Welcome to Dr. Warrick's podcast channel. Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love. Hi, my name's Dr Warrick Bishop, and I'd like to welcome you to my podcast and videocast station. Today, I have a special guest, Brian, who's recently gone through stenting, and I've asked if he'd be good enough to share his experiences with us today. Hi, Brian, how are you? Hi, Warrick. Feeling pretty good, mate. Thank you. Look, just by way of background, Brian... Tell us a little bit about yourself, your age and your background, the sort of work you do and your family. Yeah, look, I'm 59, just about to turn 60. A father of a 21-year-old daughter and 19 today, so it's his birthday today. He's happy. And, look, I was born on Flinders Island. I've been a country boy most of my life, or through my youth anyway. And I basically got into working in manual labour because I always enjoyed that sort of work. So I've been in the building industry, in the marine industry, the fishing industry, and sort of later in life I've got into boat building and sort of focused on that side of things. So that's pretty much it. So I sort of understand and recognise you've had some areas of interest outside of work, obviously, and you've kept yourself fit. You're a surfer, but you've also done some other physical stuff to keep fit over the years. What sort of things do you do to look after yourself in a health perspective, Brian? Well, as I said to you earlier, I've always been an outdoors type person. So basically, you know, a bit of bushwalking, just staying generally active, boating. I do a lot of boating. Well, I try to go for fairly regular walks. Occasionally I'll get on the rower, not as much as I'd like, but generally I suppose surfing's what's kept me fittest. I always made a point of running when I was going for a surf and running home when I left. So I tried to combine my fitness with my interest in surfing. Because we've talked about it before, there's been a family history of heart-related problems. Can you tell me a little bit more about that? Yes. Well, look, I mean, it's family hearsay, but basically from a young age, I was told that no male had lived past 50 years of age on my father's side. My father made it to 72 years old, but he had his first heart attack at 49. which created damage to his heart and really had a pretty hard life until he made it to 72. So we were aware that there was a strong family history. And just for those listening, what age are you at the moment, Brian? I'm 59, just about to turn 60 in a couple of weeks' time. So it seems like you've just about dodged the family curse. Well, it does, yeah. I'm pretty happy. From what I understand from what you're saying, I have dodged a bit of a bullet. So maybe let's wind back. I know the last couple of months have probably been a little bit confronting for you and have led up to you having a stent in one of the arteries in the heart. If you don't mind me sharing, some of the people listening may know some of the language. So Brian has had a stent placed in the... a beginning or proximal part of the left anterior descending artery. The left anterior descending artery is the one that runs down the front of the heart nearest the breastbone or the front of the chest wall. So just let's wind back a couple of months or however long we need to. Brian, tell me the story about how all that came about. Well, look, over the years when I was seeing my GP, he was generally very unhappy with my cholesterol results. And this went on for years and years. And I didn't like taking the statins, but I did try on a regular basis and took them for quite a few years. So probably about three years ago, I had a visit to my GP and I just asked him a question, was there anything available that actually looks at the arteries around your heart? And so he mentioned to me that there was a thing called a CT score. It all went over my head. But I thought that sounds interesting. So I put it in my mind that I would get it done. But being a typical probably male Aussie, I just kept putting it off because life was getting in the way. And maybe thanks to the coronavirus, because we couldn't do our... annual surf trip to Southern New South Wales, I decided to go and get the CT score done. And basically things unraveled from there that the CT score came back, not very promising. And then pretty quickly I was in to see you and I was really glad about that. Well, from my side of the story, your GP, who's an excellent GP. made that arrangement for your CT scan. And when that GP got the scan organized, asked me to look in on it and offer some advice. Well, certainly by looking at the CT, there was a suggestion that there could be narrowing in the arteries. Our test is not perfect for telling us about narrowings, but does tell us if there's rust in the pipes. And we got you in pretty quickly for a treadmill test. Do you remember that? Yes, it was all very quick, actually, and I think I'm pleased that it was. Well, we found actually surprising very little on your stress test, if you recall. You actually performed pretty well, and I think this is an important reminder for people listening and particularly coming back to what we've talked about before. If something doesn't feel right, it's probably worth getting checked out. Tell me about the symptoms that you had. as you used to run along the beach getting ready to go for a surf? Because we sort of started to get a small replication of that on our treadmill test, and that was enough for us to go to the next step. Yes. Yeah, well, as I discussed with you, I really had no chest pain, a tiny little bit of breathlessness, but nothing that I thought was out of the ordinary. But my main symptom was when I was running up the beach to go for a surf, I could feel my heart getting substantially out of rhythm. And I tended to ignore it because I've had a history of ectopic heartbeats and I just put it down to that and that maybe they were worsening. But as it turns out, it was different to that. So pretty much it was the heart being substantially at a rhythm when I was running. So in essence... That was my main symptom. Yeah, so in essence, really not a lot. And from... My experience of caring for you, when we put you through that treadmill test, you had a good exercise capacity, not a lot of changes on the ECG. You did have a little bit of shortness of breath, but nothing staggering. And in fact, because you're pretty fit for your age, you're as good as average, actually, perhaps even a little bit better. But what we did see was a suggestion of some minor changes on the ECG, not a lot, some minor changes in recruitment of the heart. But we also saw some of those extra beats that you were describing. And that was a bit of lack of blood flow, potentially lack of blood flow, causing some irritability to the heart muscle. I think with that, I said to you, we should get on and have a look at your arteries in more detail. And I think we did that within a week or so. Is that right? Yeah, it was very quick. I don't think it was even a week. It was very quick. We got you on some medication. I think I'd already spoken to the GP and made sure we got you on medication immediately to try and make you as safe as possible, as soon as possible. We