How do I find good cardio who will investigate? (new member)

Hi. I am new to this site. My first post was about Vitamin D in the General Forum.

I am a 65-year-old female in BC, Canada. I have been dealing with diagnosed occasional Afib and A-flutter and other periodic arrhythmias I can't fully identify for 5 years. I have a cardiologist. But his only solution involves a prescription pad. He is not interested in investigating or even answering relevant questions to assist me with my own investigation. I am interested in non-pharmaceutical and non-surgical approaches, and I believe I will be able to find a way with diet, supplements, identification of triggers, etc to reduce or eliminate this issue from my life without drugs or ablation. But I am also willing to do PIP in meantime if I can find the right PIP, for which I need a cardiologist who will investigate and converse with me.

I would like to know HOW I can find a better cardiologist, ideally in Vancouver or Victoria BC. I am looking for a cardiologist who will try to identify the reason behind this afib so that I can approach it better. For example, is it vagally mediated or adrenergic or both? That's an important question that affects both the drugs that are prescribed (which I am not at present taking) and my own strategies for how to stop episodes or prevent them.

I would also like to be tested for various things - full thyroid panel, full range of inflammatory markers, cellular magnesium, Calcium, blood glucose. Other things?

I would also like to wear a 30-day monitor because I have a range of events. I am in Day #3 of an arrhythmia right now but I don't think this one is afib. I do have somewhat of a rhythm going right now--peaks and valleys visible on the traveling waveform across the pulse oximeter display. But they are irregular, sometimes have long gaps. I think maybe it's an extended run of PVCs or PACs. But I don't know. And getting tied up in ER for the day for every little arrythmia is exhausting and not productive.

The only cardiologist I have will not answer any of my questions or run any further tests. He just says "I'm not going to argue with you" when I try to ask him about these things, thereby shutting down all patient conversation by branding it as "argument". He feels there is nothing to investigate, that afib once identified - is just something to be managed with daily drugs for rest of life. I disagree and need to find a cardiologist or EP who will work with me, even if I am the only one actually investigating. I need a doctor who will at least order these tests and 30-day monitor and then discuss results and possibilities with me.

By way of background... my arrhythmia started 5 years ago when I was profoundly anemic for a long time from chronic lymphocytic leukemia. The CLL was treated and the anemia eliminated. But the drug used to treated it (ibrutinib) causes afib in about 38% of patients. So my arrythmias continued while I was on the ibrutinib. I have now been switched onto a different CLL drug because of the afib problem. And the new drug has no association with afib. However my arrythmias have worsened in the 5 months I have been on this new drug. A January ER trip idenitfied Atrial Flutter. After switching CLL drugs in February, I went back to ER with another episode, and it was identified as Afib.

My arrhythmia episodes are now coming at 2-week intervals and they last 4 days before converting to NSR. I use metoprolol and aspirin as PIP (which does not seem to work - it doesn't convert me but does lower heart rate somewhat). And I take no pharmaceuticals the rest of the time.

My echocardiogram shows no structural damage to heart apart from very slight dilation of the 2 atria, no valve problems, decent ejection fraction. I have no CV comorbidities. I score 2 on CHA₂DS₂-VASc by being female and 65.

One final thing: I have the option of requesting a consult with a cardiac oncologist at BC Cancer Agency in Vancouver because my Afib is related to both my cancer and one of the drugs they used to treat my cancer, so it falls under BCCA's purview to address it. That will be my next step. I have only delayed this long because of covid risk for me to travel to Vancouver riding public buses for hours. (I am in Nanaimo.) I would still appreciate advice on how to get a good cardio or EP who will work with me long-term.

Thank you!
kim



Edited 1 time(s). Last edit at 07/11/2020 05:07PM by PoetKim.

Quote
PoetKim
I would like to know HOW I can find a better cardiologist, ideally in Vancouver or Victoria BC. I am looking for a cardiologist who will try to identify the reason behind this afib so that I can approach it better. For example, is it vagally mediated or adrenergic or both? That's an important question that affects both the drugs that are prescribed (which I am not at present taking) and my own strategies for how to stop episodes or prevent them.

I would also like to be tested for various things - full thyroid panel, full range of inflammatory markers, cellular magnesium, Calcium, blood glucose. Other things?

The only cardiologist I have will not answer any of my questions or run any further tests. He just says "I'm not going to argue with you" when I try to ask him about these things, thereby shutting down all patient conversation by branding it as "argument". He feels there is nothing to investigate, that afib once identified - is just something to be managed with daily drugs for rest of life. I disagree and need to find a cardiologist or EP who will work with me, even if I am the only one actually investigating. I need a doctor who will at least order these tests and 30-day monitor and then discuss results and possibilities with me.

My arrhythmia episodes are now coming at 2-week intervals and they last 4 days before converting to NSR. I use metoprolol and aspirin as PIP (which does not seem to work - it doesn't convert me but does lower heart rate somewhat).

I have only delayed this long because of covid risk for me to travel to Vancouver riding public buses for hours. (I am in Naniamo.) I would still appreciate advice on how to get a good cardio or EP who will work with me long-term.

kim

Hi Kim,

One, if you PM me your email address & phone, I can put you in contact with Hans Larsen, who founded this board, but is no longer active. He's in his mid 80's and lives in Victoria. I visited with him and his wife in their home a little over a year ago. He still has afib and has had it for ~30 years, so I'm guessing he knows the doc situation in your area as well as anyone. Thinking about it, email may be best as he's a bit hard of hearing. Hans is on flec and he's extremely well versed in non drug afib protocols.

The metoprolol is unlikely to convert. It is mostly prescribed to control rate.

George

PS to PM me, click the PM next to my name at the top of this post.

Thanks George. I sent you a message.

I got a PM asking about Hans' afib health. For all of you that know him, here is my reply:

Hans controls his afib with flec, so not in afib (I'm not sure if/when he goes out of rhythm), but the ablation isn't holding perfectly without meds. He's also got prostate cancer, which he describes in detail here [www.yourhealthbase.com] . The treatment they wanted to give him (he discovered) would interact with flec and could kill him. He opted for physical castration instead, and was quite pleased with that choice when we visited in April 2019. He seems well. We had a trip planned to Victoria this year, but COVID prevailed.