Another MRI-Compatible Recipient

Hi, I also just had the new Versa MRI compatible pm implanted Monday. I am now recovering from a bout of pericardial effusion (fluid buildup/inflammation from the lead extraction process. Was placed back into ICU after my BP dropped dramatically, became violently nauseaus, pain in inspiration, was blacking out suddenly, etc...... Went through 3 failed attempts to open an arterial line (ouchhhh!!!) and a PICC line, and a bunch of other bothersome procedures. Echo-cardiograms show no new increase in fluid so am home now and hoping the pain and fluid build-up will abate soon. After the surgery, the EP went to a conference and his colleagues and a cardiac fellow at the hospital took over my case. My question to fellow pm'rs is this: I'd like to go to a completely DIFFERENT EP for my follow-up care. Is this permissible? The reason is this: I have a debilitating spinal & connective tissue disease that puts me in chronic pain. I often resort to a prn regimen of 10mg of hydrocodone w/ 325mg acetominophin, and a little bit of additional acetomin. to augment (under the permissible daily limit) to help with the pain. After the surgery (and before he left for conference), the EP REDUCED my pain meds because he said I shouldn't be needing that much pain medication, even though the fluid on the heart lining and the procedures have left me in more pain than when I went into the hospital. Essentially, he disagrees with two pain mgt. specialists, my internist, and my rheumatologist, and initially tried to blame my initial symptoms (that were eventually found to be directly caused by the pericardial effusion) on being "used to too much medication". Additionally, he did not tell me in ADVANCE he was planning to reduce the med by 1/2 even though he knew that was what I was used to taking prn. His comments made me feel like I was a junkie or something and therefore responsible for the effusion that is UNRELATED (other physicians have assured me of this and clearly blame the effusion as iatrogenic (surgically related). An echo a few days BEFORE the surgery showed NO effusion. The effusion showed up only after the surgery.
Does anyone think that another EP would touch me for follow-up tx, or am I probably stuck with this guy for now? This is the same group that did my first pm but my former EP thought this second guy would do a better job at the lead removal process. Would a practice maybe allow me to "fire" one EP and keep another? Is a completely different group possible and possibly better option?

4 Comments

Name of pm???

by Yakkwak - 2011-05-06 01:05:06

Don't know what the name of my new pm is - might be Versa or Revo; anyway, it is the new Medtronic MRI-compatible one. The reason I'm not sure is that the EP rep at the hospital forgot to give me my paperwork - so they are sending it. :-p

be aggressive about it

by ElectricFrank - 2011-05-06 01:05:36

You have the right to change EP's if you aren't satisfied. The only thing that might get in your way is the availability of one that is accepted by your insurance. Just looked at your profile and see you are in Dallas. In a large area like that there should be no problem.

Now the real issue. I also see you are a psychologist. It's time you take charge of your own care and be the assertive person I'm sure you help your clients learn to be. My suggestion would be to sit down with your current EP and let him know that you are in charge. He either cooperates or you will be finding someone else you can trust.

I had to do this in the beginning with my pacer, and it is the main reason mine has been so successful.

best,

frank

First Step

by Yakkwak - 2011-05-06 04:05:13

Frank, I am hoping that my seeking another EP is a first step in asserting control over my recovery since the effusion. I understated that I really have lost all wish to have this guy on my treatment team & don't believe he deserves a chance to "shape up or get shipped out", so to speak. This next statement is based purely on only a handful of interactions. This EP is from a culture where it is not uncommon for a male to act condescendingly toward or superiorly over a female - don't know if it is typical of him. However, his "chastizing" me for my med regimen definately had that tone to it - it really took me aback as I hadn't expected that from him. Also, the early A.M. of the procedure, I greeted him by jokingly asking him if he had had his coffee and was was alert and ready (I was using humor to deal with my anxiousness regarding the lead extraction). His response was so *literal* and he seemed genuinely offended that I suggest he "used" caffeine/stimulants. Nice last thought before going under anesthesia! Thanks though for emphasizing the need to maintain control over medical care. Despite my temporarily poor health, I am struggling to do just that. I do wonder if his cohorts would want to come in on a case after the surgery point, though. I will make some calls and find out. The effusion makes typing on a keypad a whole lot easier than talking on the phone, though LOL.

I understand

by ElectricFrank - 2011-05-07 12:05:54

It's difficult to be assertive when feeling lousy. I have to work at that myself. One of the strange things I find though is that when I take charge I magically start feeling better.

Patch, I agree about being more concerned about a surgeons skills in the O.R. than I do about their bedside manor. I can deal with them at my bedside. I don't know if they can deal with me.

By the way a doctor holding another professional to a higher standard can be a trap. For instance a "professional" is supposed to know they should turn off their brain and follow doctors orders. It's not so much a high standard as it is blackmail.

life is fun,

frank

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In fact after the final "tweaks" of my pacemaker programming at the one year check up it is working so well that I forget I have it.