being cleerly blocked
70 yr old male. Had a widowmaker 12/19, stented. presently Ldl 45, ApoB 47, tri 69, bp 114/70 so numbers excellent. Calcium score paid out of pocket/cardiologist refused to order, 898. I want to know my at risk soft plaque status.
Want the Cleerly test, cardiologist refuses to order "won't change treatment". Its info I want, fu. Regular provider refuses doesn't want to piss off cardiologist.
Local imaging center has a work around, requires an additional $800 expense for outside doctor to rx and interpret. The money means nothing, the attempt to force me into paying it means everything, so I am trying to figure out a way to switch cardiologists to one who will rx (wont be covered by insurance but imaging center requires an order).
So any ideas how to cardiologist shop within my Humana Medicare HMO? Tried to get office practice manage to call me, no luck.
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Thanks for sticking up for me...but i am a he not a her lol.
No, the language was NOT fine.
I guess that is a matter of opinion ..and thanks to this great country we are both entitled to our own opinion and allowed to express it respectfully ..
lol .. I'm fresh out of new pronouns to call people .. so much for "assuming" on my part sorry ..
Oh
Supposed to get Cleerly results emailed today. Put in a pre-emptive request for Inclisiran(Leqvio) with existing cardiologist thru health portal, no response yet.
For those so inclined, if you do not meet the medication requirements for a standard pcsk9 inhibitor and would have to bear the @$6k/annual cost, going with Leqvio might be a less expensive way to go as it is characterized as follows:
LEQVIO is available to all of your Medicare Part B Fee-for-Service patients today. Medicare covers 80% of office-administered products under Part B. If patients have supplemental insurance (Medigap), their supplemental coverage may pick up the additional 20%.
So the shot is given in the doctor's office and seems to be a workaround that (hopefully) applies to me. I tried to initiate pre-approval over the phone with Humana but didn't have the "J-code" so my provider will have to call the order in.
Cleerly results back.
To recap:
Widowmaker HA 12/2019, stent placed.
Over the next 3 years drove numbers down(medications, exercise, diet (185 down to 170)) to(12/14/2022):
bp 115/75
Apolipoprotein B 47 mg/dL
Triglycerides 69 mg/dL
Cholesterol 101 mg/dL
LDL C 45 mg/dL
Calcium Test (8/30/22)
Left main coronary artery: 0
Left anterior descending coronary artery: 824.2
Circumflex coronary artery: 74.6
Right coronary artery: 74.5
Total Calcium Scoring: 973.2
Needless to say, my calcium test threw me into a funk for a couple days.
My pos cardiologist (who I love) refused to order a Cleerly test, found a location in Detroit while visiting relatives all in for $2k.
I was 100% sure I would have a scary amount of low density non calcified plaque.
For all arteries:
0% Low-Density-Non-Calcified Plaque Volume
So absolutely no so-called very vulnerable plaque. Quite shocked, that was the main reason I spent the money on this test, to get this info.
Other mild to moderate stenosis and combo calcified and non calcified plaque in 3 vessels as anticipated by previous calcium results. By the way, this info (multi-vessel presence) sucks for me as it increases my risk many fold.
My journey continues. As I explained to a friend who asked "what does it mean" i replied:
It means the gun has been removed from the back of my head. The bus will still eventually run me over, maybe even today, but I can live with that.
What is your diet? Vegan?
Not vegan.
I eat a large quantity of oatmeal with yogurt fruit nuts everyday.
Salad (85%) or soup(10%) with added chicken or fish
Snack yogurt with nuts.
Apple.
No dinner (except with family gatherings while traveling)
5% of the time, maybe a little more, I eat out for lunch, usually a chicken bowl or chicken salad. Once a month I have smoked meatloaf plate from local bbq joint.
I get 1 carrot cake single from walmart 2-3 times a month cause I am weak.
Saw my new cardiologist today, a nurse practitioner who who runs the "lipid clinic".
Finally, a progressive thinker. I hit the lotto. Not only did she rx Repatha (I chose the once a month 420 ml.) but she gave me a free sample that her asst helped me infuse. Nice $500 gift.
So I can't wait to go back in 30 days and get an ldl-c of 20.
Bingo.