As a result of Can we talk about cholesterol, cardiovascular health, and longevity . and Low dose CT of Chest and Calcium CT of heart I requested of my PCP a CT Calcium Scoring/Screening.

It's a damn good thing I did, too. The results:

quote:

FINDINGS: Numerous calcifications are present. Calcification in the left anterior descending coronary artery has a score of 205, ... right coronary artery 160... There is a high likelihood of at least one significant coronary narrowing.

The left anterior descending (LAD) coronary artery is "the widow maker" artery.

Mind you: My cholesterol has been only marginally high, I quit smoking thirteen years ago (and never was a "heavy" smoker in the first place), I've been working out regularly since 2005--incl. High-Intensity Interval Training, I've had several stress tests and heart echos over the last twenty years, and I'm in generally good health.

Meanwhile, I've umbilical hernia surgery scheduled for Tuesday.

Seeing the Calcium Scoring report I immediately called the cardiologist to which my PCP had referred me, thinking "Maybe the surgeon and anesthesiologist for Tuesday's surgery should know about this?"

I was immediately scheduled for a consult with my new cardiologist early this afternoon and he may want to do catheterization before the surgery on Tuesday!

Holy smokes

Now I'm almost afraid to follow-up on the colonoscopy referral I have

I wouldn't start planning your funeral ... just yet.

Seems it could be in line with your age.

https://calciumscorecalculator.com/

quote:

Originally posted by smschulz:
I wouldn't start planning your funeral ... just yet.

Oh, despite the smiley, I'm not

It's just like "Oh geez, srsly?"

Maybe I can arrange for a package deal? Knock me out once, do the coronary cath, colonoscopy, and umbilical hernia surgery in one go?

I got told by my cardiologist that calcium scoring should be done at least once every 3-4 years starting at or around age 60 to get a baseline. So far, no problems for me. Everyone’s different regarding if you should get one and how often.

quote:

As a result of Can we talk about cholesterol, cardiovascular health, and longevity . and Low dose CT of Chest and Calcium CT of heart I requested of my PCP a CT Calcium Scoring/Screening.

SIGforum comes through again!

Glad you got the screening done - best wishes with the treatment!

quote:

Originally posted by joel9507:
SIGforum comes through again!

It does!

What annoys me just a bit is, in retrospect, ISTM they should have recommended a CT Calcium Score two years ago when I was emergency-admitted for a stroke risk eval following my BRAO (Branch Retina Artery Occlusion - aka “eye stroke”).

Calcium build up as I understand it is not something that happens overnight but rather built up over a long time maybe even a lifetime.
Something that is easier to correct in early ages if off but generally materializes over time.
It is not easily reversed quickly from what I've read but you can keep it at bay with a correction all of the metrics of good health.

You need to take Vitamin K which has 180 mcg of MK-7. This keeps the calcium out of your arteries and in your bones.

This brand only has 100 mcg.

https://www.lifeextension.com/...ts/item02334/super-k

Saw my cardiologist. He was not immediately concerned, but, he does want a nuclear stress test.

In discussing the scheduled surgery he would have ok'd it, but, he felt it would be safer to get the stress test beforehand, just to be on the safe side.

He said that, while he would approve the surgery, the surgeon or anesthesiologist might balk when they saw the CT Calcium Score.

So I cancelled the surgery and will schedule a nuclear stress test.

My understanding is that they will stent an artery with 70 percent blockage. Simple procedure with radial approach in most instances.

I had one about a year ago. My oldest brother died of a heart attack so my doc wanted to be sure. No build up at all. They said I scored in the top one percent.

I'd be interested in hearing about your hernia recovery. I have the same type.

Umbilical hernia repairs are usually not successful over the long term. In my brothers case having is hernia repaired a year after his initial repair ended up with him dying while in the hospital on the release day. Unfortunately had NOT be reporting heart disease symptoms to any of his doctors and it ended with him going into Vtac due to a blocked LAD. As for my stepbrother the damned kevlar shifted and ended up cutting his intestine. Which led to peritonitis, surgery, and two weeks in the hospital for recovery and therapy.

My family doc asked me about getting mine repaired and I explained what happened to my brother and step brother and what I found researching it on the Net. Said he understood why I didn't want to get mine done but did tell me what to watch for and left it at that. It's been 10 years now and no change at all in the hernia. Yeah, it's pretty ugly if I'm wearing a bathing suit but at 68 years old I'm not going to win any beauty contests so my attitude can be summed up by "SO WHAT".

Heart disease, like umbilical hernias another inherited family trait going back to 1682. Yeah, my sister got bit by the genealogy bug found that no male in my direct family line has lived to see 80 years of age. The most frequent cause of death is a heart attack.

