Hitting the Road in Search of Better Care

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Better Health CareWhen facing a medical problem that is either too expensive to treat or requires more specialized care not available close to home, Americans are increasingly turning to medical tourism - with over 1.2 million traveling out of the country last year to seek medical care and surgical procedures. Sometimes you can save time and money or find a better specialist by simply traveling to a high level hospital center, medical college campus, or out of state to find a physician that specializes in treating your condition. This too is becoming more popular as modern travel and easily obtained information about other more highly specialized providers and research is readily available on the internet.

Over the past two years I have been on a bit of a personal odyssey to find the solution to what is wrong with my heart. Local cardiologists were dismissive of my symptoms once they ran a few tests. My primary doctor agreed with whatever they said. While one provider was willing to work with me on the medication that was able to keep me up and moving enough to get by, overall I was stuck, with lots of issues any time I tried to live my normal life. Playing with the kids, running, walking, spending a hot and humid day outside, and stairs were all problematic.

Getting nowhere locally, I then tried some other Midwest destinations to find some answers. Tried a cardiologist at Mayo, but since I didn’t really know what was wrong myself, this particular doctor was not a good fit and could offer no diagnosis or solutions after running a couple of extra tests. Since my symptoms were limiting but my heart appeared normal, my case was dismissed. Sure I had a small transient ischemic attack (TIA) right after that, but I was certain it wouldn’t change anything with any of the doctors I had seen. I had a few other directions in mind when last New Year’s Eve I sustained a more significant TIA with residual issues. I thought, surely now whatever is wrong with my heart will be taken seriously. And it was, kind of. I was sent to more specialists in cities as far away as Milwaukee, but still no diagnosis and treatment. By this time I had done enough research and enough tests had been done that I knew what was wrong and what could help. But I needed to find a doctor to who would be willing to diagnose and offer an appropriate treatment. After a total of seven cardiology consults and a trip to the center of Iowa, I finally did.

Since then, friends, family, and patients have shared in the joy of finally getting the right help and finally getting back to feeling like myself. But everyone asks, why did it take so long? How do I know if my doctor has the right diagnosis and treatment plan in place for me? Sometimes it is tough to know.

First, you will feel confident in what your doctor says. It makes sense. The treatment plan they are offering is helping (mine did not help nearly enough). Your intuition agrees with the decisions you are making as well - you don’t lose sleep at night about it, or think about it trying to solve the problem yourself all day long.

Still not sure? Get a second opinion. Most insurances will pay for this, because remember, they want you to get the right diagnosis and treatment as well. If you think the plan is correct and just want to be sure, find another specialist or provider like yours, or even a more specialized one if you think you need it. I was getting nowhere with cardiologists, but once tests showed that my heart anatomy and pumping ability were fine, I then realized it was a rhythm problem, which means seeing a further specialized cardiologist in electrophysiology.

Not taken seriously? This is the kind of problem that does not leave a patient re-assured. Getting a second or third opinion can help. On-line searching can help to a point, but be sure to check reputable websites like webmd or mayoclinic.org. If you understand medical and scientific lingo, check out pubmed.com, which contains all of the latest medical research on your condition straight from the medical journals. If you have a question about a medication and its side effects use drugs.com for more information.

Finally, I was fortunate in all of my searching to figure out what was wrong myself. But that still didn’t assure the correct treatment even if I went to the right specialist. I ended up going to 3 electrophysiologists, because the first two were unwilling to diagnose and treat the problem. Knowing I had already been to two specialists, I really needed to get my final visit right. I knew I needed someone who specialized in my diagnosis and in treating it. Adding to the difficulty was that I knew I needed a doc who would think outside the box, who would recognize my numbers in my case did not perfectly fit the diagnosis, but did fit the majority of the qualifications for this diagnosis to be correct. Finally, I had to prepare myself, as even if both of these items fit this doc, he still could decide that my case did not fit that diagnosis and not offer any treatment. If you can see the medical “expert” for your precise condition, you hopefully will be successful as I was, but you may need to see two of these medical “experts” to be certain if you have a more rare and difficult diagnosis.

Traveling for medical care can be a tough and expensive decision, but when you have the relief of feeling like a medical professional understands what is wrong and can offer treatment to help you feel better, it is more than worth it. It is so easy to take good health for granted, but once you lose what you once had, it really becomes a huge limitation in many aspects of your life. It makes perfect sense to start your healthcare close to home, where you know the providers and can find referrals from friends and family. In most areas and circumstances, there may be really great care close to home. However, thanks to the availability of so much great medical information, medical journals, and even doctor interviews on-line, you can gather all of the information you need to make a good decision about the direction of your healthcare, whether great healthcare at a good price is available close to home or far away.

For those needing more details about inappropriate sinus tachycardia, Dr. Brian Olshansky (Mason City, Iowa) diagnosed my condition as inappropriate sinus tachycardia with an average resting heart rate around 79bpm, and 20% of my day spent in the traditional “tachycardia” zone of 100bpm or more. My symptoms were palpitations, lightheadedness, near syncope, shortness of breath with very little exertion, heat/humidity intolerance, chest pain, and sudden weakness/full body fatigue (couldn’t hold up my head and/or trunk). This all began extremely suddenly two years ago during my 5th month of pregnancy. It was assumed by my medical providers that it would go away after I was no longer pregnant and with exercise, but it did not, and in fact it worsened over the next two years with 3 TIAs, including one with significant residual deficits. With taking 5 to 7.5 mg of ivabradine per day, I am now nearly 100% symptom free with less than 1 month on the medication. (This medication is not considered safe to take during pregnancy and/or lactation).