Well, as you may remember, I had a bit of a falling out with my cardio over management of my borderline hypertension. He went off on me, referring BP to my internist, etc. I felt as if I, the patient, was "being fired," and acted accordingly.
I did my web homework and sought a local cardio who practices at a hospital near my home, that is listed #35 in the US News survey of hospitals for heart surgeries. I also looked for a doc with experience (no newbies) and with a clinical specialty in valve disorders. Found one and blindly made the appointment.
Wow! What a difference! This doctor is a real person, comfortable to talk with, and has an honestly realistic perspective on dealing with valve disorders for patients who are not elderly.That got us off to a good start.
He did an exam and EKG, then reviewed the copy of the echo report from the previous cardio. Then he explained his opinion that the previous cardio had appropriately named my condition (no doubt that I have aortic stenosis) but had not properly identified cause. The new cardio firmly believes that I likely have a bicuspid valve, as I do not fit the profile for the other causes of stenosis. This doesn't change the ultimate need for surgery, but it does change case management somewhat. This doc reminded me (although he appreciates the fact that I had already read this) that aortic stenosis caused by bicuspid valves usually progresses at a slower rate than stenosis related to other causes. He then noted (as I had also read) that he is following closely the trials of percutaneous implantation of valves via catheter and said that "Who knows, maybe by the time you need a new valve, they will be able to do it without surgery." His current guesstimate is that I would not be "ripe" for valve replacement for 5 years, or so! How about that for a new viewpoint?
Of course, I take all this as just the current situation, as all can change very fast. We will do another echo in mid-July to get another set of markers, but I now feel that I have a doctor who understands my needs and has the experience to manage my care around good medical practice as well as my life.
Sorry for the long post, but I felt so much better that I had to share.
P.S. He did also prescribe another drug combo for the BP -- Avalide. Anyone know anything about it?
I did my web homework and sought a local cardio who practices at a hospital near my home, that is listed #35 in the US News survey of hospitals for heart surgeries. I also looked for a doc with experience (no newbies) and with a clinical specialty in valve disorders. Found one and blindly made the appointment.
Wow! What a difference! This doctor is a real person, comfortable to talk with, and has an honestly realistic perspective on dealing with valve disorders for patients who are not elderly.That got us off to a good start.
He did an exam and EKG, then reviewed the copy of the echo report from the previous cardio. Then he explained his opinion that the previous cardio had appropriately named my condition (no doubt that I have aortic stenosis) but had not properly identified cause. The new cardio firmly believes that I likely have a bicuspid valve, as I do not fit the profile for the other causes of stenosis. This doesn't change the ultimate need for surgery, but it does change case management somewhat. This doc reminded me (although he appreciates the fact that I had already read this) that aortic stenosis caused by bicuspid valves usually progresses at a slower rate than stenosis related to other causes. He then noted (as I had also read) that he is following closely the trials of percutaneous implantation of valves via catheter and said that "Who knows, maybe by the time you need a new valve, they will be able to do it without surgery." His current guesstimate is that I would not be "ripe" for valve replacement for 5 years, or so! How about that for a new viewpoint?
Of course, I take all this as just the current situation, as all can change very fast. We will do another echo in mid-July to get another set of markers, but I now feel that I have a doctor who understands my needs and has the experience to manage my care around good medical practice as well as my life.
Sorry for the long post, but I felt so much better that I had to share.
P.S. He did also prescribe another drug combo for the BP -- Avalide. Anyone know anything about it?
And you got more time in the 'waiting room'! Luck you! 
