Cardiologist

[SweetyPie]

Im sure most of you all know my blood pressure tends ro run low during treatment so im allowed to run on blood pressure in 80s. Lately the blood pressure is steady in the 60's!! Its scary to me because I feel fine...its so odd. The nurse practitioner said I should see a cardiologist. What will do beside besides prescribe me medication which I already had before and over time stops working.

[GA_DAWG]

Aisha, I can't give you the answer of what a cardiologist will do, but I can tell you that a BP in the 60's is not good, and it is dangerous in almost every occurrence.

[Michael Murphy]

I am convinced that Dialysys patients need to see a cardiologist every couple of years,  one of the side effects of hemo is strain put on the heart in the fall of 2016 I had a major heart attack and since then my nephrologist has put limits on fluid removal to avoid additional stress on my heart.  I think the heart attack was my fault since I was supposed to have yearly stress tests and I skipped a few.

[kickingandscreaming]

Lately, my BP has been running low.   Pre-D  it used to run in the high 170's and 180's (with always good diastolic) and now I'm frequently in the 90's and low 100's.  I truly don't understand this "transformation."  I only take a minute dose of one hypertensive (Metoprolal) and that is actually for my heart and not my BP.   When I was discussing these numbers with my Neph, she said maybe my heart is too weak to pump fully.  Back to the cardiologist.

[Riki]

I started seeing a cardiologist back in 2014, after I was diagnosed with Pulmonary Hypertension.  They wanted to be sure that my heart wasn't the cause of the PH, which it wasn't, but he did find that I had a moderately leaky heart valve.  I'm supposed to have an echocardiogram done every 6 months to keep an eye on it, but organizing that is the job of the family doctor, and I haven't had one since the summer of 2017, when mine retired.  Not long ago, I realized that it's been a while since I had one done, so I got the nurses to check when the last one was.  October of 2017.  Do you think my parents could sue the government if something happens to me because of that valve not being checked?

[Cupcake]

No. Its on the patient to follow up with recommended tests. It would be the responsibility of your primary care doctor to remind you, and I understand why you haven't followed up there. When I started PD I quit going to PCP as I saw nephrology monthly (I still went to gyne for mammograms, etc) and when I got to the transplant center, they kept saying "what does your PCP say about this, that? I was like, whoops!

[UkrainianTracksuit]

Riki, not sure how it works in your province, but couldn't you give a quick run through to your nephrologist and they arrange the every 6 months echo?

I don't have a family doctor either and the list is long. There's something like 2000+ waiting for one. Once I explained that and my needs, nephrology ordered the tests or gave referrals to specialists I knew I needed to see. At least in the case of my echo, the proper cardiologist dealt with the report, passed it over to nephrology and they gave a quick run through with that. When you are a complex patient, they typically try to help out.

I know it sucks though as bureaucracy dictates which doctors manage what and prefer the other to stay in their lane.

[SweetyPie]

So the doctor saw me yesterday, and ordered a cortisol blood test. He said hold off on the cardiologist appointment for now.

[Riki]

No. Its on the patient to follow up with recommended tests.

I haven't got a primary care doctor, which is my point.  I haven't had one for 2 years, after the one I've had since I was a child abruptly retired without notifying any of his patients.  We found out about it through an article in the newspaper

Riki, not sure how it works in your province, but couldn't you give a quick run through to your nephrologist and they arrange the every 6 months echo?

I've mentioned it to them a couple of times, as there are two nephrologists here, and it seems to be going over their heads.  I'm also due for a mammogram, but since I'm over 40 now, I can set that up myself.

[smsnlv@gmail.com]

I am convinced that Dialysys patients need to see a cardiologist every couple of year...

Ever couple of years?  Even though I'm have  a VA cardiologist, whom I see twice a year, I also not have a local non VA doctor I'm seeing twice a year as I've had a couple of bypases, 2002 and 2006.  No current problems other than HBP, but I feel better getting checked out often.  The primary reason for the 2nd and non VA doctor that accepts Medicare and Tricare is I'm slowly trying to get away from the VA as the trip to Houston from where we live, Humble, TX, for major medical car is a pain.  It's a 45 min to 1 hour trip in near wall to wall traffic.