My Own Private Angioplasty

[Bucko]

I'd had some pain in my right foot for about a year, which I took to be PN. It was a combination of a blow-torch ache from middle toe down with a sharp, throbbing pain in the big toe as if something were being pushed underneath the nail. I discussed it with my new doc straight away, and he concurred that it was, most probably, PN.

But about six weeks ago, I began getting severe cramping in the center of my right calf, cramping so bad that even a short walk necessitated a stop or two to rest and massage out the muscle. Earlier this month I discussed it with my doc during a follow-up, who sent me to the hospital to get some tests: an x-ray, a vascular ultrasound and an arterial ultrasound. The first two were done as a walk-in, but the third required an appointment as it's rather involved (it takes about two hours and requires a specialized technician).

During the arterial ultrasound on my legs, I looked up at the monitor and saw the program color-coded specific features: blue for veins, red for arteries against the standard ultrasound gray background. But the tech stopped, backed up and started over at several points where the screen showed a yellow obstruction in the artery. Looking first at the screen, then at the tech, I asked him if the yellow blobs were whet I already knew them to be.

"Yes", he replied, "But you're too young for those." He seemed kinda rattled, which kinda rattled me.

When I got home, I called my doctor's office to schedule a follow-up later in the week, as I'd been told that the results would take several days to be analyzed by a Radiologist and would be forwarded to my PCP. But due to the nature of the results, the results were already in his hands and he asked me to come in first thing the next day (which for me was 11:00, I'm not an early-bird). I slept poorly that night, despite 200mg of Trazadone and several cocktails and got up before the alarm.

I really like my new, insurance-available doctor for several reasons. He knows his stuff with HIV, but is an Internist, so he's equipped to handle the challenges I throw his way as an aging gay man: the ulcers, the chronic pain, etc etc. He's gay and extremely handsome, big and brawny and Lebanese, with forearms like eggplants and an ass that, in other circumstances, would be one of my principal sources of nutrition. He even has a beautiful, Brazilian assistant/receptionist. They really make quite the ambiance happen, just as one should expect for Ft Lauderdale Fabulous. He's always extremely calm and cool, professionally detached in a very appropriate way.

But that morning he was anything but calm and cool. I was ushered directly back into an exam room where he was studying films. His ordinarily implacable face was concerned and furrowed. He asked me repeatedly how I was feeling.

"Nervous," I said. "I saw the images of the ultrasound as it was being done."

He nodded and asked me to show him exactly where the pain in both my foot and leg was located, which I did. He palpitate the calf muscle then looked back at the film images, asking me how long I'd had the pain.

"Almost a year for the foot, about six weeks for the leg."

He looked at me again. "You're not supposed to have this. You're too young for this."

"Well, I've been a heavy smoker since I was fifteen."

"Even so..." He looked annoyed, shook his head and looked me in the eye. "I want you to check into the hospital."

"Now?"

He nodded. "This afternoon."

I balked and claimed that I had too much work that afternoon, and we arranged for me to be admitted through the ER that evening around 9:00. It was important that I undergo several tests immediately, including an angiogram as quickly as possible. "If they find anything, they can take care of it right away."

I got home rattled but kind of numb and told Brandon (my roommate/boss/benefactor) all about my appointment and my plans to delay going right in until that evening. Brandon saw my anxiety and knew that nothing I needed to finish with work was of a greater priority than getting this taken care of. He also reasoned that if I waited and was admitted through the ER, it was bound to take longer and be less pleasant than just getting it done through the admissions office. We bargained down to an agreement that I enter the hospital at 3:00 that afternoon. 

One of the reasons why I'd slept so poorly was that I had researched arterial blockages on the web and (stupidly) symptom-shopped my way into a quiet panic, and that panic was only enhanced by my doctor's urgency to get me hospitalized. One of the symptoms I'd seen was a raspy, froggy voice, which I'd been experiencing for as long as I'd had the foot pains, but that symptom applied to severe arterial disease. I dreaded what they'd find.

