Chest Pain. But not THAT kind of chest pain. I think. (Read 327 times)

mab411


Proboscis Colossus

    Bloodwork and an ECG do not rule out heart disease. A stress test is much better.

     

    Oh, definitely.  I even knew that going in.  I've kind of been wanting to have one done even before this happened, just to all but eliminate the chances of becoming one of those sad stories.

     

    That said, I think I am going to continue with my training plan until the stress test.

     

    One theory floated by the ER doc (not a cardio doc, like I thought, unfortunately) is that my heart muscles have become so developed that they are pressing against the artery that brings the blood in (is that the aorta, or is that a vein?), which could bring on some pain similar to a cardiac event.

     

    Anyway, about to call and schedule the stress test.

    "God guides us on our journey, but careful with those feet." - David Lee Roth, of all people

      http://en.wikipedia.org/wiki/Inferior_vena_cava_syndrome

       

      I doubt it unless you have cor bovinum, which would be really weird.

       

      http://en.wikipedia.org/wiki/Cor_bovinum

       

       

      One theory floated by the ER doc (not a cardio doc, like I thought, unfortunately) is that my heart muscles have become so developed that they are pressing against the artery that brings the blood in (is that the aorta, or is that a vein?), which could bring on some pain similar to a cardiac event.

       


      A Dance with Monkeys

        I appreciate the ER doc's creative thinking, but common things being common and vanishingly rare things being vanishingly rare, I suspect that is not the cause.

         

          Exactly.   The ox heart comment was for my own amusement   Smile

           

           

          I appreciate the ER doc's creative thinking, but common things being common and vanishingly rare things being vanishingly rare, I suspect that is not the cause.

          mab411


          Proboscis Colossus

            Called to schedule the stress test.

             

            They need an order from a cardiologist or my general physician to schedule one.  ER doctors don't qualify.

             

            Since I haven't seen what will be my new doc yet, I called my old doc's office for a referral.

             

            Old doc doesn't have anything available...until my appointment on Tuesday.  I asked them to clarify: a guy with chest pains has to wait that long to see a doctor?

             

            Her words were: "Well...it's Tuesday."

             

            Icy silence on my end.

             

            They said I might be able to see the nurse practitioner.  I asked if the nurse practitioner could give a referral for a stress test.  They said yes (it occurs to me as I type, I should check this with the cardio lab).

             

            Can I see the nurse practitioner before Tuesday, then?

             

            They took a message.

             

            Angry

            "God guides us on our journey, but careful with those feet." - David Lee Roth, of all people


            A Dance with Monkeys

              Where do you live? I need to make sure to avoid the place.

              ShuffleFaster


                Agree with Trent in terms of zerbras.  (Although I've diagnosed cardiomyopathies several times during my career, yours seems like a fairly straightforward case and work up--then again, I didn't interview/examine you so I defer to those that did.)

                 

                FWIW,  I can order stress tests from the ED during business hours.  (Although if you are conversant with the literature on such things, sometimes it does more harm than good.)

                 

                Please take it easy, and let us know how it goes.

                 

                PS:  I suspect that much of this whole mess could have been avoided with a brief telephone conversation.  (With a two hour lunch, I'm surprised your doc didn't have time to even do that).

                mab411


                Proboscis Colossus

                  NP called back, lo and behold.  No go on seeing me.  I have to wait until Tuesday.  "I mean," she said, "you're not currently experiencing any pain, are you?  Your workup came back clear.  Just don't run, and we'll see you on Tuesday!"

                   

                  A couple of options occur to me, neither of which seem very hopeful of getting this test done within the week:

                   

                  1. Call the cardio lab and see if I can just get an appointment with a cardiologist, based on the ER trip

                   

                  2. The school PT can generally get us quickie appointments at the sports clinic in the "big" town up the road...I doubt they're set up to give the kind of stress test I need, but maybe?  Also don't know if they'd schedule me without the same referrals.

                  "God guides us on our journey, but careful with those feet." - David Lee Roth, of all people

                  ShuffleFaster


                    Unfortunately, I don't think the PT or sports medicine department are going to be able to help you with this one.