I learned from what happened to my brother, so as soon as I had symptoms of Heart Issues I told the family doctor about it. BTW, I use Garmin fitness trackers and actually was wearing my chest monitor when I went into AFIB for 95 minutes. A bunch of testing led up to a Heart Cath and the diagnosis that my Mitral valve was getting pretty wonky. Got bounced out of a career in the Marines in 1976 due to a heart murmur so I finally found the cause. Most likely that was a "birth defect" that was never caught. My Dad also had a heart murmur. Anyhow that led to Open Heart Surgery to repair the Mitral Valve and replace the LAD with a Mammary graft and to other grafts taken from my legs. Surgery was in 2018 and apparently my Cardiologist asked the Heart Surgeon amputate the Atrial Appendage while he was in there. Because it now seems that appendage is probably triggering my AFIB. Which the Heart Surgeon completely ignored because surgeons are basically Assholes. Now since mid December I've been having issues with AFIB. As a result my dosage for Metoprolol has been increased from 50 mg. per day to 100 mg per day. Metoprolol is a drug that work to reduce/prevent AFIB by supressing the heart rate. Exercising with a 50 MG dose was OK if I took it 2 times a day in halves. Exercising with a 100 mg dose is quite painful because your heart cant beat fast enough to provide an adequate supply of oxygen to the muscles being used. At this point all I can manage is 3 minutes on with a 60 second rest between intervals and I have not been able to get my heart rate over 100. In addition the day after exercising I'll have some short bouts of AFIB.

Finally AFIB and Emergency Rooms. Go to an ER while in AFIB and they well park you in a bed until the AFIB subsides. That's it, no special drugs, no shock to the heart, they park you in a bed and Observe. Means that one call to 911 can cost you a big bundle of money for Copays. You can drop 2 grand on the ambulance alone. Tip, get a Kardia Mobil 6L and sign up for the extensions. If you have someone who can watch you and take your EKG at intervals during an attack not going to an ER for AFIB is a reasonable choice. Note, doctors wont agree with this advice but they are part of a corrupt medical system that is all about the MONEY.

This message has been edited. Last edited by: Scooter123,

I have a firefighter friend that is likely alive because of this test. He went to an appointment for the test and after it was complete they literally stopped him and had him brought to the hospital and was taken immediately to the cath lab. I believe it was over a 90% blockage, but he was fine after the placement of the stent. He was told that it was just a matter of time before a widow maker cardiac event, but thankfully he avoided that. I have always had good cholesterol, workout regularly and am healthy, but I have a family history of heart disease so my doctor started recommending I get these tests every three years, just before my daughter was born a little over 4 years ago. I’ve always had a score of 0 but it’s been tremendous piece of mind (I had a healthy, physically fit uncle drop dead at 26 years old). My doctor is great and she is all too happy to remind me that one can pass a stress test with a nearly 70% blockage I believe. Get yourself on the mend and back to normal soon. Here’s to a speedy recovery!

quote:

Originally posted by ensigmatic:

quote:

Originally posted by joel9507:
SIGforum comes through again!

It does!

What annoys me just a bit is, in retrospect, ISTM they should have recommended a CT Calcium Score two years ago when I was emergency-admitted for a stroke risk eval following my BRAO (Branch Retina Artery Occlusion - aka “eye stroke”).

I’m not sure what the SOP/protocol is for follow up on your BRAO, but I had to push my cardiologist into scheduling the CT Ca++ scoring. He just wanted to head straight to statins. Prior to that, I actually had to push the PA into doing the blood chem that led towards the statins RX- I was looking for certain indicative blood markers and ended up going down a rabbit hole..
All because I followed up on a routine (for me) bubble study. Keep pushing until you get answers that make sense to you, or it’s explained in a way that makes you comfortable with the information, so that you can make an informed decision.

quote:

Originally posted by Scooter123:
Umbilical hernia repairs are usually not successful over the long term.

That's not strictly true.

quote:

Conclusions

The overall umbilical hernia recurrence rate was 13.1%. Body mass index > 30 kg/m2, diabetes and wound infection were independent risk factors for UH recurrence. According to our study results, laparoscopic medium and large umbilical hernia repair has slight advantages over open mesh repair concerning early postoperative complications, long-term postoperative pain and recurrence.

