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First EP appointment

Posted by katesshadow 
First EP appointment
February 11, 2019 01:22PM
Have my first EP appt. next week. What questions should I definitely ask?
Re: First EP appointment
February 11, 2019 08:12PM
Below are some questions you can ask. They are mainly used to select an EP, but you may find some useful.
Questions to ask an EP.



Edited 1 time(s). Last edit at 02/11/2019 08:16PM by JakeL.
Re: First EP appointment
February 11, 2019 09:38PM
Jake's answer is a good start. Since it's your first appointment I would keep it simple. Let him ask the questions first. Find out what he thinks of your situation and how he proposes to treat it. If he recommends drugs, why does he recommend the specific drugs he chooses? What side effects might you expect? What are the risks? If he recommends ablation, then his training and experience with ablation become of paramount importance. Most of the questions you need to ask about that are covered by Jake's answer, but I would suggest coming back here, tell us what he said, and let us help you further. You should be in no rush to do an ablation.
Joe
Re: First EP appointment
February 11, 2019 10:27PM
Perhaps you could ask him about insulin resistance and it's role in AF?
Go to 5:30
[www.youtube.com]
I've wondering about this for a while but i can't convince my GP to do the test because my fasting blood glucose is about 4.5 which of course means very little.
Re: First EP appointment
February 12, 2019 12:33AM
Youtube theories might not be the best questions on a first appointment with a new doctor.
Joe
Re: First EP appointment
February 12, 2019 02:27AM
Forget about youtube, the MD saying it has enviable credentials. In any case, basic chronic problems ought to be sorted prior to treating other symptoms?
Re: First EP appointment
February 12, 2019 09:09AM
Quote
Joe
Perhaps you could ask him about insulin resistance and it's role in AF?
Go to 5:30
[www.youtube.com]
I've wondering about this for a while but i can't convince my GP to do the test because my fasting blood glucose is about 4.5 which of course means very little.

Clearly insulin resistance can be a driver of T2 diabetes and hypertension, both risk factors in CHA2DS2-VASc. My own opinion is that being as metabolically healthy as possible is a good thing. Whether it will fix afib per se is another issue.

I happen to know the interviewer, Ivor Cummins, I've read Dr. Kraft's book and his first paper on the topic and my friend, Catherine Crofts of NZ used Dr. Kraft's data for her PhD dissertation. In the US, it is possible to order a Kraft test (a glucose tolerance test with insulin assay) through intermediaries for Labcorp <[www.walkinlab.com] Dr. Crofts, in her research, notes that a simpler approach that gives nearly the same answer is to fast overnight take the 75 g glucose (or your largest carbiest meal of the day), then test insulin exactly two hours later If the result is <30, you are good, >50 bad, between 30 and 50 and you should do the 5 hour test. Here is her thesis <[aut.researchgateway.ac.nz]. In essence stress testing your pancreas.
Joe
Re: First EP appointment
February 12, 2019 08:31PM
Thanks for the link, George!
No idea if insulin resistance has any effect on AF either. Just wondering what the MD is thinking? Often seemingly unrelated factors facilitate a specific health problem? Hope he is wrong in this instance.
I think my insulin response/resistance is a little high going by my own test. GP says nothing to worry about because my fasting level is about 4.5 mmol/L
Your friend mentions that it should be < 30uU/ml.
Re: First EP appointment
February 12, 2019 09:51PM
Quote
Joe
Forget about youtube, the MD saying it has enviable credentials. In any case, basic chronic problems ought to be sorted prior to treating other symptoms?

I wasn't questioning her credentials or even what she's saying. I just don't think a first visit with a new doctor is the time to bring up stuff you read on Dr. Google. It's not a good first impression and it sets the wrong tone.

Let's not hijack her question, okay? What should she (or anyone) ask their EP on their first visit? That's the question.
Re: First EP appointment
February 14, 2019 05:42PM
Thanks for the input.

Is the EKG that was performed when I went to the ER in Nov. recorded in my files? As far as I know it's the only one that shows I was in AFib.
Re: First EP appointment
February 14, 2019 06:04PM
Quote
katesshadow
Is the EKG that was performed when I went to the ER in Nov. recorded in my files? As far as I know it's the only one that shows I was in AFib.

Yes, absolutely. All doctors keep records of all tests they do, plus exam notes, prescriptions, basically everything they do and say when they see you.
Re: First EP appointment
February 15, 2019 10:11AM
God solid info from Jake and Carey. What I feel is of utmost importance is that your EP and you connect. You should feel that he has your best interest in mind and should present in a way that you feel comfortable. When I started this journey many years ago I went throu several cardiologists before I found one I could work with. Finding my first EP was allot easier as I had a solid relationship with my cardio and he directed me to my EP.
Another big advantage you have in your arsenal is this site and the people here.
Re: First EP appointment
February 15, 2019 10:51AM
Quote
rocketritch
God solid info from Jake and Carey. What I feel is of utmost importance is that your EP and you connect. You should feel that he has your best interest in mind and should present in a way that you feel comfortable. When I started this journey many years ago I went throu several cardiologists before I found one I could work with. Finding my first EP was allot easier as I had a solid relationship with my cardio and he directed me to my EP.
Another big advantage you have in your arsenal is this site and the people here.

