trip to ER last night

[hensylee]

we'll be anxious to hear how it goes. Best wishes. Blessins..........

 

[ctyguy]

back from cardiologist

back from cardiologist

Just got back from the Cardiologist's office, unfortunately my guy isn't in today so I met with a different one who was very underwhelming. Don't you hate it when a doctor wont look you in the eye when he talks ? Bottom line is he didn't have much to offer me other than to order up an echo which was completed while I was there. They are going to call me back this afternoon and tell me if the excess fluid around my heart is something I need to worry about and also what meds I should take. Based on my BP and heart rate it doesn't sound like I need to worry(both were normal). It didn't sound like he was going to prescribe anything and he would recommend over the counter stuff (Aleve). I asked him about how it would interact with the Coumadin and with the Vicodin and he said he isn't a "meds guy" so he really couldn't say. Comforting eh ? A cardiologist who can't recite how drugs interact with Coumadin ? Fortunately today Im not in any significant pain, I did take a pill about 2 hours ago so Im assuming thats keeping things at bay. Now I will wait on the call from them about the echo and see what the next steps are.

 

[Ross]

Man that sounds like a lost cause. I suppose he's board certified too.

 

[geebee]

Sounds like you need to come down to Cincy and see the good docs.

 

[kevin21]

Basically doctors are no smarter than we are.....

I hate when you get non-definitve answers.

Kind of like the answer to my "will I feel better" question about the surgery...

I hope you are feeling better soon!!

 

[Lisa in Katy]

Well......luckily he is not your normal doc. I'm surprised you have to wait until this afternoon for results. I've had 3 different cardiologists throughout my life, and all 3 have told me my results within 15 minutes. The current one, who I've been with the longest, even comes into the room during part of the procedure. The techs have also been known to give me unofficial readings. If they are good at their jobs, they know as much, if not more, than the cardiologist.

If it is pericarditis, Vicodin will mask the pain, but it won't solve the problem because neither Tylenol nor Hydrocodone are anti-inflammatories. If it's not a great deal of fluid, it could go away on its own. Glad to hear that the pain is not so bad today though.

 

[ctyguy]

update

update

I just called the cardio's office and the guy I saw this AM (not my guy) is with another patient, so I have no update but I gave my number and someone will be calling shortly, probably a nurse (no offense to the nurses out there) and probably incomplete information will come back to me. This office has 10 cardiologists in it and it appears to be less than organized. Im going to let this all play out but I see myself having a sit down with my cardio guy in the not too distant future. I like him alot but I also need to know that I can count on him to at least take 5 min to call me when Im having issues. Not like Im some kind of hypocondriac (sp ?) I prefer to not take up peoples time unless its absolutely necessary. I REALLY liked the cardiologist I met with prior to my surgery at Cleveland Clinic, only issue is 2 1/2 hrs drive each way. However it may end up being the path I choose. Once I have a call from someone I will post again my result.

 

[Nancy]

I found that some of the PAs (Physician's Assistants) or NPs (Nurse Practitioners) were just the finest as far as helping out in an emergency, and the doc was tied up. If it was something they could not deal with, they would get right in to the doctor and get some clarification. Always had good luck with them getting help for Joe.

 

[ctyguy]

Finally got the skinny

Finally got the skinny

The Cardio's office finally called, heart function all looks normal (yeah !) and it does appear that I have mild/moderate pericardial effusion, which based on all the experts on this site I kinda already had that figured out ! Thanks again all you experts ! They want me to ditch the Vicodin and switch over to Advil (440mg every 12 hrs). So later tonight once the Vicodin starts to wear off (I just took one about an hr ago) I will make the switch. Hopefully within a few days this will resolve itself and I can get back to a positive recovery ! I want to get on the treadmill but I don't want to aggravate this so Im going to give it a few days first. Im still not real happy with the ER doc who totally missed the diagnosis. I told him I had OHS 3 weeks ago but he didn't make the shoulder pain connection. The funny thing is he did say there was more fluid around the heart than he is comfortable with but he said what I have is a muscle issue, totally unrelated to my heart. HA ! Im going to shoot a letter to Riverside to let them know that the ER docs should call for a Cardiology consult if you have a OHS patient in front of you, probably a smart thing to do.

Thanks again to all you who contributed to this thread, your info was teriffic and as I was telling my wife, this website is absolutely invaluable. Being able to go to the doctors office with educated questions is fantastic. I don't know what I would have done other than just take the word of the ER doc and wait two weeks for my next cardio followup.

