chest pain and hard to breathe, I need some help here

[retnav7696]

I got my results from the doc today for the ultrasounds done on my neck. The doc said I am 15 to 50 if that makes any sense at all. She also said they are going to do this test again every year from now on. And that if I were in the 80 range I would need to see a surgeon. Here are my questions. #1 She said that 15-50 is pretty good so why do this every year? #2 Can I get a print out or a copy on disc like the stent procedure? #3 Should I have this done again somewhere else for a second opinion? #4 or let another doctor see the print out or disc if I can get it? After all the other screw ups I am not so sure about this!

 

[TSandM]

Well, 15 to 50 means that you appear to have some irregularity of the inner lining of the artery, but it isn't very much, and it doesn't interfere with blood flow at this point. The reason for repeating the test is that arterioclerosis is a progressive disease, and may well get worse -- and if the blockage increases, you might benefit from surgery to clean the artery out.

You should be able to get a copy of the ultrasound portion on a disc.

I doubt you need a second opinion. Reading Dopplers is something most vascular techs or radiologists get pretty good at, as it is a common test.

However, I suspect somebody is going to tell you to get a CT scan . . .

 

[retnav7696]

LMAO, thanks TSandM! I just couldn't help it !

 

[Cruisin Home]

Haha, real funny.

 

[retnav7696]

Well hello all, yes still alive LOL. Moved from Charleston to Summerville, cmptr died been through cardiac rehab doing great. Passed my test at 6.5 mets for 25 minutes. The heart guy said great but still cant dive below 30 feet until January 2012. Plan on taking a refresher class. Cant wait to get back in. Snorkled in Roatan, Honduras and Cozmel had a blast. Hope everyone is doing great!

 

[Jax]

Good to hear things are doing well, RetNav! Thanks for keeping us up to date.

Where are you going to take your first, below-30' dive? Make sure you take pictures!

 

[JB]

I've just seen this thread, and there are some, in fact one, post that got my goat, so please forgive me for the following rant.
This case illustrates what's wrong with modern medicine. If you don't know what is wrong on history, you are very unlikely to ever make a diagnosis. We no longer listen to our patients, and rely far to heavily on investigations. The art of taking a history has been lost as we spend less and less time in consultation. Over reliance on CT...., a CT chest increases the life long risk of breast cancer by 15%, so you better have a very good reason for doing one in a female, especially a young one, and an even better reason for doing a repeat CT. Don't even get me started on the rip off "heart scans".
If you ask the village policeman, what is the cause of chest pain brought on by exercise and relieved by rest, he will know. However the original physicians seem to have been thrown off track by a negative exercise test. All goes to show every test has a false negative and a false positive rate, and every test is open to interpretation. Moral of the story, make a clinical diagnosis and then use investigations to prove it, not do a million test to CYA and pray one of them comes up positive.
I suspect this is litigation driven, the legal system probably respects a typed report from an investigation, as fact, but can't weight gut feel, experience, intuition etc.
The other problem is sub-specialsation, every one seems to be quite comfortable saying it's not cardiac, not respiratory, not gastro, but very few are capable of saying what it is. A physician consultation should last the best part of an hour with at least 30 minutes on history. With due respect "cruising home", the only true generalists left seem to be ED physicians. No one else ever seems to see hot undifferentiated cases fresh off the street. Every one else sees selected syndromes filtered through the system.
Who would I take advice from? the clinician at the coal face, in daily contact with patients, or the PhD academic researcher, with a narrow field of interest/expertise?
Rant over, phew!
Pleased this eventually got sorted, but what a run around. RetNav only a few months left before you'll be in the water, enjoy!

 

[TSandM]

With due respect "cruising home", the only true generalists left seem to be ED physicians.

Thank you for the compliment! I live by William Osler's, "Listen to the patient, the patient is telling you the diagnosis." I have a personal file of cases where I've failed to do that, and learned my lesson!

 

[gcarter]

Wow.

I hope all of you appreciate what a spectacle has just been put on for us (by just I mean I just discovered this thread).

I am amazed at the amount of goodwill and effort (unpaid!) that has gone into making sure the OP (a stranger!) got the help he needed.

This has been a tremendous advert for the medical profession. We hear too often about how the profession doesn't really care, but this certainly puts THAT story to rest.

Even with the (minor) disagreements - in which profession do the practitioners never disagree? - not a one of you stopped your efforts to help the OP.

Major, major kudos to you all.

 

[retnav7696]

Again thanks to all of you. I hope my final check up on the 18th of August is really my final. LOL I would love to go back to Roatan and dive the reef but who knows. Maybe go to the blue hole I don't know I just know I want to get back into the water. Its one of the only places we can be truly free. If he doesn't clear me I am going to be upset to say the least. I have learned alot about chest pain from all of you. One of the guys at work recently was complaining about chest pains on Friday.That following Monday he was dead. Heart attack killed him. He was getting a divorce and decided he would start working out. He was way overweight and did not get cleared to work out by his doctor. He was 45. Pay attention chest pains are no joke. Once again many thanks. I can't ever repay all of you for the advice but I will pass it on every chance I get.