San Diego

It's been awhile since I've posted! I'm looking for help for my San Diego area father-in-law. He needs a good EP. He was recently dx with " persistent" afib. His cardiologist prescribed Amiodarone and Eliquis. He has a cardio version scheduled in June. He feels much worse than he did when first diagnosed. He's pretty much bedridden. Having had a successful ablation with Dr Natale myself I so want him to see Dr Natale. He's the best! Unfortunately my father-in-law has Kaiser insurance. I don't think it's possible? Any suggestions or EP recommendations in the San Diego area for Kaiser insured is gratefully appreciated!

I heard Kaiser in San Diego uses EPs who perform ablations at Scripts..The patients are able to get an outside referral. Maybe call Kaiser membership department and ask about it. My mom in LA had kaiser and was able to get an outside doctor for oncology in Beverly Hills for chemo and Kaiser footed the bill.

I’m suggesting this because Dr Natale works two days a month in San Diego Scripts.

For what it's worth when I had Kaiser I interviewed two electrophysiologists in San Diego. The one I was most impressed with is Dr Brant Liu. I was able to switch my insurance and go to Dr Natale at scripps. Had I not been able to change my insurance I would have chosen Dr Liu for my ablation through kaiser.

It will take homework and persistence but here is Kaiser site for outside referrals:
[healthy.kaiserpermanente.org]

Thank you so much for your information! It's very helpful. We now realize Scripps coordinates for Kaiser patient care...specifically cardiology. Since posting my father-in-law has been admitted to the Kaiser hospital for internal bleeding. We're wondering if he is experiencing poor side effects from his current medication regiment, We're very concerned the initial strategy was to put him on Amaridrone? My wife is arranging for a flight to San Diego as I type. So your information has proven to be timely for us!

So sorry about his GI bleeding. It happened to me as well. Is he still on Eliquis or are they bridging him with a shorter half life blood thinner to control his bleeding since he is admitted? Others more informed on this site than me will probably post better suggestions.

Happy to help with the link. My family and I were with Kaiser since 1952 (I had a very short Kaiser ID number) so I know the importance of contacting membership services and being persistent as your own advocate. It pays off.



Edited 1 time(s). Last edit at 05/03/2023 02:46PM by susan.d.

WTF? ECV scheduled in June? This is something someone should get as soon as they want it. I'm pissed if I can't get it done in 24-48 hours.

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PavanPharter
WTF? ECV scheduled in June? This is something someone should get as soon as they want it. I'm pissed if I can't get it done in 24-48 hours.

That’s Kaiser for you. He maybe more successful if he calls membership services and demand an earlier date. our family had kaiser from 1952 to 2019 so we knew their system and the need of being persistent for your rights.

Plot thickens! Apparently he is experiencing a gallbladder duct obstruction. That's probably what he was suffering from with his initial hospital admission a couple weeks ago. That's when persistent afib was dx. It became a cardiology issue so the obstruction was not discovered. He has a procedure scheduled this morning to clear the obstruction. He has yet to be seen by or speak with a cardiologist. They don't even have him on a heart monitor of any kind! The surgeon suspects the GI bleeding is a result of the Eliquis. He says that would be something the cardiologist needs to address. He ordered that the Eliquis be stopped in preparation of the morning procedure. I don't know if a bridge drug is onboard. The surgeon did say that due to the difficulties my father-in-law is having with his medications he would be a candidate for an ablation. At this point it's difficult to determine what has caused his symptoms. The obstruction is likely a significant culprit. I wonder if the physical..and mental...stress he has been under has actually triggered afib?? My wife arrived late this evening. She will attempt to get better information and a consultation with a cardiologist prior to the obstruction procedure.

No kidding!! His cardiologist wants him on an anticoagulant for four weeks before performing the procedure. I don't know if that's typical or not. I've never heard of that. He's had a couple of heart attacks through the years. Maybe that's a factor? I couldn't believe they were making him wait.

Dr Natale had the pacemaker surgeon keep me on Eliquis during my pacemaker surgery and I had a huge hematoma the size of a largest orange. The surgeon wanted me to stop Eliquis, dr Natale said no. That’s why you need an EP cardiologist on board. Call membership services.

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Craigh
No kidding!! His cardiologist wants him on an anticoagulant for four weeks before performing the procedure. I don't know if that's typical or not. I've never heard of that. He's had a couple of heart attacks through the years. Maybe that's a factor? I couldn't believe they were making him wait.

This is standard of care, either be anticoagulated for 3-4 weeks prior to ECV OR a TEE immediately preceding the ECV. As it is Kaiser, the anticoagulation is a lot cheaper than a TEE. This to make sure no clots in the LAA when they do the ECV. The Eliquis won't dissolve any clots, your body does that, it reduces the risk that new clots form.

“ He ordered that the Eliquis be stopped in preparation of the morning procedure. ”

How is this standard care if they are stopping Eliquis before a scheduled ecv?

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susan.d
“ He ordered that the Eliquis be stopped in preparation of the morning procedure. ”

How is this standard care if they are stopping Eliquis before a scheduled ecv?

Stopping acutely is different than having it prescribed for 3 or 4 weeks.