Wednesday, March 8, 2023

Palpitations

There is something seriously wrong with the health care system in this country. For one thing everything costs a fortune, secondly despite the existance of Medicare for the elderly, that too costs money. Not only do you pay into it from every paycheck when you are working, but once you retire you continue to pay into Medicare from your social scurity, as well as paying for Medicare Advantage if you want to be able to see and have teeth—for readers who don't know, Medicare doesn't cover dental or vision. And the care is most definitely not as good as private health care, even with the same doctor. I noticed a big difference in the attention I got since I retired. Of course, I am judging this in comparison with health care in Europe which has it's own problems, but at least it is readily available to everyone.

But what I find the most frustrating is the total lack of interest in a patient's mental state. I used to have a doctor who not only listened to what you said, he listened between the lines to what you didn't say. I firmly believe that a large majority of minor disorders could be cured by just talking about what is bothering you, rather than a battery of expensive tests and a slew of unnecessary supplements and prescriptions. How many times have you felt better just because you went to the doctor? Not because of anything he said or did, but the stess had somehow been relieved.

A few months ago my husband had some medical issues. He was submitted to a number of tests the last, and most significant test had a very long waiting time. As a result we were left dangling, not knowing what to expect—I found myself literally holding my breath. It felt like the awful few months in Amazon while I was fighting for my career and finally decided to throw in the towel and retire. (See post here). Unfortunately this time there was nothing to do but wait. And try to remember to breath. 

The constant anxiety finally got the better of me. I guess I am not good at managing my stress, I just pretend that I am. I started getting palpitations. At least, I guessed that is what it was, I never had them before. I got good at recognizing the signals and warding them off with deep slow breathing. It didn't happen very often and usually only lasted less than a minute, but after one somewhat prolonged episode while grocery shopping, I decided I better talk to my doctor. I knew it was anxiety and assumed he could give me something to make it go away, or at least calm me down; better yet, do something to reduce the wait for my husband's appointment. 

My own doctor was not available so I went to see my second choice. A man with a dismal personality, a lousy bedside manner, but an extremly good doctor, or I thought so. Of course, he wasn't in the least bit interested in my personal woes, so maybe not so good after all. If the truth be known, he probably wasn't very interested in my health, just doing the clinical CYA steps. After conducting a EKG in the office, the result of which was perfectly normal, he referred me to a heart specialist. 

Now, for my age I am remarkably healthy. my cholesterol is on the high side of normal, blood pressure has always been good, yes I am overweight mainly due to a thyroid that is lazy, but other than that I am good. I workout regularly, eat sensibly and oh yeah...I drink red wine—it is good for you, right?


Anyway, the worst part about the heart specialist is that he was a full hour drive from where we live.  The heart doctor sent me home with a heart monitor stuck to my chest. I was to wear that for two weeks and if I experienced palpitations I had instructions to tap it and fill in a diary listing exactly what I was doing at the time. Diary was also supplied.



He also referred me for a CAT scan, a treadmill stress test—don't be fooled by the picture, the treadmill I was on was set at a very steep slope—and an echocardiogram, which I have to say was fascinating! Both the stress test and the echo were at his office, so at least two more, two hour round trips in our future. But first, the two weeks with the thing stuck to my chest recording every heartbeat. I was so relieved when I was finally able to remove it, pack it in it's box and send it back. 

Before each visit I was required to sign a document stating that if Medicare refused to pay for the procedure I would pay. Leading me to belive that happens quite a lot.

Sample echocardiogram

Funny thing, the day after his nurse stuck the thing on me, I had the worst, longest episode of palpitations I had ever experienced. It lasted a full twenty minutes. So I tapped the device and when the flashing lights behind my eyes stopped and my heart beat returned to normal, I filled in the diary: Just had my shower and sat down at my computer. The instructions were 'write down what you were doing', not what you were thinking. Perhaps that would have been a better clue. I had been thinking about my husband and how long we had to wait for his next procedure, and oh yeah, the stupid monitor stuck to my chest. The good news is that since then, six weeks ago, I have not had another episode.

All of the test results were normal. I did tell him on my first visit that I believed I was wasting his time but he had to go through the motions I suppose. Though I never did get any results from the heart monitor readings. I guess that means I will eventually have to return yet again to hear him recite those findings.



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