<< Subj: Re: Nuclear Medicine and Cardiac Catheterization - Recommendation
Date: 3/18/99 7:13:13 PM Eastern Standard Time
From: Phlzfan@desupernet.net (Phlzfan)
To: SolarFry@aol.com
CC: wwpotter@tscnet.com
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I'm not a cardiologist and am almost never an apologist for the medical
profession, but it seems reasonable to make a few comments:
1. I'm assuming that Solar Fry underwent a so-called Stress Thallium test
wherein radioactive material is injected and the heart scanned with a kind of
geiger counter (Gamma Camera) during and after exercise to determine whether
or
not blood flow to all parts of the heart is equal. This test is useful if it
is
perfectly normal but is not so helpful if the flow is not scanned as being
uniform
over the entire heart. It is designed to have few or no "false negatives"
(i.e.
tests that show normalcy where there is actually blockage) at the expense of
more
than a few "false positives" (tests that show impaired flow where there is NO
blockage). Thus, occurrence such as that described by SF are not rare (i. e.
Abnormal Stress Thallium normal catheterization).
Yup!
2. Getting an insurance company (or Medicare) to pay for the second study
would
be nearly impossible and one could buy a very fine used sailboat for the cost
of
the test..
It seems they would be happy to avoid expense of Catheterization... But, you
are right they just want to save money up front...
3. There are other indirect tests of coronary blood flow (e.g. Dobutamine
or
stress echocardiogram) that might help to clarify nuclear false positives.
All negative...
But, it seems since Nuclear Medicine is the ultimate... Too much attention is
paid to its results and there is no desire to question it... Can you risk it?
4. Cardiac catheterization is often 'way over utilized.
But then, who is willing to take the risk?
5. Pottering is definitely a much better way to spend an afternoon than
being
in the cath lab.
Indubitably!
6. Careful communication of symptoms to a carefully listening physician is
still the best diagnostic tool.
Only if they have the time... Insurance payments don't allow for much
listening...
7. The centerboard on a P-15 will keep you awake ALL night.
If you wrap a Cardiac Catheter around the centerboard that might quiet it down
as it wont bang against the trunk sides. <EBG>
Scott Paist, M. D.
TUMP P-15
Lancaster, PA
>>
You are right and it made me laugh!
best
Catheterized Solar Fry
BTW:
The combination of massive gastric distress, relentless pain in right
shoulder/arm/fingers combo from spinal column down to fingers plus heart
palpitations induced by either the drugs or pain convinced me and doc that I
had heart trouble. In his words... "heart disease hides behind esophageal acid
and gas pains". "So I recommend a stress test". From there on fear takes over
and things move quick... Especially when you can't get rid of the stomach
distress after stopping taking Relafen and going strictly on hydrocodone. I
even went so far as to not eat or take anything for 36 hours. I became
totally useless with pain and just could not take it any more.
This event is now in the past. I hope to leave it there and have learned from
the experience...