Stress Test; BP Down Not Up

[karen14]

Hi everyone,
Had my cardio appt today. My history is that I was diagnosed with prothesis mismatch, with the pressure gradient of blood still too high going through my aorta after corrective surgery. So today the new cardiologist I got (but same group as the past that did my surgery), stated that we won't be doing a re-op yet (yay), that it's "complicated," (not explaining what that meant), & that he wants to talk with some other doctor's first. Plus we may do a heart catherization to look at it. What's also weird is that he said that my BP went down while doing the stress test, to which your BP normally goes up during exercise. Weird. Anyone know why this might occur? And what do you make of all this? Thanks in advance.

 

[Maryka]

BP going down during exercise means the heart is not coping well with the exercise, I think. But, I (OBVIOUSLY) AM NOT A DOCTOR! I have forgotten why you did not switch doctors after the first problem???? You are in my thoughts and prayers! You are a survivor and I trust you will find your way through this!

 

[karen14]

Thank you Maryka! I live in a smaller southern Oregon town and my choices are limited. I got a different doctor in the same clinic, but in my same town (was going to the city a ways over, & this clinic dominates all of southern Oregon; is called Southern Oregon Cardiology). But I assure you, I'm investigating my options! It was definitely a weird visit to say the least. I just need some practical feedback apart from myself.

 

[Luana]

Hi Karen!
Good to hear your news. What was bp when test was started and what did it drop down to? I agree with Maryka that it could be a sign your heart is not coping well with exercise, but might that be something to do with just generally not being in good physical shape? I don't know what your activity level is like now, but I'd be asking if increasing it would be good or not so good for what's going on with your heart. Did you doctor give you any restrictions with exercise? I think the cath will be able to tell more of what's going on. Any chance you could get to a bigger city or even Stanford to get another opinion?

 

[nngbwh]

Glad you didn't chicken out this time. Did you ask your cardio why your BP went down doing a stress test ?

I am not sure why but hopefully someone here can give you more information.

 

[karen14]

Thank you Luana! I am going to look into going elsewhere for my cardio care. Just not sure how to go about that yet. You mentioned Stanford, and another guy on this forum gave me a surgeon in San Francisco that does re-op's. But how would I travel there? Is a long ways. Not quite sure yet on this. Perhaps there's a good Portland, OR doctor that does valve re-op's someone knows of? But how I would do it or afford it is another matter.

Thank you too nngbwh, and yes, I asked why my BP went down with exercise. This is where the doctor told me he wasn't sure & wanted to talk with some other doctor's. I feel still kind of in limbo yet. But the fact that I don't have to do a re-op soon IS great news! Thank you all SO much! Means a lot to me.

 

[Luana]

Well, if your insurance is a PPO plan, you should be able to go elsewhere for another opinion and use your out-of-network benefits. I think I'd be wanting to get that heart cath done soon; hopefully it will lend more info about the valve than the stress echo. Was that what was done, a stress echo?

Sorry, but I'm a pushy broad. When that doc said "complicated," I would have stopped him right there and said, "please define what you mean by complicated."

 

[karen14]

Hi Luana,
This doctor was not answering my questions and he wouldn't let me get a word in edgewise, I'm serious! I did ask why complicated and he was evasive. This makes me so mad & frustrated as well. I hadn't mentioned that before, but it was like that. So I do want to find someone else who WILL give me straight answers. I kind of think they're being vague because they think I'm going to sue them. Do you think this is viable? I don't know. Also, Medicare is my primary insurance. So I should ask my primary to get a doctor out-of-network?
Thanks again Luana & everyone for feedback,
~Karen

 

[tobagotwo]

Get a copy of all of your records, including from the hospital and surgery, ASAP. You can do that through the staff, without him.

It wouldn't hurt to give him a chance to come clean. Tell him, "I need to have straight information, and not have you avoid difficult answers."

He may just not have figured it out yet (it can be complicated). He may also be stalling to talk to the other doctors in his group and figure out a good way to say things without getting anyone into trouble (why you want to go out of group if possible when changing due to dissatisfaction). He may be too impatient to explain enough to you so that you can understand what he's saying, and is avoiding it. He also may be uncomfortable giving news that isn't what he thinks you want to hear, like that you will need a reop (you'd think a cardiologist would get used to giving all kinds of news).

Best wishes,

 

[Luana]

What insurance do you have to go along with Medicare? Is it a supplement plan or an Advantage plan? PM me if you're not sure and I can help you figure it out.

It's easy to see why you feel you're still in limbo; you are still in limbo. Working in sales has been a huge advantage for me. There is no way someone is not letting me get a word in. I know what you mean by how you described your doc, and I don't fault you. He's being defensive by being evasive. Years ago I had the best family doctor. Whenever she didn't know something, she'd say, "I don't know, but I'll find out for you," and she always did.

 

[karen14]

...He may just not have figured it out yet (it can be complicated). He may also be stalling to talk to the other doctors in his group and figure out a good way to say things without getting anyone into trouble...

Thank you Bob, I had a REAL sense of both of your ideas here when listening to my doctor (his wording changed greatly from the first visit, as if he had been talking to other doctor's)! And your suggestion of giving him a chance is interesting. I will give it some thought and prayer. My instinct is to find another doctor, but that won't be easy to say the least. I sincerely want to make good decisions. Since I don't have to do a re-op immediately, this gives me time to get feedback & investigate my options.

Any feedback & information is greatly appreciated!
Many thanks, ~Karen