AORTO BI-FEMORAL BYPASS

My friend aged 51 had an aorto bi-femoral bypass 2 years ago. Her legs have started to burn when she walks even the shortest distances. She was told if she didn't stop smoking that the prosthesis would only last two years. She has been unable to stop smoking. What are your experiences out there? Does the prosthesis block up somehow? Can they open it again without doing another implant?
Any information or advice would be very appreciated.

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She needs to go back to her vascular. There have been many people on this board who have had to have their bypass redone because they blocked up. Some of them even within weeks of their surgery. She also can be clogged in other areas. From my understanding they cannot reopen the graft that was done and will probably have to redo it. She really needs to quit smoking. It is hard but you have to do it.

I am sure others will be along to post and answer your questions too.

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Thank you for your response Msmichie. I see all the trouble and pain you have been having and really hope that your doctors find the solution.
I never even knew there was such a thing as this operation until I met my friend. I really want to help her and find out if there are any alternatives to making things easier for herl

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Oh, yeah, the graft can block up again (occlude) for the same reason the aorta occluded. Unfortunately there is no crystal ball to predict when/if/how this will happen. When I had mine, I was told that it would last nearly the rest of my life as long as I stayed off the cigarettes. My graft occluded in around 6 weeks. I had another bypass and had an occlusion (not the whole graft this time - or so far I should say) in about 3 months. I had a re-do of the part where the occlusion is (where the graft meets the femoral artery in the groin) just a few weeks ago and I'm still in pain.

Although my doctors don't really know why I continue to occlude, why I'm still in pain and if there's anything that can or should be done about it, the consensus of opinion is that I would be in worse shape - or dead - if I had continued to smoke. Hard to do? OMG, I would have gladly gone through 4 more natural labors of 22 hours each instead because that would have been soooo much easier than quitting smoking. But I did it and there's a wonderful group here at Inspire just for people who are quitting - I've been on it and it's wonderful. When she's at her doctor's, ask him for Wellburtin (sp?) - it really helped me quit.

MsMichie is absolutely right - your friend needs to get into see her vascular surgeon immediately. Probably the pain she has on walking didn't just materialize but has been getting progressively worse for some time now. The sooner she can begin to deal with this new one, the better it is. Perhaps the graft is not 100% occluded and can be cleared or maybe it's another area that is acting up and can be fixed with something other than another big surgery. That's not something any of us can tell you - only her doc can. And if she's embarrassed to go back to her surgeon because she has not stopped smoking - I'm sure she won't be the first patient he's had who continued to smoke nor will she be the last.

What we can do is what we do best - listen and share and support each other - and even make one another laugh when things look pretty miserable. We would love to meet your friend if she would like to join us. There's little that can beat support when you're going through this - especially with something that it seems no one has ever heard about. Talk about special!! That's us.

Sharon

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I agree with everybody the 1st step is to get back to Dr. to find out exactlly whats going on.And i share her pain with the smokes i'm on again off again.As we all know this desiease is so frustrating and never ending maintence .I also had my graft cleared at the connection to the Illiac artery for scar tissue 1 1/2 yrs. after surgery.but if it occuled again i would have to have a do-over and i know this needs to be done now.Same pain ,purple toes and all the good stuff we got But waiting now for Social Security office to send me to their Dr. for disability claim.Keep us posted and know that we all care for your friend.

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Oh goodness! You all seem so positive even though you go through so much pain. My friend is much the same. Never complains. So Tember, you say you had your graft cleared for scar tissue? How long since that happened? So you would happily go through the surgery again? My friend says it was terrible! She actually was rushed back in after 12 hours as the graft failed and they had to cut her right open again and put another graft in. She is coming up for her 2 years on 30th June now. They told her it would only last two years!
How many times would they actually do this operation then on a youngish person?

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Well, aren't you sweet to say we seem positive. Sometimes it's hard to see that from this end. So thank you for that. I like to believe that we have a choice to laugh or cry - and usually we choose to laugh. It helps for those times when there's nothing to do but cry. And when the tears come - well, we understand that one too and are all here.

I don't know how many times they can do the operation. I know my surgeon has not eliminated the possibilty of another bypass surgery sometime in the future - and that would be my 3rd. Maybe someone here has heard of a number - I think it is probably just how strong a person is to be able to handle that operation multiple times. Remember, the bypass is one of the largest operation a person can go through. My surgeon told me after the first one that, if you quantify this surgery on a scale of 1 to 10, based simply on the level of assault the surgery has on your body, that it would fall right around 9.8.

