Concur with Lynne and DocVikingo. Unless you're symptomatic elsewhere, a CT scan is not appropriate here.
chest pain and hard to breathe, I need some help here
- Thread starter retnav7696
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OP
retnav7696
Registered
Ok then, I will ask doc for a screening carotid doppler. I have changed my lifestyle a bit so far. I am walking more everyday and paying attention to what I eat. I know the cola/coffee is killing me but I just can't help it LOL. I just cant survive without my cup of joe 1st thing in the morning. I sure do appreciate everything all of you have done for me and I am a firm believer in the heart cath now. All of you have helped save my life and help me avoid a heart attack. Thank you all so very much. After i get the doppler test done and while I am there I plan on getting the disc the VA said I could have and I will upload it and send it to all whom would like to see it. I know I do want to see what and how they did it. Once again thanks to you all! As far as I am concerned Scubaboard is an outstanding tool that all should use and support!
Unless you have severe high blood pressure or heart rhythm problems, a cup of coffee in the morning is not going to hurt you! Just focus on the positive nature of the increased exercise and diet changes, and don't worry about an occasionally caffeine dose 
Cruisin Home
Contributor
RetNav
Although they are both experienced and mean well, my fellow advisors are just giving you the straight medical workup reperatoire that is synonomous with the American healthcare system. The system is totally driven by money and statistics. but singular people and conditions dont fit into statistics (ie suppose only 1 in a 1000 have a contraindication; what if you are that 1 person; do you give a damn that the 999 others didn't?!) i am giving you advice based upon direct experience with this disease state and total expertise in the design and performance in the diagnostic systems used (U/S, MRI, CT, etc).
Ultrasound while not bad, cheap, and without really any risk, is also fairly inaccurate (at least 20%). (that's not good enough for me or my family). Now lets consider this for a moment: Lets say you have a Coratid U/S and your left is 65% stenotic and right is 50%. these advisors say fine, dont worry, stck to your diet/exercise and you'll be fine. Year later you have a stroke. turns out you werent 65% your were 80%, and worse, the blockage was not hard calcium deposit but soft lipid deposit that is "sticky" to blood clot. Lets say instead you have a CT or MR angiographywhich is probably 2% inaccurate, they find anything over 70% and are likely performing intervention such as stent or surgery. Sure Ultrasound cost $50 and CT cost $300. The system picks U/S, I pick CT.
The above story is not fiction, it is actually what has happened with my lawyer 3 years ago, I will PM you his contact info if you wish to consult him. he like you was also Post cardiac stenosis. He went on diet/ exercise, statins, etc. and it didnt make a difference, he continues to develop blockage, mostly lipid. My theory is genetic. he now has had both coratids done surgically and will likely live another 20-30 years without concern.
I gave you the advice, not as a memeber of the healthcare establishment, not as some low level ER doc with a new found hobby, but as a world renowned expert in the design and performance of these diagnostics. And as I would a friend or family member and mostly a fellow veteran, diver, and resident of Charleston SC. I am not on here like some others trying to advise everyone on everything down to diaper rash. I picked your case to reach out because I knew it was wrong from the start, and while its going good right now, you cant be lulled into a false sense of security. Stay vigilant and you will live long and prosper my fellow soldier.
From one vet to another, Happy New Year!
Although they are both experienced and mean well, my fellow advisors are just giving you the straight medical workup reperatoire that is synonomous with the American healthcare system. The system is totally driven by money and statistics. but singular people and conditions dont fit into statistics (ie suppose only 1 in a 1000 have a contraindication; what if you are that 1 person; do you give a damn that the 999 others didn't?!) i am giving you advice based upon direct experience with this disease state and total expertise in the design and performance in the diagnostic systems used (U/S, MRI, CT, etc).
Ultrasound while not bad, cheap, and without really any risk, is also fairly inaccurate (at least 20%). (that's not good enough for me or my family). Now lets consider this for a moment: Lets say you have a Coratid U/S and your left is 65% stenotic and right is 50%. these advisors say fine, dont worry, stck to your diet/exercise and you'll be fine. Year later you have a stroke. turns out you werent 65% your were 80%, and worse, the blockage was not hard calcium deposit but soft lipid deposit that is "sticky" to blood clot. Lets say instead you have a CT or MR angiographywhich is probably 2% inaccurate, they find anything over 70% and are likely performing intervention such as stent or surgery. Sure Ultrasound cost $50 and CT cost $300. The system picks U/S, I pick CT.
