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-   -   after some help for my wife (http://board.crossfit.com/showthread.php?t=29529)

Dave Gibbs 03-26-2008 08:48 PM

after some help for my wife
 
Hi all,
I am posting this here really out of desperation and frustration with the medical fraternity. Apolagies in advance to anyone who is part of the medical world, I know you are not all bad, we just must be unlucky.
A little about my wife. She is 41, 5ft 7in ,145lb. She runs her own PT business and has been regularly exercising for 15 years. Although she is not "superfit" she is streets ahead of the average 41 year old mother of 3.
10-12 years ago when she did long runs of an hour of more she would start to get headaches and feel generally ill afterwards. We kinda put this down to maybe nutrition or low blood sugar as she would be fine in a couple of hours but as our knowledge improved she cut back her longer runs anyway.
In the last 2-3 years she has started to get these symptons more regularly even after low intensity exercise but in the last 6 months things have got much worse.
She has started to get chest pain, heart palpatations and suffer extreme lethergy after comparitively low intensity exercise and this obviously worried us. She has so far had a stress test which was useless (ride on stationary bike for 10 minutes, if you dont die you must be ok), worn a heart monitor for 24hrs (showed some palpatations but she felt ok that day) and also had an echocardiagram which showed some regurgitation of the mitral valve and some thickening of the valve.
I shoud also mention that my wife seems to have a very high heart rate whilst exercising although this does not indicate intensity (ie if we both go cycling my HR sits about 130, yet at the same intensity hers will be 170+ and yet she is not puffing or exhausted and can chat away with no problems.)
Anyway reason for my outpourings now is that we saw a cardiac specialist today and he was useless. His answer was "dont do things that make you feel ill, its just your physiology" and frankly just made us feel like we were paranoid and should accept that having to lay down for three hours after 20 minutes of low intensity cycling is normal.
He also suggested that the reason my wife was feeling so frustarted by all this was that her endorphins were a bit low, patronising A hole.
I dont know what I expect back from you all, I guess I am just desperate and a problem shared is a problem halved, etc.:thanx:

Matt DeMinico 03-27-2008 07:08 AM

Re: after some help for my wife
 
Find a new doc. There's going to be good ones out there. Talk to them on the phone before you set up the appointment to see where they may stand. Then again, don't go searching for one who's going to run all kinds of tests just because he knows you are willing to pay for them because you want an answer.

Frank E Morel 03-27-2008 08:07 AM

Re: after some help for my wife
 
matt... No doctor is going to give any kind of impression over the phone without ever seeing the patient. period. There is a huge liability issue behind this one. Two...it one does..its bad medicine.

None of the test that woman had were given unnecessary. They were all the usual screening tools for anyone with a cardiac complaint.

The single test that would have yielded some information before their eyes would have been a treadmill stress test. ( running and for at least 20mins. (hell they do this with old people for pacemaker checks)) ... but I am going to assume that when she did her holter she did the day as usual routine and didnt lighten up on training.

Yes I do agree with matt on finding another doctor. Either another cardiologist that does electro physiology testing or a sports medicine doctor (not an orthopedic guy which many do claim sports medicine backgrounds)
case and point.. a sport clinic in perth with the docs and accreditations
http://www.sportsmedsubiaco.com.au/directors.html
all of them have backgrounds in musco-skeletal injuries.. no pure physiology.
hell .. one guy is a radiologist.. ( he reads x rays )


I do know that perth is a big city but you may have to travel to the east coast of oz for a better access to these guys. Not sure.

http://www.rph.wa.gov.au/emeritus/fitch.html this is a guy that maybe of value to consult with.
here is his clinic
Fitch Ken Dr
Sports & Medicolegal Medicine
146 Mounts Bay Road PERTH
Telephone 9322 6399

Inbox me if you wish

Darrell E. White 03-27-2008 08:29 AM

Re: after some help for my wife
 
Dave:

Standard disclaimer: the following is to be used as general information. It does not constitute medical advice or treatment. For medical care consult your personal physician.

The answer to your wife's problem lies in the echo results: thickened valves and regurgitation. All of her symptoms are consistent with that finding. She needs a stress echocardiogram, a treadmill stress test of maximal tolerated exercise followed IMMEDIATELY by an echo. It should be done under the auspices of a cardiologist who is comfortable and familiar with young patients, athletes if possible but not necessary (the original cardiologist gave standard advice for sick people, not athletes).

Now, as to how to get such a doctor, here's some advice from a doc (incidently, I just visited a rather famous orthopedic surgeon with my oldest and had a very unsatisfying experience so don't think it's just you): lose the attitude that it's all physicians and all of medicine. Doctors, etc. get good at what they see all the time, and doctors will typically prescribe the safest course of action if they are out of their comfort zone. Politely ask the people on the phone at the doctor's office about the kind of patients they see, if they see athletes, etc. Ask if they will accept the tests you already have as a baseline (go elsewhere if the answer is no). Gently describe your wife's goals as well as her problem. Plan on calling multiple offices. Don't express your frustration to the person on the phone (she can't help). Have a script of questions so you don't get flustered by an answer and forget other questions. Put a smile in your voice--you want something from these people.

