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[Pressure] Pressure Help after Angioplasty
#11
RE: Pressure Help after Angioplasty
Yes, I'm currently on Brilinta (ticagrelor 90mg) twice a day, which I think is a pretty heavy dose as I take 2 hrs to stop bleeding from a simple nick from Shaving.

Ive just found this https://www.google.com/url?sa=t&rct=j&q=...PiFPRIHhsE

and this  which suggest AHI's go crazy with these meds.

Now the question is, can I adjust IPAP and EPAP up or down to counter these effects ? Im not really sure where to start. I can also turn on the auto bipap function of my other machine, but i'm currently just shooting in the dark.
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#12
RE: Pressure Help after Angioplasty
If it is the Brilinta that's increased your AHI then that could be a temporary issue. I hadn't heard of the drug but it seems to be an alternative to a medication I was prescribed after my stents were inserted, called 'Plavix' - another anticoagulant. These are used to prevent clots forming on the stent while it is new and exposed to the blood flow. However, endothelial cells eventually cover the stent and it becomes just another part of the artery. At that point (in my case six months) your cardio may take you off the anticoagulant and, if that's what is pushing your AHI up, you should hopefully return to normal.

Do you know if your stents were the 'coated' type? I suspect they all are these days, but it might be worth checking. Coated stents are less 'sticky' and so more resistant to clotting. Mine were the coated type. This probably determines how long you need to take anticoagulants for.
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#13
RE: Pressure Help after Angioplasty
Seems like i'll be on the meds for at least a year. I'll be seeing the cardio in January.

TBH I dont even know what kind of stent, nor was anything about different stents explained to me. I was in hospital for a check up and in surgery within 2 hrs, knocked out cold.  I'll ask the next time round when I do the followup.

Really appreciate you taking the time to share your experience over the holiday Season ! Again, a safe and peaceful holiday season to all!
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#14
RE: Pressure Help after Angioplasty
You were knocked out for the angioplasty? That's a new one to me. Both my procedures (2 stents each) were performed while I was awake. Apart from a local anaesthetic in the groin, where the incision was made into the femoral artery, all they gave me was a 'chill pill'.

The first procedure was, like yours, an emergency, and went without hitch. The second was a minor disaster. First they forgot to give me the chill pill, then a 'learner cardiologist' performed the stenting under guidance from my own, very experienced guy. He over-inflated the first balloon, which almost gave me another heart attack (the pain was intense), then almost mis-positioned the second, leading to more pain as he fumbled around a bit.  To cap it all, when I was awoken the next morning, the nurse almost fainted when she checked on the artery insertion point. The 'tennis ball' that they clamp to the wound to stem any bleeding hadn't seated properly and the night nurse forgot the 30 minute observations. I had been bleeding into my leg all night. It was black and blue all the way down into my knee. Turns out I really dodged a bullet there, because a femoral rupture can result in death within seconds.

Turned out I hadn't use all of my nine lives motor racing and motorcycling after all! Annoyed-and-disappointed
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#15
RE: Pressure Help after Angioplasty
Wow, what an experience.

For me I've never been in an OT, much less spent any time in a hospital since I was born. I asked if I could be sedated before the procedure, and they brought in an anesthesiologist. I knocked out cold as they shaved my forearm.

Woke up 4 hours later with a bandaid on my arm. Doc said it was a difficult and complicated procedure that took 3:45 to do. I hear angioplasties are usually quick, but not mine.

Yours sounds like a hell of an experience. If I went through that I'd probably be on the lookout for a lawyer.

But Wow. Glad to hear you're ok now! I'm still bumbling about after 3 weeks not knowing much on what's going on.
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#16
RE: Pressure Help after Angioplasty
So your stent was put in through your arm? I have had an angiogram performed that way, but not stenting. I know that one of my stents was the largest they make, so maybe that has to go in via a big artery? Dunno. I have since had another angiogram that was performed via my wrist - much less dangerous.

For all the problems the second time around, I am of course super grateful for the care and treatment I rec'd. It is now almost thirteen years since those ops and I'm still here!

Because I had a hearty, my treatment included lots of follow-up and support with exercise and diet, though to be honest, my diet has always been good.

I have a leaky valve and an enlarged aorta too, so all in all, not the strongest of tickers. I used to wonder why I got palpitations and chest pain while sitting on the grid back when I raced cars and karts. I was to find out why almost fifteen years later ... Cool

What follow-up do they have planned for you?
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#17
RE: Pressure Help after Angioplasty
I have a not so serious, secondary blockage of maybe 40-50%  blocked, which they could not get to the first time round because of the complexity of the 100% blocked artery, already having a healthy longer than usual dose of radiation / dyes and what not for 3:45 hrs.

