This is the title I chose for my personal blog, which is meant to give me an outlet for one of my favorite crafts – writing – plus to use an image from my favorite sport, golf.  Out of college, my first job was as a reporter for the Daily Astorian in Astoria, Oregon, and I went on from there to practice writing in all my professional positions, including as press secretary in Washington, D.C. for a Democrat Congressman from Oregon (Les AuCoin), as an Oregon state government manager in Salem and Portland, as press secretary for Oregon’s last Republican governor (Vic Atiyeh), and as a private sector lobbyist.  This blog also allows me to link another favorite pastime – politics and the art of developing public policy – to what I write.  I could have called this blog “Middle Ground,” for that is what I long for in both politics and golf.  The middle ground is often where the best public policy decisions lie.  And it is where you want to be on a golf course.

“Stentology.”

Yes, this is a word I coined to describe what has happened recently to my wife, Nancy.

And, what happened to me now just more than 19 years ago.

What?  Insertion of what are called “stents” in our hearts to re-enable adequate blood flow after arteries and other vessels had been blocked.

So, what is a stent?  It is a small mesh tube that cardiologists insert – incredibly, yes “insert” —  into the heart to re-enable the blood view in coronary arteries, which provide the heart with oxygen-rich blood.

Nancy and I are two of an estimated two million people who get coronary artery stents every year, and if you have coronary artery disease, there is a good chance your doctor will suggest you get one, as happened in our two situations.

Apart from a statistic such as this, one aspect of our experience impressed me more than any other:  It was the capability of our cardiologists for whom inserting stents is a routine practice.  To do the job, they either go through your wrist (yes, your wrist!) or your groin (yes, your groin!) to fish a tube up or over to your heart.

This occurs when cardiologists do angio-grams or when they insert stents.   Sometimes, the two processes occur at the same time.

Here is quick background on the two separate situations affecting my wife and me:

• For me, I became sick on the evening of December 1, 2004, so, with my wife’s help, went to the hospital emergency room in the city where we live, Salem, Oregon.  It turned out that, as I arrived by ambulance, I was having a heart attack (I still call it an “episode,” a term I like better), so the doctor on call immediately inserted a stent that saved my life. 

I had two more non-emergent stents inserted the next day before I began a recovery process.  So, I now have three stents!

• For my wife, discomfort in her left shoulder a few weeks ago prompted her to consult a cardiologist.  And, while she did not have a heart attack, one was close, she was told, so the cardiologist inserted what turned out to be an emergent stent, then another one three weeks later.  So, she now has two stents, one less than me!

As I often do these days, I went on-line to get more information on what I call “stentology.”  So, I limit myself to the following top-10 list of questions and answers, which appear in no particular order of priority:

1. What percentage of blockage requires a stent?

Jon Resar, an interventional cardiologist and director of the adult cardiac catheterization laboratory at Johns Hopkins Hospital says this:  By clinical guidelines, an artery should be clogged at least 70 per cent before a stent is placed.  A 50 per cent blockage doesn’t need to be stented.”

• How long does recovery take after a heart stent is placed?

The National Heart, Lung, and Blood Institute suggests that, for many people, a full return to normal, everyday activities can take as little as a few days or a week.

• What should you avoid after a stent?

In most cases, you’ll be advised to avoid heavy lifting and strenuous activities for about a week, or until the wound has healed.  Plus, no car driving for about a week.

• How long does a stent last in a person?

It is permanent. There is just a 2–3 per cent risk of narrowing coming back, and if that happens it is usually within 6–9 months after installation.

• Why do I have to carry a stent card?

It documents the patient’s details, the length of time the stent should remain, and contact details for the patient to use if they have not received any dates for stent change or removal.  All of which is helpful information in the case of an accident or further hospitalization.

• Can you live a long life with stents?

A person with a stent(s) can be more physically active, travel, feel more energetic, and notice improvement in overall health.  As long as one follows a person’s doctor’s advice and consults the doctor regularly, there is every chance that one has a longer and healthier life span post an angio-plasty.

• How often should a heart stent be checked?

As recommended in the National Disease Management Guidelines, patients with coronary heart disease and those who have undergone stent implantation should be followed up regularly (every three to six months) by their cardiologists.

• Which is better bypass surgery or stents?

A narrowing or blockage in the left anterior descending artery (LAD) is more serious than narrowing or blockage in the other arteries.  Bypass surgery usually is the best choice for a blocked LAD.  If the LAD is not blocked, and there are no other complicating factors, stents are more likely to be used, even if both other arteries are blocked.

• How do you keep a stent from clogging?

Although drug-coated stents are much less likely to close up than bare-metal stents, the price of this benefit is taking anti-clotting medications for a year or more and then aspirin indefinitely to prevent the rare but potentially deadly formation of a blood clot on the stent.

1. Can you go through a metal detector if you have a stent?

You will not set off any metal detectors after stent implantation.

Okay, enough, but this final question:  How much does a stent cost?  Well, the answer, pertaining to a stent that is coated with medicine (as most of them are now), is $38,000.

For my wife and me, worth every penny!