739242 tn?1234217827

Self pay and Cleveland Clinic

I am trying to schedule a second opinion appt. at the Cleveland Clinic for my PACs/PVCs etc., and was shocked by a couple of things. First, I am uninsured and will pay for my appointments out of pocket (actually, my parents have kindly offered), and I was stunned when they told me they would run a credit check on me before deciding whether or not to see me. Second, every doctor on the roster is in the pocket of drug companies, and they list this on their profiles so that we will know of their potential conflicts of interest.

What has happened to America? Is this the best we can do for our sick citizens? Credit checks to decide whether we are worthy of our own health?

I never thought I'd say this, as a Cuban American, but I am seriously considering going to Cuba with my family to seek care for these problems. The doctors there are as good as anywhere, and even though supplies are scarce (thanks to the US embargo), they will not ask me how much money I have before treating me for free.

How sad it is that the richest country on earth cannot help me (even if I can pay), but one of the poorest in the world is willing to welcome me with open arms, for free.

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Avatar universal
That is very sad!  I can't believe they want to do a credit check. I have never heard of this. Cleveland Clinic is not the only place to go to for help. I would check into Texas or Univ of Penn. Texas has Dr Natale and Penn has Dr Marchlinski that are top notch.
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177337 tn?1310059899
Wow, that is unbelievable.  Do you live near the Cleveland Clinic?  Have you tried other teaching hospitals to see if you get the same answer regarding just wanting to pay with cash?  

What you need is peace of mind.  It has done wonders for mine over the last few days.  Can you go back to your original doctor and just ask for another holter to see if there are any changes?  Did he recommend you try a beta blocker?  Maybe you should.  
I know these things can feel horrible especially if they are happening every minute.  They will settle down.

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267401 tn?1251852496
Looks like she lives in New Mexico, and the Cleveland Clinic is in, well, Cleveland.  Seems like a big trip for something like PVC's.  Texas is closer and has probably one of the top EP's on the planet in Dr Andrea Natale (who used to be at Cleveland Clinic).

But even so, I don't recall how many PVC's missalisa is having per day, but this seems like a big trip and expense for something that for most is not life threatening.  

Check that.  I did dig around and find that missalisa's having around 2,000 PVC's per day.  It's certainly more than 50, but it's far less than the quantities many here experience daily.  

Missalisa, I'm worried about you.  Not about your heart, but about the rest of you.  You've had PVC's for a month and you're withdrawing from your family?  You want them to get used to the idea of living life without you?  I think you need to talk to Frenchie's doctor.

I find strength in reading the stories of people like Brooke_38, ireneo and other who've gone through way more than I have; tons more than you, yet their outlooks are bright and they look forward to the future.  It sounds like you're shutting it down, all over PVC's!  No SVT's, no bigeminy (which both tend to be pretty darn minor), just PVC's.  

I mean you haven't even looked into cardio-selective beta blockers, calcium channel blockers, and you still have some weight to lose, yes?  You haven't had a lick of medical intervention yet you're pretty sure you're done.

If you were, I mean, if you only had 10 days left with your family, would you rather run away and not see them, or spend every moment with them to make sure they knew how much you loved them before you went?  And so you could get as much love as you could in return?  

I have to wonder if this hasn't done enough damage to your psyche to warrant a visit with a doctor who could help you with what might be some understandable depression or anxiety that's tagged along with your PVC's.  I know many people report PVC quantity going way down once they aren't as worried about them.

Stuff to think about, anyway.  Maybe you can pursue a few of those avenues and fight to spend more years with your family before you give up.  Just my $.02, anyway.

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177337 tn?1310059899
Well said Wisconsin2007.

