Monday, January 26, 2009

Doctors...hmmmph!


****Sorry this is wordy!! YOU may want to grab a cup of coffee, tea or diet coke to get through this!!****


I don't like to rant...but I think I am over-due!!! As most of you know I have been dealing with this whole "heart" thing for a while now....all seems to be going well. At my 3week check up after the angio-gram the cardiologists seemed very pleased that my LDL and Cholesterol levels had dropped...BUT...my liver enzyme levels elevated ever so slightly. So, the decision was made to drop the lipitor down to 10mg. a day...and wait three months and have blood drawn at that time. Well, I had my blood drawn week before last, went to my apt. on Monday of last week with hubbin in tow. My levels were almost a carbon copy of the previous levels...except for one thing...one of my liver levels (ALT) had risen from last time...it is at almost double what they consider normal...normal is anything between 6 - 40 U/L??? Mine is at 94..so it is a little more than double. The doctor told us they don't like to see these levels rise, but that does happen sometimes w/Lipitor or any statins...but they usually only get concerned when they rise to 3 times the norm...that they do not consider changing the Lipitor dosage unless that happens. So we're still OK...but he wants me to go to my Primary Care Physician in 6 weeks and have another test run.(I was a bit perplexed as to why my PCP should run this test instead of the cardiologist, after all he's the one prescribing the Lipitor!) OK...this is where I'm about to get a little mouthy. First, he asks..."have you had to take any of your nitroglycerin tablets?" to which I answered..."NO...thank the Lord"!...to which he did not comment!! I did go on to tell him I do have some chest pain from time to time and explained when it happened and how I felt...he just basically said, "oh that's probably your chest cavity muscles that could be weakened or your diaphragm!" OK...could you elaborate on that PLEASE...no such luck!...He then wanted to go over the list of meds I was taking, he did not like something...I could tell by his tone!! I went over the list of the 2 meds he had prescribed, another med I take for my stomach and then the vitamins I have added since menopause and this whole heart issue developed. I take a woman's vitamin as directed along with calcium and Vit. D...which was encouraged by my gyno...plus I'm in the midst of menopause and my cardio will not let me take Hormone replacement, b/c he thinks they could cause blood clotting and of course we don't want that...so I suffer w/the side-effects of the BIG M...but believe me I probably don't suffer in silence! However, I adhere to his rules because he has deemed this "best" for me! I also decided to add 200 mg. of CoQ10 to my daily intake...b/c of research I have done on it's positive effects on heart issues and help alleviating side-effects accompanied by Lipitor. It is suppose to help w/cramping which is a side-effect of statins. Ok...folks, I did my research and EVERYTHING (including some cardiologists reports!) I've read and gathered has said it is a good thing...that it is mostly vit. E and it is suppose to help with keeping your arteries pliable...wouldn't you want pliable arteries if they have plague in them??? I mean it makes sense to me. WELL, the cardiologists did NOT like that I was taking something he had not prescribed and proceeded to tell me THAT was probably what was causing my ALT to elevate and HOW could I possibly put in my mouth and ingest something that had not been FDA approved (sounds like he may have stock in the pharmaceutical company that makes Lipitor!)...hmmm...I never thought about a natural substance such as Vitamin E as something BAD for me and believe me I'm not overdosing on the stuff...I'm taking 200 mg. a day...I started out with 100 mg....but the cramping was still there, so I went to 200mg...the studies show that you can take much more...but I DON'T b/c what I'm taking seems to help! THIS is after he just sat there and told me that Lipitor causes some folks liver enzymes to elevate...but not to worry b/c mine weren't 3 x the limit! Then he decided I needed to another stress test to determine how much I could work out (because according to him I needed to be working out...uh...I want to Doc...you're the one who told me to hold off for 3 or 4 months!!) He seems to be so full of contradictions, he's really starting to tick me off! Oh and this was mentioned only after he tells me for the SECOND time...to call my PCP and set up the blood work for 6 weeks out...then he had the gall to say...almost like he was "wiping his hands clean of me" that he would see me in a YEAR!!! OK...at this point my head was almost spinning like the possessed child in the movie The Exocors***, you know the one! WHAT...I have questions...you have not answered...???? Then he walks out of the exam room! I'm still sputtering and stuttering...but he's already started his dictation in the hallway and can't be interrupted!!

