Re: The Democrat's Candidate

On Fri, 02 Nov 2007 21:58:38 +0100, Matthias Voss
<spammat.voss@xxxxxx> wrote:

John Kulp wrote:


I did consulting work for HCA or Hospital Corporation of America
relating to their attempted move into home healthcare.

Not an easy job.


Could you please specify what you mean by preventive care
for heart diseases provided by physicians, else than what
common sense would tell anyway, above waht is done routinely
here ( blood pressure, weight, blood analysis, ECG,?


Sure, I did that in another post. In my case, I have no known cardiac
risk factors other than being a little overweight, though not enough
for concern. As with lots of people, my cholesterol was on the high
side, about 220 as it is measured here with a target of 200 or below.
So I was put on Lipitor, one of the statins and covered by my
healthcare plan.

Without a preceding diet plan?

No doctors routinely advise one to lose weight, as well they should.
I have lost about 25 pounds to date with more to go. It easier said
than done here, however, as anyone who has ever wandered into a US
supermarket can attest. Try finding any healthy food among the carbs,
oil and sugar. A lot of people don't know it, but the average per
capita (that's every man, woman and child) consumption of sugar alone
in the US is 130 pounds per year. And, to top that off, being a fat
ass is now being promoted as ok by companies trying to sell their
products to them. Wait until the health bill comes in for that.



This lowered the overall reading to about 120, but
didn't lower the bad cholesterol as it's called as much as my doctor
wished. So he suggested that I get a heart scan which is not yet
covered by my insurance as it is still thought to be experimental. I
did that and it cost $350, now down to about $250. That showed what
is called a slightly elevated calcium count in one of my arteries
while the other 3 were fine. Based on that, my doctor changed my
medication to Vytorin which both lowers bad cholesterol and raises the
good. And put me on a higher preventative dose of aspirin.

More than 100mg/d? With arteries, you mean the big arteries
nursing the body, and brain, or cardiac arteries? They
probably did a duplex doppler sonography to see and analyze
the blood flow, velocity distribution, vortices?
An US-scan also gives the wall thickness or the arteries,
which is significant for hemorrhagic insult prediction.

Yes, 325 mg, the standard adult dose. It was the cardiac arteries
that were scanned. Along with the lungs. No sonography, just the
scan to get an indication and then the nuclear EKG.



He thought that was enough, but I thought "hey this is my heart we are
talking about here" so I looked up the top cardiologist in Denver
where I live and made an appointment with him a week later as he was
in my insurance plan. I could of gone even earlier but had a business
conflict. He reviewed what my doctor had done and said that, based
upon the information he had, what he had done was correct BUT a heart
scan can only give an indication something might be amiss and said
that he could do a nuclear stress electrocardiogram where they inject
nuclear medicine to do a contrast so they can see if there is actually
any blockage. This was done that day and cost me a $25 copay and
showed nothing wrong.

So they were looking for signs of coronary blockage. All
right with that.
The SOTA here is fast MRI, like they do at Kiel University.
It is so fast that despite the heart's beating imaging is
crystal clear, and on top of that you can do a virtual
vessel endoscopy with programs like OSirix.

Yes, I've of that and they do that here as well is they feel they need
a more precise analysis. They found nothing so it is just being
treated with medication which the cardiologist told me probably has
already lowered the calcium count.


I also described in the post where a well-connected Danish friend of
mine with high risk factors for cardiac disease got none of this, even
though he has several doctors in his family and dropped dead of a
heart attack last year. If he had had the tests I had his blockage
would have been found and he would still be around.

A normal stress ECG can assess risk here, but not
necessarily. Some drop dead by cardiac arrest w/o any signs
in the ECG.

That's right and the same thing has happened here. Makes one wonder
what they can really assess with it without the contrast. Some have
dropped dead doing the stress one as well, which is why mine was done
at the cardiologist's office at the hospital with something like 5
other cardiologists there in the office. If something was going to
happen, that would be the place to be.


You are legally not allowed to see a doctor in Sweden and
say, I want to have a physical? Yes or no?


I don't know the law per se, so I can't answer this, but I have been
told by several Swedish friends of mine that these aren't done. Maybe
it's the law or maybe it just the practice or maybe it's the law but
takes forever to get an appointment. I don't know, but I do know that
they now allow people to buy private insurance if they want to avoid
the waits.

Well, many people just take for laws waht is published as a
strong statement, or meant to bias people in a certain way.
A good reason to have a strong, free, and indepent press.

Yup. It pays to do your research from whatever source. Swedes get
top notch medical care once something is found in general, though not
necessarily state of the art in the sense of trying the latest thing
because a lot of that is in research programs in various places around
the world. The problem is getting the preventive care and diagnosis
in the first place.
.

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