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Old 03-27-14, 03:35 PM   #1
RonH
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My new cardiologist wants me to have a heart cath

I knew I had a "bad" heart. My cardiologist in Atlanta never talked about a heart cath. He just said, "Lose 20-25 pounds and keep riding. Its the best thing you can do for your heart"
I know cycling has helped keep it as strong and healthy as possible but .....
Now I have to decide if and when.
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Old 03-27-14, 03:55 PM   #2
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You may want to read this:

Amazon.com: Worried Sick: A Prescription for Health in an Overtreated America (H. Eugene and Lillian Youngs Lehman) (9780807831878): MD Nortin M. Hadler: Books

and

http://www.amazon.com/30-Day-Heart-T...+heart+tune+up

My doc just requested a blood test and echo cardiogram, because I have elevated blood pressure w/ low pulse. But a very low max heart rate. She mentioned stent and said I'd be back on my feet in no time

I didn't have the "heart" to tell her, that hell no, I'll go to Hadler / Ornish route... If it comes to that.
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Old 03-27-14, 04:04 PM   #3
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Hi Ron,

I had one at Citrus Memorial three years ago. The procedure was bad at all. You are awake during the whole thing and the room must be the coldest one in the hospital... That may only be the rule in FL. I was a little sore after for a few days. My problem was that the test was negative for blockage.... normally a GOOD thing. But for me it meant that my heart failure was due to something that can't be repaired by diet, meds or a stent. Still it was nice to know that my heart arteries are clean. Basically it just another set of data on which your heart guy can use to tailer your heart management.

Good luck.

Bruce
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Old 03-27-14, 04:17 PM   #4
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You should google some info on that....let me help

My Mom had one of those like 25 years ago... she's like 90 now. I wouldn't welcome one... but like a colonoscopy... these kind of tests add years to our collective lives. Cycling.... adds value to the years.
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Old 03-27-14, 04:45 PM   #5
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I worked in health care (biomed) for 30+ years in radiology and cardiology and know all about the procedure. I just never thought it would be my turn.
I've never had elevated cholesterol or high blood pressure, just the crappy heart I inherited from my dad. He had his first heart attack at 53. He had a total of 3 or 4 and died of lung cancer. He never quit smoking.

We have always lived a healthy lifestyle and eat healthier that 98% on Americans. We read everything we can and are always learning new things (more new studies).
The low fat, high carb diet (fruits, veggies, whole grains, etc) is what has kept me between slightly and somewhat overweight my whole life. My wife and I learned about six months ago that wheat (not gluten) and some others grains cause problems for both of us. We have given up on all kinds of bread, pasta, wheat and grain cereal, etc and have managed to lose 10+ pounds each with no other changes to our diet. If we want spaghetti we have the usual homemade sauce on spaghetti squash. YUM.

My new cardiologist knows about my heart problems from my Atlanta doc. The nuclear stress test I did yesterday showed a few "problems" and he wants to take a closer look.

I'll keep you posted.
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Old 03-27-14, 05:13 PM   #6
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Based on my recent history, do it! All of the tests, and other stuff didn't find my problem. The cardiac cath, DID!
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Old 03-27-14, 05:45 PM   #7
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Had one back in '98, there wasn't any painful action in the surgery whatsoever, it was strange to watch the monitor and hear the cardiologist say that my coronary arteries were like giant water mains and clear as they could be. Turned out that the nerve running along my esophagus very close to my 2nd peptic ulcer's scar got agitated and mimicked the pain symptoms of an MI. Glad that I went in and found out what it was making me hurt and sweat while it was cool in the building I was working on. Best of luck Ron, hopefully the problem will be found and fixed easily. You aren't getting out of the moderator duty that easily.

Bill
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Old 03-27-14, 06:55 PM   #8
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Seriously, my heart cath was like a walk in the park. Don't sweat it.
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Old 03-27-14, 07:40 PM   #9
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Old 03-27-14, 08:26 PM   #10
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Ron, good luck sorting this out. If it were me, I would probably go for it - at the very least, the doctor would have more information which may turn out to be a help later on.
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Old 03-27-14, 08:26 PM   #11
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Cardiac catheterization has become a day surgery procedure. When I first started in health care, 20+ years ago, patients would tell me that the worst part of the procedure was *AFTER* the procedure, when they'd have to lay flat on their backs for six hours with a sandbag on their groin. Now, with advanced closure devices like StarClose and radial artery access (rather than femoral artery), even the post-procedure recovery has gotten much easier. With StarClose on the femoral artery puncture, post-procedure bedrest is only two hours. And with a radial artery approach, there is no post-procedure bedrest.
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Old 03-27-14, 08:28 PM   #12
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There's the rub .... never thinking it will be our turn. Hope whatever you decide works out for you.
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Old 03-28-14, 04:41 AM   #13
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The procedure-related mortality rates were 0.2%, 0.1%, and 0.5% for total, diagnostic, and therapeutic procedures, respectively.
Complications of cardiac catheter... [Catheter Cardiovasc Interv. 2001] - PubMed - NCBI

1 out of 200 mortality for therapeutic?

