Thursday, January 21, 2010

Pulmonologist visit

I went to the pulmonologist yesterday and had my Spirometery test to test my breathing. There are many different values it measures and to be honest I am not well read in this area, so I can only go by what he told me. The FVC and FEV1 values I gather are the main values. Normal range for these values are 80-120. 80 being the lower end of normal. My FVC value was 72 and my FEV1 value was 70. The pulmonologist said it was most likely because I had a bullectomy in Aug. 2000 and because I have a straighter spine than normal and because the distance from my chest to my back is small, so my lungs are compressed. He did not think it was caused by any damage from smoking and if so very little. Thankfully I quit smoking in Sept. 2009.

I gave him a list of all my other issues I am having which of course was down played to "me being very in-tuned with my body", "anxiety being the cause of my heart rate being high", saying I should take a beta blocker. I explained that I was not like this till after I came off xanax. He explained to me how benzo withdrawal only last 3 days (Which is just plain stupid, even ER doctors who mistreated me in the past admitted it was 4 weeks). He didn't think I should have tapered off the benzo and should have just stopped cold turkey. I told him if I had done that I think I would have had a seizure and he said "I see". As if I am making this up. No one ever should cold turkey stop a benzo.

I asked him if he had ever heard of POTs and he asked me what it stood for and I said "postural orthostatic tachycardia syndrome" and he said "oh yea, but you are not passing out, so you don't have that.". I said "Yea, but only 30% of people with POTs pass out, the other 70% have no change in the blood pressure or it spikes more than normal." and he said "Yea, but since you are not passing out you don't have that." (OK did he just hear what I said?) he continues "besides there is nothing we can do for that anyway." Which is not true. I figure if I have to tell him what POTs stands for he know very little about it. If he thinks benzo withdrawal lasts only 3 days then he is grossly misinformed and ignorant to this, which I can not understand since he claims he work with these drugs. His poor patients.

He told me he has been taking a beta blocker for years because his blood pressure is normal, but at work when he works in the ICU and people don't do something he asked them to do for his patients his blood pressure would be 180/120 and his pulse would on the beta blocker which he takes daily and has no side effects from he is steady. My first though was that is not "high blood pressure" as much as it is a rage problem. He told me that when he forgets to take his beta blocker that within 24 hours his heart is racing faster than normal and he starts snapping at people because of the rebound effect, that how today he forgot to take his beta blocker and in 3 hours he knows he will be on edge and snapping at people. I told him "Have someone bring you your pill." Why would I want to be on a drug that does that? I do not want my body to require crap like that.

We went on talking about how I had to stop smoking because a cigarette was increasing my heart rate by 50 beats..he explained to me that cigarettes increase heart rates and I said yeah by 5 to 15 beats for 20 minutes on average not 50 beats for 2 hours. He said "50, have a very sensitive nervous system." Hello? What part of this was not happening until March 4th 2009 are you or any doctor not getting?? Do you think I would have sat there smoking for 11 years with my heart rate increasing to that speed and vomiting from it as it caused chest pain? So, instead of beating the shit out of him and throwing myself out a window I sat there and teared up several times as I listed to him. He also said "I think maybe you have a sensitive sinus node in your heart." Again I didn't till March 4th 2009, I do not understand why no doctor will even consider that a medication messed me up.

When he told me I was "too in tuned to my body" is the only time I defended myself immediately..I said "No. If I had a fork and kept poking you over and over, day in and day out on your hand with the fork, you would feel it. You would not be too tuned into the fork." I hate that whole "you are tuned in crap" it blames the person for feeling something and it is a cop-out.

Since he has a poor lack of knowledge on over half of what we talked about, why should I trust him on why my lung function is lower than normal? Eventually, I might take my results and get a second opinion just to make sure.

Oh I also told him about how when I stand my heart rate keeps climbing. So he clipped this thing on my finger and I laid down, then stood up. He had me stand for about a minute and said "Yea, its up to 110 now." (It would had went higher if he let me stand there longer.). He said "Let me aren't an athlete?" I said "No, but I do do the treadmill often since I quit smoking." and he said "Oh you do?". I told him how I can only go 2mph and with that my heart goes to 140 and if I go faster it goes to 170+ at 3 to 4 mph..and when that happens my face is pale after. I also told him how my heart will race for an hour after that before it will almost be back to where it was before I exercised. Also, that I am wore out for the rest of the day after I exercise. I got that look like "Why do you know your pulse?" The whole athlete question, which I have got more than once is annoying and I will tell you why. Do you have any idea how many overweight people are in that office? How many people who I know damn well are not very athletic and many probably have desk jobs...where is there high standing heart rate?