I went in on Tuesday for the stress test (of course it was his day off so I couldn't get the results then)...I was told I would get a call back from the doctor by Thursday...I get a call late Friday 15 minutes b/f the docs office closes...and I'm not here, they leave a message for me to call on Monday...so I wait till today to get my results...after calling in...I received a phone call about 3 hours later...and the nurse proceeded to tell me that I could work out...but COULD NOT get my heart rate over 120 bpm...ok that was a surprise...seriously 120 bpm...I get that rate going up and down the stairs...they mentioned that my heart rate was up to 150bpm while I was there...but it seems that there was some stress to the heart during that time (I knew I was getting tired, but felt no pain in my chest)...so for safety sake they wanted me to keep my rate at 120. No explanations...nada!! I asked her lots of questions...to which she had NO answers...and when I asked her "due to the recent developments from this test, did the doctor mention if he needed to see me sooner than 1 year out?" SHE did not know...nor did she attempt to find out...she did tell me that my cardiologist was sending a detailed transcribed letter to my PCP and that maybe he could explain it all to me! OK...that just made my heart rate go WAY over 120 bpm! I knew I wasn't going to get anywhere with Nurse "doesn't-know-a-thing! So I decided to "let her go" and then immediately called my primary and talked to his nurse...she told me they had not received anything from the cardio...but as soon as they did she would schedule me time to see Dr. B...she too, wasn't very happy with what was going on....it wasn't 5 minutes later, she calls back and tells me the report just came in the afternoon mail...and that she was going to get me in ASAP! OK! can anyone explain to me my cardiologists attitude...why? oh why? do these Cardiologist think they are above explanations...why do I have to see my PCP to find out what another doctor is thinking! I'm so livid...I tell you, if my heart doesn't blow a gasket by Thursday (my appt. date) I'll be lucky! I'm not at all happy with the cavalier attitude of my cardiologist...who if you remember told me after my angiogram...that he WOULD NOT sit by and let what happen to my dad, my mother and brother happen to me. I've been thinking all along about getting a second opinion...NOW I know I'm going to...loosing my parents and brother to heart disease has certainly enlightened me about some things...but it also occurred to me that they all went to the same clinic that I am currently going to; a different doctor but the same association...hmmmm...and look where that got them! I know that sounds a bit crass...but I'm just a little peeved about this whole thing...first the man scares me to death and tells me all the things that are wrong or could go wrong...then gives me some meds...and basically after 2 visits tells me he'll see me in a YEAR, then has his nurse relay (vaguely) that I can only work out and get my heart rate up to 120bpm and then doesn't want to see me again! That just doesn't seem right...uh huh...that's not how I roll...I want answers as to WHY? AND I don't want to WAIT another dam year to talk to him and find out...why?? WHY I can't get my heart rate up to over 120 bpm AND if I will ever be able to get it up any higher? Will this change after some time on the treadmill???....will, I have to continue the beta-blockers once I start exercising? Is it the 75% blockage in one of my arteries that is causing stress on my heart...or is it the 30-50% blockage in the LAD artery or the 40-60% blockage in a lesser artery causing the problems? Or ALL the above??? Why can't they do a little balloon or angioplasty? I know I can't be stinted (they certainly went over that enough times) but what else can be done? Plavix...have they EVEN heard of that and if they have...why can't I take it??? Yea, folks this doctor with the "God" syndrome is not answering my questions and I'm not going to take it anymore....So bare with me during this rant...I just have to let off some steam...or I may blow that gasket after all! Just so you all know this took place in a matter of about 10 minutes...my appt. actually lasted over 15 minutes (this is the time I spent in the exam room...not the 45-50 minutes I waited to see the doctor in the waiting room...and probably 5 minutes of his time was spent in the hallway trying to find the nurse to track down my Lab report from the week before!)...do I sound peeved???

Whew...I already feel better and I just KNOW there are many of you out there that probably know some of the answers to my questions. I'm seeing my PCP on Thursday...I start Yoga on Wednesday...I fly to California on Thursday night...and I want ANSWERS before I go! OH!! and I know "they" recommend one glass of red wine a day for women to keep there heart healthy...I think I'm overdo for a case!...and believe me they have a LOT of nice little wineries in northern California...and by golly...that's just what I might do...relax a little...do what I can...and above all FIND A NEW DOCTOR!! and possibly do a little "self medicating" while I'm at it!

Thanks for letting me vent...I'll try harder next time to only post "good" things!


One more thing...if any of you out there have good questions you think I need to ask my Primary doctor on Thursday...please don't be shy about letting me know...I've thought of a lot of things...but you guys out here in blogland are so smart...I thought you may have some good questions to ask. I know some of you have been through similar trials...so any "wisdom" you have to pass on or questions you don't think I've thought of are welcomed.... So fire away...ladies...and gents!






10 comments:

Terri Steffes said...

Listen sweet pea, I am no cardiologist but I am a relatively smart girl. This guy treated you like dirt. You need to find a doc that understands that we are not a bunch of veins and muscles but a human with soul. I am surrounded by brilliant people (as in the medical field) and not one is as unfeeling or as almighty as your doc. You are so much more deserving than that. Also, I just hate men who think women can't think.

Now my heart is racing (which is a good thing since I didn't exercise today!)

Justabeachkat said...

Oh, girlfriend, I'm fuming too and I agree with Terri...you need to find a doctor who listens to you, answers your questions and doesn't leave the room until you are satisfied and understand all you need to know. Good grief! My heart rate must be elevated just thinking about it.

I hope your trip to California is fun and by all means enjoy some red wine.

Keep us updated.