I'm going for a ct scan to ascertain the need for clearing the second one, but I'll probably not go for it as im feeling much better already.
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#18
RE: Pressure Help after Angioplasty
Circulation is a very big deal.
First Aid 101: ABC, Airway, Breathing, Circulation.
Ask the docs, is this a do now or a watch closely situation, if watch closely, how often and what is needed. I'd pretty much go with what the doc says on this.
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#19
RE: Pressure Help after Angioplasty
Just be aware that blockages, once started, can accumulate quickly, though your meds should slow that down. Angina is a sign of your heart being in distress and, over time, this can lead to damaged heart muscle similar to an actual heart attack.

Much depends on where the blockage is, too. I still have some blockages but, because they are near the end of branches, they're not 'mission critical'. My cardiologist is anti-intervention, which is refreshing these days. I trust him to give good advice and he will happily explain everything in great detail, so I feel well informed.

A complication for me is that it's almost a certainty that I will need a valve replacement and maybe an aortic stent in the future. He firmly believes in waiting until these things are absolutely necessary, but I'm 65yo and leaving it too long would compromise my body's ability to cope with and recover from such an operation. A real quandary!
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#20
RE: Pressure Help after Angioplasty
(12-26-2021, 10:25 PM)StevesSp Wrote:  I still have some blockages but, because they are near the end of branches, they're not 'mission critical'. My cardiologist is anti-intervention, which is refreshing these days. I trust him to give good advice and he will happily explain everything in great detail, so I feel well informed.

A complication for me is that it's almost a certainty that I will need a valve replacement . . . . . He firmly believes in waiting until these things are absolutely necessary, but I'm 65yo and leaving it too long would compromise my body's ability to cope with and recover from such an operation.

I can't add any useful PAP advice but do agree, swordfish, you need good MD advice and corrective measures soon. Your knowledge base was benefitting from all early comments here --I've been slow to finish this post--as mine was too. My closing's stent question is not PAP-therapy related for posting in the main forum, but it could be PM'ed to you, Steve, if need be and OK. But what you might share there could well help swordfish here. All three of us need good heart patient info to weigh medical advice. We never know when our MD, whom we have good reason to trust, may become unavailable.  

Dad, at 73, long a heart patient and just retired, had a crisis A-fib event where, family gathered there 240 miles away, he and we all were told he must have a quadruple bypass within days. He tabled that, got in touch with a contact who had chelation, had it done out of pocket and then lived 8 more years, walking legs off my wife, having much warmer feet at night and happily eating iceburg lettuce and more long-time no-no's once again. He had but took no more nitro pills carrying their trash from kitchen sink to the trash barrel outside. 

His chelation practicing MD (Dr. Halstead near Loma Linda U and Azusa, CA) was later jailed, as I recall. It's deja vu all over again (thankyou Yogi). Those present aromas of the IVM resistant medical hierarchy and acceptable "community medical practice" are redolent of that experience. It's the same set of themes: anecdotal benefits, insufficient blind studies, no money in old successful methods, off-label mis-use--chelation for heavy metal extraction was OK, but not for pulling calcium from plaque so it can be pee'd out.

Seconding Steve here, swordfish, my cardiologist kept me on Plavix (Clopidegrel actually) for 6 months post stent procedures. After a third stent in the Circumflex, 7/2020, he put me back on 81g aspirin after having started me on Eliquis and Repatha biweekly injections in 1/2020 after a 12/2019 TIA. He emphasized, still does, taking his Rx antibiotic 30 minutes before any dental cleanings or other work.  

Steve, I hope your condition and eligibility allow a TAVR for your aortic valve replacement. I (age 82 now) was fortunate to have a TAVR (trans-arterial valve replacement via the groin) in 5/2016. The TAVR, a cardio MD team had to get specially approved back then, was no more limiting than 2 nearly back-to-back LAD stents ( via wrist 12/2015). The TAVR: in one morning and out next noon as though nothing happened--just watch the insertion point.

All 4 of my implants were put in before damage; the first two immediately thanks to continual pressure to have my first angiogram, which was incidental to my 12/2015 ER visit with upper left chest pain. Subsequent monitoring and unmerited favor (grace of God), have kept me above turf. (My PCP had sent me to a cardiologist, long before any of this because of an increasing heart murmur from childhood rheumatic fever. When called by ER MD's, my MD advised me and immediately snagged my then-new to me cardiologist to do the angiography immediately--angiography along with, it turned out, his first two of my three stent insertions and the TAVR).

Post procedures I had good "covered" TAVR and stent qualifying rehabs for 12 weeks at 3 per week, I extended it for 4 years out of pocket and will be able to resume January 3 after our second covid hiatus at my hospital's excellent cardio rehab gymn.

I don't mean to hi-jack your thread here, after being drawn here by your OP topic, swordfish. But, Steve, regarding my 6yo LAD stents, they are more upstream and we know stents are known to close. Given your own experience and knowledge gained, you may be able to help prime swordfish and I with anything you can offer about new implants and dealing with need for stent replacement.
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  (Disclaimer use permitted by sheepless)

 
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