A Story Illustrating the NECESSITY of a Second Opinion (and following your gut)

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pipersmith

I haven't checked-in in a bit. I would like to share what has been going on in the hopes that everyone (someone else) will really see - what you all have said all along - get another opinion and listen to your gut feelings!!!

I was diagnosed with aortic insufficiency in July. Nothing at all is wrong with my valve - it is just leaking. I have had no/little pulse in my left arm with very low blood pressure in that arm, and severe dizziness and vision disturbances, and a few instances consistent with a TIA. My cardio disounted the blood pressure variances - "that happens with insufficiency." I asked so many times "why when my heart function is normal (EJ and LVF, etc). He continued to ignore my questions. Though my gut kept telling me I had a secondary issue - I liked him and trusted him and just accepted his answers. Some of you may remember that I have asked extensively about these issues in here (blood pressure, neck pain, vision disturbances).

Sunday, I passed out and had what seemed to be a seizure. Thank goodness for an awesome ER doc. He admitted me saying I should not be living with these issues - I would not leave the hospital without some answers. I spent 2 days in our local hospital - many tests until they finally realized that ALL of the large vessels in my chest (going to my arm and head) are stenosed - some almost completely blocked. I was sent to a larger hospital (Vanderbilt) where they did extensive tests (and LISTENED extensively) and I was diagnosed with Takayasu's Arteritis. They started me on steriods and I am feeling better. I have much to learn and issues to deal with - but I am feeling so optimistic and I am at least treating the correct condition now.

I was scheduled to have a tubal on Thursday (that I did not need and could have been dangerous). My blood pressure in my arms has been really low, and the blood pressure in my legs crazy high. After the tubal - the surgeon was planning to schedule a Cath and then an aortic valve replacement surgery. Hopefully, the cath would have discovered the blockages, however they are not near my heart - so that may be a slim possibility.

Here is my point - the valve problem was a symptom - not a diagnosis. My cardio found the first problem, assumed that it was the answer and stopped looking, even though there were MANY signs. For instance, the doc that did my TEE said "look for blockages in the upper chest" mentioned "subclavian steal" - so they did an MRI that only went as high as the arch of my aorta. If they had followed his advice - they would have found the blockages. I asked him pointed questions on every visit (thanks ENTIRELY to this site!!) and he assumed that I didn't really know - he was the doc. I will admit that this is in hindsight - and I really did trust him. I SHOULD have taken the initiative to find another opinion, as many have said before. My diagnosis is rare, I do not expect that the first person to look at me would have found it - I do expect that doctors should do more than scratch the surface. I came dangerously close to having several procedures that I DON'T need.

I am not whining - I hope it does not appear so. I think that events conspired to put me exactly where I needed to be. I am lucky, I have EXCELLENT care. This came together like a puzzle. I just want to stress that you should research AS MUCH AS POSSIBLE so that you can be as informed as possible, ask questions, seek additional input - even if you are happy with your doc, follow your instincts. I was not being a hypocondriac - I was sick. I knew my body - and I let it go when I should have pushed harder.

These answers may not be for everyone's issues - but in the case that they may apply: (You never know)
the neck pain that I complained about was from the blockages of the arteries in my neck.
the vision issues were from a lack of blood and possibly some vessel issues in my eyes themselves (still to be determined)
the artery going to my left arm was almost completely blocked (+90%). To the point that my body formed another vessel to feed my arm. That was why no one could find a blood pressure or a pulse.

The best news is - if the steriods continue to decrease the inflammation (Takayasu's is an auto immune disease). Then I should not need to have the valve replaced - certainly not in the near future!!!

And - if anyone is considering Vanderbilt - THEY ARE AWESOME!!!

My last question is - since I likely will not need a valve replacement - can I still hang around here - I LOVE YOU GUYS!!!!! (it is still leaking :) )
 
Best wishes. I sounds like you will have something to really be thankful for next week for Thanksgiving.:D Keep us posted.
Barbara
 
exactly why everyone should seek a 2nd or even third opinion. and another reason to look beyond your local community hospital. Vandy is a University of excellence. Good decision.
 
pipersmith said:
...Here is my point - the valve problem was a symptom - not a diagnosis...
I am not whining - I hope it does not appear so... I just want to stress that you should research AS MUCH AS POSSIBLE so that you can be as informed as possible, ask questions, seek additional input - even if you are happy with your doc, follow your instincts. I was not being a hypocondriac - I was sick... I knew my body - and I let it go when I should have pushed harder...
Thanks, Piper. Good points. And, NO, you are not whining. We are all educated by your explanation of your personal experience. Thank you. Hoping you continue to feel better and better...
 
I'm so sorry that it took so long for them to find the answers, but so thankful that you were persistent and they did. Thanks so much for sharing this with us- your message is clear and of course we want you to stay around- your input is invaluable! Best wishes that the steroid treatment does it job and a huge sigh of relief that you have found the answer and the best of all medical care!:D
 
I echo Lynn's reply---WOW! And I definitely wouldn't call it whining.
Happy that things are now headed in the right direction.
 
Thank you so much for sharing your experience. It is an encouragement to all to pursue answers. Even in areas thought to be well understood, there is still so much to be learned. It is very easy to see just one part of something, not realizing that there is much more to the picture.

I have heard of Takayasu's arteritis in connection with aortic aneurysms in the chest. Here is one of no doubt many resources about it
http://vasculitis.med.jhu.edu/typesof/takayasu.html

Best wishes,
Arlyss
 
Wow, piper ...