Hugs sweet friend!
Kat

Dawn Marie said...

this is horrible treatment of a human being, woman and a patient. I'm glad your taking things in your own hands and making some decisions. How scary is this. The doctor sounds like a baffoon. I wonder--if you were HIS wife--would he treat her like this?

Tonja said...

What a pile of ****! The nerve of that guy. But, you are right, it is the God complex that so many of them have.

First thing I would do is write a letter to the office manager, telling her/him how you felt after your visit. I would tell them that this is unacceptable to you as a patient, and if he would rather you look for a doctor who has more time to listen and explain things to his patients...you will be happy to. Then state that you will be looking for a reply to your letter.

I'd throw that ball back to their court and see what they do with it. If this is the best doctor for you, you don't want to burn bridges. I still would look for another opinion. And remember my advice I gave you earlier...make sure you get a copy of every test and report that is done. All you have to do is ask at the radiology department and they will give you your test on a CD.

I hope you have a wonderful time in CA. Are you planning to go to the wine country while you are there, or is this a home hunting expedition? Whatever...enjoy...relax...and find some goooooood wine.

Blessings,
Tonja

Lisa said...

What a great rant! My thoughts are basically a ditto of the other ladies. I think you are on track - listen to your instincts and find another doctor. Even if this guy is supposed to be 'the best' in your area - because when a doc has this kind of ego he isn't doing 'his best' for you.

Case in point: My dad had an unsuccessful back surgery some years ago. His surgeon's response to the fact that his pain had not been alleviated was that if HE couldn't bring relief, there was no one out there that could - because HE was THE BEST. He further recommended that my dad learn to 'live with' the pain.

Don't let this cardiologist treat you with such disrespect. EVERY person deserves respect -whether or not they have M.D. after their name. Stand your ground, girl!

Unknown said...

Oh my. I know how frustrating this is. First of all I would find me a new doctor, one who really listens to you. I'll keep you in my prayers that you find the right person for your needs and have fun in California and I hope you can relax and enjoy yourself.

Susie Q said...

You have every right to fuss and fume. You were treated like a non entity. I have been there and it is awful. And they wonder why so many women do NOT see a doc regularly. I have been blessed to see some of the most caring of docs but also some of the worst.
Do not take this Teresa...you are far too smart a woman to be treated like this. We all love you and want you to feel great and live to be 125.
Kipper says he would be glad to come out there and bite that doc in the rump...: )

Have a sweet time in CA!

Love,
Sue

Sandi McBride said...

Okay, NOW HEAR THIS! Find yourself another Cardiologist and make sure you tell him why you changed Docs! My Dr. Grainger is wonderful and takes the time to listen very carefully to all I say and yes, told me Vitimin E would help with the cramps! I'm on Lipitor, too...have been for over a year...But I am serious about the question to ask your PCP...ask him who he would see if needed a good Cardiologist because you can't stand yours anymore!
hugs
Sandi

Lavender Chick said...

Okay - I'm livid reading this. First of all, ditch your cardiologist. You need to a see a doctor that is a board certified lipidologist. I will do some research to find one for you. This is a special board certification and there are not many of them. Some lipidologists are cardiologists, some are Internists - But, lipidology is the true art of figuring out (and straightening out) your lipid levels so that your cholesterol, C-reactive protein, and other markers for heart disease are all in check.

Also, you are obviously not responding well to Lipitor. There are other choices in statins out there, and just becuase your enzymes are elevated on Lipitor doesn't mean they will elevate on others, such as Crestor. We're all different and respond differently meds. This doctor has wasted too much time keeping you on Lipitor, and there is no way the 10mg will get you to the goals you need. There was a recent HUGE study using Crestor (called Jupiter), and a very large number of the patients in this study were women - Lipitor has VERY few women in any of their clinical trials, and in fact, some studies are indicating that Lipitor is not the best choice for women. Crestor is a newer generation and also is proven to alter the natural progression of plaque in the arteries.

I will get back with you on the name of a lipidologist. You HAVE to do this for your health and for your wonderful family.

Oh - I'm angry!

Julie said...

Teresa - have you ever been tested for Hep C? I do not talk about it on my blog - but my husband has advanced Hep.C and we monitor everything as it causes his liver enzimes to change.
I am on Lipitor and it does have a bad side effect of reeking havoc on your liver ..that is why you must be tested every so often..and everytime you change your prescription. It is just a safety precaution.
I don't know your doctor - but I already hate his guts. I come from a family of doctors and they don't all act like that. Yours is an ASS. Find a new one! Communication is just as important as his skills and he gets a big fat F in communication!...and PLEASE - when you do change doctors, don't be shy (you don't have to be rude or mean) about telling him why you are changing doctors!

With my husbands progressing disease - I am constantly asking for copies of his blood work tests, asking questions about different drugs I read about on the internet and every other curve ball you can imagine. I want what is best for my DH and leave no stone unturned to make sure we fight this with everything there is to use. If our doc. was not agreeable to my approach - I would VERY SIMPLY find one who was. Remember - the goal is to get/keep YOU well...not to inflated his ego!
(((((((hugs girl))))))))))