The procedures that we’ve been discussing are usually performed in cases where only one or two arteries are blocked, though there are exceptions. It’s important for you to realize that such procedures are palliative-that is, they relieve the condition, they avoid heart surgery, but they do not free the patient of coronary artery disease. These procedures are more likely to be effective when patients are ready to take charge of their own destiny by giving up cigarettes, by exercising daily, by reducing stress when possible, and by learning better methods of stress management. And, of course, lowering cholesterol is important.
Even under the best of circumstances, these procedures

require, before you submit to them, that you talk openly with your doctor about an alternative plan. Once again, if the doctor is offended or evasive in response to such questions, or if you have the impression that the doctor is too busy to answer your questions, you may need to find another doctor. Again, it’s your job to be courteous, open, and nonthreatening. It’s the doctor’s job to give you all the information you ask for.

It’s true that some patients don’t want to know. But if you were one of them, you wouldn’t be reading this book. In general, the better informed you are about a procedure and about what may follow, the less worried and the less anxious you’ll be. And the less worried you are, the better for your heart.

One patient who had refused angioplasty treatment later explained: “It wasn’t that I didn’t want the angioplasty. But the doctor seemed in such a big hurry, like I wasn’t important to him, I guess I was just scared. I wish I had asked more questions.” Take those words to heart. If things are moving faster than you’re comfortable with, slow them down. Ask your questions. (You’ll find more on this subject in Appendix 1, “Your Rights as a Patient.”)

Procedures involving the heart-coronary bypass surgery. angioplasty, stenting, or atherectomy-can be stressful anc even scary. Ease your mind by asking questions and gaining knowledge. Besides relaxing you and relaxing your doctor, this tactic lets the doctor know that, as an inquiring and informed patient, you have high expectations of him or her and of the hospital.

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