It’s best not to categorically expect the very worst. It is fair to say that there is wisdom in being prepared for the worst. Delightful surprises can ensue.
About a month ago I interviewed a new cardiologist. He seemed to have very good communication skills and a genuine interest in my case and story. He was referred by the EECP treatment center I was going to and attached to the same hospital cardiology group. I thought I might have a shot with this guy. He requested films of all my prior tests since I was hospitalized two years ago for congestive heart failure and offered to review them with me on my next visit in a month. This was something new. It was encouraging. Never heard this before from any of my care-givers. He picked up the fact that I was an active participant in my own healing. An extremely active one. Proactive, even. It was only on the way out the door that I realized that he was a intervention cardiologist. It was right there on the appointment card.
Through all my dealings with these guys, I’ve learned to be suspect of them. Especially intervention doctors. They tend to be Hell bent on doing angioplasties and implanting stents and such. Of course they are. That is what they are trained to do. I imagined myself having to fight with him to avoid some kind of procedure that I really knew I did not particularly need, and prepared many mental dialogues, come-backs and logical conclusions. Adamant alternative treatment people like myself are poison to most of these doctors.
So, I got the films, brought them along with my collection of PDF files of every report and written record from the last two years on a separate disc ( my history, as they call it). The nurse/practitioner I’ve spent some time with adjusting and reducing my medications over the last few weeks was duly impressed. As it turned out, there was a problem with the office computer system, so I left the films on loan until they could upload them to the hospital network. In the following conference, my new guy agreed that what we really needed was a radioisotope scan to see what was going on since the EECP treatment, adding that in all probability, nothing more need be done. It appears he gets it.
It also appears that I have made the right decision about my care for the second time in a row. Looks like I found an advocate outside of myself- in the most unlikely of places.
It’s not really worth expending energy on anger or rage. I’ve wisely learned that those things rain havoc on my physical being. I’ve decided on this approach instead. I may be annoyed, but it is healthier in my case.
Yesterday I decided to review test results from my initial hospitalization in light of my decision to NOT have bypass surgery and go instead with EECP treatments to spur the development of the collateral vessels around the blockages in the main arteries that feed my heart. I’ve been saying all along that I believed there is evidence that the process was already happening judging by scans done earlier this year and improved overall health of the heart. I do not pretend to be an expert in medicine or cardiology. I can, however read. I can see. I can do comparative analysis, and have very good attention to detail. Maybe even better than that of those expert and trusted with my care. It’s no news that I bear distrust toward these professionals. Here is what they saw and did not talk about with me, and it has been hiding in plain sight in black and white on my cardiac catheterization report since June 10, 2011:
LCX: This vessel is 100% occluded proximally. There is a long OM which fills retrogradely from collaterals.
RCA: This vessel is 100% occluded proximally and fills retrogradely via collaterals from the LAD septal branches.
Those two above, in plain English, indicate what is termed “natural bypass”. Or at least the strong beginnings of the process.
To add what I quietly call interest to all this, prior to my last cardiac catheterization in February of this year, the intervention cardiologist performing it introduced himself and looking over the prior report stated that we were going in to check my current status and implant a stent. I presume this was intended for the partially blocked LAD. The team nurse quickly questioned why he would do that, as the cardiologist who ordered the procedure did so in preparation for triple bypass. It is all becoming painfully clear to me now. I am doing the right thing staying away from that crew. Above lies my proof.
quod erat demonstrandum
It has been a while since I have even thought about this thing I consider a scourge on the the current state of health care, let alone comment on it or raise my voice about it. It came to mind today in a roundabout manner in the course of my EECP treatments. I am about a third of the way through to date. My vitals are taken daily before and after each session, and for the last week my blood pressure has been trending downward. Ordinarily, this would be a good thing, however, the trend is dipping low enough to be of concern. In particular, the systolic number is at an all time low for me. My attendants even had each other check it to be certain. This phenomenon can be brought on by any number of reasons, not the least of which being the treatment itself improving the function of my heart. I am convinced that at this point my medications are over-dosed. Two of the blood pressure lowering drugs were doubled by my cardiologist at the beginning of this year in anticipation of an open heart surgery procedure to bypass several main cardiac arteries. Since I decided to not go that route and do the EECP treatment it is only logical that the dosages should return to where they were. I explained this to the nurses, adding that I was aware that no one at the center is in a position to advise on prescriptions. I also added that ordinarily these things are determined by my cardiologist, but I was considering changing him for someone more attuned to the approach I am taking. In so many words, I was honestly informed that I will not find any such cardiologist, not even the hospital group attached to the EECP center. The reason being that there is no big money attached to this method. As if I didn’t already know this. People have to demand this therapy. If they even are aware of it. The bill-for-service machine driving US heath care isn’t going anywhere any time soon. I’ll just stick with the guy who knows my history the best for now and hope he can deal with me.
I had a feeling about this one. After all, it only makes sense when you do the math. Having gone through my first week of EECP treatments, I could not help but notice an immediate effect of more energy than I’ve had in some time. It’s wonderful. It’s similar to the feeling I remember from back when I used to regularly work out a long time ago. They call it runner’s high, and it is accompanied by a bit of tired soreness of the muscles involved, that being the thighs and gluteus maximus. It’s the result of forced and increased flow in the circulatory system, and for the moment I should approach it with caution. These treatments take seven or so weeks to reach the maximum benefit, so it’s a lot to ask of them out of the gate. But it’s a little bit euphoric, in truth, for the moment- and, as it turns out, potentially dangerous. Luckily I had already figured it out to a large extent. So I must approach increases in activity in small increments. There’s plenty of time for more later. As in life itself, it is a day-to-day affair. As the nurse/technicians cautioned, the fastest way to land in the hospital is to exert yourself as much as you feel you are able to at the onset of this treatment regimen and course. Baby steps to a new life. I’ll take them in stride.
OK, now we’re getting someplace. Friday late in the day I got a nice, friendly call from the folks that provide my health insurance telling me that after review of my case, I was approved for a full course of EECP therapy. This is a good thing, as data available to them indicates what I’ve been saying here. There’s a very good chance I could really benefit from this approach. It appears I’ve done my research well. It’s not for everyone but I meet the criteria for the best chances of success. It would fit a nice return-on-investment profile, if you will. I cannot stand back and not make a very strong point: Compared to cardiac arterial bypass, this approach is a bargain. It’s of a bargain basement magnitude bargain. Considering that in relative terms EECP costs around $6,000.00 and CABG costs upwards of $200,000.00 when it is all said and done.
The cynic in me was not surprised, needless to say, but that does not matter nor is it the driver in my own personal choice to go with this. If you have a basic working knowledge of medical terminology, the flow chart above taken from a study on the process shows how this can be used. Even if you don’t know the words, it can give you an idea. The comparative illustration on the left is a simplified picture of what is hoped can occur. Simply put, this treatment stimulates a naturally occurring mechanism that seems to be in progress, that being the development of collateral vessels around the blocked arteries. It involves 35 treatments, one hour a day, 5 days a week. I’ll be giving my impressions of this therapy once it gets scheduled and under way.