From practically the time I was admitted, I was shuttled from test to test, all sorts of X-rays and ultrasounds right through the evening, and I was hooked up to a heart monitor, which brought home the gravity of why I was there The Ambien I'd requested didn't relax me a bit, and the fitful sleep I did get was fraught with very strange and disturbing dreams. I was roused before dawn to have an IV placed in my arm and was taken downstairs for yet another test. It was around 8:00 when I was wheeled down for the angiogram.

The techs were incredibly cheery, cracking lame-ass jokes. If I hadn't been so anxious, I'd have certainly made at least one smutty comment, especially when I was being shaved. The doctor performing the angiogram exuded confidence and explained that, although he'd be exploring my right leg, he'd be entering the artery from my left hip because he "want[ed] to spread out".

He went quickly through what he expected would happen that morning, reiterating what my PCP had said about "taking care of a problem right away". He then went through a laundry list of unlikely though possible complications. Oddly, none of these potentials rattled me: my mind was deep into horrors of probable advanced arterial disease that the risks involved that morning seemed negligible in comparison. A clipboard was proffered under my nose and I signed pages of release forms. 

With all web-surfing I did, I neglected to research the nature of an angiogram. In my mind, I had an image of the kind of equipment used in liposuction (more or less) and it terrified me. The doctor explained that I'd be sedated but not asleep, because there would be occasions when I'd be required to shift position when requested, and would not feel any discomfort during the procedure.

I was wheeled into the OR with no sedation yet, and was hooked up to yet another heart monitor. I looked around as I was transferred from the stretcher to a very thin operating table and they locked my arms into half-cylinder-shaped restraints that they attached to the sides. By this point no amount of joking on the part of the techs could distract me from utter terror. I was literally begging for drugs. One of the female techs injected a syringe into my IV line, and instantly I felt better, though not yet sedated and said so.

"Give it a moment," she said, "You should begain to feel it."

"I feel it, but it's not enough."

Moments passed before she injected another syringe into the line. "How's that?"

"Better" I inhaled steadily through my teeth, finally relaxed but still not exactly sedated. The doctor strolled in and another tech began opening plastic bags of instruments required for the procedure. I didn't see anything the size of a meat thermometer (as I was expecting), but the fact that I was still aware enough to recognize what was happening meant that my anxiety spiked again.

The doctor leaned over me and asked me how I felt.   

"I'm still aware, doc, and pretty nervous."

The doctor looked at the tech who'd been administering the sedation, who looked back at him with an incredulous look and told him that I'd already received two doses. The doctor looked at me and told her to give me one more. I thanked him out loud.

One more dose and I slipped away, if not losing consciousness then no longer (painfully) acutely aware. I remember one of the techs placing a sheet of white paper from my groin up my torso, covering my face; when I objected, a voice reminded me that I'd really rather not see the procedure as it was happening.  I have a vague memory of the actual puncture required for the angiogram, and similar, equally vague memories of a bantering between physician and technicians spoken from above, the details of which remain lost thanks to the sedation. I wasn't asleep and wasn't awake, but something in between, aware but strangely indifferent, at least as much as I can recall.

What I recall next is being off the operating table, back on a gurney. The doctor leaned over me gripping my upper arms with a shake and telling me that, as expected, everything went well. He found (and removed) two obstructions from my right leg: one from my upper thigh and another somewhat nearer to my knee. The pain, he told me, should be entirely alleviated. He rubbed my head, smiled, and told me that I was gonna be all right. I smiled (weakly) back.

The male tech lifted my gown and placed a tiny wad of folded dressing over the puncture, sealing it with tape. He warned me not to lift my head, specifically not to work my abdominal muscles for hours, until told it would be OK by the nurses on my floor. Immediately I began feeling itches I'd been forbidden to scratch and smiled wryly at yet another example of the perversion of my impulses, content to merely turn my head.

Back in my room, the nurse who greeted me on arrival denied me even a pillow, warning me once again to not so much as lift my head ,let alone attempt to sit up as she attached fluids to my IV. Still floating on the sedation, I drifted back to sleep.

