Tuesday, February 21, 2006
The "Speed Bump"* comic in yesterday's paper was funny. There's a guy lying in a hospital bed, and a doctor talking to him: "We successfully replaced your pacemaker with an iPod, Mr. Wyatt... Now you can march to the beat of any damn drummer you want."
*it's a single-panel cartoon that runs in daily newspaper, by Dave Coverly.
*it's a single-panel cartoon that runs in daily newspaper, by Dave Coverly.
Monday, February 20, 2006
As predicted, Johns Hopkins has indeed phoned me twice since my last visit, to get my address and insurance info and mother's maiden name and first 10 digits of pi, in preparation for my surgery next month. Why can't they get their computers to talk to one another, instead of phoning me at 8:15 in the morning?
Friday, February 17, 2006
From an article a couple months ago in the Baltimore Sun, some medical websites. You've probably already found most of these, but if not, try them:
http://www.medlineplus.gov (NIH and National Library of Medicine)
http://www.healthfinder.gov (Dept. of Health & Human Services)
http://www.ahrq.gov (Agency for Healthcare Research and Quality - reportedly not very user-friendly)
http://www.pubmed.gov (National Library of Medicine)
http://www.consumerreportsmedicalguide.org (Consumer Reports; mostly free but some info requires a subscription)
http://www.healthratings.org (Consumer Reports' ratings of other medical websites)
http://www.mayoclinic.com
http://hms.harvard.edu (Aetna and Harvard Medical School)
http://www.pdrhealth.com (medicines)
http://www.safemedication.com (medicines, run by Amer. Soc. of Health System Pharmacists)
http://www.crbestbuydrugs.org (Consumer Reports again)
http://www.medlineplus.gov (NIH and National Library of Medicine)
http://www.healthfinder.gov (Dept. of Health & Human Services)
http://www.ahrq.gov (Agency for Healthcare Research and Quality - reportedly not very user-friendly)
http://www.pubmed.gov (National Library of Medicine)
http://www.consumerreportsmedicalguide.org (Consumer Reports; mostly free but some info requires a subscription)
http://www.healthratings.org (Consumer Reports' ratings of other medical websites)
http://www.mayoclinic.com
http://hms.harvard.edu (Aetna and Harvard Medical School)
http://www.pdrhealth.com (medicines)
http://www.safemedication.com (medicines, run by Amer. Soc. of Health System Pharmacists)
http://www.crbestbuydrugs.org (Consumer Reports again)
Wednesday, February 15, 2006
This week's news articles:
First, as the overweight, couch-potato, baby-boom generation starts edging into the "normal" age range where heart failure becomes more common, what a surprise! Heart failure rates increase! What is of note, regardless of age, here, is that survival rates are improving - finally! We were getting tired of those mortality statistics not budging, despite newer meds and newer surgeries. Finally, it appears, the cumulative effects of those things are having an effect on mortality.
Next, a reminder to us all that we should have our kidney function checked regularly.
First, as the overweight, couch-potato, baby-boom generation starts edging into the "normal" age range where heart failure becomes more common, what a surprise! Heart failure rates increase! What is of note, regardless of age, here, is that survival rates are improving - finally! We were getting tired of those mortality statistics not budging, despite newer meds and newer surgeries. Finally, it appears, the cumulative effects of those things are having an effect on mortality.
Heart failure increasing in older adults
Feb 08 (Reuters Health) - The rate of heart failure in the US among older adults increased from the 1970s to the 1990s, but survival rates have improved, new research shows. Both of these trends were more apparent in men than in women.
"Hospitalizations for heart failure have more than doubled between the two periods," Dr. William H. Baker, from the University of Rochester in New York, said in a statement. "Heart failure is the most common discharge diagnosis for men and women over age 65."
The findings, which appear in the American Heart Association's journal Circulation, are based on study of new cases of heart failure in the early 1970s and 1990s using data for more than 300,000 older adults enrolled in an HMO in Oregon or Washington.
From 1970 to 1974, a total of 387 patients were diagnosed with heart failure. The number of new cases from 1990 to 1994 was 1555. After accounting for age, a 14 percent increase in the rate of heart failure was observed between the two periods. As noted, this rise was greater in men than in women.
Deaths due to heart failure fell during the 20-year period by 33 percent for men and by 24 percent for women, the report indicates.
As to why survival did not improve as much in women, the researchers believe that it may be because older women have more additional diseases than men or because they are more physically frail.
"The increase in incidence and survival for heart failure suggests an accelerating rise in this disabling and costly disease that is of public health and clinical importance," Baker emphasized. "In the future, heart failure deserves the highest research priority into its precipitating factors and its management."
SOURCE: Circulation, online February 6, 2006.
Next, a reminder to us all that we should have our kidney function checked regularly.
Poor kidney function ups death risk in heart failure
Feb 07 (Reuters Health) - Impaired kidney function raises the risk of death and hospital admission in patients with chronic heart failure, even among those patients with fairly well preserved heart-pumping action, study findings suggest.
So-called "renal insufficiency" has been shown to increase the risk of death in chronic heart failure patients, but most studies have involved patients with markedly reduced left ventricular ejection fraction (LVEF) -- a measure of the heart's blood-pumping strength.
