Just had 4 stents put in

TLDR - Just got stents, rather than open heart surgery. Recovery is a MF'er for open heart. My problems in health are rooted in highly disturbed sleep of long duration. Eat well, exercise, protect your sleep.

On D-Day anniversary I had a heart attack. Found multiple blockages. I had the option of CABG (open heart surgery - Coronary Artery Bypass Graft) or stents.

I went with stents.

My life is not in a place where CABG makes sense for me - it would make me a burden to others during recovery and I can't have that.

My health issues have been in motion since I returned from Iraq - I have not slept normally in over a decade. Prolonged sleep disturbance can be summarized best by the following (IMO) - it's like being overtrained. You know you're overtrained, you can sense it, you know you need rest and food. You feel like just one day of eating a relaxed diet, no stress, with a good night's rest, and tomorrow you'll be right back to normal. But, with prolonged sleep disturbance, tomorrow never comes.

Also, sleep disturbance means that the sun coming up or going down is meaningless to you. For about a decade now, my life has felt pretty much like one really long day. I do not recommend this approach to life.

Lack of sleep is pro-inflammatory, messes up blood sugar regulation, disrupts endocrine function etc. A while back my thyroid stopped working, body stopped making testosterone, fasting blood sugar was 380 at the lab, next visit it was 170, then 125...all over the place. I have since paid more attention to carb intake. They checked my sugar in the hospital and was between 101 and 125, which is reasonable, but you generally want it below 100 if you are fasted. My fasted blood sugar was the highest one on this trip and I assume that was because of gluconeogenesis (liver releasing sugar to keep levels stable).

I see threads here about various issues and it's common to suggest that people address quality sleep concerns - I fully endorse that idea. Protect your sleep. The second you begin to experience disturbed sleep, find a way to fix that. Our bodies cannot function for an extended period without restful and recuperative sleep. Since 2010 I've had less than a dozen days with proper sleep, in my estimation. On those days, however, I feel like I've gone back in time to when I was healthy. That's how much of a difference it makes. I have taken melatonin. It's not all that helpful and I have refused harder medications. In the military I saw what guys looked like when they were on things like Ambien and we had to wake them up if something happened. They were like zombies holding rifles. I don't want that.

I'll be on anti-platelet drugs for the rest of my life. (baby aspirin and Plavix)

Stents have come a long way since they started coating them with medication. Recent trial data also played a part in my decision making, in addition to my life situation.

Procedure was quite long - about 4hrs. That's a long time to lay stiff on a fairly hard surface. They say they gave me some sedation via IV but I didn't notice any effect. I was awake and alert the whole time. Procedures are usually much shorter, but they usually only put in one or two.

They went in through the femoral artery and chose to use an impella device - this is a pump that helps maintain cardiac output during the procedure. Then they went through the process of placing the stents, which is a bit more complicated than assumed. They don't just chuck some chicken wire into the artery wall.

Admitted at 7am yesterday, left the hospital at 1pm today. I was ready to leave yesterday evening but they like to keep you overnight.

This was done at a VA hospital. My local VA is a good hospital. VA's around the country seem to vary. I've been happy with the team at my VA.

Data on CABG v Stents is somewhat hard to parse but in the past CABG was vastly superior, before coating stents with medication. Stent tech has pretty much brought things to parity. In a trial looking at death, heart attack, or stroke, they only found a 1.4% difference between the two after 3yrs. Statistically significant due to sample size, but that's not a practically significant difference, IMO.

In some studies looking at outcomes after putting in stents, blood sugar control was pretty important. Not surprising.

Naturally all the other stuff is important, too - don't drink excessively or smoke, live healthy and so forth. I don't do any of that. My problems are all rooted in sleep.

I asked about exercise precautions - since starting to pay more attention to my carbs, I've lost some weight but I want to lose more, get fit again, etc. I used to be a gym rat. I've trained at various times in my life as a bodybuilder, powerlifter, triathlete or gym fantatic. The gym used to be my haven and I'd like to make it that way again. Doctor said he would put in a referral for cardiac rehab to try to help me get the routine going again and add to whatever I do on my own. (this doctor did my followup and discharge - the doc that did the procedure was a female) This is something that is generally more commonly available through the VA than the private sector, to my understanding. He said to avoid a lot of bending over at the waist for a few days and said I should be careful not to lift anything over 30lbs for about 30 days. Bummer. But, this is far, far better than CABG. Once they crack you open you'll have a ton of precautions for a good amount of time. My daily life won't be affected unless I want to buy a super heavy bag of groceries or re-arrange the furniture.

Drove myself to the hospital and drove myself home, just like when I had the heart attack.

I don't know if anyone else is facing this situation, or if this helps. I'm just putting things out there in case it helps someone.

Live healthy, protect your sleep.