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Old 07-20-2016, 05:41 PM   #21
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"A Time Bomb Near My Heart
Discovering you have an aortic aneurysm could save your life. But first you have to figure out what to do with the information.
By KEVIN HELLIKER Staff Reporter of The Wall Street Journal
Updated April 22, 2003 10:23 a.m. ET

In September I learned I have an aneurysm in my aortic artery just above the heart. This stunned me, in part because I felt great. At 43, I was thin and fit, and ate well. Not a drink since age 22, or a smoke since 28. Only two weeks before getting this diagnosis I set a personal record in the Olympic-distance triathlon (two hours, 28 minutes), finishing ahead of most competitors half my age."


Many athletes have incredible endurance, but they're not as healthy as they think. This is especially true in distance runners and bicyclists. Their hearts often beat very slow, but very, very hard. And fatal heart attacks are not uncommon.

I had a friend in Atlanta that was this way--the example of great health. He owned a large bicycle shop and ran organized cycle tours. At about 40 years old, he suffered "the big one" and only God kept him from dying. After surgery, he's okay but slowing down.

There are all kinds of aneurysms. We're talking aortic aneurysms here, which my mother had at age 75. Her's was as large as her aorta, and it required surgery by one of the premier heart surgeons anywhere. When he got into the procedure, my mother's aorta was paper thin. He wouldn't have done the surgery had he known how fragile she was. She survived and lived with congestive heart failure until age 91. It was all being well taken care of and the cardiologist treated her like his own mother.

Welcome to National Healthcare. If I found out I had such a problem and my internal medicine doctor was on vacation, his partner would be referring me to a cardiologist to be seen immediately. An aneurysm is nothing to mess with.
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Old 07-20-2016, 05:56 PM   #22
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Welcome to National Healthcare.
It's great......so long as you don't get sick.
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If I found out I had such a problem and my internal medicine doctor was on vacation, his partner would be referring me to a cardiologist to be seen immediately. An aneurysm is nothing to mess with.
Our Family Doctors (if you can get one) are (generally all) General Practitioners.....if you want/need to see a specialist you require a referral...can't knock on their doors.....ah, bureaucracy.
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Old 07-20-2016, 07:28 PM   #23
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Again, Ontario.....that's not how it 'works' here.....couple days ago called the hospital where the MRI was done to ask just that.....response was "Come to Emergency (and likely sit for 8 hours or so waiting to see an anonymous doctor), we can't talk over the phone, or let you talk to anyone else...(and we'll probably tell you to see your family doctor (whom we haven't even met yet, because our previous Dr. relocated to British Columbia))".


Appreciate the file......we've seen part of it before, but not the whole thing. Thanks.
I know you would wait for a few hours, but wouldn't you want to try ER anyway and see? Or you are OK waiting until August?

I am new to Canada (I am from the US.). I went to ER a few months ago (Ontario) when I had a problem with my left eye. It wasn't life threatening, but I might have had a tear and they couldn't dilate my eye without having a specialist check out a couple of things first - and my appointment with a specialist was over a month away (I had been waiting for 4 months already at that point...) and I needed to get the back of my eye checked out right away due to an unexpected injury. I called Ontario Telehealth and they told me to go to ER.) I waited there for 4 hours and saw an "anonymous doctor". She had no expertise (which you would expect), so she had me wait another 2.5 hours until the in-house eye doctor/surgeon could check out my eye. Within an hour after seeing me, the eye doctor did a surgery on my eye. He became my eye doctor from then on and I dealt with him directly (no middle man) - I went back to him for checkups and a month later, he did a surgery on my other eye also. This was kind of like opening up a direct life line to a specialist, bypassing all the buraucracies (the specialist I was going to see in over a month from this hospital visit was someone who would just test my eyes to determine if I needed a special surgery or not, so after that, he would have had to arrange the surgery so God knows when the surgery would have actually taken place. What I learned is, if I need something in a hurry, to go to ER.
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Old 07-20-2016, 09:09 PM   #24
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I know you would wait for a few hours, but wouldn't you want to try ER anyway and see? Or you are OK waiting until August? .
I'm in a quandary here, my Dr.'s appointment is 'only' 2 1/2 weeks away; from what we've been reading 42 mm is not at the 'critical' stage, and in all likelihood, (based on my limited understanding), I'd probably be scheduled for a CT sometime in the future regardless.