You should be on Oprah! WomenHeart.org has a symposium every year at Mayo which trains you to be an advocate for women with heart disease. I went this year, and met an incredible group of young women, all with various diseases. I left feeling less alone in my diagnosis, and ready to challenge any doctor who implys that my symptoms are "all in my head."

I also was diagnosed with AI three years ago, and my doctor at the time said he couldn't explain my symptoms, that they were "all in my head." A cath to check my coronary flow found occlusion of the small arteries feeding my heart, microvascular disease. The medications I take have slowed down the disease process, and have improved the symptoms.

Best of everything,
 
I had noticed.....

I had noticed.....

Hi Piper, I had noticed you hadnt been around for a few days. Boy, thats some story. It amazes and frightens me all at once, because what you say about ''your gut feelilng'' is exactly how I feel. I just know I couldnt feel this unwell without there being something 'nasty' going on and yet it seems as long as im breathing and able to stand up NOTHING is gonna be done about it. I hear words coming out of my mouth, I see my doctor dismissing what Im saying as clearly as if its written all over her face, and then I sit there while she (or he) speaks back to me, all the while a feeling of despair coming over me, because I know in about 2 minutes i will be walking out the door on my way home having received no help whatsoever, and crying inside. I dont have the finances to demand second opinions etc so I feel like Im STUCK. Sorry Im rambling on but its just that your story makes me see that what is happening to me is real. So much so that Im going to uproot my family next April and move to England in the hope that I get better care there. But April seems soo far away, when every day is a struggle.
*Anyway, I am truly pleased for you, I know youve probably gone through a lot to get to this point, and I hope your health continues to improve. What is life without our good health....
 
What a story! Thank goodness you had an ER doctor that wasn't going to just look at your previous Dx and assume the cause lay there.

And the answer to your question - YES! Please do continue to hang around here. We'd miss you!
 
Oh My Goodness, that is quite a saga! Something everyone should read, whether or not they have cardiac issues. Most of us tend to trust our docs (and usually with good reason), but it doesn't mean we shouldn't listen to our bodies and take our symptoms seriously if we aren't getting a good answer (or a good listener!).

Sorry you had to go through all of that, glad that the steroids are helping you feel better. And great news that you may not need a valve replacement, but you are already stuck here with VR.com!

Take care,
 
Piper,

I have to echo what everyone has said so far: Wow! -what a story! Thank goodness for that ER doctor - you were very lucky he was on duty!

Hope you continue to feel better and get more answers about your condition.

I would also like to echo your advice about being your own health advocate. One suggestion that I would urge all of you - especially any "newbies" to the board - get copies of all medical tests that you have done! In the last 6 months I have been dealing with other health issues other than my MR and have experienced 2 problems:
1) in February the report from a chest CT scan was not sent to my GP or the GI doctor who ordered the test but instead was sent to my ENT doctor who fortunately notified me there was a problem. I immediatley contacted my GP who sent me to a pulmonologist. By the way the GI Doc called me in AUGUST and wanted to know if anyone had talked to me about the nodule on my lung that was found in February. Do you think he needs a better system of keeping track of tests he sends his patients for????
2) never hearing back from my surgeon about my upper GI and when I called him he apologized and said the report was filed in my chart without him seeing it.
Moral of the story: You need to get copies and then follow up with someone because they don't always follow up with you.
 
Hello,
I used to work as an RN in a radiology suite where we would image various vasculature in our patients. I remember only one patient diagnosed with "subclavian steal" and wanted to attach a link to clarify the definition. The link that gave the difnition in more layman's terms that I found is:
http://www.medterms.com/script/main/art.asp?articlekey=23015 and states:
Exercising the arm causes the blood flow to reverse and the subclavian artery "steals" blood from the vertebral artery. The subclavian normally supplies blood to the arm while the vertebral artery conveys blood to the brain, so what is happening in the subclavian steal is that blood meant for the brain is stolen by the arm."
So, when the person does exercise such as painting or cleaning out a cabinet above your head, the person might get dizzy because the subclavian artery is taking or "stealing" blood from your vertebral artery which normally supplies your brain.
Just an FYI about a fairly uncommon diagnosis... - SaraC
 
Congratulations on getting a proper diagnosis. I am sure you are relieved that you now know what is going on with your body.
 
You rock Piper!:) I am so glad you got proper care and a diagnosis...unfortunately that can be hard to get sometimes...keep us posted! Deb
 
That is quite a story!! So glad that you fell into the right hands and got a proper diagnosis! I'm sure you are relieved to have the information now, to carry on with your life.

Don't even THINK about leaving us! Your threads and responses are greatly appreciated and heartfelt. Stick with us, please! :)

Best of luck and please keep us posted on anything that you discover. I know that the title of your thread will catch attention and bring many people around who could use that extra bit of confidence to seek a second opinion (or more!). Thank you for your story.

Marguerite
 
What an amazing post. You have given us all a very valuable lesson.

I'm so happy you encountered that wonderful ER doc.
Will you still be using your regular cardiologist? Should be interesting to hear what he now has to say given all you have learned/been diagnosed with.

The best of good luck to you.
Please continue to come here and share with us.
 
Piper
Thanks for sharing your interesting story. Thank goodness for the ER doctor that was on duty that day. I hope you have brighter days ahead.
Kathleen
 

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