Confused and concerned

[susieq14]

I've been away from the board for quite a while and actually wasn't a very good member when I was here and I'm not sure what I really want to ask you but I just need to talk with someone who may have "been there, done that" if you don't mind.

I'm having a cardiac MRI on Wednesday and am very nervous; so much so that they gave me a script for Ativan. Now I'm worried about taking the ativan as much as having the MRI. have any of you taken ativan or something similar for an MRI? I've never taken it.

the reason for the MRI (last one I had was 5 years ago)is that my cardio thinks it might help resolve some issues as a result of an echo I had on Jan 10.

the echo was not done at my cardio's office (and boy was he angry about that!) nor did he originally read it. however after I got him a copy of the echo on CD he totally diasgreed with the original report done by another cardio

History: August 2004 (age 53) diagnosed with moderate to severe MR but no MVP (echo and stress echo test). Started lisinopril, walking and lost 30 pounds. Dx changed to mild MR. Continued to see a cardio every 6 months with yearly echos all showing mild MR until Aug 2010 when echo showed “mild MVT with mild to moderate MR and small pericardial effusion”. “Compared to 7/09 echo MR was slightly worse and the pericardial effusion was new.” Cardio set an appointment for a 6 month echo in March 2011.

why did i have the echo in January? long story short: Had sinus surgery on Dec 28 and next day at noon passed out and fell and spent 8 hours in ER getting IV fluids and potassium pills due to being dehydrated. Saw my PCP the next week and he sent me for an echo at the cardio office he is affiliated with. PCP called me and said I should follow-up with my cardio because this echo showed Mild to Moderate MR but also showed some differences i.e. it showed MVP and mild diastolic dysfunction present.

Brought the echo on CD to my cardio and after he scolded me for having an echo at another facility (he can’t trust if the echo technician did the echo correctly) he told me that I did not ever have MVP nor do I have it now and there is no DD because there are 4 criteria needed for DD and I only have one which is minor. He actually said the tech did a good job but couldn’t say that about cardio who read the echo. Thus the MRI this week.

My head is spinning at this point. Who do I believe at this point? I asked my PCP for a referral to another cardio (I have an HMO) and he said that wouldn’t help because that would just give me a possible 3rd opinion so he said just have the MRI.

thanks for listening.

 

[LeakyUK]

I am taking fluoxitene (Prozac) for Anxiety - it takes several weeks to become effective but is safe to use long term. A google search suggests Ativan is a fast acting Anxiety treatment to be used for a limited period. I can only suggest you read the accompanying information leaflet before starting treatment. BTW there is no such thing as a not very good member, the wonderful people here always seem willing to help, and have eased some of my concerns and added some desperately needed
humour.

David

 

[Jkm7]

Hi Susie,
Good to see you posting. It's been a long time.
Sorry to hear you have to deal with these issues but to address the ativan one first, IMO, sure you should use it if prescribed by your doctor. Anxiety and heart disease often have a close relationship. It is useful drug and it hopefully will make this process a bit easier for you. Of course, use only as directed and no more than necessary.

As to who to believe, that's a tough one. You know these doctors, have the personal relationship and have to trust your instincts. Do you have faith in both? A much longer, closer relationship with one vs the other?

Why not have the MRI, see what each have to say about the results and take it from there. Sounds like both agree you should have this examination so why not wait until it is over before taking a next step. It may result they are in agreement about the results and your choices may become clear.

Wishing you the very best. Please let us know how you are doing.
(I am still grateful to you for your support. )

 

[johnp]

I understand Ativan is prescribed for short term or situational anxiety. For example, they gave me 1 mg 30 mins before I went in for heart surgery.

But I think this is not something you want to be on long-term, and I certainly would not drink or drive while taking.

You might feel closed in while doing the MRI, so Ativan might be used here as well. When I had a heart MRI years ago they also gave me Ativan. I was fine.

 

[susieq14]

I was given two 1 mg tablets of Ativan one to take one hour before and then one immediately before my MRI. Not being used to an anti-anxiety med I am just concerned how it will make me feel. I hope it makes me very drowsy and doesn't make me feel dizzy. I wouldn't want to be dizzy inside the MRI tube.