Then, there is the risk of stroke due to dislodged atherosclerotic plaques fragmented by the catheter and guiding mechanism.

The mortality rates have declined over the years but the risk is not trivial.
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Old 03-28-14, 04:57 AM   #14
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Ron's familiar with the procedure and probably doesn't need to be schooled on the risks.

Machka had one recently, through the wrist. When I had mine back in 1997, it was through the groin. In both cases, care was needed afterwards to ensure the wound remained intact and can heal properly. That includes limiting exercise to avoid high blood pressure.

We also had clear results. Thank goodness.
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Old 03-28-14, 05:41 AM   #15
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Rowan, my post was not directed at Ron per se. It was to those who have claimed that the procedure is a walk in the park, not to sweat it, and the general theme that this day surgery is simple when in fact there are real risks to be weighed against potential benefit.
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Old 03-28-14, 05:46 AM   #16
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It's definitely not a walk in the park, but the risks of a complication are minimal for the benefits, whether than means the insertion of a stent, or indicating whether further resolution is required, or getting a clear diagnosis/prognosis.

Weighed up against dying, I think the risks were worth it for me.
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Old 03-28-14, 06:03 AM   #17
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Quote:
Originally Posted by RonH View Post
I knew I had a "bad" heart. My cardiologist in Atlanta never talked about a heart cath. He just said, "Lose 20-25 pounds and keep riding. Its the best thing you can do for your heart"
I know cycling has helped keep it as strong and healthy as possible but .....
Now I have to decide if and when.
I have had 3 mi's 3 trips to the cath lab one as recently as 2 years ago never had a problem in there, fairly easy procedure to recover from. When my cardiologist speaks I listen, if not for him I would have died in 1996. This is probably not a good time to seek alternative medicine or Bf opinions on what you should do.
just sayin

Allen
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Old 03-28-14, 07:33 AM   #18
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Your mileage may vary, but I would probably choose not to have the procedure. If you do, make sure you trust the doctor to hold your own health interest above his economic interest, because there is a lot of overtreating, not all risk-free or cost-free, out there.
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Old 03-28-14, 08:11 AM   #19
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Complications of cardiac catheter... [Catheter Cardiovasc Interv. 2001] - PubMed - NCBI

1 out of 200 mortality for therapeutic?

Then, there is the risk of stroke due to dislodged atherosclerotic plaques fragmented by the catheter and guiding mechanism.

The mortality rates have declined over the years but the risk is not trivial.
There are risks with any invasive procedure. And there are risks in not intervening as well; those plaques can and do dislodge on their own. If your cardiologist is suggesting a cath, it is likely because you are already exhibiting symptoms, and he or she feels the risks of the cath are roughly comparable to risks of not intervening.
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Old 03-28-14, 09:26 AM   #20
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Better to have it done elective than to be hauled in on the little red bus for it like I did.
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Old 03-28-14, 09:32 AM   #21
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Of course there are risks. I'm saying that the procedure itself was quick and painless. Whether the risks are worth taking is between patient and doctor.
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Old 03-28-14, 09:36 AM   #22
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Your mileage may vary, but I would probably choose not to have the procedure. If you do, make sure you trust the doctor to hold your own health interest above his economic interest, because there is a lot of overtreating, not all risk-free or cost-free, out there.
Of course, you can't be sued for malpractice because you don't practice I can't give out advice like that, nor would it be responsible for me to do so.

But geez, if he had the big one a few days after declining a cath, would you feel any shame?
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Old 03-28-14, 09:54 AM   #23
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Of course, you can't be sued for malpractice because you don't practice I can't give out advice like that, nor would it be responsible for me to do so.

But geez, if he had the big one a few days after declining a cath, would you feel any shame?
I merely stated what I would be inclined to do (or not to do) for myself under similar circumstances. Everyone needs to make his/her own informed decisions in life.
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Old 03-28-14, 10:32 AM   #24
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I merely stated what I would be inclined to do (or not to do) for myself under similar circumstances. Everyone needs to make his/her own informed decisions in life.
You planted needless seeds of doubt in someone who is already nervous about a procedure, and about the worst possible thing: suggesting that his doctor may be unethical.

Your comments were irresponsible and insensitive.

As I said, I'm bound by a code of conduct not to make that kind of remark. It's a shame you aren't.
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Old 03-28-14, 10:38 AM   #25
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Thanks for all the information and thoughts. The heart cath is scheduled for April 10 at 4pm. At least its late enough in the day that I can get in a few miles beforehand.
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