Monday, February 13, 2012

Yearly Meeting with Cardiologist

Last Thursday I made my yearly visit to my cardiolgist. I've been seeing him yearly since my GP got me to do the heart scan a little over two years ago. I've had a thalium stress test with my cardiologist about that time also.

He did take the initiative to put me back on Crestor at 2.5mg/day. That was a key, along with my GP's recommedation of Trilipix, also about two years ago. Along with Omega3, I've had the best lipid profile for years and it has been consistent over the past two years. Nor has this caused real problems with my liver enzymes. Thus I can hold back a bit on Niaspan and use it when (and if) I need to; for example, when the system becomes habituated with the current levels.

The outcome of my visit? Ok EKG, stress test next year. He also discouraged me from doing the full bodfy scan. Not on the basis of radiation, but general need. He drew a diagram on the exam-table paper showing calcium both on the inside and outside of an artery. He says that with the calcium scan, you don't know which side. That is why he gave me the thalium test to check for obstruction.

The weekend before the visit I did the 35 mile Cal Poly ride, then a 5K on Superbowl Sunday. It's my conjecture that a stress test wouldn't have shown anything that wouldn't have shown up on those events. This is the issue of predictability. This is not to say that there couldn't be real problems to be discovered, only that the stress test isn't a good predictor with individuals who have a certain level of fitness.

I asked what the obstruction level was with the calcium stress test, and he didn't answer, saying that it doesn't show real obstruction. I asked for the results of the thalium stress test hoping for millimeters dialation of some such, but only got "not obstructed". I also asked for the "picture" generated with the thalium test, and got something like "noted" and "I don't see a picture in your file." Yet the results were based on a picture. I'd like to see it and may follow up. VitalImaging faxed the results directly to my cardiologist and said they would mail be hard copy. Need to look at their point system again.

Ownindex now 36 on 725; 40 on 810. Biggest disparity between the two that I've seen. Will check again with the 725 today. I want to see if I can detect any consequences of the Palm Springs ride or my increased exercise level over the past month or so.

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