Sarah is right about the doctors rotating through the VA. This by itself makes for poor health care in many cases. In the In the just over 5 years I have been going to the VA I have had 6 different Primary care (usually NP or PA), 7 different shrinks, 2 cardiologists (that I only saw 1 time each), don't know how many Neuros as each visit was a different one, and 1 eye doctor.
How can a patient establish a working partnership with their doctors if you are constantly get a new one every few months or so? This is especially true when it comes to mental health problems where it is even more important for the patient and doctor to get to know each other.
I don't think the "rank has its privilege" plays much of a role at the VA any more as the information a doctor sees doesn't contain that info. What does seem to me to play a role is how high your service connection for health problems are. I have notice that my level of care has improved since I got my 80% S/C. For example prior to thew 80% I had to get an appointment with a VA Neuro in order to get a visit to my MS Neuro approved. This meant that the 6 month follow ups were more like 8 or 9 months apart. This last time since I was 80% I didn't have to see a VA Neuro, call or anything. It was automatically approved.
Dennis
It sounds much like my mitral valve problem. The cardiologist who did the ultrasound said it was "stage 1", meaning not everyone would pick up on it but they keep an eye on it just in case. I was told for years it was a murmur but it was the late 80's before anyone called it a MVP.
The good part is that you will have a VA much closer when you relocate to Maine.
VA? Having 4 offspring who all went in the service, Ive heard good and bad but mostly bad and it seems to depend on where you are. Ive heard that doctors rotate thru the VA so the situation changes and of course, there is the "rank has its privilege" clause, although unspoken of. I think it best we not open "that can of worms" as it can go OT in a hurry and take up pages of comments. We all have our own opinion of VA care depending on who we know.
The new rule of thumb is to get you out of the hospital as soon as you are able; hospitals are where you can get sicker! Insurance, unfortunately plays a big part, the new ER rules are unreal, and our new healthcare laws, soon to be in place, will have all of our heads spinning.
Am glad you are on the mend Dennis, and sounds like you are knowledgeable about what is going on and what to look for. I had knee surgery and was driving a U-haul truck 3 days later, stubborn one that I am!
Sarah
Sorry you have "been thru the ringer"! And agree, its a good thing you realized that something was going on with your heart and you didn't just ignore the symptoms!
My mother-in-law had a mitral valve replacement. By the time it was found and diagnosed as "leaky" she had substantial heart damage. She kept getting told she was having asthma flares...finally a NP did more testing, and sent her immediately to the Cardiologist. The surgeon tried to repair the valve, to try and avoid the need for blood thinners, but it was too far gone, so he had to replace it.
Take care, and hope things improve and keep improving for you!
Regards,
C
Of course you mowed the lawn lol only you would think that was a good idea after a triple by pass......groan!
I'm assuming your feeling condident with the care you got at the VA this time around (well you sound like you are) and hopefully you will be feeling more your self very soon.........er that is if your not mowing any more lawns :D
HUGS.........JJ
ps ess, thank you for telling a good VA story, someone sure went above and beyond, i always like to hear about good things :o)
That is great about that "one" vet, but what about the thousands of vets the VA has "killed", "seriously injured", or "shortened the life of" due to lousy medical care?
Take Dave for example. He complained of pain for almost 2 years before they decided to check it out. By that time he had stage 4 lung cancer.
Or the Vet with MS I know in MI that has fallen many times including once breaking several ribs. But the VA would not even give him a cane to help him walk safely.
That one incident does not in the slightest way make up for all the wrongs done by the VA to vets.
Dennis
Oh Dennis, what an ordeal! I am so glad you knew enough to not take chances and get to the hospital.
I wish you a speedy recovery,
Corrie
This is a bit OT, but since we talk a lot about the VA here, I thought I'd mention something good for a change. My sister lives in semi-rural NY, and an elderly man they know went to the VA for a routine checkup, feeling fine. Routine bloodwork done. The man went about his business, and meanwhile the VA lab found life-threatening levels of potassium in his blood or urine, I don't know.