Thanks David and John for replying. I wish you well David as you prepare for your surgery and to you John as you recover. My best to both of you.

Judy - it is so good to hear from you! I've been seeing my cardiologist since August 2004 so he is the one that I know the best and who knows me the best but he is very laid back and always telling me I worry too much and also is very laid back. I've only been seeing my PCP for about 18 months - he took over my old PCP's practice. I haven't figured him out yet! As for the other cardio I've never seen her as a patient - but I do know her - she is the cardio that told my husband that he needed a cardiac cath in 2009 and might need a stent. He didn't need the stent - there were 2 small blockages (a 20% and 30%). I remember that he had his nuclear stress test on a thursday and she called us on Friday night at 8:00 pm to tell us the test showed a problem ad she made us come in to the office at the end of the day on Monday. Total opposite of my cardio.
However, my cardio certainly expressed his displeasure wth my PCP and Cardio #2 to me. He was so angry that I had the echo done at another facility and when I told him that I was only doing what the PCP told me to do, he replied that i should have just said no and come to see him. Ironically when my PCP told me he wanted me to have an echo I told him I had one scheduled for March 3, but he insisted I have it now with his cardio. I'm not sure if there is some bad blood between them - my PCP and Cardio #2 belong to a new medical group here that is affiliated with Partners in Boston and my cardio is affiliated with the community hospital that is trying to stand its ground against Partners and MGH and BWH by creating a new partnership with Tufts Medical. Makes me wonder.

I hate to say it but I was actully a little glad to have the echo read by a different cardio because I've always wanted to know what another doctor thought. Wow - be careful what you wish for!

Anyway I will have the MRI on Wednesday (if I can stay in that scary tube) and see my cardio the following Wednesday to get the results.
I'll let you know how things turn out.

 

[ALCapshaw2]

You might want to take some Ear Plugs to wear during the MRI.

Some have some mirrors arranged so that you can look 'down the tube' to the outside.

Try not to get too concerned. I don't recall reading of anyone having any 'bad effects' from an MRI.

 

[normofthenorth]

My elderly Dad always wondered who was breaking a bunch of glass when he had MRI exams, 'cause that's what the machines seem to sound like (I think).

Your two Cardios both sound like they're in a turf war, maybe short of business, wondering where the cash for the next yacht or family trip to Europe will come from! Either that, or they're professionally very insecure -- and THAT could make me even MORE nervous!

My Cardio is one of the most respected Cardios in the very heart-savvy city of Toronto, and he uses contract people to do his stress echo cardiograms, and maybe the non-stress ones, too. And there are one or two of THEM whose results he doesn't trust or believe (and with reason)!!

So you don't have to be dealing with turf wars or professional jealousy or insecurity to find that echo-EKG results are a matter of subjective interpretation. I WISH I could tell you that MRI results are different in that regard, but I don't think it's true. The good news is that you'll get a DIFFERENT view of the shapes in the clouds, for the experts to interpret (and maybe fight over).

Will the second Cardio get to see your MRI results? Will your first one have a hissy fit if he finds out that she did?

Life would be so much simpler without all the HUMANS, with their emotions and their needs and stuff!!

 

[Protimenow]

I wouldn't worry about ativan. It's non-addictive, and, for the proper reasons can even be taken daily for long periods. Its drug name is lorazepam - and you often see it being called for on the medical shows. A large dose will let you sleep. I don't believe there are residual effects - - it works quickly and leaves the system after a few hours.

As far as your MRI -- yes, it sounds like turf wars to me, too. I have trouble imaging a doctor being visibly angry at a patient and expressing the anger (although I know it happens).

Good luck negotiating the maze - and I, personally, wouldn't worry about the ativan -- it'll help smooth out the anxiety about the current state of things and the MRI.

 

[Jkm7]

I wouldn't worry about ativan. It's non-addictive, and, for the proper reasons can even be taken daily for long periods. Its drug name is lorazepam - and you often see it being called for on the medical shows. A large dose will let you sleep. I don't believe there are residual effects - - it works quickly and leaves the system after a few hours.

<snip>

Ativan is very addictive and can cause psychological and physical dependence.......

A one time or occasional use of this drug for situational anxiety will not lead to addiction. You would have to be using it regularly for some length of time