Carolyn65

I was doing a "Comment" to "Post Message" from "Quemal re: his first visit to his Dr. after his PM implant and what he should expect. I, the worrier, became long winded as usual in my comment, then decided this should be my problem/question and should be to the PM Club members who have experienced my "dilemma". I feel like this is how my implant went after reading Quemal's similar "story". I need your input PM friends.

I went into the Heart Hospital of Austin on a scheduled Friday afternoon (10/2/09), they did the on-going paper work, I saw my cardiologist so briefly before ablation/dual PM implant, it seems like a blur to me. In the surgery room, they prepped me and I obviously went to sleep. When I woke up, I was in a hospital room w/nurses coming in/out for overnite observation. This all happpened on a Friday afternoon @ 3:00 p.m. This was a scheduled implant for 2:00 p.m. A couple of days before PM implant, the Dr.'s scheduler called me & tried to move "my" time up to 6:00 A.M. the same Friday to "free up" my cardiologist's Friday afternoon, as "Quemal" describes of his.

I have not seen my cardiologist since pre-PM implant in the surgery area. The very next day, Saturday morn ~ the wknd., an "associate" of my cardiologist came by about 7:00 a.m., stayed a whole 5 minutes or less. I had asked him several questions I had, and he told me the PM rep. coming in would know a whole lot more answers. At 9:00 a.m. that same morning, a rep from Boston Scientific came by & plugged in a computer, played with his computer & left in a few minutes. I attempted to ask him some questions, and he looked at me like I had said a "bad word" and told me to ask my Dr.or email/call Boston Scientific! One week later, I had an appt. to go to my cardiologist's office. After arriving & waiting, I was shuffled into a tiny office with a computer. A Lady put something over the area where my PM was implanted, played on her computer and said she would see me again in 3 months. When I asked about seeing my cardiologist, she said, "no, I would only need to see him once per year now"!

I always have a "long standing" appt. with my GP for interval "follow-ups", to what I do not know what we are "following-up". He just does the usual, BP, listen to lungs, chat, & see ya' again in a few months! I do get a flu shot this time he said. I go to the GP on 11/2/09. He has not been involved in any of the "heart biz nor decisions for my health.

I guess my PM implant went by "the book", of which I am very lucky and thank the Lord. I had minimal pain around the dissolvable stitches for a few days (used generic Vicodin for a couple of nights to sleep more comfortably), hardly have any scar, etc. Heck, I do not know if it is even working. I do not feel it doing anything, as I read from the PM Club members, "pings, pongs, shocks, movements of the PM, infections, etc." I am @ "80" like before PM for the next 3 mo.

I feel like a "step-child" outside in the cold; turned away by my cardiologist, the PM tech, no PM rep saw me post hospital and my GP has no clue, other than what those people involved might have sent to him.

My question is, who renews my prescriptions? My GP started my prescriptions for BP, cholesterol many, many moons ago. When I ended up with the cardiologist, he re-newed my prescriptions for several months. Now that he is "done" with me, who re-news my prescription which are becoming very low in supply? I would assume my GP is "out of this loop" and would not have a clue as to my meds now/PM implant/what I need after these many moons of not seeing my GP.

Oh, & here is just another one of my concerns: My cardiologist has never "addressed" my swollen feet/ankles, even on 3 different visits pre-PM & he looked at them. They do not swell as much on most days now, but they still swell. I think because it is getting cooler weather is why they don't swell as much. My cardiologist is rated as one of the "best in the nation" ~ just no bedside manners at all, for sure!

Does anyone have any comments/input and/or answers to all of my "long winded" delimmas; not just the meds renewing? THANK all of you again for all your help. I know I "post" a whole a lot, but after all of you have given me answers and I finally go back to the PM tech next year in January 2010, maybe I will become a lil' more "educated" and won't have so many long questions/experiences. Later, Carolyn G. in TEXAS ( :

3 Comments

Concerns

by SMITTY - 2009-10-25 01:10:26

Hey Carolyn,

My, my you do ask a lot of questions. Now I'm just kidding you because your questions are exactly the same ones that most of us have asked ourselves, doctors (without an answer) the nurse/technicians (usually with out answers too) and here on the PM Club. I can tell you from my experience I have gotten many more answers - mostly good answers too - here than I have gotten from the medical experts. In fact using what little knowledge I have acquired here I have been able to ask questions of some medical personnel that got me answers from them for the first time.

My guess is a set of parameters was established for you and your pacemaker when it was implanted. This means the settings may be tweaked from time to time, but it will be most unusual for any major changes to be made unless you present a specific complaint that they can be address by making changes in the settings of your PM.

While my GP-PCP, works for the HMO as do my pacemaker people, I have found they are in the loop to a degree. I ran into a prescription refill problem not long ago. (the doctor that prescribed the med initially was on leave) When I asked for a refill, of course there was no one to approve it so when the pharmacist learned that he asked for my PCP and contacted them. I got the refill without further delay. I think we sometimes over look the fact the pharmacist understands the importance of the meds we take and knows if we can afford an interruption in taking them. ALSO, he is in business to sell medicines. So most of them will do whatever is necessary to see that we get our meds. Also, they can contact our doctors better than we can many times. What I'm saying is don't you worry about getting a refill yet. Leave it to the pharmacist and if he can't get if for you, from the original prescriber, then have him contact your GP.

As for the edema, I ran into a big problem of swollen everything when my PM went into VVI mode on the 10th. My heart rate dropped from 80 to <65 in this mode and fluid became a real problem. I contacted my PCP and was told to come in immediately. After a quickie examination my diuretic dosage was changed and while it stopped my feet from growing it didn't do much for the rest of me. However I did hold my own and since I have my new PM and a HR back up to 80, I'm back to my old diuretic dosage and losing weight daily.

I guess what I'm trying to say is don't undersell your GP. They can do wonders for us even when we may think it involves something they are in the loop on. I'll stop now, but don't give up and don't worry too much about what may happen. Wait until you are facing that bull.

Speaking of bulls, how about them horns last night? Ain't no justice though, "they" still have the Horns in 3rd place!

Good luck,

Smitty

Questions

by lenora - 2009-10-25 01:10:59

Carolyn, these days most cardiologists employ cardiac nurse practitioners who act as a liasion between the patient and the doctor. Your wisest move is to find out who that is and ask to speak to them when you have questions. Make an ongoing list before you call though. As to who renews your prescriptions, call the cardiologist's office early on Monday morning and you'll probably be directed to a voicemail number for prescription renewals. Mention the edema when you leave your prescription requests and the nurse will direct it to the attention of the doctor.

Find a new cardio!

by golden_snitch - 2009-10-25 12:10:54

Hi Carolyn,

I can't tell you who will renew your prescriptions since I'm not in the U.S., but what I can tell you is: find a new cardiologist! The way you have been treated is definitely not "by the book". Unfortunately, I must say that what happened to you after ablation and implant goes with what happened before. I remember that you were not at all well informed by your cardio, didn't really understand why you needed the pacer etc. So even if this is a center with a great reputation, for me it doesn't sound like the right place to go back to for checkups etc.

This might be a stupid question to ask but are you sure you had the ablation? Just wondering because you never mentioned anything like venous punctures in your groins or below the collar bone or having to lay flat for a couple of hours.

Best wishes
Inga

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