                     

                    A lot of your remaining options depends on what type of insurance plan you have since they will restrict what you can do.  If you are a cash person, I don't know a cardiologist on earth who would turn that down.  Wink  Another option to get a cardiac CT Angiography (they have centers around town that will do them on an outpatient basis by appointment without a referral).  However, that is also a non-functional test in that they do not stress your heart during the test.  Therefore, while they can show static blockages, they won't show what happens with your heart under stress.  Still, if you have completely clean coronaries on the cardiac CT angio, that probably puts you in a very low risk group for significant coronary artery disease, as the test generally has a high negative predictive value, depending on how good the scanner is.  The primary risks are the radiation exposure, contrast dye related risks, and expense to you.

                     

                    I'm sorry you are having to go through all this.

                     

                    Take care.

                    mab411


                    Proboscis Colossus

                      Update: I've called and made an appointment at the cardiology clinic, to speak with a cardiologist, who can then schedule the stress test.  Closest appointment they had was Wednesday.

                       

                      I went ahead and made that appointment based on the fear that my general physician would add another step and refer me to a cardiologist, who would then refer me for the stress test, and then it's two weeks before I can get in for the dang thing.  Seems to be the way the wind is blowing at that clinic.

                       

                      Is that fear justified, do you think?  My only hesitation is the possibility that my general physician would have ordered the stress test on Tuesday and I could have gotten in on Wednesday.

                       

                      I worry I'm being an entitled baby here, but it doesn't seem that unreasonable that my general physician could give me a quick five-minute exam (he hasn't seen me in over a year, is why he won't just call in the order) and order the test, does it?

                      "God guides us on our journey, but careful with those feet." - David Lee Roth, of all people

                      mab411


                      Proboscis Colossus


                         

                        I'm sorry you are having to go through all this.

                         

                        Take care.

                         

                        Thanks, and thanks for your input.

                         

                        The long-term effect of this is, I'm afraid, the next time I feel a little twinge somewhere that might be important, I'm going to be a lot more tempted to blow it off.  I won't, especially if it's heart-related, but knowing I may be off for days while hacking through a bunch of administrative tape and scheduling issues will not encourage me to speak up.

                        "God guides us on our journey, but careful with those feet." - David Lee Roth, of all people

                        ShuffleFaster


                          I'm glad you got in to see the Cardiologist--that's a very positive development.

                           

                          FWIW, I don't think you are being entitled.  You don't strike me as an abuser/overuser of the healthcare system, and you are doing what you can to stay healthy on your own (i.e, running).   Your situation is what the healthcare system is for.  Plus, I'm assuming you have that other person on the right side of your picture to think about.

                           

                          What some of us docs forget is that we are paid to take care of people.  That includes answering their questions and addressing their concerns.  (To be fair to your PCP though:  In this day/age of ever-increasing regulatory hoops/documentation to jump through, sometimes patient care gets lost in the shuffle.)

                          cookiemonster


                          Connoisseur of Cookies

                            Frustrating though it may be, it's good you have the cardio appointment the day after your PCP appointment.  At least that way you don't have to wait another two weeks to get in to see a cardiologist.

                             

                            As for everything else offered by Trent and ShuffleFaster, well, +1 to what they said.

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                            "C" is for cookie.  That's good enough for me.

                            mab411


                            Proboscis Colossus

                              Frustrating though it may be, it's good you have the cardio appointment the day after your PCP appointment.  At least that way you don't have to wait another two weeks to get in to see a cardiologist.

                               

                              As for everything else offered by Trent and ShuffleFaster, well, +1 to what they said.

                               

                              Thanks.

                               

                              Wait...are you saying I should keep both the PCP appointment and the cardio appointment?  It's my understanding that either one can order the stress test.  Though at this point, I feel the wheels will turn a lot smoother going to the cardiologist.

                              "God guides us on our journey, but careful with those feet." - David Lee Roth, of all people

                              cookiemonster


                              Connoisseur of Cookies

                                Either should be able to order the test. Your PCP, however, may elect to defer to the cardiologist. If so, you already have the appointment and don't have to wait to get in.

                                 

                                You'll have to play that part by ear. I've dealt with both scenarios: PCP ordering the stress test and the PCP deferring to cardio.  You're in a good position by being prepared.

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                                "C" is for cookie.  That's good enough for me.