Am I too sensitive?

[Aussie Chris]

It has been 4 months since surgery and I have just been to the Cardio for the results of the echo and holter. The echo shows all is looking good with only minimal leakage. Fantastic news! I was probably expecting this result, but am now cautious as the last echo I had back in September was to be a routine check up which I had brought forward, but turned into the bombshell news that I needed surgery. I have returned to all pre surgery activities, such as surf lifesaving, surfing, swim squad and despite needing some work on the overall fitness, I would say I am 95% back to normal. Even the chest wires which bothered be initially when surfing, now I don’t even notice. I am really grateful for the smooth recovery I have had.

I was put on a holter monitor because my heart rate has been high since my operation. My average HR is 97BPM. For this, the cardio has put me on a beta blocker Atenol. He hopes that that will help my heart reset itself at a lower level.

I asked him what if any side effects there were from the drug, and I received an interesting response. “I don’t know if I should tell you that”. Why I ask? He implied that too much information can make some patients imagine side effects, and implied that I may be one of those patients. This was because I made a couple of phone calls to him prior to my surgery to check that a sudden jump of 20 points in my blood pressure, and to check that chest pain I had just started to experience wasn’t a problem. I think he thought that now I had been diagnosed as needing my mitral valve operated on, I was now getting psychosomatic symptoms. Does that constitute being a hypochondriac, or is that just being responsible and reporting changes in your body? After all they say that men too often shrug off health issues when they should report them to a doctor. That really got under my skin. I reminded him that it was me listening to my body that brought me to him 2 months earlier than my scheduled check up because I was noticing my swim times were increasing and with that attitude he is really encouraging patients to not report symptoms and purely go on diagnostic testing. I think some Dr’s think only they are able to interpret information and don’t realize that sometimes a well informed patient can manage their own health responsibly. Too often the medical profession lacks someone who can manage effectively all the information coming from the various health practitioners. How often do you see a Dr just scanning through your notes when you come in to see them, rather than properly studying the notes prior to a visit. How often are simple items of health history overlooked which could be brought to the Dr’s attention by a well informed patient?

He had me really fired up so he promptly changed the subject. Who knows what he thinks about this patient now. He managed to change what should have been a great news visit into one where I really questioned whether I wanted to continue seeing this Dr.

What do you think? Was I too sensitive? Is it time to seek out a new cardio with a more balanced outlook, or was I just too sensitive?

 

[geebee]

Any doctor that even vaguely implied I was imagining things would be history.

I don't think you are being too sensitive - I think he is an insensitive doctor.

 

[Marguerite53]

My cardio is like that. But I trust her, so I just basically met her in the middle and simply demanded to know what she knew. Or, I would come in with something I'd read on the internet (or here) and wait to see if she would poo-poo it, or comment. We finally learned to understand and appreciate each other. Eventually, too, I realized that she was right about a few things!

I just got off Atenolol. At first, I loved it, but frankly, I think it may have begun to make me very tired. I only know this because when my recent bout of PVC's got me on the phone with her, I asked her to let me try another drug. I've been on Toprol XL now for about 3 weeks. The first thing I noticed was that the aches and flu-like tiredness vanished. I had been bursting into little sweats (thinking it was hormones....I"m 53 and have ceased my periods) and they promptly vanished also. Basically, I feel SO MUCH BETTER off of the atenolol! But then, when I first began the Atenolol 2 years ago, I felt immensely better also.

You can Google all these drugs and get info on their side effects. I went to a site called www.askapatient.com and found some interesting (though not terribly current) info on people's reactions to them. You don't really need your doctor to tell you the side effects, even a call to the pharmacist will get you informed.

Do not stop the beta blocker without permission.....it can send your heart into distress. IF you find you want to try something new, be sure you do it wiht the advise of your doctor.

If you like this guy otherwise, I'd keep him. Just don't let him bully you!!

GOod luck!

Marguerite

 

[ruth]

You're being too sensitive? It's YOUR body, you have to live with it! No, you're fine.

Your cardio is either insensitive or having a bad day. There's nothing you can't learn about Atenol with a simple Google search, so who does he think he's protecting? Like he can manage your reactions by how much he tells you? Which generation is he living in?

Glad to hear you are doing so well!

Ruth

 

[Karlynn]

It's so reassuring to know that it's not just doctors in the US that assume a woman is a hypochondriac. I had a doctor prescribe Valium for me because he thought my symptomatic complaints were "all in my head". I never took the Valium, switched doctors and asked my surgeon to please send what was left of my valve (which was next to nothing) to this doctor.

