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Spookygal

Well-known member
Joined
Jan 24, 2024
Messages
51
Location
NJ
So today I had my new cardiologist appointment - it went pretty well!

First of all, I instantly clicked with this doctor. He was really nice. He was really funny. He answered all my questions, and he just made me feel really safe and knowledgeable about everything that’s going on. The appointment was almost an hour. He answered every single question I had. He took a look at both my scans from 2022 and 2024 and he basically said that my regurgitation isn’t as bad as they thought initially. It’s mild at best which is great! When we went to the aneurysm part, he got a little confused… basically when I got my MRA in 2022 it said I had a dilation of 3.6 which is top normal and that was it. With my scans in 2024 it came back 4.2×4.1, but that was a CT, the echo also showed conflicting reports. When I told him I was here for basically a second opinion because I wasn’t really vibing with my cardiac PA. He said first and foremost, no offense, but as a nurse, you should’ve went right to a doctor - no shade to PA’s but you really need expertise when it comes to organs and things of that nature.

But we got back to the aneurysm part and he is sending me to get a repeat CTA this time. Then he wants me back in the office in three weeks to go over what he saw sees. Basically he’s not convinced that the readings are accurate because I went to three different places and got three different readings on and he wants his own hospital and his own radiologist to read my results. He even brought up my imaging in the office and was trying to measure them, and it just wasn’t adding up, some spots were vastly different sizes than other spots and it was just too unclear. There’s still a chance that my aneurysm grew exponentially and if so, we will cross that bridge when we get there but for now it is a “watchful waiting” until I get the results and I’m just hoping that it’s not as bad as it looks and the results were a bit skewed….

My cardiologist even gave me his cell phone number and said the moment I get the results give him a text so he can look at them immediately because he knows how anxious I am. It was really sweet.


He also said to postpone my cardiac surgery appointment I have next week because if I walk in there with what I have now, they’ll laugh me out of the room! Ha!


Also, I don’t know if I’ve mentioned this, but I have hypertension as well and I’ve been on lisinopril for a few years. He changed me to 25mg of Losartan today and added 25mg of Metoprolol as well. He said anyone with an aortic aneurysm should be on a beta blocker.

Hoping I don’t get too much of side effects from these new meds!! Has anyone had this cocktail before?

Also asked if I could drink coffee and exercise and he said absolutely.

All in all I had a knowledgeable conversation with a great doctor and while I’m still not sure how this will end, I had a good day. 😊
 
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Thanks for the update.

I'm glad that you found a cardiologist who is a good communicator. As I recall, your PA seemed at the opposite end of the spectrum. It also seemed that they were too eager to refer you to surgery. Given the size of your aneurysm, it didn't seem to make sense for the referral just yet. He is right that more data is needed before the surgery consult. Hopefully, there will be some good news from the CTA that you are still a ways off from needing surgery. Fingers crossed.
 
Spookygal, I’m pulling for you for more good news. You may end up on the watchful wait list for a while but if not you are doing a lot to be prepared for surgery.

A couple comments. It’s not surprising they have provided you different measurements across different imaging modalities. That’s pretty common. The CTA will be very useful information providing them an amazing view. Especially if they use 3D processing. This is a surgeons dream. However, I could be wrong but I thought MRI was the aneurysm confirmatory method. You may want to ask them.

Secondly, I was on an ACE inhibitor ( enalapril) and a beta-blocker (carvedilol) for 20 years prior to and after my initial aneurysm surgery. There were side effects early on but they do get better over time. Dizziness, short of breath, low heart rate mainly. But side effects do get much better and best of all you are quite protected. Prior to my last surgery I was switched over to an ARB (losartan) and I did some background checking. As it turns out ARB’s are now the primary drug of choice over an ACE inhibitor in patients with valve disease. You may also receive some early dementia protection as a “ side effect”. It was a pretty easy switch. After my surgery I am now on losartan and a diuretic, no more beta blocker.

You are doing a great job chipping away at this. Keep us posted when you can.
 
Spookygal, I’m pulling for you for more good news. You may end up on the watchful wait list for a while but if not you are doing a lot to be prepared for surgery.

A couple comments. It’s not surprising they have provided you different measurements across different imaging modalities. That’s pretty common. The CTA will be very useful information providing them an amazing view. Especially if they use 3D processing. This is a surgeons dream. However, I could be wrong but I thought MRI was the aneurysm confirmatory method. You may want to ask them.

Secondly, I was on an ACE inhibitor ( enalapril) and a beta-blocker (carvedilol) for 20 years prior to and after my initial aneurysm surgery. There were side effects early on but they do get better over time. Dizziness, short of breath, low heart rate mainly. But side effects do get much better and best of all you are quite protected. Prior to my last surgery I was switched over to an ARB (losartan) and I did some background checking. As it turns out ARB’s are now the primary drug of choice over an ACE inhibitor in patients with valve disease. You may also receive some early dementia protection as a “ side effect”. It was a pretty easy switch. After my surgery I am now on losartan and a diuretic, no more beta blocker.

You are doing a great job chipping away at this. Keep us posted when you can.
Thank you so much for these super helpful and kind words!! Sounds like you got it all figured out :)

I’m chipping away!! Trying to stay positive!
 
Thanks for the update.

I'm glad that you found a cardiologist who is a good communicator. As I recall, your PA seemed at the opposite end of the spectrum. It also seemed that they were too eager to refer you to surgery. Given the size of your aneurysm, it didn't seem to make sense for the referral just yet. He is right that more data is needed before the surgery consult. Hopefully, there will be some good news from the CTA that you are still a ways off from needing surgery. Fingers crossed.
Thanks so much chuck!
 
Congrats on finding what sounds like finding a good Dr. Someone willing to listen & giving good answers is very impt. Someone you trust can make a world of difference in your attitude and ease your mind. Right there is a reason to celebrate.

Am surprised he said it was OK to drink coffee and exercise though - what if you spill that hot coffee all over? (small joke)

I just wanted to say that although I've not had that med cocktail you asked about, metoprolol by itself really screwed me up. Could not function on the regular dose (think it was 25mg like you mentioned but don't remember for sure). Was too tired & sleepy to do anything but lie in bed, watch TV, dozing off all the time. Got confused trying to do anything especially driving, going somewhere. And horrible incredibly vivid nightmares that woke me up screaming. I've talked about it up here b4 in some threads. Some people do fine on it though, like Pellicle, saw him discussing it recently in another thread, think he's been on a form of it for years (but I 4get which one, tartrate or succinate, extended release etc?).
 
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