Tuesday, January 09, 2007

Replacing Dr. Wayne

Today was my appointment with Dr. Stephen DeVries, a noninvasive cardiologist who practices in the University of Illinois Medical Center in Chicago. I know I promised several of Dr. Wayne's patients that I would provide them with a critique of my experience and I have been pondering what I should write. Let me tell you about my visit to the Illinois Medical Center Heart Center.

I was escorted from the waiting room by a very friendly and efficient RN. She obtained my weight and vital signs, took a history and asked of my current symptoms and had me list all of the medications, both cardiac related and otherwise. The only thing she seemed surprised at was my BP reading - 98/52. Then I was taken to another room by an EKG technician. She took about ten minutes setting me up and fiddling with the leads until all interference was gone and then she took the EKG.

Dr. DeVries entered the exam room within a few minutes after I had come back from the EKG. A thin, unopposing, affable man with a winning smile and great bedside manner, I immediately felt comfortable with him. Once we got the small talk out of the way, I told Dr. DeVries about the loss of the best cardiologist I ever had and told him frankly that this visit was an interview in search of a suitable replacement. Whether or not I chose him, depended on how he answered my questions.

He replied by saying he respected the patient's right to take charge of his own medical treatment. Likening himself to a presidential advisor, DeVries said, "The president gets advice from different advisors about which country to go to war with, but the final decsion lays with the president." He would give me advice and would give me all the facts so I could make a rational decision.

I explained to Dr. DeVries that I had been angina-free from May 2004 to November 2006, by taking Dr. Wayne's medical regimen. But in November, while running through Charles De Gaulle airport in Paris, I felt a twinge of angina. Since then, these twinges have repeated themselves several times a day, during exetion or fairly severe stress.

Dr. DeVries, although a noninvasive cardiologist, said he felt I needed a new stress test and nuclear images by cardiography during the test. I told him I no doubt would fail, then he replied, "Then I would recommend an angiogram and if necessary, possible stents."

Dr. Wayne had warned me that the medicine probably wouldn't work for ever and I may need a CABG some time in the future. He also had told me on many occasions, that angiograms were useless tools, so the fact that Dr. DeVries wanted me to have one sent a red flag up. I asked why a 64 slice CT wouldn't be acceptable and he responded, "When we do an angiogram, we can put stents in or do a baloon angioplasty." Again, not eh most encouraging response.

He asked about my cholesterol level and I said I had no idea what the numbers were and that Dr. Wayne strongly objected to me being prescribed Lipitor by my neurologist. I told him I wasn't worried about the cholesterol levels and he still wants me to get fasting lab work to check my levels.

I like Dr. DeVries and until I can find a cardiologist who seems to be schooled in the techniques and philosophy of Dr. Wayne, will probably continue to see him. I will do the blood work and the stress test and cardiography but I will, under no circumstances allow stents or angioplasty.

I don't know if I will get a CABG or not. Dr. DeVries prescribed Imdur 60mg i qd and NTG 1/150 i SL prn chest pain x 3 to be added to the medication regimen I am already on. He also increased my aspirin from 81mg daily to 325mg qd and recommended Nordic Natural EPA Fish Oil pills, 2 with breakfast. Let's see how that does.

I also will see Dr. DeVries in February, after I return from my work in Africa. So while I am going to start seeing Dr. DeVries for the time being, I cannot recommend him as a replacement for Dr. Wayne. You may want to check out Dr. Thomas A Preston, MD, Professor of Medicine at the University of Washington School of Medicine and Chief of Cardiology at Pacific Medical Center, Seattle, Washington. Scroll down to his guest editorial.

Also, check my Cholesterol Conspiracy Links. You will find them very enlightening.

1 comment:

Wil said...

Re: Your story of chest paints running through paris airport. Was that while you had low BP? I experienced pains while my BP was 98/60. Dr. Wayne found my BP was to low at times and adjusted my meds. You good clue is if your jaw gets tired while chewing. Hope this will help others