Ref: Long-term follow-up results of umbilical hernia repair

quote:

Recurrence

The recurrence rate was 6.0% (n = 20) at a mean 3.1 years after index repair (median, 1.0-year; range, 0.33-13 years). The primary suture repair recurrence rate was 9.8% (16 of 163 patients), and the mesh repair recurrence rate was 2.4% (4 of 169 patients). Postoperatively, 10 (50%) of the recurrences occurred within the first year, 15 (75%) occurred within the first 5 years, and 5 (25%) occurred after 5 years (Figure 1). Sixteen patients (80%) who had a recurrence underwent primary suture repairs, and 4 (20%) underwent mesh repairs. Within the primary suture repairs, 4 of the fascial defects were repaired with absorbable sutures, 11 were repaired with non–absorbable sutures, and 1 was repaired with unknown sutures. Within the mesh repairs, 3 were overlays and 1 was a combination underlay and overlay. Mesh location and type of suture could not be analyzed because of our small sample size.

Ref: Factors Associated With Long-term Outcomes of Umbilical Hernia Repair

There is a slew of articles that say essentially the same things.

If you read closely the contributing factors to poor outcomes they largely consist of obesity, diabetes, smoking, and poor physical condition--none of which apply to me.

quote:

Originally posted by irreverent:
I’m not sure what the SOP/protocol is for follow up on your BRAO, ...

I was admitted to the hospital for an emergency stroke evaluation on the strong recommendation of my ophthalmologist. They kept me for twenty hours and ran a metric butt-load of tests, incl. brain MRI, and heart and carotid artery echo's.

I'm just kind of surprised they didn't recommend a CT Calcium Score at the time, is all.

quote:

Originally posted by irreverent:
... but I had to push my cardiologist into scheduling the CT Ca++ scoring.

I didn't have to "push" anybody. I told my PCP I wanted a CT Calcium Score and she cut the referral ¯\_(ツ)_/¯

quote:

Originally posted by irreverent:
Keep pushing until you get answers that make sense to you, or it’s explained in a way that makes you comfortable with the information, so that you can make an informed decision.

Oh, I always do that.

My PCP's and hospital system's new patient portal is a God-send in this respect. I get to see my own lab results. This is what caused me to elevate my PCP's referral to a cardiologist to an immediate, pre-surgery consult.

I will be discussing it with her when we meet for my annual wellness check. Given the "high likelihood" bit in the results, I feel she should have given it a bit more urgency.

Then again: Even the cardiologist wasn't especially concerned. Perhaps my recently hitting heart rates of 151 BPM, without distress or discomfort, during HIIT cardio sessions, coupled with excellent recovery times (±116 BPM after one minute, ±108 BPM after two minutes), are a mitigating factor

Update:

Had my nuclear stress test April 24. Had the follow-up with my cardiologist yesterday.

Bottom line: My heart's fine.

Given the results of the stress test, my cardiologist believes the calcium detected in the calcium score test is on the outside of the arteries, rather than the inside. He saw nothing in the results of the stress test to suggest narrowing of the arteries.

"So I'm GTG for my surgery?" "Yup. As regards your heart you could hardly be a better candidate for surgery." "I can safely go back to doing HIIT cardio?" "Yup."

And he said something I nearly never hear a doctor recommend: "I recommend patients do strength training to at least fifty percent of their strength capacity three times a week, and at least light cardio regularly."

quote:

Originally posted by ZSMICHAEL:
My understanding is that they will stent an artery with 70 percent blockage. Simple procedure with radial approach in most instances.

My cardio guy said 'over 75%' when I had my LAD (which was 99% ) done last year.

99 percent blockage you were knocking on Heavens Door. My cardio explained the blockage INCREASES with exercise reaching 100 percent in short order.

quote:

I requested of my PCP a CT Calcium Scoring/Screening.

If you don't mind me asking-
Did your insurance cover this?
Did you require pre-approval?
Does Medicare cover it?
If not, what is the total out-of-pocket cost for this procedure (where you live)?

quote:

Originally posted by 229DAK:

quote:

I requested of my PCP a CT Calcium Scoring/Screening.

If you don't mind me asking-
Did your insurance cover this?
Did you require pre-approval?
Does Medicare cover it?
If not, what is the total out-of-pocket cost for this procedure (where you live)?

Not OP but I wanted a baseline for comparison should the need arise. My doctor got me approved for a stress test. My insurance at the time required pre approval. We fibbed a bit about me having chest pains to ease the process. Stress test came back weird which actually helped with the next stage. I got a cardiologist consult and he got me approved for the CT scan and some other tests. I paid a small copay for the cardiologist consult but insurance covered the rest. No idea about Medicare as I’m late 40s. I believe the billing statement was over $10k for the CT scan. This was a couple years ago. I recently had a lower abdomen and pelvic CT scan in the ER that billed out for around $10k.