Are you in a major centre? We're in a relatively small city of ~50,000, and I'm unsure as to whether the necessary specialists are resident here anyway.

DW suggests we call the Dr.'s office in the a.m. (although it's unlikely we'll get to speak with him directly....although his nurse might be available), and ask whether, in his opinion, we should wait or visit the Emergency and hopefully get the ball rolling.

Appreciate your input, thanks.
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Old 07-20-2016, 09:17 PM   #25
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Are you in a major centre? We're in a relatively small city of ~50,000, and I'm unsure as to whether the necessary specialists are resident here anyway.
I live in a city with about 200,000 people so the hospital here may have more specialists, but that's just a guess. I might have been just lucky that day that there happened to be an eye surgeon at the hospital when I visited ER. I have a feeling you would have an easier time finding a cardiologist on staff than an eye surgeon at your small local hospital.

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DW suggests we call the Dr.'s office in the a.m. (although it's unlikely we'll get to speak with him directly....although his nurse might be available), and ask whether, in his opinion, we should wait or visit the Emergency and hopefully get the ball rolling.
It sounds like a good idea. Can't be too cautious.
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Old 07-21-2016, 05:37 AM   #26
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Nemo, can't offer you any advice other than wishing you get treated quickly and this all works out well for you. DW had a few family members die from aortic aneurysms, and this has always been a great fear for DW since she thought this could be an inherited trait, so she has had checks for it in the past and so far no indications.
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Old 07-21-2016, 06:11 AM   #27
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Nemo, can't offer you any advice other than wishing you get treated quickly and this all works out well for you. DW had a few family members die from aortic aneurysms, and this has always been a great fear for DW since she thought this could be an inherited trait, so she has had checks for it in the past and so far no indications.
It's good that she gets checked, and, as I understand it, (which is probably not very well), it can definitely be hereditary.

My father, (who was 38 when I was born), lived to be 67, (he had a bunch of brothers, most of whom died in their 50's, AFAIK from strokes/heart attacks.....although smoking was ubiquitous at that time and may have been a strong contributing factor).........I didn't really give it much consideration until my early 30's...and then I listened to the words of Eubie Blake: "If I'd known I was going to live this long, I'd have taken better care of myself."

Ah well, game's not (quite) over yet.
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Old 07-21-2016, 06:25 AM   #28
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How long did it take you to get the MRI? Here, ( in FL, USA) I feel they would want to address it immediately. We do not have to wait for CT Scans and MRI's. In our case We DO need to pay a premium for them over our regular insurance and get authorization first, although the doctor does all the paperwork and applications. The Insurance companies DARE NOT take a doctor's recommendation.
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Old 07-21-2016, 06:49 AM   #29
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DW suggests we call the Dr.'s office in the a.m. (although it's unlikely we'll get to speak with him directly....although his nurse might be available), and ask whether, in his opinion, we should wait or visit the Emergency and hopefully get the ball rolling.

Appreciate your input, thanks.
That is excellent advise .
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Old 07-21-2016, 06:53 AM   #30
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How long did it take you to get the MRI?
We visited the Emergency in a smaller town, (pop ~ 15,500), about 25 miles from here, since the wait times to see a doctor are often shorter.

Requisition for MRI was submitted June 13, and I underwent the procedure July 05, so basically 3 weeks......DW & I were both quite astounded that the wait period was so short...we were anticipating a much longer interval.
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Old 07-21-2016, 11:21 AM   #31
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How long did it take you to get the MRI? Here, ( in FL, USA) I feel they would want to address it immediately. We do not have to wait for CT Scans and MRI's. In our case We DO need to pay a premium for them over our regular insurance and get authorization first, although the doctor does all the paperwork and applications. The Insurance companies DARE NOT take a doctor's recommendation.
My Doctor will say I need a test or procedure, and then I have to get permission or approval from some insurance company clerk (who probably gets bonus based on $$$ saved).
This non-doctor will then proceed to evaluate if my doctor is correct or not.
Looks like we don't need medical schools anymore .
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Old 07-21-2016, 11:39 AM   #32
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My Doctor will say I need a test or procedure, and then I have to get permission or approval from some insurance company clerk (who probably gets bonus based on $$$ saved).
This non-doctor will then proceed to evaluate if my doctor is correct or not.
Looks like we don't need medical schools anymore .
This does NOT happen in a single payer system, at least not the ones I am familiar with as insurance companies as such are not involved. The Doctors make the final decision and then bill the single payer accordingly. Also they are NOT FOR PROFIT as healthcare should be.