Who takes care of the local football team? The local university athletes? Rugby team? This is where to look. You may not get a better answer in the end, but right now you need another answer.

Good luck.

Matt DeMinico 03-27-2008 09:24 AM

Re: after some help for my wife
 
Quote:

Originally Posted by Frank E Morel (Post 280898)
matt... No doctor is going to give any kind of impression over the phone without ever seeing the patient. period. There is a huge liability issue behind this one. Two...it one does..its bad medicine.

No, but the conversation should give you an indication of whether they're going to blow you off or not.

Dave Matteson 03-27-2008 12:57 PM

Re: after some help for my wife
 
Darrell pretty much hit it spot on. A thorough follow-up of the valve pathology as he recommended is the same path I'd recommend.

Karin Jonczak 03-27-2008 03:25 PM

Re: after some help for my wife
 
Any history of asthma, or has anyone checked her tidal volume (Tv) (how much air is moving in and out of her lungs?)

Consistent low Tv can cause increased HR etc.... worth a look into at least. Either way, if she thinks something is wrong (and it really sounds like it is) she needs to find another doctor. In the long run it may have to remain 'cause unknown', but you should not be blown off like that (at least thats my 2 cents!)

Good luck,

Karin

Dave Gibbs 03-27-2008 10:56 PM

Re: after some help for my wife
 
just wanted to say a big thanks:thanx:

I really didnt expect much but you guys and girls have touched me with your care and generosity.

Thanks again

Dave & Caz

Aileen Reid 03-28-2008 01:46 AM

Re: after some help for my wife
 
Has she had any blood tests. Just thinking of amyloidosis???? One of my friends wives had it. Buildup of a protein in tissue, lungs and heart go stiff eventually.

A bit rare.

Ken Fitch is a good guy, have seen him myself.

Cal Jones 03-28-2008 03:03 AM

Re: after some help for my wife
 
The above is all good advice. However, it's also worth noting that hormonal imbalances can cause things like palpitations and feeling unwell. Your wife young to be going through perimenopause but it's certainly not unheard of (perimenopause can drag on for many years, also). It's worth having her FHS/oestrogen levels checked out along with the other stuff when she has a blood test. Also get her iron checked - she could be anaemic.

Aileen Reid 03-28-2008 06:49 PM

Re: after some help for my wife
 
Read your post again, another couple of comments. I once felt funny in a run and asked for a stress test. As a runner I insisted it be done on a treadmill, not a bike so it was done at Murdoch SJOG. When I got there the woman took me up to some pathetic heart rate and then stopped so I got stuck into her! I explained I was a runner and had these symptoms when running so I needed a decent stress test, at my normal running herat rates and above. After a few odd looks I got what I wanted. She did the proper one where they lift the incline every 1-2 mins and keep going till you see stars. Got my HR up to 197 I think it was. So that was fine - just stick out for what you want.

I went and saw one Perth cardiologist with Mum (for her). He was totally useless I wonder if it was the same one. :_: Mum was blacking out from low BP - he didn't seem to think it was an issue. Even though I'd taken the trouble to monitor Mum's BP through the day for several days and present him with the data!

Another thought, I have recently seen Carmel Goodman at the Superdrome for my back issues. She was good - she's a sports med doc and exercise physiologist. I had previously seen two docs and got no where.

BTW - isn't it ironic two Perth people discussing stuff on a US website - oh the wonders of the net!

Justin Shipley 04-09-2008 06:29 PM

Re: after some help for my wife
 
for a perth doc with a wholistic perspective and an open mind look up dr Dane Pervan (pronounced DAR_NAY PURR_VARN) 217 nicholson rd, shenton park 6008, phone 08 9381 3691. good luck

Dave Gibbs 04-29-2008 10:15 PM

Re: after some help for my wife
 
Thanks for the help. We have found another cardiolagist at St John of God who seems very keen on getting to the bottom of things. She is on betablockers which are helping but still doing tests to find the route cause.

Aileen Reid 05-01-2008 02:21 AM

Re: after some help for my wife
 
Good luck, hope things look up.

Doug Holland 05-02-2008 07:24 AM

Re: after some help for my wife
 
Dave was her Thyroid ever tested? Especially after morning workout - lets say afternoon test?

My mother has the exact same symptoms and she corrected it with thyroid medication. After 20 years she no longer has a thyroid but when she overexerts herself those same symptoms appear. Its worth asking your Doctor if you haven't.


Doug

Dave Gibbs 05-04-2008 06:02 PM

Re: after some help for my wife
 
cheers Doug, I think they tested that but will double check.
Unfirtunately she has had to come off the betablockers as although they helped the palpatations the side effects got worse and worse and she was suffering chronic nausea and dizzyness.
Back to the drawing board, they have collected her urine for 24hrs and she is waiting for a tilt table test which sounds positively medievil

Aileen Reid 05-09-2008 02:40 AM

Re: after some help for my wife
 
Do keep us informed, hope you get some positive stuff happening soon!


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