I'm Lost Now, Sqad.

[gness]

Morning....I have just received a photocopy of the letter sent by Peterborough Hospital to my GP on 1st Oct.

It tells him I have severe stenosis of the left iliac artery and moderate of the right which may be suitable for bilateral iliac kissing balloon angioplasty.
Forty years ago I had a reaction to IVP contrast so he is going to ask the radiologist if she can go ahead with the angioplasty in the light of this. He says he should have her decision when I attend the clinic on Dec. 5th and he will then discuss with me the angioplasty.

Sqad, unless I am going mad none of the above was told to me last week.
Thank god I took a friend into the appointment with me. We were left thinking it was a minor blockage and I needed an exercise programme. The last thing the doctor said last week was...We are not abandoning you...if the pain gets worse phone and we will see you.

There is no mention in this letter of the neuro consultation I was told last week that they had asked my doctor to arrange so no wonder he hasn't.

Honestly, Sqad....I'm beginning to feel like two different people now...one with a problem and one without....depending on who I see and what the weather is like.....I am just so confused.

I have a GP appointment tomorrow......will he be any less confused?

Gx

[Sqad]

Well, gness, I am just going off to the Club but I will answer on my return, which will give me time to think. Will be back in 2 hours.

Hold on.

[gness]

Okeydoke.....won't tie the noose just yet.... :-(

[gness]

Update, Sqad. I spoke to my friend who was as amazed as I was at the difference between my appointment last week and this letter... I am sane.

I phoned PGH to speak to the original consultant...he is on military deployment. The chap I saw last week is off somewhere else.... probably the gym or a long walk.

I explained my concerns to the lady who answered the phone and she accessed my notes....... seems something is not quite right..... she was surprised I had been sent away just with instructions to phone if the pain got bad and told me they will have investigate and get back to me.

I did lay it on a bit thick about how worried I am about the contents of this letter and how it contradicts everything I was told last week.....

Again...so glad I had someone with me.....I won't have any appointments on my own in future.

We shall see.....☺

Gx

[Sqad]

OK...still at Club, but you have priority.

Now what do we know.

You have pain in the legs on exercising and angiograms show a major blockage in the left iliac, almost certainly the left internal iliac and to a degree a reduced blood flow in the right internal iliac.

That is what we know for SURE.

Now the $ 60,000 question is.........is the blockage in the arteries consistent with the pain that you are having in your legs?

If it is, then angioplasty will be a God send to you BUT of it isn't then it will have no effect on your leg pain.

I will be honest gness,the characteristics of your leg pain is not entirely typical of IC and you are surprisingly active for a woman with a blocked internal iliac artery. But in my opinion, the pain is NOT inconsistent with IC and I sympathise, to a certain extent, with the hesitancy of the doctors.

What would I do?

If my life was being made unacceptable by my leg pain, then I would go for angioplasty! but if I had a quality of life that was tolerable.....I would " monitor" the situation.

Another point is that angioplasty would be a diagnostic too as well as therapeutic aid in that if after angioplasty, the pain disappeared, then bingo, you would have cracked it.

I hope that I have been some help.

[slaney]

The contents of the letter make far more sense as regards your symptoms Gness. It's almost as if the consultant didn't have the correct notes; which consultant wrote the letter, the original one or the one you saw most recently?
It will be interesting to hear what they say when they get back to you.

How was the diagnosis of severe stenosis reached - did you have Gadolinium angiography which is useful for those allergic to iodine based contrast?
It would also uncommon for a radiologist to mention angioplasty unless this was a distinct possibility.

Can I ask - are you being investigated for the episode of loss of consciousness a few weeks back - is this why you have been referred to a neurologist?

[Sqad]

slaney.....no, the neurological opinion is for some physical symptoms in the foot!but no doubt gness will mention the episode that you have mentioned to the neurologist.

[slaney]

Sqad - I see - thanks.
I think it may be the left common iliac artery which is mainly involved as Gness has said in the past that the blockage was just below where it joins the aorta,

[Sqad]

slaney.......yes......more likely the common iliac artery as you say.

A difficult decision for her to make and I can see how confused that she is with the situation.

[slaney]

I agree - this is where a good GP can come in useful, both with advice and getting full possession of all the facts.

[gness]

Sqad and Slaney...thank you both so much for your thoughts and input.