 

[Freddie]

ctyguy

ctyguy

ADVIL???????

Excuse me if I'm wrong ............But Advil and warfrin don't mix. It can cause bleeding in the stomach/ulcers. My doctor told me to stay away from it.

 

[Superbob]

ADVIL???????

Excuse me if I'm wrong ............But Advil and warfrin don't mix. It can cause bleeding in the stomach/ulcers. My doctor told me to stay away from it.

I'm no expert, but just looking at drugs.com, it appears that Advil may not be safe to take if you are on Coumadin, as Freddie indicated.

http://www.drugs.com/advil.html

Perhaps they are adjusting dose, or doing some other special precaution?

I am just passing this on FYI. To repeat, I am no physician or pharmacist. Just wishing you well...

 

[ctyguy]

Im going to the coumadin clinic in the AM for the first time and according to the Cardiologist's office they spoke with the Clinic and their response was that its ok to take Advil on a short term basis (under 1 week) as long as its properly managed via your INR. The intention is to get the inflamation under control and then back off the Advil. They don't want me to take the pain killers at all while Im on the Advil so I won't be mixing Advil with the Tylenol thats included in the Vicodin.
Im not feeling too bad tonight so Im holding off taking the Advil it until I get to the Clinic to confirm. I've read the same things however if you dig a little deeper on Tylenol you will find that its recommended to not take more than 2275mg in any 24 hr period with Coumadin either. If you have a headache or some other ache or pain they want you to use Tylenol, I guess Advil is only allowed if its being monitored.

 

[S2R1000]

Water water everywhere and every move I make hurts

Water water everywhere and every move I make hurts

Hey, I had the same problem. Dont assume the fluids are the cause of your pain. Fluid is there and may or may not be the root cause, maybe part of it but you dont knwo how much if any. Practise your DEEP long breaths (pushes water out of lungs) . Stay STRICT on the exercise regimen they gave you if the doctor says OK. If you are younger as I am, cracking of the chest goes hand in hand with (very) bad pain. Nerve, bone, and muscle repair take weeks. I had a bad bout losing a shoe tying contest with my four year old. Get off the Narcs and stay ahead of the pain with the advil / tylenol with strict regimen. They work differently (one for swelling pain and the other for pain pain. Trust your doctors and relax, you will be fine. Its over now. Rest and heal and (oxymoron) try and not stress over the pain which is a big reason for healing problems. They are related. You did what you were supposed to do and saw your doctor, questioned it, now move on and enjoy your new you. It really gets much much better.
Now just dont sneeze, caugh, hickupp, or push to hard with any bodily function including blowing your nose.

 

[ctyguy]

S2R1000...your just down the road from me, Im up in Worthington. This pain I was having in my shoulder cropped up just the other day, this was very different from what I had experienced thus far in the healing process. Actually my incision is healing up nicely and I don't have alot of discomfort besides the shoulder. I bagged all the pain killers early last week, went a few days on Tylenol. I was sore some but managable and then this thing with my shoulder cropped up. After a visit to the ER and now the Cardiologist it seems like I do have mild/moderate pericardial efussion. Im hanging reasonably well today(I have taken 3 Vicondins however) and if I can get past this shoulder pain I think I will be ready to rock and roll on the treadmill with a light to moderate amount of exertion. I was in good shape going into the procedure and now Im 20 lbs lighter so Im anxious to get back to running just so I can see what I can do. The cardiologist wants me to bag the pain meds (sounds great because they were messing with my digestive system, hence my decision to try Tylenol only) and try Advil for a few days to reduce the swelling. They said they talked with the Clinic but Im going there in the AM so Im not going to change anything until I talk with the clinic myself. One thing I have learned in the last few weeks is that alot of these docs aren't nearly as dialed into Coumadin as those of us that are on it are. I had my PCP doc tell me that optimal INR for me was 2.5 to 3.5, yet the Cleveland Clinic where I had my procedure done said 2.0 to 3.0. I called the Clinic and they said my PCP was kinda right, 2.5 to 3.5 is the recommended for the Mitral Valve, 2.0 to 3.0 for Aortic. I referred that back to my PCP and he said he was going to run that down to confirm, which he did ! Not a big difference but Im a numbers guy so Im assuming the Clinic will know better than anyone else.
I totally feel I am past the hard part of this whole experience and that over the next few weeks I will regain strength and get back to living life. I know I need to pay close attention to my INR and if you were to ask my wife she will be the first to tell you how anal I am about this whole thing. Im using spreadsheets to track times/dosages of everything I take !

