I hate my Cardio today

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kevin21

Hi Guys,

I've been in and out over a good 5 years to this site.


Today, 4 days after I did another 6 month Echo and a CPET(first one), I get a call from on of the RN's up in his office with the results. She tells me he says he recommends surgery and have I ever seen a surgeon.

Of course I have 1 billion questions. #1 WHY IS HE NOT HAVING ME COME IN TO TELL ME THIS HIMSELF??????

Is this normal protocol? I know I need surgery, have for about the past ummmmm 21 years. Why all of a sudden is he gung ho on it and he's been a wait and see guy so far? What did he see that made him say go see a surgeon? Is she reading notes from past visits? WTF? (sorry)

I called to make an appt, for me to come in to discuss. I get "first avail. is March 31". Are you kidding me? You say the S word and nearest time is 20 days away. I don't think so!!!!

I told her to have him call me asap. I don;t think this is proper technique for a guy that has been my doc for the past 15 years, do you???

He may be humored to know that his RN is spouting off to people over the phone. Honestly!!!!!!
 
Here are some of the Echo results.

Can anyone tell me where the mean gradient is on here? How bad do I look (you guys in the know)?

AoR Diam 4 CM
EF 55 to 65% est.
LVOT Vmax 110 cm/ s
LVOT Max PG 5mmHg
AV Vmax 131 cm/s
AV Max PG 7 mmHg
LA Dimen 3.3 cm
Severe Aortic Regug (duh)

It says no significant change from last test.

I'm betting this girl jumped the gun.
 
Just wanted to say "I agree", your doctor of 15 years should have at least called you himself to tell you the news. A call from a nurse to basically say "See a surgeon." is pretty poor.
 
Sorry to hear you have received this news and also think it was handled poorly by your cardio's office. Such a message should be delivered by your doctor IMO..... ONLY by your doctor.
 
nurses call for surgery

nurses call for surgery

hi,
i know how you feel though, just getting through to our cardio or surgeon is a chore. we tried a new one today, but it wasnt much better, he didnt have much to say. just wanted someone we could communicate with, but i guess that is a thing of the past. so on with surgery and our own research, i wish that i had a doc that i could sit and ask questions to and they would give of their time. if we had more time then i guess maybe we could find one, there is just not enough time so i guess we have to go with the best that we can in the time frame that we have, that is just how it is. good luck to you though since you have had him for 15 years you must like him some, just see if you can talk to him on the phone at least.
alpha 1
 
Kevin, I agree that your cardio's nurse should have asked you to come in for an appt with the cardio to discuss the echo results. I know this is a big bomb to have dropped in front of you, but seeing him on
March 31 is probably the best they can do. Hang in there!
 
Kevin:
Sorry you've encountered this. I'm sure you're in a big state of shock about the change in his thinking.
What's the comparison of the latest results with the last echo's results?
In order to really be properly evaluated by a surgeon, you would need to have copies of various reports from the cardiologist. Therefore, no, you could not have seen a surgeon yet.
Before my husband could see a surgeon last spring, he had to have copies of all his echoes, stress echo, heart cath & TEE. We took them to both surgeons we had consults with.

Have you had any tests, other than the echoes?
 
Kevin, I can relate to the "shock" of the sudden change in your direction when everything is apparently the same as it has been. I have lived 44 years thinking everything was basically "fine" until my cardio told me last Sept. he thought it was time I persued getting my heart fixed. However, he told me that in person and then asked me to bring my husband back in the next week so that he could talk to both of us about what was going on. Since then, he is always just a phone call away and has been very supportive of me. I think your cardio at least owes you a decent phone coversation. Good luck to you.

Kim
 
Maybe it's time to see another cardiologist? And to start looking at your options for a surgeon? If you're in Houston you're very lucky.

Take care of yourself and it's so good to be proactive.

Judith
 
kevin21 said:
Hi Guys,

I've been in and out over a good 5 years to this site.


Today, 4 days after I did another 6 month Echo and a CPET(first one), I get a call from on of the RN's up in his office with the results. She tells me he says he recommends surgery and have I ever seen a surgeon.

Of course I have 1 billion questions. #1 WHY IS HE NOT HAVING ME COME IN TO TELL ME THIS HIMSELF??????

Is this normal protocol? I know I need surgery, have for about the past ummmmm 21 years. Why all of a sudden is he gung ho on it and he's been a wait and see guy so far? What did he see that made him say go see a surgeon? Is she reading notes from past visits? WTF? (sorry)

I called to make an appt, for me to come in to discuss. I get "first avail. is March 31". Are you kidding me? You say the S word and nearest time is 20 days away. I don't think so!!!!

I told her to have him call me asap. I don;t think this is proper technique for a guy that has been my doc for the past 15 years, do you???

He may be humored to know that his RN is spouting off to people over the phone. Honestly!!!!!!
Click to expand...
Kevin,
that's messed up. I would keep calling.
be persistent.
they should have neve left you in the dark like that.
 
Kevin, It seems unusual for the nurse to give you this news. Who is your doctor and where in Houston is he located? If he is in the Medical Center, particularly St. Luke's, Methodist, or TCH, the wait for an appointment is pretty standard. People come from all over the world to see those docs and they make their appointments months in advance. If he is outside of the Medical Center, that is unusual, but remember that most schools are on Spring Break next week, so perhaps he will be out of town? Still, this news should have been delivered in person. One thing about doctor's offices. They are so used to dealing with these things that they sometimes forget what a shock it is for others.

The good news is that he obviously doesn't think this is an emergency.

My Cardiologist is Philip Berman and Surgeon was Donald Gibson. They are both at Memorial Hermann-Memorial City, which has a large Heart & Vascular Institute. According to their website, they see 6,000 patients each year. Dr. Gibson is Baylor trained, and I recommend him highly. If you live in the west part of town, you might want to visit with him. He is very proficient with the Da Vinci robotic thingy and beating heart surgery, although I'm not sure if either of these things are an option for you.
 