I agree with Gina, if it were me, that doctor would be history. One of the reasons that more women die of first heart attacks than men is because doctors are not receptive to their complaints. And believe it or not, I saw a study that said that women doctors did not come out any better than male doctors in their receptiveness to women's complaints.

 

[Aussie Chris]

Thanks Ladies, it is reassuring to know that I am not over reacting. I think very highly of a number of doctors and surgeons but sometimes I think those letters after their names go their heads and they think that only they have the ability to think rationally about health issues.

One of the side effects of my surgery was my high blood pressure was reduced to normal level. So far I haven't had a reason given by any doctor why this would be so, however a nurse in my rehab clinic was able to offer a very logical reason for it.

Give me a doctor without an inflated ego anytime.

 

[Susan BAV]

...One of the side effects of my surgery was my high blood pressure was reduced to normal level. So far I haven't had a reason given by any doctor why this would be so, however a nurse in my rehab clinic was able to offer a very logical reason for it....

I was told it's not uncommon for high blood pressure to resolve after OHS but then to come back again later, within months. Mine resolved post-op and then came back.

Glad to read that your recovery has been a good one.

 

[briansmom]

I wouldn't even worry about whether you are being sensitive or not. Give your doc the benefit of the doubt and assume that he would have said the same thing to all of his patients. Do you still want him as your doc or not? Everyone has their own style. You need a doc that matches your style (not the other way around).

 

[tobagotwo]

All of the high blood pressure medications avaialable have possible side effects. Everything that can do something good for you has a possible price. It's just a matter of whether you're the one who pays it, or the next person. Everyone's unique chemistry makes different drugs work better for them.

Some of the side effects of various drugs are intensely serious, and the drug manufacturers want you to be aware of them and they want your doctor to remove you from the drug immediately. They don't want deaths or permanent damage to be associated with their compounds. Drugs that are torn off the market because one in a thousand had a bad reaction can damage the lives of the other 999. To deny you information that may be important to your health because he's afraid you might imagine symptoms is medically irresponsible.

In the US, tons of paper with warnings come with prescriptions. Annoying as it is, you're a fool if you don't read it. Also, ask your pharmacist about side effects. Then pull the drug up on several websites and print those that show the most side effects.

Chances are, on an initial dosage of Atenolol, you won't be experiencing side effects. However, if you do, you should not let your doctor talk you into thinking you imagined them.

Note that most of the respondents are women? They're used to this treatment from doctors. What a shame.

Best wishes,

 

[Karlynn]

I agree with Gina, if it were me, that doctor would be history. One of the reasons that more women die of first heart attacks than men is because doctors are not receptive to their complaints. And believe it or not, I saw a study that said that women doctors did not come out any better than male doctors in their receptiveness to women's complaints.

I should have said that some doctors are not receptive to women's complaints. I love my cardio. If I mention " a little something" to her, she takes it way more seriously than I do.

 

[Superbob]

Another Perspective

Another Perspective

I agree the doctor should not have said that. Still, I wonder if he said it as a light-hearted quip rather than a serious comment.

I agree that as informed patients, we should read up on all the possible side-effects, even those that are rare, of any drug. Still, there is a kernel of truth in suggestions that the minute details of every possible side-effect may freak us out at times. I know I delayed for months accepting my doctor's advice to start taking glucophage for my high blood sugar because some of the remotely possible side-effects were scary. But since finally starting this med, it has helped me get type 2 diabetes under better control.

Bottom line: sure, we should be informed medical consumers and we should advocate for ourselves. However, if this guy is otherwise a good doctor, you might want to stick with him and cut him some slack for that comment. Doctors are just humans like us: They are not immune from foot-in-the-mouth disease.

 

[catwoman]

Chris:

Sounds like your doctor may still be getting his medical journals via stone tablets and isn't aware how much information is available to patients via the internet.

There should be a universal law that medical professionals provide information about Rxes if asked. Doctors do have pharmaceutical reference books. My family doctor frequently consults his before writing a scrip for me to determine what works best with warfarin and advises me of any unusual side effects.

 

[Nancy]

I think that any doctor that makes you feel like less than an adult, infanticizing your concerns and fears, should go back and get some additional training in how to deal with real live people.