 

[S2R1000]

Advil and Tylenol

Advil and Tylenol

Hey, I just read your post. Do what they told you to do about hte Advil and Tylenol. It takes like 4-8 hours to start reducing swelling related pain and I bet your INR range is way greater than you think. Your not going to bleed to death from thinners and advil. I was alergic to opiates and a great number of strong pain killers and had the unique opportunity to be on only advil and tylenol. Goodie for me right
Swelling is all around bad. If Doctor said take something, I would think twice about discounting it. Take the OTC like CLOCK WORK, its the only way they work. The scale of what you are dealing with is far greater than a headache.
My fathers a pathologist and told me its easier to replace red blood cells than brain cells. Dont worry you are not going to puncture yourself and explode. Even if you get too thin (INR) its not like you wouldnt notice, then you go in, they give you a shot and everything is OK. Try not to make decisions on one in a million chance that you will be on an episode of "HOUSE" and they cant figure out why your bleeding to death. I can see the episode now "ohh the advil did it". I know its hard to tell whats worse , the pain or the worry. You'll be fine. Ask questions, try not to self diagnose everything wrong with you. Listen to your doctors as much as or more than us. Go to sleep, its late, you need your rest so you stop worrying

 

[S2R1000]

Ohio hospitals RoCK

Ohio hospitals RoCK

I had mine done in Cin City. Christ Hospital. Clinic also great place. Spoke with the head valve doctory there (Swede I think). Cant remember his name. He was really cool. I tracked all my numbers and meds for almost four months. Im an engineer I have the ONX Aortic valve.
How about the chest huh.... looks like pie doe crust for a while right.
You'll be fine, stay in touch. I wish I had used this as a resource more, earlier.
When I get fired up or mad at the office, my staff gets creeped out becasue they can hear my ticking get faster and faster.
Fastest weight loss plan ever. I picked up my twenty over six months plus five. Feeling great now. Didnt realize how bad I felt befor. Its even beter as 6 months rolls around. Take it easy, dont worry, get your rest, Im sure your wife is taking great care of you. Suck it up cause it wont last Once they know you are OK again, watch out rolleyes:

 

[Ross]

One thing I have learned in the last few weeks is that alot of these docs aren't nearly as dialed into Coumadin as those of us that are on it are. I had my PCP doc tell me that optimal INR for me was 2.5 to 3.5, yet the Cleveland Clinic where I had my procedure done said 2.0 to 3.0. I called the Clinic and they said my PCP was kinda right, 2.5 to 3.5 is the recommended for the Mitral Valve, 2.0 to 3.0 for Aortic. I referred that back to my PCP and he said he was going to run that down to confirm, which he did ! Not a big difference but Im a numbers guy so Im assuming the Clinic will know better than anyone else.

The numbers are suggestions, not set in stone. It is recommended 2.5 to 3.5 for Mitral and 2.0 to 3.0 for Aortic, but there is really no significant difference. My own aortic, 2.5 to 3.5 is my range. Those of us that self dose and self test are happy with anything between 2.0 and 4.0. Don't get too anal about this stuff or you'll lose control. If your having troubles with your INR, come on down to anticoag forum and lets hash it out. Usually those taking care of you are the cause for screwed up INR's.

 

[ctyguy]

I have my first appt with a Coumadin Clinic today, they will begin tracking my INR (although I will be tracking it as well). Im going to use the Clinic for a while I want a good baseline established, maybe 3 to 6 months. At that point I want to move to self testing if my insurance cooperates. We got the bill from Cleveland Clinic yesterday and so far my insurance has been charged over 125K for my procedure. Im sure if self testing is cheaper for the insurance they will let me move to it in the future. I will take your advice and be happy if Im between 2.0 and 4.0. But I still want to target 2.5 as optimal.

 

[Ross]

No offense, but set your sites a bit higher, that way you can eat more vegetables (green) without disrupting your INR very much. We all like to stay on the high side of our range for this reason. It gives us that "wiggle room".

Another thing, don't expect to hold it at 2.5. It's impossible to maintain a specific number.

Let us know what the clinic gets, then what they want to do about it when you know. Lets see if they know what their doing.

 

[Freddie]

Another thing, don't expect to hold it at 2.5. It's impossible to maintain a specific number.

Gee, I must be doing something right/wrong. I've been holding my INR at 2.5 since Jan 22/08
I know I'm not normal, but thats why I'm here.