got you in for the invasive coronary angiogram where we literally squirted die down the arteries. And in fact, it did show a very tight narrowing somewhere around 95 to 99% down the artery running down the front of the heart. That particular location has been referred to as the widow maker because it has been the location of a ruptured plaque that's led to sudden cardiac death. quite unexpectedly in blokes at a relatively young age. So having found that narrowing, we kept you in hospital overnight and I organised for one of my colleagues who implants stents to help out the next day and open that artery. Just tell me how you felt after, tell me what the angiogram was like for you and then how you were emotionally that night and the next day. And I suppose this is a point I'd like to make to anyone listening is I found the whole process extremely easy. I was fairly relaxed through the whole thing. Even though they keep you awake, they give you a drug that makes you feel sort of comfortable. And there was no pain involved. And I literally found the whole thing really interesting. And when you told me afterwards I needed a stent, I thought, oh, well, good. We know what we're doing. And I was wrapped when you told me we'll be doing it first thing in the morning because I thought, right, let's get it done. And I wasn't going to be waiting around for weeks stressing about what may happen. So, yeah, look, I really did find it quite easy. And the night in hospital, I loved it because I was getting full attention. And, yeah, it was really quite enjoyable, to be honest. Wow. I think that's pleasing to hear from this side because we want to be caregivers who make the journey as smooth as possible. I have to let you know that when I saw the narrowing in the artery, it was really my poker face that said, look, Brian, we might just keep you here overnight and see if we can sort things out rather than throwing my arms in the air and go, wow, that looks a bit scary and you could almost die. I try and play that down for everyone's best outcome, but certainly no anxiety. around that space is useful. So you see yourself through it smoothly. Yeah, I think that was a really good move. Look, I cottoned onto it probably halfway through the night. I thought there might be a little bit more going on here than what you were letting on. But I think it was, as I say, the whole process was really easy and great. Look, certainly from my perspective, one of the things that I think is really, although you left... getting a CT scan may be three years longer than you should have. One of the things that I think is incredibly valuable from this, your story is that we can sort out these potentially life-threatening problems between nine to five, Monday to Friday, with clear heads, with clear thoughts, without ambulances, without that risk of... heart attack and dropping dead because we had the chance to look at your arteries and see what was going on in advance of a problem occurring. And I think that's an extraordinary opportunity and your testimony to just how valuable that is. Yes. Well, I think, I mean, to me, I suppose I look back at it and think, you know, it was intuitive for me to go and ask, you know, is because I had no idea. to go and ask, is there some way they can look at the arteries around your heart because of this problem of family history and also that my doctor was never happy with my cholesterol levels. So to me, it just makes a lot of sense. If you can actually look at the arteries right at the heart, why wouldn't you? So one of the things that's really important to me is if we find individuals who have problems with their arteries to ask the question about other family. who could be at risk. So do you have brothers or sisters who you need to speak with and talk about getting checked out in a proactive way like this, Brian? Yes, look, I've got a sister. I've got two sisters still alive. And one of them's had a lot of major health issues unrelated to heart disease and is in quite a bad state. I won't go into it because we haven't got time. My sister in Adelaide, I did have a talk to her because she sort of reminds me of me a fair bit. And I just mentioned to her that, you know, maybe she could think about it, asking about a CT score. And look, I'm not sure what she's thinking, but the one big difference between her and me is her cholesterol levels have been substantially under control. So I think at the moment she feels pretty happy about her state. But, you know, from what I've learned after reading your book, you just don't know. And if you can get a picture, that might tell you something that you're totally unaware of. Yeah, I think there's some truth in that. Look, Brian, apart from coronavirus potentially mucking up your plans so that you could get this scan done, do you have any advice for others? So we may not have another coronavirus shutdown that forces people to go and get their heart scan because they couldn't go on holiday. But apart from just your particular opportunity to get a heart scan done, what would you say to others who might be listening? Look, I'd basically just say, as I've said before, you know, I'm an outdoors person. I'd always relied on my physical strength to barge on through life. And having had this lesson, I think I'd say to people, you know, if you're a bit worried about it and, you know, you're sort of noticing things that you're not quite sure. you know, it might be worth a talk to your doctor about having a CT score done. But certainly I'm so glad that I did it because I think I was on the edge, as I've said. So, yeah, my advice is, you know, just don't tough it out so much and don't let the stresses of life and the busyness of life stop you from investigating, you know, what... potentially wouldn't be a problem, but it's really nice to know, you know. Yeah, don't let life get in the way of saving your life. Yes, that's right. Brian, I'm going to wrap it up there. I thank you so much for your time. For those who are listening, that story is just remarkable. Brian and I will probably start surfing again in the next couple of weeks. I was out yesterday and Brian's now been given clearance to start surfing again. Absolutely. And it was quite a bizarre feeling for me because I saw you on Friday and you gave me the all clear. And that afternoon I was at the front of your house having a lovely, I've got seven lovely little waves and just kept looking up at your house thinking, wow, this is quite surreal, you know. And I'd like to thank you very much. or basically saving my life. That's the way I feel. So thank you for it. Thanks very much. It was a part of a series of events, but I was delighted to be part of it, Brian. And look forward to seeing you in the surf. And the kids have said you can drop in on them anytime. That's great. You've got wave priority from now on. All right. Look, thank you so much for sharing. For those who are listening, I hope you took something away from Brian's story. Thank you so much for joining me. If you have any queries or questions, drop me a note at info at drWarrickbishop.online. Take care. Thank you for being with me. Until next time, please don't die from a heart attack. 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