I woke up hours later and buzzed for the nurse, requesting a pillow. She came in and cautioned me to to be careful with undue bending and twisting. I put my left hand on my hip and felt for the folded dressing, reminding myself of what had happened. As if on cue, the local anesthesia  was gone and I felt a dull ache under the bandage.

My PCP came in, adorable in his green hospital scrubs, with a concerned face, asking how it went. I smiled weakly and made a stupid joke, then lifted the bedding aside, moved my gown and showed him the folded dressing on my hip. At that point I noticed the strip of tape over the dressing; it was green and had the brand name of "Angio-Seal" printed across the center. The ridiculous thought crossed my mind that I'm not a label queen.

The next day, when my PCP came by to check in, I expressed my concern about what lurked under that dressing and the "Angio-Seal". With a flourish, he ripped off the dressing, exposing a tiny red welt, bigger than an IV scar but smaller than a bee-sting. When I expressed surprise that it was so small, he gave me a funny look and asked me what I expected.
 

[Robert]

brent.


it sounds like you have some good Drs who know their stuff.  I'm so glad they caught this before it broke loose and, then, well, we all know what could have happened then.

And thanks for the lovely recital.  As usual it's a great read.  Very entertaining, thoughtful.  "Masterful" as the critics would say.

robert

[heartforyou]

Mon amour,

What a creepy experience.
Glad that you had these removed before they did their damage.

Now, take time to recover and rest.

Bisous,

Hermie

[komnaes]

He came in, left a story and then dropped out again..

And I am just grateful that you're doing fine Brent..

Hugs, Shaun

[J.R.E.]

brent.

it sounds like you have some good Drs who know their stuff. 

It certainly does !! Sounds as though you were in good hands. Glad to hear that everything went well for you.

Take care of yourself-----Ray

[allopathicholistic]

Thank you for sharing this important account with us. You are helping me more than you know. I want to ask you a question. At any time did you hear any of the following words:

1. atheroma
2. calcify/calcification

 

Too young indeed.  I hope light continues to shine on you.

AH

[Alain]

Brent,

Timing was right on. You don't want complications with stuff like that.

Sounds like your in good hands with very good caring doctors.

Too young for sure; still have lot's to say.

Looking forward to read you soon and take care, Alain.

[AlanBama]

Sorry you had to go through this honey, but so glad it was caught and corrected.

Love & hugs,

Alan   

[aztecan]

Hey Bucko,

All in all, it sounds like quite an experience. Sorry this happened to you, but glad you came through with flying colors.

Loved the description of the doctor, too! 

Hope you are back to your studly self very soon.

HUGS,

Mark

[Lisa]

I'm glad to see this nipped before before you allowed it to go much further sweetheart. Had you gone longer, the danger would have increased by leaps. Rest, and recover Buckles....we like you best when feisty.   

[Bucko]

brent.


it sounds like you have some good Drs who know their stuff.  I'm so glad they caught this before it broke loose and, then, well, we all know what could have happened then.

And thanks for the lovely recital.  As usual it's a great read.  Very entertaining, thoughtful.  "Masterful" as the critics would say.

robert

Robert-
I grateful to the docs and even more grateful that I have insurance so I can see them. Thanks for the compliment. As you know, I'm a sucker for sincere flattery.

Mon amour,

What a creepy experience.
Glad that you had these removed before they did their damage.

Now, take time to recover and rest.

Bisous,

Hermie

Des gros bisous, mon petit chou...coo coo 

He came in, left a story and then dropped out again..

And I am just grateful that you're doing fine Brent..

Hugs, Shaun

I do what I can, Shawna. The story took five hours to write and edit, yet there are still some typos 

It certainly does !! Sounds as though you were in good hands. Glad to hear that everything went well for you.

Take care of yourself-----Ray

Thanks, Ray.

Thank you for sharing this important account with us. You are helping me more than you know. I want to ask you a question. At any time did you hear any of the following words:

1. atheroma
2. calcify/calcification

 

Too young indeed.  I hope light continues to shine on you.