The neuro part came about because the first consultant did some simple tests which showed nerve damage to my left foot. This has been a problem since I damaged it badly in a fall but I think it's getting better and I'm not worried about it.
However the chap I saw last week tied the need for a neuro appointment in with the original problem that I am bothered about, saying that a neuro problem could be the cause of the cramping inability to walk at times.

Slaney...the letter I have is from the original consultant following consultation and the ultra sound tests...and the radiologist did say she was sure an angioplasty would be offered when she was looking at the screen.
It is the left common iliac artery. I have only had the ultrasound. I was supposed to have an alternative method of diagnosis at Kettering but they MRId my spine by mistake.
I haven't mentioned the loss of consciousness yet. I was going to at last week's appointment but....well I didn't but will tomorrow. I think that was just a blip.
I am wondering if the second chap had the right notes or results.

Sqad...if I can convince myself nothing will go wrong I will opt for an angioplasty in the hope it helps or is at least a diagnostic tool.
I am active but believe me I have been pushing myself. In my heart I do think it's IC......the more I research it the more it fits.

Thank you both....it's much appreciated....Gx

[slaney]

You do need to mention the loss of consciousness as it needs reasonably urgent investigation.
I hope things go more smoothly for you from now on Gness.

[gness]

Just had a nice chat with my GP and I am off to take this letter to him... because he hasn't received any communication from Peterborough other than a letter some time ago telling him that they were arranging an MRI scan.... which is news to me.

Does this happen to lots of people or do I trigger a...let's confuse this woman button..... when I attend a hospital?....☺

[gness]

Lovely long chat with the GP who showed me everything he'd had from Peterborough which is not much.
A letter saying they were going to do an Ultrasound and if it was all clear we were to consider a neuro appointment. If it showed blockage they would consider angioplasty.
The letter I received yesterday, which I gave to him, shows all is far from clear and my account of last week's appointment has him as confused as I am so he is faxing the hospital.
He has persuaded me to try statins again....not happy but I will as that seems to be beneficial for the angioplasty....I think...and if I am offered one of course.....I won't hold my breath.....☺
Some things are sheer hard work!

Gx

[Sqad]

LOL......seems to be coming to a head now.

If statins worry you, ask your GP if you can try Ezetral which is not a statin but does the same thing, lowers the cholesterol and has less side effects.

Thanks for the feedback.

[gness]

Thanks, Sqad....I wasn't offered anything but statins...Atorvastatin...will give it a try but if the feet swell or I hurt I'll stop....
He also said it was rare to develop liver problems but that will be checked...too flipping true it'll be checked. I'm fond of my liver and I seem to be more than capable of doing...rare!

There is enough going on without self inflicted problems......☺

Gx

[anneasquith]

G. what is your objection to statins ?

[gness]

Hi, Anne. I have tried statins and they made my legs swell.

I'm sure they must lower cholesterol but I think prescribing to anyone with a level above 5 is a bit experimental and may not be necessary.

MrG had a level of 2-3...I have always been around 6. My diet was much better than his so I think 6 could be normal for me. My eye pressures have been above 30 for the past twenty five years which has resulted in far too many hospital appointments to be told I have nothing at all wrong with my eyes.....I just think again....normal for me...as is having my very low blood pressure.

So I'm not happy having to take pills which come with side effects possibly resulting in more pills to get rid of the side effects!

We must all be different and this doesn't seem to be taken into account when it comes to prescribing statins....just my opinion but it does bother me and if the consultant wasn't insisting on them if he is to consider angioplasty...if indeed he is....I wouldn't touch them with a barge pole.
Still....I suppose I could lie or come off them when I am sorted,walking well and climbing walls and hills again....☻

[slaney]

Gness - I don't think it is the cholesterol number that is being treated here - it's just that there is evidence that statins are helpful in intermittent claudication.
http://circ.ahajournals.org/cgi/content/meeting_abstract/114/18_MeetingAbstracts/II_633-d
And the loss of consciousness investigations..?

[gness]

Thank you for that information, Slaney. The conclusions are indeed interesting....and makes trying the statins more acceptable.
I almost wish I was in a lot of pain or felt unwell which is an awful thing to say I know....but, the walking aside, I feel so fit and healthy and I'm reluctant to jepordise that....but needs must I guess....

We discussed the passing out and he said not to worry about a one off but any more episodes will need investigation....good reason to stay upright as I really don't like being investigated.

Gx

[anneasquith]

would you think of trying the statins again, and report side effects to your doctor, they certainly keep my cholesterol at a low count.