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 tl;dr.  Richard had an angiogram today that resulted in a couple of new arterial stents. For various reasons it was a more complex procedure than the outpatient angiogram I breezed through a few years ago, and he's spending the night in the hospital. He's had a very uncomfortable day, but will probably be home tomorrow and fully recovered within 5 days. Hopefully, much more than recovered - there is reason to believe that he will be feeling much better.

Richard has been having increasing angina for the past 2 or 3 years. In the past year it has gotten bad enough that he really can't walk more than a short block without stopping to rest, and he sometimes has episodes when he isn't even exerting himself. He finally took his complaints to his regular doctor, who scheduled him for a stress echocardiogram (the type where they shoot you up with a drug to exercise the heart rather than using a treadmill). The test showed everything was just fine - no sign of arterial disease. But since he experienced no chest pain during the test, he doubted that whatever it was testing was actually relevant to the symptoms he was having. Both of us thought he needed an angiogram, but our kindly GP was doubtful about that and referred him to the Cardio Clinic at Methodist. The cardio doctor he saw thought it was most likely to be Multiple Coronary Artery Disease, which is not detected by the test he had and can't really be treated very effectively. But she recommended an angiogram to narrow down the diagnosis. 

He had the angiogram today, and guess what? There turned out to be a couple of severely blocked arteries that could be stented. This is exactly the diagnosis that the fancy high-tech stress test was supposed to detect, but somehow did not. Richard kept saying that his symptoms were exactly like the symptoms he had back in 1989 when his circumflex artery was closing off. He had a stent put in back then, and it worked. Even though he did end up having a double bypass in 2011, the circumflex artery did not need work at that time. But now that old stent appears to have reached the end of the road, and once again the circumflex artery was closing down. So they stented that artery again, along with a less crucial artery that also seemed to be in pretty bad shape. He had a rough recovery day (partly because they shot him up with enough heparin to treat an elephant and it was 7 hours before his blood was clotting well enough for them to remove the "sleeve" from his groin) but they finally got the sleeve out and he seemed to be feeling a little better. Should be home tomorrow.

As always, I am deeply impressed with the staff at Methodist Hospital, which either has the best working environment of any hospital in the country or has replaced its entire nursing staff with happy Stepford Wife robots. 

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