And, I think also it would depend on how motivated you are. I gladly went through the second surgery simply because I was in so much pain I was willing to do anything that would stop the pain. Now? I'm in pain but not like before and, at the moment, I'm not putting another big surgery on my calendar. However, if my leg turned blue or my toes turned black or any other symptom that I might lose my legs - then I would be highly motivated to go through the surgery yet again.

As far as clearing out the graft, etc. - I'm sure someone here can tell you stories. I can't because my aorta was so occluded that nothing could be gotten in there to "rotor rooter" it and the graft was so occluded that it was considered "dead". ewwww, huh?

Has your friend called her surgeon yet to get an appt.? We're thinking of her.

Sharon

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Hi Kalonakini
Here in South Africa unless you have very expensive medical aid, you have to go to a government hospital. Getting to see a surgeon is such a mission that you tend to put it off. My friend was subjected to a very brutal hijacking by 7 gang members who were instructed to kidnap, rape, torture and murder a woman as part of a gang initiation ceremony. My friend fought for her life and after 6 hours she managed to steal one of their vehicles and escape while they thought she was unconscious. As a result of the abuse and damage they caused with kicking her in the stomach etc, the doctors feel that permanent damage was done and could be the cause of her PAD. She had terrible pain in her legs for three years after the assault until she collapsed and they diagnosed her and immediately did the transplant.
What I would like to know is, you all seem so young for such a horrible thing to happen? What causes it? My friend is very sceptical that smoking is the root cause. Is this what you have all been told?

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Sharon, you explain our situation so well.I thank you for that and your view on it.Sharzi i had my graft cleared 1 1/2 yrs after my Bi-Fem. Before my surgery at that time the DR. told me we were going to try this and if it was not successful we would have to re-do the graft with a new incission so i agreeded to try this first . I cried for a few days you would think after so many procedures that this is the one that will work.I've had stents balloned numerous times and i know this surgery needs to be redone .i probally should have went back in OCT. to do it but i'm still waiting it out .When i first discussed this Bypass with my Dr. i thought well this back and forth about every nine months for extra stents or to balloon both sets is really getting old and expensive much less time off my job that i had been on and loved for 9 yrs.It's a struggle to have all these invasive procedures that only cause more scar tissue which eventually is going to lead to Bypass and that doesn't take away your pain and symptoms like we all hope it will.It simply slows the process.In my case i inhertied this and i'm sure my smoking has not helped .Although my Dr. finally told me after crazy amounts of blood work and 3 years of trying to figure me out that i simply have extremly small arteries . When they measured my legs for the surgery we couldn't use them because they also were small and needed to keep them for later on in case i had to have them for my heart.And so we ordered one to make it work because what they keep on hand was to big and as you see this goes on and on and on.But most of all when you think about it i'm so apprecative of technology and how far it's came because without it I would not have my toes today and maybe not my legs,so we all do what we got to do to keep walking and sometimes we wait til we feel like we can't take anymore .You learn your body and it's limits and when it's time to go fix it again. I wish your friend well and hope for her not to have to wait for medical attention that she really needs.And God bless a friend that will take their time to learn how to be there and support her .She is lucky to have you

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the more i read the more i get scare in another words thsi surgery do not always work and might have to be redone, several times. i have blocakage in both legs one not as bad as the other.is seeen my vascular surgeron he ask me if i will consider surgery. are i will like to try medication but recomend me to have the sugery. he prescribe cilostzol 300meg half tab twice a day. one of he side affects is swelling . which is on just one foot which i lucky i can put my shoe on sometimes. i read that they found that asprin work just as well. the AMA study shown that people a who took asprin could walk 30% more than those taken prescribe medication. i started taken asprin and feel no different but without the swelling. my real concerns is that i so frail because of copd i do not know if my body could withstand multi sugeries. my PD told me to take asprin it help with the blood flow (thinning). but the phramiscts told me not to take asprin with the medication i was perscribe.

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There are some great websites about PAD that explains the causes in medical detail. Your friend had a horrendous experience and seems like an extremely strong lady. And that will hold her in good stead for the challenges to come. I'm not sure I could have survived what she went through. What's an operation compared to that?