Less is known about the impact of kidney function on heart failure in the presence of preserved heart-pumping power.
To investigate, Dr. Hans L. Hillege, from the University of Groningen in the Netherlands and associates studied 2,680 heart patients -- 1087 of whom had an LVEF greater than 40 percent indicating preserved heart-pumping action.
At baseline, 36 percent of patients had poorly functioning kidneys. During a median follow-up of 34.4 months, 950 patients died of cardiovascular causes or were admitted to the hospital for heart failure, and there were 625 deaths from all causes.
The authors report that both poorly functioning kidneys and lower LVEF were significant independent predictors of worse outcomes.
"The strong independent effect of renal function in our analysis after adjustment for numerous cardiac risk factors shows that renal function is a valuable predictive variable in evaluating outcomes," the authors maintain, "even if it probably represents partly underlying atherosclerotic or hypertensive vascular disease."
SOURCE: Circulation, February 6, 2006.
Tuesday, February 14, 2006
Reading KateMonster's post reminds me to also be thankful to the doctor who diagnosed me. I had been taking drugs to treat asthma, which are directly harmful to hearts with cardiomyopathy, and the same thing could have happened to me. However, when my GP, frustrated with my nonresponsive "asthma," referred me to a pulmonologist, it took him about 5 minutes to correct the diagnosis - even though he was a lung specialist, not a heart specialist, he looked at my heart in the x-rays, not just the lungs, and listened to my heart as well as my lungs. He was so sure of the diagnosis that he wrote out a couple of the necessary prescriptions - Lasix and digoxin - right away, even as he wrote up a referral to a cardiologist. So thank you to him, and to his ready box of Kleenex and kind nurse. That was 3 years ago, and I'm still alive now. Yay!
Friday, February 03, 2006
On the first of Feb., I got to see an electrophysiologist at Johns Hopkins - one of the reasons we moved up here to Baltimore!!
My regular cardiologist over in Howard County had referred me, and this EP had an opening relatively soon in his schedule. I swear, the longest part of the whole deal was waiting in lines once I got to Johns Hopkins Outpatient Clinic. First you walk in the lobby and wait in a check-in line, to then be told that since you are new you have to go wait in another line to get a "history card" after which you are finally permitted to approach the elevators and go up to the correct floor, where you wait in line for a floor concierge to direct you to the correct wing, where you finally wait in line at the check-in desk for the group of doctors you are actually there to see. At each and every one of these stops, you wind up repeating your name, and your mother's maiden name, and the first 6 digits of pi, and... well, not quite that, but an awful lot of repetitive info - especially given that I had already given all this info during not one, but TWO phone calls the previous week.
Then I got to sit in a waiting area - there are several of them in the cardiology pod, each with at least one more person waiting than there are chairs. I did get a chair, however, and got some knitting done. I am finished with the first wrist-warmer made out of self-striping sock yarn for my friend Fade!! Yeeha!
And in other good news, Dr. Sinha is sure that he can indeed put the third lead in, so that I will have bi-V pacing finally, and he is quite convinced that he can persuade my insurance to pay for it. The fact that my EF is still only 21%, when after 3 years and all the medication and so forth they would expect it to improve to 30%, is prima facie evidence that something needs to be done.
So something will be done, on Thursday, March 2. I have to be there at 6:30 a.m. - I told him I would not even need a sedative, let alone anesthesia, at that hour. Anyway, I am sure they will phone at least once more to ask all the same questions over again about my name and medications and mother's maiden name and pi and the lost treasures of the Incas.
My regular cardiologist over in Howard County had referred me, and this EP had an opening relatively soon in his schedule. I swear, the longest part of the whole deal was waiting in lines once I got to Johns Hopkins Outpatient Clinic. First you walk in the lobby and wait in a check-in line, to then be told that since you are new you have to go wait in another line to get a "history card" after which you are finally permitted to approach the elevators and go up to the correct floor, where you wait in line for a floor concierge to direct you to the correct wing, where you finally wait in line at the check-in desk for the group of doctors you are actually there to see. At each and every one of these stops, you wind up repeating your name, and your mother's maiden name, and the first 6 digits of pi, and... well, not quite that, but an awful lot of repetitive info - especially given that I had already given all this info during not one, but TWO phone calls the previous week.
Then I got to sit in a waiting area - there are several of them in the cardiology pod, each with at least one more person waiting than there are chairs. I did get a chair, however, and got some knitting done. I am finished with the first wrist-warmer made out of self-striping sock yarn for my friend Fade!! Yeeha!
And in other good news, Dr. Sinha is sure that he can indeed put the third lead in, so that I will have bi-V pacing finally, and he is quite convinced that he can persuade my insurance to pay for it. The fact that my EF is still only 21%, when after 3 years and all the medication and so forth they would expect it to improve to 30%, is prima facie evidence that something needs to be done.
So something will be done, on Thursday, March 2. I have to be there at 6:30 a.m. - I told him I would not even need a sedative, let alone anesthesia, at that hour. Anyway, I am sure they will phone at least once more to ask all the same questions over again about my name and medications and mother's maiden name and pi and the lost treasures of the Incas.