Missalisa - you don't need to spend that kind of money to travel that distance and have all those tests run.  Go to the "ask the doctors forum".  Review their responses to pvc's.  These doctors say the same thing ours do.  PVC's are not life threatening no matter what the frequency, if your heart is structurally normal.
Search out another doctor in your area and get a second opinion for peace of mind.  Ask for a beta blocker (like tenormin) for temporary relief until those darn things decide to settle down.  I understand your fear and my suggestion is based on what I did to calm my anxiety about this.  You don't believe your doctor but how can he be wrong?  The Cleveland Doctors and our doctors all say the same thing as yours.  Benign.  They can't all be wrong can they?
The day I wore my moniter was one of the worse days I have ever had.  I had every symptom you describe in your journal.  I was up most of the night with all kinds of crazy issues from my heart skipping, to fluttering around like a butterfly, to vibrations in my chest and muscle twitching in my chest, to tingling in my fingers and shortness of breath.  I was certain that they would find something horrible.  I was so horribly afraid that I took the holter off myself in the morning before my appointment because I just couldn't bear to have any more problems show up on my way to his office.  My heart skipped every few beats all the way there.  When I got there I thought I would pass out.  I really didn't think I could get out of my car.  I was so worried that my doctor had the results of the holter for me in less than 6 hours after I delivered it to him.  Fast forward to his phone call.  He assured me that everything I felt was not life threatening.  Within one hour, my pvc's had reduced in frequency and as of this evening (even after a martini) I have felt not one.  My point is that your anxiety (your mind) is controlling these things right now.  Just like mine was and will again.
I'm sure mine will start up again at some point and I will probably need reassurance again.  Just make that phone call and get another opinion with another doctor in your area.  Get that moniter on one more time and then if he tells you that you will be fine..BELIEVE...Get it done.  You will feel like a new woman by the end of next week.
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363281 tn?1643235611
I read your journal andI can understand your fears and the feelings you are going through. I would say with almost 100% certainty that your symptoms are anxiety related. I have chronic anxiety, and I have the chest pains, shortness of breath, feeling slurry when I talk at times (that is due to tight muscles in your face), everything. Anxiety is a mimicker of so many things. I know your sadness and fear, everyday, I fear I will have a PVC that will kill me, even though my doctor has said they won't and my echocardiogram was OK. It is a horrible feeling, and once this fear gets a hold on you, it will grow and grow until you take control. That is so hard to do, I know, because when you are in fear, a person does not think too well.

There is another forum here that is just for sufferers of anxiety, you might want to go there also and post your worries, I bet they could help, I am a member, but have not posted yet, but, I have read some threads, and they really seem to help each other.

Also, a book by Dr. Claire Weekes, called "Hope and Help for Your Nerves." it is wonderful, very easy to understand, and has been a big help to me and to others as well. You can purchase it on the net through Amazon I believe.

I know you miss you, I miss me too, but, we CAN survive this, we have to fight it, it is an invisible enemy. I do not know your religious beliefs, but, if you are a Christian and believe it prayer, it can be a wonderful source of comfort as well.

Anyway, I hope this helps. I will pray for you.


PS. I also agree with the others, it would be best if you could see another doctor for the second opinon somewhere closer to home. It is always easier. I live in a small town, and have to go out of town for most doctors and it sure can be a hassle.

I am surprised about the credit check, I know some doctors in the state of Washington, were I live, do that, and it makes me angry, especially when I say I will pay cash, what is wrong with folks?

If you want to talk to a doc from this clinic try the Professional forum, there is a fee for it, but, you can ask a doctor your question, and they will answer.
Helpful - 0
739242 tn?1234217827
Thanks for all the comments. I'm on a beta blocker now, and all it does is make the thuds less powerful. They are still there, and seem to be getting more frequent, I just feel them now as more of a flutter than as a bang. My resting HR is very low now, and I get dizzy standing up, from the Beta Blocker I believe. I'm still having about 3 or 4 PACs/PVCs a minute, almost constantly. I also have chest pain, and pain in my upper left back. I just really want to know what made this start! Two months ago, I was blissfully unaware of any of this stuff. Now, it is all I think about.

My doctor says that if the symptoms remain unbearable for me - and they are very disconcerting - he'd like to get me on flecanide (sp?). That scares me.

As for PVCs/PACs being benign - there is evidence to the contrary. People who have them during the recovery phase of exercise are at much elevated risk of "cardiac events" in the future, and there's not a thing we can do about it. Not diet, exercise, nothing.

All the crying and withdrawl of late has helped me to mourn my old life. I feel more at peace with the loss now. I had to go through that. I feel like it would have been unnatural to simply go on as normal, when things are no longer normal. I had to grieve my own heart. We each come to terms with things in our own way.

Helpful - 0
363281 tn?1643235611
Well, there was a gentleman that posted a while back, I do remember his name, seems it began with an "A", anyway, he had tons of PVC's and when he did a stress test, he actually outpaced them, but, when he was in the recovery phase of the test, they came back. This did not concern the doctor and he said that as long as the heart is structually  normal, they are no more dangerous then than any other time.

I will say what is a much better indicator of future cardiac events, and that is the length of time it takes for the heart to recover back to the resting rate. In a good, healthy heart in a person who is used to working out, it should slow down at least no less than 12 beats after one minute, if it is less than that, then you shuold check inot the matter. However, if you are not in good condition, it will take longer, but, the more you exercise, the better your heart condition. So, that is from a person who specializes in hearts says.

Heck, if the recovery rate were really that serious regarding the PVC's, then all of us would be in trouble as we all have them at rest or anytime, so, recovery, to me, is not different. Just my opinion though.
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363281 tn?1643235611
I found one post regard recovery phase and PVC's here was the doctor's answer:


Member since Jun 2002  

, May 22, 2004 12:00AM

Thanks for the post.