The VA couldn't get hold of him by phone, so they got the local police to find the man and bring him to a hospital, where he was admitted and began treatment for kidney/potassium problems. I had never heard of such diligence by the VA or any medical outfit, so my hat's off to them.
Let's hear it for the VA!
This time the VA is doing a better job than the civilian hospital I first went to. They were just going to watch me over night and send me home. The VA hospital actually did tests to see what damage had occurred and if they could do anything in the way of repair. The VA hospital also cave me a new RX for a blood thinner which makes it less likely for me to have another heart attack and also changed my cholesterol medication to something stronger in order to help prevent another attack.
In 1995 when I had my first heart attack I was suppose to get out of the hospital after 24 hour hours when they did the cath back then. But I had a severe bleeding problem when they removed the port for the cath. It took 5 blood soaked nurses on top of my groin in order to stop the bleeding so I had to stay flat on my back for an extra 24 hours. But even then as soon as they allowed to to sit up I started bleeding like crazy again so I spent another 24 hours flat on my back.
Even when I had my 3x bypass in 2007 I only spent 5 days in the hospital. And as soon as I got home I was out mowing my lawn. So I was moaning and groaning about having to spend 48 hours in the hospital.
Dennis
BUGGER!
Why are you home, seriously i'm not understanding how they could send you home on your own, if you just had a heart attack! Admittedly i'm am worried about you, because your VA experiences are really shocking most of the time, and this is your heart. I want the best medical answers for you and what i can understand is.............??
Sorry, all thats going through my head is, what are these dr's doing to stop you from having another heart attack?
HUGS........JJ
Karry,
They were checking my clotting about every 1.5 hours while in the hospital. This is probably the first time I have not had a sensitivity to a medication. as they were increasing the Heparin IV every 1.5 hours in order to get the clotting to the right value. I'm now on a pill CLOPIDOGREL BISULFATE and would expect they based the dosage on what dosage they used in the IV. I'm suppose to see my PC in 3 weeks and expect they will check my clotting factor again then.
Dennis
JJ,
No I had a heart attack due to blocked artery. It was just that during the heart cath it looked like I had a severe leakage of the Mitral valve but when they did the echo it turned out there wasn't any leakage they could find.
Dennis
Dennis, what an experience!
JJ I think he did have a heart attack, a mild one, and like Guitar Girl said, everything settled down afterwards. Her explanation makes sense to this nursing brain.
Ok Dennis, smart of you to recognize the signs and get yourself to the ER!!
You might want to stay on Metamucil all the time! Kick back and do some relaxing for a few days……….sorry you had such a time of it. After reading your experience, I'll stop whining about my fatigue!
Get well my friend………the pond and the ducks await you next spring
Sarah
GG,
No I don't remember that you did that work. The only thing I remember about you as far as things you do is the music. Probably because music is such a big part of my life now. It was music that got me though my divorce back in 1992 since that was and still is the only way I can express my feelings.
I was DX with Mitral valve prolapse back in 2009 after my PC heard a heart murmur and they did a echo of my heart. This was about 3 years after my second heart attack. Since then several doctors, including 1 cardiologist have not heard the murmur. During this period since then most of the doctors have heard the murmur. My last PC has on occasion indicated she heard the murmur and on others occasions not heard it. This is what I was going on for my question of maybe MS related to this problem. Maybe it is just varying like you said though so sometime they can detect it and other time they can't.
Dennis
Hi Dennis, wow you sound like your having a bad time. I hope you are relaxing a bit after that little adventure.
I was wondering who is monitoring your INR levels & what INR level have they suggested for you? It's important to keep within the recommended INR levels which involves pretty frequent blood testing particularly at first. As I'm not sure if you are on a tablet like warfarin or an injection like Clexane I am uncertain of what to tell you.
I had couple of Pulmonary embolisms after I had a PICC line inserted which resulted in twice daily injections at first & then tablets for 3 months. I have been thoroughly checked & they don't see me having a clotting disorder & I could therefor cease treatment.