This simply makes so much sense. But of course the insurance companies would not like it. (No contributions for you! )
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Old 07-21-2016, 11:59 AM   #33
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Back from the local Emergency, (went in ~ 11:15 a.m. out by 01:15 p.m. - which reinforces a previous theory that persons 'of a certain type' flood the hospitals around 01:00 a.m.); saw a great doctor who quickly explained that, for an aneurysm where mine is, they won't operate until it's considerably larger, due to the fact that the risk from the operation is greater than the risk from the aneurysm for anything smaller.

Future CT scans will be ordered.
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Old 07-21-2016, 12:00 PM   #34
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My dad went in for a scan of his throat for an unrelated issue and the radiologist noted his aortic arch was 6.2?mm/cm?. My dad is a tall guy and was otherwise in great health. The experts recommended he go under the knife as a precaution. We had long discussions with the surgeon before agreeing as this was a gamble. The doctors have no way of knowing whether your vessel will burst. They are using statistics. Open heart surgery to replace the arch with a Dacron tube and replace the valve with a biological valve. In the end, after a difficult 10 hour surgery with some complications and a long recovery, he is fine. Not sure I would have gone thru with it if it were me....
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Old 07-21-2016, 12:05 PM   #35
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Back from the local Emergency, (went in ~ 11:15 a.m. out by 01:15 p.m. - which reinforces a previous theory that persons 'of a certain type' flood the hospitals around 01:00 a.m.); saw a great doctor who quickly explained that, for an aneurysm where mine is, they won't operate until it's considerably larger, due to the fact that the risk from the operation is greater than the risk from the aneurysm for anything smaller.

Future CT scans will be ordered.
What a relief! I am so happy to read that you will be OK for now. WHEW
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Old 07-21-2016, 01:48 PM   #36
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Hey,,, Nemo2.... good news. Glad it worked out for you.


Just got back from the hospital where I picked up my own CD copy of the CT scan I took yesterday. 135 pictures of stuff that goes on in the chest, and the specialist's analysis... :

Quote:
CT CHEST WITHOUT CONTRAST 7/20/2016

HISTORY: Aortic root dilatation.

FINDINGS: Noncontrast imaging of the chest was performed. Comparison is made
with 11/23/2015.

There is dilatation of the ascending thoracic aorta. Maximal transverse
diameter measured at the level of the horizontal portion of the pulmonary trunk
5 cm distal to the aortic valve plane is 4.6 cm. This is unchanged from the
prior study. There are calcifications in the aortic valve. Some
calcifications are seen along the wall of the aorta. Dense coronary artery
calcifications are present.

Lungs are clear of nodules or infiltrates. Calcified granulomas are seen. A
few scattered bullae are present. Limited images through the upper abdomen are nremarkable.

IMPRESSION

1. DILATATION OF THE ASCENDING THORACIC AORTA TO A MAXIMAL DIMENSION OF 4.6 CM.
THIS IS UNCHANGED FROM 11/2015.
2. NO ACUTE PULMONARY PROCESS APPRECIATED.
3. DENSE CORONARY ARTERY CALCIFICATIONS AND MILD AORTIC VALVULAR CALCIFICATIONS.
Same comments as the last time.

We live to fight another day...
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Old 07-21-2016, 01:59 PM   #37
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Hey,,, Nemo2.... good news. Glad it worked out for you.
Not so fast! Where yours is ascending, mine is in the arch which is, apparently, considerably more difficult to repair........time will tell.

Now, we have to obtain precise dimensions to see if I can still qualify for out of country medical insurance......if not, it's vacations in Canada from now on.

Glad you're doing well though!
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Old 07-21-2016, 02:06 PM   #38
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Keep us informed... best to you...

FWIW, here's what the scan image looks like... #107... Taken from the CD.
Attached Images
File Type: jpg Scan2.jpg (108.5 KB, 58 views)
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Old 07-21-2016, 02:29 PM   #39
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I am sure that you feel better now. Hopefully it will stay the same size. Hoping that you can continue traveling outside Canada.
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Old 07-21-2016, 02:30 PM   #40
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Glad to hear that yours stayed the same, Imoldernu.
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