Q:"In simple terms, in your opinion does PVC's at rest , during or after exercise increase the risk of death in a structurally normal heart?"

A qualified No.  If they only occur after exercise, then perhaps to the risk of death is marginally increased, but probably not because of a direct PVC effect, but because of some as yet unknown association.

Here is the link to the complete post:  http://www.medhelp.org/posts/show/253492?camp=36

There is lots of controversy to this, but, all in all the risks seem only marginal.
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267401 tn?1251852496
I'm not sure why you're worried about flecainide.  A couple days ago you were extracting yourself from your family because you were pretty sure you were a goner.  If there's an Rx that can help, why be nervous?

I do think the medications might address one side of this equation for you, but maybe not the right one.  Beta blockers and the other antiarrhythmics, if I understand them correctly, are designed to prevent the uptake of the adrenaline response your body is creating, lessening the chance of your having an adrenaline-caused response.  Because these PVC's are so controlling of your well-being, I'm wondering if the other side of this equation needs addressing for you - the prevention of the fight-or-flight mechanism that releases the adrenaline in the first place.  In other words, anti-anxiety medications of some sort.  

If you're sitting in bed until the early morning fearing every skipped beat, that's too much worry and it can only bring about more of the thing you fear, because it's stimulating that fight-or-flight response.

You said the Holter caught 2,000 PVC's, and you also said you get 3-4 a minute.  You must then have periods of the day when you don't get them, because 3 a minute even for 16 hours a day would net you about 3,000.  So they aren't constant (even though it may feel that way).

And for the study you quoted - let's get that straight.  Avg age was 56.  The study showed an increased risk for people who only got PVC's post-exercise, and only for those who had >7 PVC's during the recovery phase (and PVC's were only one among the symtpoms, such as couplets, triplets, bigeminy, trigeminy, VT and Vfib).  

The studies that have been done on the general population show that a huge portion of people have PVC's.  If it was such a dramatic predictor of death, don't you think we'd hear more about it?  I guess it could be a big conspiracy to get those of us with PVC's to die off quick so the "healthy" ones can live on, but that would mean that 90% of all people over 60 shouldn't be alive, either, because they get PVC's.

As for exercise not helping, I have to disagree.  A trained heart is better able to withstand everything better than an untrained heart is.  Might not mean you have less PVC's, but if that progresses (over decades, not weeks ;) ) to something more serious, your heart will be better able to survive it.

Okay, this post is getting long enough.  Consider anxiety treatment, get a local 2nd opinion on the PVC's, and if you think you're already doomed, don't fear the Rx.  My folks have both been on Flec for years.  :)
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363281 tn?1643235611
My goodness Wisconsin, you are knowledgable and write so well. Your posts are a big help to me and others. You must be in some type of medical field?

Your advise to Missalisa is very good, and Alisa, please do not think we do not care or are taking what you say lightly, we sure aren't we just want to help in any way we are able.
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267401 tn?1251852496
Nope, not a doctor.  Just a guy who's read more than he probably should on the topic.  Missalisa might consider me gifted.  ;)

And to echo Sassylassie, it's not that we don't care - I wouldn't spend the time to write all that I have if that were the case.  But I think you might be well served investigating the options I and others have presented.  Obviously this is preoccupying your every thought and hurting your quality of life.  It doesn't need to, and the sooner you're able to backburner this almost-always benign condition, the better off you and your family will be.
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520292 tn?1232035850
I am not suprised at all.  Where I am from a doctor will NOT see if you do not have insurance.  A specialist will not see you until they have called your insurance company and verified your policy is active.  They will also pre-authorize certain treatments so if the insurance company denies it, they will not offer you the treatment.  The only place that can not refuse you is the E.R.  You may have to go there and rack up thousands of dollars in bills to be seen.  If a doctor or practice knows that you dont have insurance, they will not run the tests on you.  To many times in the past they have, and never recieved payment for the services.  Trust me I am a nurse and I know how messed up the healthcare system is.  It is a **** shame.
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612551 tn?1450022175
Sorry to read of the difficulty with insurance.  I'm an old guy and grew up with the "system" we have.  My wife and I did not have insurance when our first (daughter) was born in Seattle, way back in 1961.

We had to "jump through hoops" and make a down payment at the hospital before the Catholic (seems related to a charity type organization) would give my wife an appointment for handling delivery.  Her doctor was much better, he seemed to be sympathetic, and we paid him and the hospital in full.  

When I graduated from college I got a job that included health insurance, so we've not faced that again...it is sad that this is the case, and this is the reason it has gotten so much attention in the political arena... just talk so far.

I think, however, we have better doctors and hospitals than Cuba and better than most/all other places in the world.

Cleveland Clinic is the "gold" standard in heart treatment, but I don't make the trip, I had heart surgery in a small local hospital, Doylestown, PA.
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