I remember things like "green leafy Vegies" were to be limited as they can alter your INR level. I also would have to be careful brushing my teeth as they would bleed. The PICC line I had to keep in for a while & due to the thinner blood it would need redressing regularly because blood would come from the wound. I don't remember having any worse constipation but I already suffer from that so I probably didn't notice.
I would take small amounts of Metamucil only at first because it can cause bloating & discomfort. You must drink lots after taking that or it can cause you problems. I have found when it comes to constipation there is only so much you can do with increasing your fibre. Often a stimulant may be required but these can become habitual. I find "Osmotic" laxatives the best because they draw fluid into your intestine & bowel & taken regularly should not cause you any pain or discomfort. I'm not sure what types are over in the US but if you ask your pharmacist they will know what "osmotic" drugs are available.
I'm sorry I don't have much for you. I would be checking with your primary care that your INR is correct though. You don't want it to be too high or too low really.
Take good care of yourself.......Karry.
A faulty valve can't cause a heart attack. Just sayin'... Coronary artery disease can.
OMG Dennis, so are you saying you actually did have a heart attack because of a faulty valve OR because they didn't find a faulty valve during the ultra sound, the dr's now don't think you did have a heart attack?
But what does this mean!!?
HUGS............JJ
Wow, Dennis, what a weekend! I'm sorry you had to go through all that.
The only thing I can comment on is the presence and later absence of a leaky heart valve during, but not after your heart cath. You probably remember I'm an echocardiographer myself, with 33 years of experience. What appears as a leaky valve on heart cath is closest (time wise) to your heart attack. Since you had your echocardiogram sometime later, your heart had time to relax, take up the ASA, and any other blood thinners they gave you, and come closer to baseline. I don't know which of your valves is leaking, but the mitral valve is highly influenced by the function of the left ventricle (the main pumping chamber). During a heart attack, or when the heart is stressed in the presence of coronary artery disease, mitral regurgitation is highly variable. If that's the case, and echo done later may not have revealed serious mitral regurgitation.
I'm also sorry you're going through a flare! Dang! When it rains, it pours!
Hugs to you, my friend!
I forgot some things. Surprise. NOT!
I'm now on a new better working cholesterol medicine and a blood thinner in addition to my usual aspirin. The blood thinner (Plavix) has me kind of worried. Both of my feet are numb constantly due to the MS. I have in the past put a 2 inch long gash in the side of my right foot (the worst foot) and not known it. The only reason I found out the I had cut my foot was that several hours later I notice bloody foot prints all over my home. While in the hospital a simple Pr1ck of my finger for a glucose test had me bleeding profusly for about 5 minutes and when they removed the IV needle from my arm I ws bleeding for about 20 minutes even with constant pressure.
I also had one bad experience with one of the nurses while in the hospital. On Saturday morning after not having a BM since Thursday night I mentioned this to my nurse and she said she would ask my doctor about the constipation. I asked her again later in the day and again she said she would talk to the doctor. Once the night shift nurse came on duty I again asked about this and she checked and the day nurse had not contacted my doctor at all. About 1/2 hour later the night nurse came in with Metamucil and a stool softener. About 1/2 hour later I finally had a BM, but I spent all day in pain because I could not go.Constipation is a noted side effect of Heparin.
Dennis
One thing that bothered me while all off these doctors and nurses where checking is that I lot of them were asking me how long I was having speech problems. I didn't know I was having speech problems at the time.
I also seem to have entered a full blown relapse starting Saturday night. MS hug, major tremors in right hand, numb right side of face. They gave me a double dose of my baclofin but it didn't help at all. And since I just had a heart attack IV steroids are out right now to help with that.
So anyway they kept me for 48 hours as they wanted my to be on Heparin for that long and finally about noon today they said I could go home. My nurse told the doctor I had no means of being picked up to be taken home and that I needed some form of transport arranged. Finally about 2.5 hours they had arrange for transport to my truck in Columbia so that I could get home. The transport they had arrange really surprised me. I was going to be transported by ambulance back to the hospital in Columbia. I had figured they would have set up a taxi for me.
Dennis