Monday, April 5, 2010

A trip to the CARDIOLOGIST

I have an appointment with a cardiologist on wednesday. My pulmonologist is sending me to him because I have been short of breath for several months now and there hasn't any improvement there. There also hasn't been any deterioration either. He did an echo cardiogram and told me that there was nothing abnormal there. I think he is practicing a little defensive medicine.

My lipids were fine a year ago and I really do not think I have any heart stuff going on. I have to be honest, I am a little concerned about the cardiologist being a fat hater. Every doctor that I have met through this hospital has been fair and some have been actually remarkably understanding about my fat.

My pulmonologist sent me for am echo cardiogram which did not show anything abnormal.

I think that my breathing troubles are about my lack of movement. I joined the Y and have been to one water aerobics class. I would like to get the these classes more often. I think that I can recondition myself to better breathing.

I just want the cardiologist to be fair. If he is not, I will have to go see another one. I actually would like to get confirmation that there is nothing going on with my heart. I hope I get a sane enough doctor who can help me find out if that is in fact the case.

Is there anyone out there that is willing to share via comments or via links any experiences with cardio docs from a HAES perspective and does anyone knows what medical tests/procedures can confirm that my heart is in fact healthy, please comment.


  1. Hey Ivan,
    I can't help with the doctor advice, only can commiserate. My last doctor wasn't fat hating, she actually never mentioned my weight, but she also never mentioned anything else about me that might be medical, just ordered tests without talking, hence I've gotten a new doc. New doc's sending me off for my second stress test in as many years, but I do have some weird heart stuff in my family history so I go even though I'm young (early 30s) and my tests are fairly good except for a little high on the triglycerides. I get chest pain sometimes, and out of breath too, but I tend to equate that with anxiety (since the previous heart tests always show me as fine and I can be an anxious woman)and my lack of movement this winter season. That said, I too would like to hear comments on the 'healthy heart' stuff. It's all kinda new to me.
    Btw, first thing new doc's nurse did was figure out my BMI. Boy did I bite my tongue on that one. I figured I should get to know new doc first, and I like him so far.

  2. Hi Ivan,

    I haven't had cardio doc issues either. I did end up in the ER for chest pains once and everything came back fine. Later I read that chest pain / tightness can be a symptom of asthma as well as heart problems.

    Shortness of breath can be a symptom of asthma too.

  3. I have asthma and last year developed a bit of panic disorder (as well as being very fat) so I often have the symptoms you're describing, went to the hospital with chest pains due to the first real panic I ever had and got fully checked out cardio-wise including the echo and they told me everything was good (i even had better bp than the thin young doctor who checked me out) it was just panic/anxiety attacks, but knowing that doesn't always help me remember that I'm probably fine when the symptoms kick in. :/ hope you check out fine too, best of luck!

  4. Hi Ivan! I just wanted to send you good thoughts and healing vibes. I don't have a cardiologist recommendation for you, but my pulmonologist is fabulous and within driving distance of NYC if you are interested. Best of luck to you!

    Fatsister CTJen

  5. Like some of the other comments have noted, asthma can definitely cause the symptoms that your describing. Although people don't usually think of asthma as being affected by activity levels it definitely can be. I injured my knee dancing and then became pretty sedentary while it was healing and had symptoms similar to what your describing that are just starting to go away now that I've slowly started moving more again. My doctor was kind of concerned about blood clots though because of the lack of movement and knee injury which I guess can cause breathing problems if they wind up in the lungs but that's been ruled out. That's about the only major problem I know of that would not show up on an echo cardiogram. There's also a not too well known but not uncommon condition related to sleep apnea that's more common amongst asthma sufferers and us larger folks called Hypoventilation Syndrome(use to be called Pickwickian Syndrome), where shallower breathing and sleep apnea at night cause day time shortness of breath and drowsiness.
    Best of luck with your visit with the cardiologist.

  6. Hi Everyone,

    Well I have to say the cardio doc visit could not have gone better. Even to the point when I sat in the chair the Doctor asked if I was comfortable and the arms of the chair was really bothering me, when I asked, he gladly... I mean gladly gave up his armless desk chair and took my chair to his computer to take my history.

    Young guy. Warm, welcoming. I told him that I immediately felt relief because sometimes heart docs have a bias against fat. He said that would be like having bias against someone for having any other condition people come for medical treatment. Then he looked at me and said I want to know if you see any of that here, I am in charge of cardiac care and that better not happen here.

    We went through everything. He said the ECHO showed one area of thickening of the heart muscle which he said is easily reversible with conditioning. He said a stress test wouldn't make sense at my level of conditioning. He indicated there is something called a high speed cat scan that can see plaque in the arteries, but insurance will not pay for it. THey is another type of PEPSCAN? machine that can also get some good pictures of my arteries but the machine is offline for repair and he plans to send me there when it comes on line.

    We agree that this was a defensive, lets be on the safe side, visit.

    He said that the way my weight is distributed is to my advantage, (less padding from my sternum upwards.)

    We agreed that it was most likely what I thought, extreme de conditioning due to my sedentariness. SImply put, my lungs did what they are designed to do, handle my breathing while I go about my life, most of which had involved very little movement due to pain management issues ( and motivational ones too which is a topic for a blog post in the future) Since the surgery I move less.

    He lit up when I told him about the drum circle. He also said he will see if they can help me with the co pay for Resp Therapy.

    He did ask me about weight loss surgery and I told him that was not an option due to all my prior abdominal surgeries (I only hae 5 feet of intestine left.) I didn't want to go there with him because he was being so nice to me.

    I think that there may be an opportunity to get him to read about the risks vs rewards of WLS.

    I walked away, feeling a little increase in the speed of my pace without getting winded as I walked home from this doctor visit.

    So I have to figure out how to find the motivation to move more as it is the only thing that is going to increase my lung capacity.

    That being said, I feel better knowing that I saw the heart doc and we were both in agreement that we do not suspect heart disease here, and that everything I have can be improved on. Although he wants me to try to lose weight (although it was not an order) and I actually didn't go into it with him, I basically get a clean bill of health even though I have this fitness issue. The doctor thinks it is COPD, but none of the meds gave me any relief. Which is why I think it is about conditioning.

    I will go for that PEP thing when the machine comes on line to further rule out heart disease, but I am feeling fairly confident that I do not have it/. YAY!!!



  7. I don't have any answers Ivan but I hope it all comes out good for you in the end. Good health to you my friend.