AH

Pathie-

"Calcification" was used by the tech who did the arterial ultrasound, but "atheroma" rings no bells at all. One of the reasons why I posted here in the LTS forum (amid the fumes of BenGay and stale poppers) is because this premature PAD (Peripheral Arterial Disease) could well be related to 25+ years of harboring the virus. I was told back in 2000 that the rapid degeneration of the discs in my cervical spine was "almost certainly" HIV related.

We bug-infested Old Farts chart new medical territory every year that we survive. Medical professionals who can pull their egos back will admit to as much, though not often.

I hope you can resolve whatever's been ailing you, doll. Honestly, I've found the dread in anticipation is much worse than most of the trials I've endured (as the last paragraph of the OP suggests). NDEs are tit (I've had two): it's the contemplations of their meaning that keep me up sometimes.

Brent,

Timing was right on. You don't want complications with stuff like that.

Sounds like your in good hands with very good caring doctors.

Too young for sure; still have lot's to say.

Looking forward to read you soon and take care, Alain.

Merci, Alain-

I write about all kinds of things, but most seem to remember my histoires du cul 

Sorry you had to go through this honey, but so glad it was caught and corrected.

Love & hugs,

Alan   

Thanks, Alan-

I really wish I were a brave little toaster with these things, but I never am. And I've spent way too much time in hospitals lately: three times in eleven months is a personal record I'd just as rather not best any time soon.

Hey Bucko,

All in all, it sounds like quite an experience. Sorry this happened to you, but glad you came through with flying colors.

Loved the description of the doctor, too! 

Hope you are back to your studly self very soon.

HUGS,

Mark

Mark-

I've been on intramuscular testosterone therapy for about a month (about which another post is required), and ooooooooooo baby! I'd forgotten what it's like to have Uncle Buckles Junior wake me up in the morning. In another month or so I'll take him out in open water instead of just buzzing around the cove like I've been doing 

I'm glad to see this nipped before before you allowed it to go much further sweetheart. Had you gone longer, the danger would have increased by leaps. Rest, and recover Buckles....we like you best when feisty.   

Lisa-

I had visions of open-heart surgery and by-passes when Brandon drove me to the hospital that afternoon. I'm grateful that such never came to pass and that I have the time to hang out and chat with my old friends.

[RapidRod]

Brent, glad you caught it early. When I first started reading and got the new doctor part I had to grin. Only you would forget about the pain by looking at a good looking doctor. 

Rodney

[Bucko]

Brent, glad you caught it early. When I first started reading and got the new doctor part I had to grin. Only you would forget about the pain by looking at a good looking doctor. 

Rodney

One gets one's strength as one can, Roddles.

Thanks for the comment.

[BT65]

Wow, Brent.  I'm sorry I'm just getting to this now. 

This was actually one post I could get all the way through.  Usually when someone does a long post, I can never get through it.  But with your writing, I'm able to.

So please, take care of yourself.  It sounds like it really could have turned into something serious (well, more serious than it was).  I need to read your postings and would miss them terribly should something happen. (I missed them when you weren't here).  Rest up.
  Luv,
Betty

[komnaes]

I do what I can, Shawna. The story took five hours to write and edit, yet there are still some typos

Typo or no typo.. please stick around..

Shaun

(who is the official king of typo here)

[allopathicholistic]

I hope you can resolve whatever's been ailing you, doll. Honestly, I've found the dread in anticipation is much worse than most of the trials I've endured 

Thank you. High LDL cholesterol courtesy of Norvir and lipo on the knees - larger than a hazelnut but smaller than a tangerine, both knees.    C'est la vie. ........ But this thread's about you, and on that note I'd like to say

We bug-infested Old Farts chart new medical territory every year that we survive. 

Thank you immensely. To all the LTS guys and gals out there: Thank you times a 1,000 cuz I need you. Live long and prosper, Bucko.

[jkinatl2]

Bucko, I am so sorry you have had to go through so much.

sometimes it's one gaddamn thing after another.

You are made of steel, sir.

Steel.

