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4 days ago · His-pacemaker technique in Heart & Blood Health

Hi @corjianne. I'm glad Teresa @hopeful33250 asked me to look in on your conversation. But I have to start by saying I have no first person involvement with Pacemakers. A brother-in-law had a Pacemaker installed and updated at Mayo Clinic in Rochester, but we have not discussed his experiences in detail. In addition, my wife recently contracted supraventricular tachycardia, and as a result, our house is building confidence in our own electrophysiologist for the first time. We're approaching a decision point on whether to have medication cardioversion procedure in June or July.

I can say, however, that the advice Teresa has provided is spot-on and will advance your chances for improved understanding of what's ahead with the new pacemaker-installation protocol. I also can strongly recommend that you pay close attention to anything you get from @kanaazpereira; she has unusually close connections to the cardiology teams at Mayo in Rochester. Martin

Wed, May 15 1:59pm · Should I consider ablation? in Heart Rhythm Conditions

Hi @catmom777. Just to be clear, a wine or two a day didn't trigger my Afib. Instead, it neutralized my Coumadin anticoagulant medication so that my risk of bleeding went to the ceiling. To deal with that, my medical team had me drop my Coumadin for two days. When I went back on, a clot had already formed during those two days; it traveled up to the hippocampus in my brain, causing a "small stroke." Thankfully, the stroke symptoms have been been minor — slight imbalance when erect and walking, slight loss of memory, slight problem forming words. With physical therapy, my brain is learning again how my parts should work when I call on them, so the months-long recovery has begun. Martin

Wed, May 15 12:47pm · Should I consider ablation? in Heart Rhythm Conditions

Hi @afrobin. I tripped over your final sentence about a friend with Afib who doesn't want to give up his wine and coffee. I wish him well, given my experience. My Afib was diagnosed four years ago by a EKG in my annual physical, but I have never felt any symptoms. Nevertheless, I had a small stroke almost a year ago as a result of a blood clot formed in my heart. Since then, I have religiously obeyed the FDA-approved label on my Coumadin anticoagulant — no liquor at all and reduced consumption of coffee. Hated to abandon my vintner, but I don't want another stroke from alcohol thinning my anticoagulant into the danger zone.

I also appreciate your other observations, especially the one regarding statins. A friend has SVT and was experiencing periods of dizziness and lethargy, so her doctor took her off Simvastatin (because it conflicts too much with her antiarhythmic meds), transferred her to Lipitor and — in short order — cut that dose from 20mg a day to 10mg per day. As a result, less threat of intensifying her Diabetes-2 and, more important, no more dizzy spells for over a week now.


Fri, Apr 26 9:48am · My dad has a mass on bladder and kidney not functioning in Kidney & Bladder

Hello @formydad. Sorry that you need more information about your father's experience with a bladder growth. I've been through much of that, but with an important advantage — my 12 bladder tumors, although malignant, were small and on the surface of the bladder lining and were readily removed in two phases: 1) walk-in surgery using TURBT (transurethral resection of bladder tumors) in an hour-long procedure and 2) six treatments with a solution of "BCG bacteria" to ensure that any cancer seeds were killed. My bladder had been blocked periodically by prostate tissue growth which, when removed, revealed tumors hidden behind it. I had been a moderate smoker for 45 years. Fortunately, the treatments cleared up my problems. In your dad's case, I'm optimistic that his kidney function will return gradually after the removal just this week of the growth in his bladder. My optimism, though, is based on faith not facts, and your doctors are the ones to provide you the information you need and want about the immediate and long-term future. Are you expecting a report soon from the doctors on how the surgery may affect his bladder and how soon kidney function will resume? Martin

Thu, Apr 18 1:21pm · Episodes going on and I don't know what to do. in Brain & Nervous System

Joan (@sakota), you're strong and focused, and that's a real advantage. I also am encouraged to see these key words: "neurologist" and "Mayo." That combination is going to illuminate your path ahead, and we'll all be interested in hearing about what you'll decide to do with the help of your good doctors. Martin

Wed, Apr 17 9:58pm · Episodes going on and I don't know what to do. in Brain & Nervous System

Dear @sakota, I will have more insights for you a week from today, after my wife's cardiologist returns from vacation and we have a comprehensive discussion about her heart arrhythmia. I'm telling friends I feel like an intern for a medical degree and a caretaker intern at the same time. The shaking of your arms and hands is reminiscent of my brother's Parkinson's Disease or my own neurological reaction to my Atrial Fibrillation and its side-effects. Your chills and racing heartbeats, mixed with sleep incidents, are components of my wife's current symptoms under a preliminary diagnosis of tachycardia caused by electrical problems in the heart, just above the ventricles (supraventricular tachycardia – SVT). She is just two weeks into a very complex diagnostic process involving her heart, thyroid, adrenal glands, and diabetes 2. Fortunately, her personal care physician is an Internist whose job is to figure out whether she needs specialists to home-in on the causes of her symptoms and to clear the way for her appointment(s) with each of the specialists. Does your PCP perform this crucial function for you and, in effect, knock down the door to the specialists you need? Could Medicare or your health insurance help you chart a path to finding out what you need to know? Would you be interested in talking with Mayo Clinic intake and funding personnel to see how you could access their renowned patient care system in search of a diagnosis and therapy?

Wed, Apr 17 10:55am · Taking warfarin and antibiotics at the same time in MAC & Bronchiectasis

Hello @sayaboleh, I'm responding at Ethan's invitation and from the perspective of a long-time user of Warfarin. I haven't heard of any caution about interactions between Warfarin and antibiotics, and I have not taken an antibiotic since I started taking Warfarin 5 years ago. The infective agent you mentioned is contracted from water-borne bacteria, is rare among humans, and is known usually as a agent found in hospitals. Literature also says it is resistant to antibiotics in a significant percentage of cases. I take Warfarin to prevent blood clots forming in my heart and blocking small arteries carrying oxygenated blood around my body. Do you have access to a primary care physician (in addition to your pulmonologist) who could evaluate your antibiotic and your Warfarin prescriptions? Can you communicate with your doctors by phone or email?

Mon, Mar 25 9:26am · I'm having multiple odd episodes that are keeping me undiagnosed. Help in Brain & Nervous System

Jennifer, I have studied the literature on the anticoagulants and remain committed to Warfarin (Coumadin). When I started on it, it was the only anticoagulant that had a ready antidote. That became crucial to me after a friend and neighbor on Warfarin died when the ER to which he was taken by public ambulance had no Warfarin antidote on hand, so they called for a helicopter to take him to another hospital. He died enroute from a brain bleed. I sang at his funeral.

There are now two anticoagulants for which antidotes are on hand in ERs that care about the quality of their life-and-death services — for Warfarin and Pradaxa. No antidote for Eliquis has yet been approved by the FDA.