Doctors have to tell us the most difficult things, that is part of their job. But there are good ways to treat people and bad ways to treat people. Patronizing doctors are one of my big pet peeves. There is no need for that to happen, except for ignorance.

They have to remember that they are dealing with people who are worried and may not understand their conditions to the depth that they do. They have to share that information and help the person through it. That is also part of the job which often gets cut short, because they are too busy going on to the next person, and calming someone takes time out of their schedule.

We are all human beings and need to be treated as such.

 

[Susan BAV]

I think that any doctor that makes you feel like less than an adult, infanticizing your concerns and fears, should go back and get some additional training in how to deal with real live people.

Doctors have to tell us the most difficult things, that is part of their job. But there are good ways to treat people and bad ways to treat people. Patronizing doctors are one of my big pet peeves. There is no need for that to happen, except for ignorance.

They have to remember that they are dealing with people who are worried and may not understand their conditions to the depth that they do. They have to share that information and help the person through it. That is also part of the job which often gets cut short, because they are too busy going on to the next person, and calming someone takes time out of their schedule.

We are all human beings and need to be treated as such.

Nancy - I love how you word things. I am completely serious in the following thought: you could certainly write a book from you experiences -- or handbooks too, including one on improving doctor-patient relationships.

 

[hensylee]

if you continue to see this doctor, please let him know that you are knowledgeable and can manage any news and are entitled to know all information. Then go home and check it for yourself on the net. Everything you can think of is there. I always double check my meds at home.

Sensitive? - not!

 

[Aussie Chris]

Thank you all for your thoughts. It is always good to bounce ideas off others.

I took myself off to our family doctor today and asked for a referal to another cardiologist for a second opinion. I wasn't going to go into why, but as she asked I explained. She to gave me much the same response as all of you. She said don't feel badly about getting a second opinion as patients are becoming more informed and are questioning rather than accepting everything blindly.

It was reasuring to know that our family doctor was on our wavelength. She also leads a very active life and runs marathons, so she made the comment that a B blocker may not be good for someone like me who also leads an active lifestyle as it would prevent the HR from reaching the levels it should during heavy exercise.

I think to myself. Great back to being breathless while exercising.

I also had some feedback from Don "DLH" a VR member who had very similar symptoms post surgery and is now 15 months post op and his resting heart rate has slowly gone down to 60 without the use of B blockers.

Anyway I'm off to see the new cardio, I've gone with a lady this time, on 26th March.

 

[Nan]

So glad to read that you have gotten a referral to another cardio for a second opinion....hopefully that means you might be able to have a another cardio period?

I really think he was out of line. You are in tune with your body and that is an excellent thing. Many folks are not. But you are clearly very physically active and an athlete, which I am sure helps you be more aware of your body than most folks.

You don't need someone who is making you feel like a child instead of a competent adult! You were not being too sensitive. He was being insensitive!

Good luck with a new cardio.

 

[Aussie Chris]

Cardio calls.

Cardio calls.

I had an interesting phone call today from my cardio to check how I was on the new medication. I thought that was strange as last week he wasn't interested in seeing me for 4 weeks.

Had he reflected over the weekend or had he been advised by his receptionist that I had cancelled the follow up appointment because I was seeking a second opinion. Probably the latter. Any way I informed him that I wasn't taking the drug until I had a second opinion as I have been monitoring my pulse and it is slowly coming down without medication. He suggested I speak to my family doctor before doing this. I advised that I had discussed it with my GP and that she was happy for me to wait for the second opinion.

When I was asked who I was now going to for the second opinion I mentioned the new cardio's name. On reflection I wish I hadn't, but it is too late now.

Just thought I would share that. I was so surprised that now he was showing greater interest in my symptoms/progress!

 

[tobagotwo]

Hope he doesn't call ahead to your new cardiologist and poison the well.

Beta blockers are very common after the surgery, and as long as they're removed after their good has been done, they are a useful tool to help ease a newly cut heart back into the mainstream. The difficulty seems to be when they are overprescribed, or when the cardiologist fails to try to bring the the patient off of them, with some internal rationalization that they're probably doing some good for the blood pressure, even if they're not strictly needed.

Let's face it: OHS isn't a natural phenomenon. During recovery, some assists can be very helpful. Just not so much that they cause problems of their own or defeat the heart's own attempts to regulate itself.

Best wishes,

 

[hensylee]

any doctor should be glad for patients to seek another opinion. Sometimes they even suggest it. Sounds like your cardio is the one who is sensitive - or not sure of him/herself.