Hi Lisa, I guess Houston is one of the places to be in terms of heart related problems. I live up near the woodlands and my Doc is up here. I actually saw a surgeon (at St. Lukes Heart center in the Med Center) about 3 years ago and he did a TEE and MRA on me and agreed to wait and see with my cardio (though I'm 95% sure he never talked to him). If I have surgery it will be down there at St Lukes or Memorial. None of this regional hospital junk up here in the woodlands. Give me access to a pro and the rest of the "bad asses" down there in the Med center just in case!!

I called this morning and they tried to tell me I had to speak with the RN again and I basically demanded that the doc make time or speak with me over the phone. I wouldn't pull that kind of stuff with one of my long term customers.

If I don't get a call back today I', going in there tomorrow and demand to see the guy for 5 freaking minutes.

It is probably time to seek out another Cardio. I think someone down at Memorial or St Lukes is the ticket. Just hard to go and explain 31 years of heart BS to a new person.
 
Kevin, I used to work at Houston Northwest Medical Center and saw a Cardiologist up there for a while. He is in a group practice called North Houston Heart Associates. His name is Gary Coleman (not the Different Strokes kid!). They have an office in The Woodlands. I'm not sure if this is who you are seeing now, but he was always available for me. In fact, my office was in the same building and when I was having issues with Pericarditis, I could call, get on the elevator, and usually be seen within 30-45 minutes.
 
Lisa,

I see a Dr in that office. They called to tell me he would call with the RN tomorrow and that he wants me to see the surgeon I saw a few years back.


Should I see 2 or 3 surgeons? I felt pretty good with the original guy I saw but I guess I need second opinions.

I'm kind of leaning toward tissue at this point, due to my lifestyle and my tendency to suck at taking my medicine. I don;t know if I have the patience to manage coumadin. I'm 31 and I know re-op would be sooner but when you're out building sheds, working in the yard, chopping wood, and rough housing with a 3 yr old (and a 6 month old) I think bruising and cuts would be an issue for me. Someone also mentioned a bruised member after sex? No Way!!!! That does it for me right there.

The timing of this is going to stink. I currently run an insurance office and I am building custom homes on the side (including my new home).

2 weeks without work and I may never go back in due to the pile-up. I also don't need my house sitting idle while I am down.

Maybe he'll give me a few months to make some plans. Man I hope I come through this. I can't leave to little guys without their daddy. 3rd OHS (one at 6 and one at 10) may prove a bit trickier than some one on their 1st. I'm a pretty strong and fairly healthy guy (i lifted and did cardio for 6 years, up until about 2.5 yrs ago) so I should have a good surgery and recovery. There will be some old scar tissue and wires in my sternum so I hope that isn't an issue.
 
I only saw one surgeon, but since I had worked at the hospital, I already knew his background and he came highly recommended. I also trusted my cardiologist implicitly. I think that after you've spoken with your cardiologist, you'll have a better idea of what to expect from the surgeon.

If you have had your chest cracked twice already, you probably have a build-up of scar tissue and repeated surgeries become more complicated. Coumadin is not really that big a deal. It's a pill or two each day. I'm not sure about the member as I don't have one :D , but do you really examine it that closely afterwards? :D :D :D

Good luck with your phone conversation. I know that this is worrisome now, but look at how many people on this site have been in your shoes. Chin up!
 
Kevin,

Just wanted to wish you good luck with it all. I am due for surgery soon and only chose to see one surgeon but he came highly recommended by some others on VR.com and I was really happy with the way he spoke to me and his level of experience. Let us know when you have booked a time for the visit and also what your cardio says when he calls....
 
Per your question, gradient is measured in millimeters of mercury (mmhg). Your aortic notation was: "AV Max PG 7 mmHg." AV means "Aortic Valve," PG means "Peak Gradient."

You have aortic regurgitation, so it's not a very high number. Stenosis makes it bad. My peak gradient a couple of months before surgery was 68 mmhg...

Best wishes,
 
Doc called at 4:45 yesteray.

About time.

He says that he thinks the valve leaking is weakening me more than I'd like to let on. We did that CPET Test (the one where you ride a bike and do breathing exercises) and it showed my activity level as being restricted for my age.

My problem with this test is 1, I had bronchitus no less than 6 days before the test and was just finishing a Z-Pack of anti-biotics. In fact, during the deep breathing I was wheezing due to the lung stuff. I don't ever wheeze when I am not sick. Number 2, it was done at 9:30 am and you can't eat breakfast. I never worked out in the am. My peak is in the PM.

I think I will schedule another one of these things now that I am not sick.

However, my echo looked the same as the previous ones (over the past 2 years). No enlargement of the LV etc... EF was 59% est.

I'm going to see the surgeon, who last time said I could probably wait. He may get me another TEE to check it out. TEE's suck but not more than the actuall surgery.

We'll see. My parents and wife don't know what to think. I tell them don't worry. You're not getting rid of me that easily.
 
tobagotwo said:
Per your question, gradient is measured in millimeters of mercury (mmhg). Your aortic notation was: "AV Max PG 7 mmHg." AV means "Aortic Valve," PG means "Peak Gradient."

You have aortic regurgitation, so it's not a very high number. Stenosis makes it bad. My peak gradient a couple of months before surgery was 68 mmhg...

Best wishes,
Click to expand...

About 5 minutes after I asked that I realized what the measurement was for.

If I sit and think of the physics of the heart I can usually figure out what measure is for what and why one affects the other.

The heart is complicated but not the dynamics of it. I have an engineer side to my brain. Good thing I chose to work in sales (idiot)...
 
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