The above story is not fiction, it is actually what has happened with my lawyer 3 years ago, I will PM you his contact info if you wish to consult him. he like you was also Post cardiac stenosis. He went on diet/ exercise, statins, etc. and it didnt make a difference, he continues to develop blockage, mostly lipid. My theory is genetic. he now has had both coratids done surgically and will likely live another 20-30 years without concern.
I gave you the advice, not as a memeber of the healthcare establishment, not as some low level ER doc with a new found hobby, but as a world renowned expert in the design and performance of these diagnostics. And as I would a friend or family member and mostly a fellow veteran, diver, and resident of Charleston SC. I am not on here like some others trying to advise everyone on everything down to diaper rash. I picked your case to reach out because I knew it was wrong from the start, and while its going good right now, you cant be lulled into a false sense of security. Stay vigilant and you will live long and prosper my fellow soldier.
From one vet to another, Happy New Year!
I know nothing but when doing nuclear in-service inspection it was common to receive the 3 rem quarterly limit. While inspecting a "hot" reactor I once received the quarterly limit in three minutes. I have become a little jaded to the risks.
I seriously don't appreciate this characterization. After all, I was the one who told the OP to get the cath that diagnosed and treated his life-threatening condition.
I don't denigrate your expertise, Cruisin Home. I would appreciate it if you don't denigrate mine.
We have a difference of opinion as to what constitutes adequate screening. I have posted my reasons for why I think my strategy is adequate; several other clinicians have agreed with me. You are welcome to post yours -- the OP will have to make his own decisions, consulting his own risk tolerance AND considering the medical system within which he has to work (and remember, he had to twist arms to get a cath in the face of symptoms which darned near any medical student could have diagnosed as angina).
I am damned good at my job. You are probably damned good at yours. But our jobs are different, and OP lives in the real world.
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OP
retnav7696
Registered
I don't care about the cost because all the money in the world won't do me any good if I am on the other side of the dirt! The VA and Tricare pick up the tab anyway. When I see my doc on the 3rd I will ask for the complete work up with the ct and doppler scan. Both of my daughters are certified and my son did the free intro to scuba right before Christmas and loved it! I told him to get certified and late this year hopefully I can get cleared to dive and my kids and myself will take a trip to the Bahamas to dive together. It will be a kodak moment for me! Besides I have to live atleast until my youngest turns 18 too, LOL. I have paid attention on here and it has done lots of good for me as well as others that have written and read all of the posts. Thanks to you all for everything you do. All of you just remember if it were not for you and your advice I may not be here to write these posts. Thanks again for all you do! And my kids thank you too!
Not cool, mate. Kindly keep it professional. Insults don't benefit anyone and detract from intellectual and clinical discourse.
OP
retnav7696
Registered
Yes I know I am starting this very early but here is my question. #1 Am I supposed to wait a year before I return to diving or#2 am I supposed to wait a year and be able to maintain a sustained workload of around 6.0 - 6.5 mets such as being able to walk 2 miles in 24 min (12 min miles) or #3 or reach a max of 13 mets? Now if I can hit the 13 mets on the treadmill or 6-6.5 mets sustained by walking 2 miles in 24 minutes would the doctor consider allowing me to return to diving after 6 months if there is with no other issues or problems during this 6 months? Now all of this is based on me having the doppler and ct scans and no other issues/problems being found or coming up.
Retnav,
That's a little beyond what we can answer without actually seeing you and your medical records. Our standard recommendation is to wait a year, then get evaluated by your cardiologist. Beyond that, I can PM you contact information and we'd be happy to see you in clinic, or you can make an appointment with Dr. Cone and colleagues at the Palmetto-Richland hyperbaric center in Columbia, SC, which is a little closer to home for you. It sounds like your recovery is going well!
Cheers,
DDM
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