[Bucko]

Wow, Brent.  I'm sorry I'm just getting to this now. 

This was actually one post I could get all the way through.  Usually when someone does a long post, I can never get through it.  But with your writing, I'm able to.

So please, take care of yourself.  It sounds like it really could have turned into something serious (well, more serious than it was).  I need to read your postings and would miss them terribly should something happen. (I missed them when you weren't here).  Rest up.
  Luv,
Betty

BT-
Some things simply cannot be summed up in fifty words (not that I ever aim for a concise style, ya know).  But having my intent understood is very important. If I occasionally post fluff, it's in the OT area, where it belongs.

Typo or no typo.. please stick around..

Shaun

(who is the official king of typo here)

Shawna-
I'll try. It actually takes a large effort sometimes just to bring up the main page. See more of that below-

Thank you. High LDL cholesterol courtesy of Norvir and lipo on the knees - larger than a hazelnut but smaller than a tangerine, both knees.    C'est la vie. ........ But this thread's about you, and on that note I'd like to say

Thank you immensely. To all the LTS guys and gals out there: Thank you times a 1,000 cuz I need you. Live long and prosper, Bucko.

Paths-
First of all, have you consulted a nutritionist? Kaletra (which contains Norvir) spiked my cholesterol from 150 to 525 in fewer than 30 days back in 2001. I was put on an absolute no-cholesterol, no-fat, no-kidding-never diet. It ruined my appetite for food (which I've always loved), but with the diet, Lipitor and Crestor my lipids slowly came down out of horror range. The good news was that I didn't get a hump or a gut or a heart attack, but I did lose all my "insurance weight" and then some, going from a size 32 to 28. My ass (which was never my best feature anyway) evaporated, as did most of the subcutaneous fat in my face and arms and legs.

One of the big reasons why I withdrew from treatment (NOT AN ENDORSEMENT OF THE PRACTICE) was so I could eat normally again, and I've gained back about 10 of the 30-35 pounds that I lost, so I look less lipoatrophied and AIDSy than I did three years back. But I also needed to embrace my "new look" and decide to enjoy my cheekbones as much as I enjoyed eating butter again.

It may not work for you (mileage does vary), but the saved my life.

You are made of steel, sir.

Steel.

Nah. Just certain parts and just with the right consort, my dear friend 

[allopathicholistic]

I was put on an absolute no-cholesterol, no-fat, no-kidding-never diet. It ruined my appetite for food (which I've always loved), but with the diet, Lipitor and Crestor my lipids slowly came down out of horror range. The good news was that I didn't get a hump or a gut

Glad to hear that, and kudos to you for sticking to the diet. I was given a referral to a nutritionist but I dont see myself picking up the phone and making the call. all i can picture is a strict diet and misery. besides, I don't know how much she knows about HIV. Take care, AH

[Bucko]

Paths-

The clinic I went to in New Haven (where I was living at the time) was pretty comprehensive. It was in a hospital, so they had access to all the toys and specialists at their fingertips. And the nutritionist was part of the team, so she must have had some specialty training related directly to HIV.

The urgency to not let it sit was immediate, even if the timing really sucked: I was in imminent danger of a pancreatic melt-down and was sent directly from the doctor's office to ultrasound. The tech was rather skittish about me stepping in without an appointment, displacing a waiting room full of pregnant women. I broke the tension by cracking a joke about "little Hildegaard and Herbert, the twins" which caused her giggling fits throughout the procedure. It broke some of the tension I'd felt earlier.

i never really felt that I had much of a choice about the diet, unless I wanted to share the fate of a goose readied for foie gras and have my insides explode 

[aztecan]

Hey Bucko, not to hijack the threa, but I almost bought some foi gras yesterday. It looked so good, but the amount of cholesterol in it would have forced me to eat nothing but rice and water the rest of the week.

Stick to the diet hon. It is so much easier than than trying to fix what will happen if you don't.

HUGS,

Mark

[northernguy]

Just reading this now Brent.  Glad you came through it OK, and I hope the pain you were having before the operation has completely disappeared.