j.c. mattingly
moffat, colo.

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April 14, 2014
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John Mattingly: Socratic Rancher 4-14-14

This column will be a temporary break from the prior running series about climate chaos. I had a heart attack about a month ago, and was lucky to be close to excellent treatment. Medical understanding and technology, when they collide with a bit of luck, can result in a happy ending for “unstable angina” also known as a heart attack.

My cardiologist was able to place a drug eluding stent in my left anterior descending (LAD, aka the widow maker) coronary artery when it was 99 percent plugged up. After that stent went in, I felt 35 years younger, and told the doc that the next day. He told me I needed to get enough monitored exercise for about four weeks to bring back the portion of my heart that had essentially atrophied — in the same way a limb shrinks when put in a cast and subsequently loses tone and muscle mass due to lack of action.

The doc also told me I had to come back again for more stents in the coronary arteries on the right side of my heart. This did not come as a big surprise. I had five stents placed in my coronary arteries 10 years ago, and all had gone well until recently. The current problem was not with the existing stents, which were patent. The problem was new blockages.

Part of the reason I decided to do a column on this subject is that there is some correlation between breathing diesel fumes and inflammation of the coronary arteries that can lead to hardening of the arteries. When I was a kid, on an old International Harvester M tractor, I tended to get up close to the exhaust pipe to stay warm in the spring winds and Arctic zephyrs of fall. Nowadays most of us in farming have cabs that insulate us from the exhaust, and it probably doesn’t affect everybody the same. I know a few old boys who did the same way I did with cabless tractors, breathed in a lot of diesel fumes, and they’re healthy as a double dickerin’ bull. Whatever my cause, I have coronary arteries that build up plaque.

Sixty years ago, back when Dwight Eisenhower had a heart attack, I remember people became more aware of heart attacks in general, and Dwight was out of commission for over six months, the nation nervous and concerned for his recovery, which was very slow. I recall my parents being worried that Nixon would become President.

In those days, it was common treatment of a coronary to lie down and take a couple of aspirin with a shot of whiskey. If they were lucky with this treatment, they lived, but with reduced energy in proportion to how much of their heart was damaged. In a very few cases, open heart by-pass surgery was performed. A few of those folks went on to live into their dotage, but most had greatly diminished lives followed by death or stroke. The first by-pass surgeries in the U.S. began in the early 1960s at the Einstein College of Medicine in the Bronx by a group of doctors headed by Robert Goetz. The Soviets first performed a successful by-pass in 1964, by Dr, Vasilii Kolesov.

Though it is obviously necessary to give account to individual differences and treatments, it wasn’t until the 1980s that by-pass surgeries and angioplasties became more common and the medical technology improved to give better outcomes.

Angioplasty as a procedure was first initiated by Dr. Dotter, an interventional radiologist, back in 1964. His first work was with peripheral artery disease. Using a catheter and stent percutaneously to dilate the stenosis, or closing of an artery in the leg, of an 82-year-old woman, the stent restored blood flow and the woman died of unrelated pneumonia some years later. Dotter is commonly known as the Father of Interventional Radiology and was nominated for the Nobel Prize in medicine in 1978, and his work was foundational to the operations done in today’s “cath lab” of interventional cardiology.

I feel very grateful to all the doctors, technicians, and support staffs that have, over the last couple of decades, continued researching and experimenting to a point today where interventional procedures are doing truly extraordinary things. The stents today (which resemble electrical butt-splices) are made of titanium and are impregnated with a drug that has a proven ability to prevent the body from rejecting the stent and thus covering or occluding it with scar tissue and plaque.

As one old boy said, “It’s like get your pipes cleaned.”

Indeed. ❖

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The Fence Post Updated Apr 10, 2014 08:51AM Published Apr 28, 2014 02:43PM Copyright 2014 The Fence Post. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.