Anyway, this is what I was told. My mother had a massive heart attack at 45 (and survived). My father had multiple strokes and arteriosclorsis. My brother had a heart attack in his 40's (and survived). My sister has PAD. My father smoked since he was 11; my mother smoked for about 20 years, my sister is still smoking, I smoked for 39 years and my brother has never smoked. My sister has high cloresterol, my brother and I were called "walking time bombs" our cloresterol was so high and no one knew there was cloresterol when my mother and father had their issues. There is an extremely strong family history for me and that didn't help. But smoking is the root cause of arteriosclorsis (hardening of the arteries), which is PAD. These websites can actually tell you the whys and wherefores - but I think we all have to admit that smoking played a real big role in our disease. It's a hard one to get our head around and it can bring up a lot of "what ifs" and even guilt - but there's no need to go there if you don't chose to. We didn't know - that's the crux of it. Everybody smoked when we were growing up - in movies, on tv, on the news - hell, even the newscasters smoked. We cannot hold ourselves responsible for that which we did not know. However - now is different and we make our choices based on our best information and take responsibility for those choices. Not good, not bad - just our choices.

My surgeon is, uhh, a different sort. The first time I met him, he walked into the exam room, slapped my films into the viewer and said "well, you're a prime candidate for a double amputation". Ummm, good morning to you too? lol Was he trying to scare me? Yep. Did it work? Sorta. It made me take my medical condition seriously - I mean really seriously. (and I trust him with my life)

So there you have it. Was I told smoking caused PAD. Unequivocally yes. Was it held up by research I did on the web? Yes again.

I would suggest, since it seems that getting an appointment is a chore, your friend starts now to get in. I know it's easy to procrastinate, but the possible ramifications aren't worth it. This disease doesn't just cause pain - it can do some serious damage that you don't really want to think about.

Please keep us in the loop with your friend and tell her I admire her tremendously for having survived and know that strength is there to do anything she needs to do.

Sharon

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P.S. - I too have extremely small arteries. I have no idea if that has anything to do with it but I know it drives my surgeon nuts - the last surgery he had to literally rebuild a portion of the graft to make it fit into the artery. And it is extremely discouraging to go through these procedures hoping this last one will work - and it doesn't. But one of the members here reminded us that all these procedures, including the surgery, are nothing more than bandaids. There is no cure. One time before my second surgery, I was soo discouraged. I wanted a cigarette so bad, I was in pain, I didn't know how I was going to finish my work that day and I didn't want to deal anymore. So I went outside to go buy some cigarettes because I had just had it with the whole world's situation. I walked outside and there was this guy getting out of a van. He was in a wheelchair. He was a double amputee. And he had a cigarette in his mouth. Sometimes you get a little help remembering what's important and why you're going through all this - bandaids and all.

Sharon

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i got a appt .tomarrow with the surgeron what i read i think i going hold out and see the med help out. like u kal i have small arteries and veins j i have to have a special needle just to draw blood. and the area get badly black and blue

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just got back from sugeron had a few questiona none answers why i geting cramping at nite on the bottom of my feet that keep me up most of the nite. the puffyness of my feet. told me it a lack of use umm. the discomfort i getting moving my big toe.

the sugery is up to me i told him let see how the medication he gave me u said it take about 12 weeks to see any improvement. than he said the medication just relive ur symtoms not improve ur PAD the tightness of the calves when walking.

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Seems to me that amputee was a God-sent sign for you then!

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Hi there
I was hoping somebody would be able to give me some answers. Can somebody who has had Aorto-bifemoral bypass take long flights? Is it safe? Are there any possible problems she could suffer? Any precautions she should take etc?

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Hello Shariz, just wanted to touch base with you and tell you that i had 2 stents put in last week in my graft so they can try to open the graft before replacing it. just wondering how long these will hold up. cleared it last July ,Stents this July oh goodness it never seems to end.

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Hello Tember
I am so sorry to hear that you have had to have a further procedure. I understand how you must feel that surely this is the last procedure and now you can just get on and live your life. But as you said, you are so grateful for the technology that has allowed you to continue functioning and being a valuable part of your family's lives.
Keep keeping on Tember.
God Bless.
Sharon

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the more i read about the operations more i think noway i'm going though this. i so frail from COPD and my veins are small. giong push more on my execcises i can do and them med i was prescribe. if they can fine why i getting the cramps and discomfort in my big toe i think i will being able to live with not havin the operations.

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bgri50, i'm sorry that we scare you with our complications with this ,but you need to listen to your Dr. and learn what your body is telling you .If your toe is hurting maybe you are blocking off again sometimes my toes hurt and feel like thier itching and burning on the inside

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