned about one of her coronary arteries. It was extremely narrow, and performing angioplasty on it could cause a heart attack or stroke. The doctor told Millie that heart surgery was the best choice.
"I was scared stiff. I told everyone [her doctor and her family] that I wanted to go home, think about it, and come back in a couple days," says Millie. Her daughter refused to allow this. "It was probably good that I stayed in the hospital. I would have just gone home and fret about it." Says grandson Kirk, "When we heard she needed surgery, we were apprehensive yet relieved, as we were hopeful this would take care of her problems once and for all."
Millie's heart surgeon chose to perform a beating heart bypass procedure using the Medtronic Octopus® device. In the great majority of cases, the beating heart procedure allows the patient to avoid being placed on coronary pulmonary bypass – CPB. (CPB is used in many heart surgeries and works in place of a patient's heart and lungs to provide oxygenated blood flow throughout the body.)
Beating heart bypass is made possible with the Octopus, which uses suction to stabilise the heart. The surgeon attaches the suction "pods" of the Octopus to each side of the coronary artery to be bypassed. The Octopus device stabilises that portion of the beating heart so the surgeon can perform the bypass grafting. Millie's heart surgery was performed by Dr. Ted Spooner at Methodist Hospital in St. Louis Park, Minnesota.
"The surgery was done Saturday morning and the next day I was sitting up and I actually felt pretty good," says Millie. "My family was surprised to see how well I was doing and commented on how good my skin colour was. They had known other people who had had heart surgery with coronary artery bypass who looked so ashen after their surgery," Millie says. "I was walking by Monday, and I went home Tuesday."
"For a 75-year-old-lady, she recovered amazingly well – and quickly," says Kirk.
Millie was able to drive 3 weeks after the procedure and resumed all her usual activities within 3 months. Two months after her surgery, Millie was able to babysit her great-granddaughters – although she was restricted from lifting them. "Every once in a while, I have to be reminded to slow down!" says Millie.
As part of her cardiac rehabilitation, Millie continues to exercise (including a weekly round of golf) and maintains a healthy diet. When asked to compare her health from a year before her surgery, Millie is quick to say, "Oh, it's very good now. I feel much, much better. I have a lot more energy, I'm less out of breath, and I don't have that squeezing in my chest." Millie says she does have a little pain around her incision, which her doctor has assured her will heal in time, and she continues to take Procardia daily.
"I'm sure glad I had the surgery done," says Millie. "I'm swinging pretty well these days!"
This story reflects one person's experience. Not every person will receive the same results. Talk to your doctor about your treatment options.