Yes. I have learned pretty much everything from this forum. Thank you.
Re: First EP appointment
February 15, 2019 10:53AM
Quote
Carey

Is the EKG that was performed when I went to the ER in Nov. recorded in my files? As far as I know it's the only one that shows I was in AFib.

Yes, absolutely. All doctors keep records of all tests they do, plus exam notes, prescriptions, basically everything they do and say when they see you.
I wasn't sure that EKG would be on file. I would like for him to look at it since it is the only record of an A-fib episode (actually the only one that I know I've had) that they have of me. I've never seen him before but hopefully he can give me more personalized attention than I have received yet.



Edited 1 time(s). Last edit at 02/15/2019 10:55AM by katesshadow.
Re: First EP appointment
February 15, 2019 02:24PM
Quote
katesshadow
I wasn't sure that EKG would be on file. I would like for him to look at it since it is the only record of an A-fib episode (actually the only one that I know I've had) that they have of me. I've never seen him before but hopefully he can give me more personalized attention than I have received yet.

Call the doctor who did the EKG and ask them to send the EKG to the EP you're going to see. They'll probably require you to stop by and sign a release, so you could also just get a copy yourself and that time and bring it with you.
Re: First EP appointment
February 15, 2019 02:38PM
Quote
Carey

I wasn't sure that EKG would be on file. I would like for him to look at it since it is the only record of an A-fib episode (actually the only one that I know I've had) that they have of me. I've never seen him before but hopefully he can give me more personalized attention than I have received yet.

Call the doctor who did the EKG and ask them to send the EKG to the EP you're going to see. They'll probably require you to stop by and sign a release, so you could also just get a copy yourself and that time and bring it with you.

The EKG was done in the ER at the hospital where the office I'm going to is located. The doctor on call at the ER is in the same group so the file is probably the same I would think.
Re: First EP appointment
February 15, 2019 02:43PM
Quote
Carey

I wasn't sure that EKG would be on file. I would like for him to look at it since it is the only record of an A-fib episode (actually the only one that I know I've had) that they have of me. I've never seen him before but hopefully he can give me more personalized attention than I have received yet.

Call the doctor who did the EKG and ask them to send the EKG to the EP you're going to see. They'll probably require you to stop by and sign a release, so you could also just get a copy yourself and that time and bring it with you.

If your EP works out of the same hospital that you went to ER gettiing him the ekg should take little more than a phone call. He should be able to pull your file from that visit and get all your info.
Re: First EP appointment
February 15, 2019 08:57PM
Oh yeah, that makes it easy for sure. Now just hope that a busy ER didn't lose your EKG. That's been known to happen.
Re: First EP appointment
February 16, 2019 09:19AM
Quote
rocketritch


I wasn't sure that EKG would be on file. I would like for him to look at it since it is the only record of an A-fib episode (actually the only one that I know I've had) that they have of me. I've never seen him before but hopefully he can give me more personalized attention than I have received yet.

Call the doctor who did the EKG and ask them to send the EKG to the EP you're going to see. They'll probably require you to stop by and sign a release, so you could also just get a copy yourself and that time and bring it with you.

If your EP works out of the same hospital that you went to ER gettiing him the ekg should take little more than a phone call. He should be able to pull your file from that visit and get all your info.

Thank you!
Re: First EP appointment
February 16, 2019 09:20AM
Quote
Carey
Oh yeah, that makes it easy for sure. Now just hope that a busy ER didn't lose your EKG. That's been known to happen.

Oh goodness, I hope not!

That's the only record available of an Afib episode winking smiley
Re: First EP appointment
February 27, 2019 10:15AM
Well, I had my appointment.

He asked me about my Afib attack that brought me to the ER on 11/28.

He then went over the tests that were performed and told me I had a "fantastic" heart.

He told me that I should stop taking Eliquis. He based this on the fact that I had only the 1 attack, the tests that performed and the CHADS score (1 for HBP).

We talked about triggers, went over things I should be doing (exercise, keep an eye on my BP,etc.), but there was no way to predict when there would be a next episode. Said if I had one, take an Eliquis, and that most people self-convert. If I did not convert within 12 hours, I could come to the ER (or come if I felt uneasy at home).

He tried to reassure me that, other than the Afib, my heart was in good shape. He told me to live my life, and come back in a year.
Re: First EP appointment
February 27, 2019 05:36PM
Quote
katesshadow
He told me to live my life, and come back in a year.

Best news ever!
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