Is this the norm?

[csutherland]

Jerry had his AVR almost 3 years ago and of course had the follow-up visits, with an echo before each one. After his Dec 2003 visit no appointment was made for this year's. About 2 months ago I realized it was coming up on a year and called the card's office. They seemed unconcerned and said if he really wanted to see the dr that they'd make an app't for Jan 4. I asked if he would be having an echo immediately before the app't and they said "no".

Just yesterday we were walking at a fast clip to get out of the wind and into a ballgame and he dropped back saying he was SOB. This morning (on his own which is unusual) he called the card's office again to see if they'd be doing an echo before the app't. He explained that he has a St Jude's and is SOB. Again, they said he'd have to see if the dr. thinks he needs an echo, mentioning insurance issues, etc. Well, he's on medicare and there has never been a question about anything like that.

Is it normal after 2 relatively uneventful years to assume all is well?

 

[Ross]

Most Cardio's want yearly echos. Not all of them though. Some will wait until they have a reason for ordering the test, which is what it sounds like is needed here. I'd certainly see the Cardiologist and see if an echo is warranted for the symptoms presented.

 

[ALCapshaw2]

Since you and your husband ARE concerned, and it makes a lot of sense to have the test results DURING the annual office visit, I would do one of the following:

1- TELL (not ask) his nurse you want to have an echo before the annual exam and explain your reasons.

2- IF you still get a NO, talk with your Primary Care Physician who can also order an echo and get that done before the exam.

3- IF the cardio gets P.O.'ed, find a new cardiologist.

'AL'

 

[tobagotwo]

While an annual echo is optional (although usually recommended), it is surprising that a cardiologist would not request a precautionary echo for a patient with a replaced valve who is citing symptoms. It would certainly seem easier to deal with echo results at the annual checkup, instead of seeing the patient without all of the relevant data, prescribing the echo, waiting for the results, and then waiting for a new appointement to roll around to see him again (that can easily be six more weeks).

There are also other reasons for SOB, including possible blockages, anxiety (he has just been reminded of his heart issues by the appointment), inactivity, etc. I sincerely hope it turns out to be minor and easily remedied.

Best wishes,

 

[Nancy]

Celia-

Maybe if you get really business-like and start a diary of Jerry's symptoms you will get much more attention. My guess is that Jerry probably has more symptoms than he's let on to you, so put them into writing in chronological order and copy them for the cardiologist appointment (keep the original). Make sure to date the list and have Jerry sign it. Having things in writing has magical properties.

And please tell Jerry to not be shy about anything he's been feeling and to document it. SOB is something that has to be checked out, with people who have known heart conditions.

 

[McCln]

I would insist that he be seen and a echo done. And explain that medicare has covered his procedures before and is part of their plan for cardiac patients. They have made some change in medicare but I would not think for cardio patients, they need care and not much different than diabetes. Good luck and give them Hell.

 

[Lisa in Katy]

I am now 6 1/2 years post-op and until this year, always had an echo at my annual visit. I asked my cardio why he didn't do one this year, and he said that after 5 years with no recent problems or symptoms, he treats me as a "normal" patient. That means I get one year follow-ups with a quick listen to the valve, review of meds, and some conversation regarding my heart and life in general. Of course, if anything worries him or me, he will immediately order an echo. Without other health concerns (age, weight, etc.), SOB would be a symptom that should warrant an echo.

 

[Debrinha GT]

getting an echo done.

getting an echo done.

I went to see my cardio a couple of weeks ago and thank God everything still seems to be under control. On the way out I asked him when the next echo would be and he said around July which would be a year after the last one. I then told him that we'd decided to do one every six months and he agreed. I was happy to see that he wasn't worried anyway because it meant that I really am doing ok. My surgeon also told me that an yearly echo would be just fine unless I didn't feel well or something like that, but I said I'd prefer it more often. So, I should be geting my next one around the beginning of March and the good thing is that it's the cardio himself who does it and tells me right away how things are, no need to wait. Just thought I'd share this with you. Coming up for midnight!!
Happy New Year!!!!!!!!!!!
Débora