Letter from Neurologist Concerning my Recent Visit

[Braveheart]

Hi Everyone,

Hope I'm not boring you with this and I shall drop the subject soon I promise. As you know I had my appointment with the Neurologist last Thursday concerning the visual disturbances, which were originally thought to be TIAs. The appointment went very badly and I was upset and angry with the doctor because he now believes they are migraine!! I have been very rational about the whole thing throughout, I only became anxious as he calls it, when he started back-tracking and labelling the episodes as migraine, which I do not believe for one minute.

This morning I received a copy of the letter he has sent to my Cardiologist and GP. It made me quite annoyed just reading it.

I typed the letter and saved as a .txt file and attached to this thread. I would really appreciate your un-biased comments.

Kind regards and thanks,

Jonathan

 

[Peter Easton]

Jonathan --

Thanks for sharing the letter. Seems not too egregious to me, insofar as the doctor is leaving you all latitude for a second opinion, which is really the way to go, I think. It's ALWAYS worth checking out if there isn't more going on here.

As I mentioned before, I believe, I myself have been subject since youth to varieties of migraines, happily ones that are not very painful or accompanied by the kinds of other distressing symptoms (nausea, incapacitation) that can be associated with the condition.

My migraines have reoccured and changed form somewhat since my aortic stenosis kicked up and since I was operated. They are more characterized by my vision being suffused from one corner or another by a stain or wash of color or greying out, less by the flashing lights than before. Luckily, they still aren't very painful and I haven't worried a great deal about them (perhaps wrongly, it they in fact represent TIAs!) I'll talk this over with my own surgeon and cardiologist next week.

Peter

 

[Zazzy]

Jonathan,
Please don't every feel that you are boring us... I do enough of that for all here!! lol

I would get a second opinion if I were you... and I don't think I would show any records, letters, etc. from the previous doctor.

I haven't had an episode of blanking out since my heart surgery, nor have I had any visual disturbances of any kind. I always thought that these episodes were related more to my sinuses than anything else and I would always have problems whenever my sinuses were bothering me.

Good luck and take care,
Zazzy

 

[MSN2B2]

Please don't ignore your symptoms. On July 7, 2000, I had what I thought was one of my usual migraine auras (partial loss of my vision). Unfortunately, I chose to ignore it all day. I thought it was unusual that the migraine never came, but I kept waiting (and actually thought I was pretty fortunate not to have another headache).
When I woke up the next morning, I still had abnormal vision. I called my Internist who sent me off to the Opthalmologist. He took a look at my left eye and immediately told me that he wanted me to see the retinal specialist. She did an angiogram and found swelling around one of my retinal arteries. She explained that this is often associated w/a blockage, and with my cardiac history, it was very likely an embolus. Whatever it was was (a calcification that had come off the valve, or an actual blood clot) was no longer present.
Since then, I have had my surgery (AVR w/ a graft of my ascending aorta, and closure of a patent foramen ovale, 11/03/00). I have also found out that I have a genetic clotting disorder that causes me to clot. I continue to have migraines. And I have lost 1/3 of my vision in my left eye.
I say-go with your insincts, and keep on searching for an answer! Don't let him make you feel like a hysterical mess!

Tina

 

[Hank]

I agree with Tina

I agree with Tina

Do not EVER accept what any doctor tells you if you are not convinced he is correct. Doctors are in many ways overrated in their "infallible" professions.

 

[Mara]

Jonathan

Jonathan

You know Migraines are a funny thing. Maybe you are better off getting a second opinion.

My word of caution would be that you don't go shopping doctors just to find one who says what you think you want to hear. Go see a competent physician who excels in the field and let him or her perform the examination and interpret the data.

One thing you don't want to get caught up in is self-diagnosis. You will drive yourself insane. Don't rush around trying to get validation for some major illness when you might have something much more simple, like migraines and not TIAs.

That said. You are right to want a second opinion. But, don't get yourself put on that "crabby patient"list at the NHS.

-Mara

 

[Nancy]

Jonathan-

Is there a very good ophthalmologist that you can go to see? My husband's was very concerned that they get the problem solved. And he didn't think it was migraines. Maybe he/she could sort out the problem. If the problem is mainly in the eye, it couldn't hurt to have a "look see".

If you have run out of help from the frontline docs (and it certainly seems as if this one is a particularly nasty guy), try another avenue.

I'm really offended for you that this doctor has chosen to send you to a specialist and rather than just list the symptoms, he has performed the diagnosis for the specialist. It would have been more to your benefit to have the specialist come up with his own conclusions. Sounds as if there's a little CMA going on. In the US that means Cover My A--. This is the doctor's little defensive action. Really too bad.

 

[Bill Hall]

Jonathon - Similar to your situation, I went to my cardiologist and explained my symptoms. He is convinced that my dizziness is not heart related and gave me good rationale. However, I am still not convinced since the dizziness and other symptoms occured just after surgery. I am going elsewhere and hope to get the real answer. I am not completely disgarding his opinion, but this is not going away and I need a good answer. Good luck with your problems, I think you need to search further.

 

[Phil]

And doctors wonder why we don't sometimes trust them.

 

[Jean]

Go With your Heart!

Go With your Heart!

Jonathon,

I have been an internet buddy of yours for over two years now through "Braveheart" and Steve's site. I have never known you to be silly or neurotic or anything of the kind.

Stick to your guns and get this settled for your peace of mind...even if it does turn out to be migraines.

Good luck and God speed.

 

[ticktock]

migraine?

migraine?

What a cop out your Doctor pulled. The letter was definitely "CMA" rhetoric. Dont give up. Continue to follow your instinct, it has gotten you this far.

 

[Sam Scholz]

Boy, having read that letter, it reads like a fairly sympathetic western doc. Being a Migraine sufferer and a victim of TIA's (none to lately) I can see where the Doc is coming from. He does seem to be a little bit to much toward the Migraine than valve issues. But that is what neuro doc's are all about, migranes are sexy, lots of reasearch grant money. The thing that I would ask is, what is going to really cause damage, while migraines hurt and are a much studied phenomea (sp.) They are not going to cause you great damage in the long run, they might hurt lots, but that is it. TIA or Aural disturbances on the other hand, can cause a host of problems. I would lean towards finding someone to address those issues. The issue of stress though especially in heart or valve patients, really must be addressed. Whether it be via excersise, spritual, or a pharmacological solution, this must be addressed. I think the doc stresses that also.

Find another doc. Not necessarily a Nuro one, maybe one who minor in it.

Sam