Anyway, that is all I can think of for now expect to say that my test was suppose to be at 8am, I checked in at 7:45am, at 8:20am they said they were looking for me and didn't know I was there. The receptionist didn't put my chart where it should be. Then I was suppose to see the pulmonologist at 8:40am. I was taken in, then he told me there was a scheduling error and he was sorry and he had to give a lecture. He asked if I could return at 9:50am when he returned. I said "yeah that is ok." and I sat in my car till it was time to go back in.


Anonymous said...

Actually, Brian.. a beta blocker might not be a bad idea for you. It does not have addictive properties as benzo's do.

I've been on a beta for going on 5 years end of this month and i have to say it helps a great deal. But then again-- i have heart issues i deal with whereas you do not, fortunately. That'd be the last thing you need right now i can imagine.

My betas keep me calm, keep my heart rate down and help keep my BP normal.. and even make me have enough muster to leave the house once in a while to go out and about to theatre or to see friends out for a drink and such.

I know you have reasons for not wanting to be on "yet another pill" and for VERY good reasons at that. I don't discount that one bit. But you may want to consider letting them put you on a beta blocker. They start you off on a very low dose and raise it slowly as youd body adjusts. There are some side fx- don't let him lie to you on that one LOL. But as your body adapts they become less and then none.
It is something to consider, anyway.

And as always Brian- i totally understand and get where you're coming from. If you choose not to go with a beta- you will certainly get no judgement from me.

also to refer back to my previous post to you.. i would never think of you as a spoiled brat. Family dynamics differ so greatly. Who has the right to form such an opinion just because you don't like the way your parents treat you- benefactors or not. I certainly do not, my friend.

Perhaps i should not have been so harsh about your mother- it just really pissed me off that they were treating you the way they are/were. And frankly.. i hope your dad DOES read your blog. Maybe it will give him a bit of insight he lacked before.

Take care and be well, Brian.
Drop me a line any time if you want. I totally get where you're coming from and never judge you.


Marie said...

Did you ever think of going in to the doc and not mentioning the xanax history or anxiety? So that way they do not dismiss you and your ailments so quickly. Also, why has no one have you wear a Holter Monitor for a few days. And also, I think you should get your potassium checked again. My heart was racing like crazy the past few days..all day..scary. Now for me mine is worse when I have pms. Anyway. I thought back to what my doc said and I had two glasses of oj and a banana and it stopped racing within 10 minutes and was fine the rest of the day. You can also drink v8 but yuck. lol

Brian Underwood said...

The first time I went to see him I said nothing at all about the xanax or even anxiety. He is in the hospital that I went to March 5th 2009. He pulled my medical records on his laptop and there was notes. "Xanax, paxil, panic attack, fainting." He was up till that point listening to me. It took a turn from that point and I felt that I needed to defend myself. Esp. when he didn't even think people needed to taper off a benzo. This time the cat was already out of the bag and he already new. That is why I decided that when I see a Cardio Doc again it will not be at either hospital I went to last year. I did have a 24 hour holter. It shows the fast heart rate. They simple say it is "anxiety". Echo was good. I am looking to have a stress test and tilt table. However I want stress test first.

Brian Underwood said...

I am not against using a beta blocker if it came to that. I think my concerns right off the bat for me would be, it would have to be a beta blocker that did not lower blood pressure because there are plenty of times my BP can be 90/60 as it is. Also I am unsure how it would effect me during times that my heart rate is sitting at 57 beats a minute if I am sitting for a long period of time at night. I wouldn't want it lower than that.

For me I would really like to get to the reason for the fast heart rate before trying to cover it. I know that sinus tachycardia is a symptom and not an illness. Sort of like if I was dizzy all the time, there are meds to stop that, but I would like to know why I was dizzy before I just ignore it and covered it up. Esp. if the dizzy spells were an important symptom pointing to another illness that needed to be addressed.

Also, as I know you understand, taking medication right now, I am trying to avoid unless I absolutely had too or for comfort reasons later should I actually be diagnosed with something. Like if they do a scope and find inflammation I would def. take something till it healed up and then take a natural route to keep it that way if possible.

Thankfully as of now my heart rhythm is not a dangerous one, just a very fast normal one.