Do I "really" need an annual stress test? (I lift weights and ride

Hi all,

For the last 3 years, I have been getting my annual medical checkup from a internist who is also a
cardiologist. Besides doing the normal lab tests and BP, he insists that I take the echo and the
stress test. He and his staff give these very expensive and I assume profitable tests.

I'm a 55 yo, male non-smoker with no known heart problems and no family history (my Pop is over 90
yo). I have been going to gym last 2+ years, lifting medium weights 3x a week. I commute to work
by bicycle about 20 miles daily and rode over 6000 miles last year. My resting pulse is about 50
and my last 2 stress tests were normal. My BP has been consistantly "boringly" normal (quote from
my doctor).

Although these tests are covered by med insurance, I prefer taking these tests once every 2 or 3
years. This year the new stress test includes ingesting "short 1/2 life" radioactive isotope. Since
I normally stay away from medicine, I feel uneasy about ingesting these foreign materials. I also
don't want to take the tests if they are truly unnecessary since they help increase the cost of
health insurance.

I would appreciate some good common sense opinions.

Thanks

 

What does your doc give as a reason for this test being necessary?

Charlie

<[email protected]> wrote in message news:[email protected]...
> Hi all,
>
> For the last 3 years, I have been getting my annual medical checkup from a internist who is also a
> cardiologist. Besides doing the normal lab tests and BP, he insists that I take the echo and the
> stress test. He and his staff give these very expensive and I assume profitable tests.
>
> I'm a 55 yo, male non-smoker with no known heart problems and no family history (my Pop is over 90
> yo). I have been going to gym last 2+ years, lifting medium weights 3x a week. I commute to work
> by bicycle about 20 miles daily and rode over 6000 miles last year. My resting pulse is about 50
> and my last 2 stress tests were normal. My BP has been consistantly "boringly" normal (quote from
> my doctor).
>
> Although these tests are covered by med insurance, I prefer taking these tests once every 2 or 3
> years. This year the new stress test includes ingesting "short 1/2 life" radioactive isotope.
> Since I normally stay away from medicine, I feel uneasy about ingesting these foreign materials. I
> also don't want to take the tests if they are truly unnecessary since they help increase the cost
> of health insurance.
>
> I would appreciate some good common sense opinions.
>
> Thanks

 

>I would appreciate some good common sense opinions.
>

Wow, what a great insurance company - to pay for these tests annually.

I believe there are standard protocols for the frequency and age advisability of tests like these.
My wife (RN) recently applied for a position in Colorado further developing protocols such as these.

I think a Google search might ferret out some of these protocols.

I know, that I, at 63, have not been asked to take these tests. Last stress test was a long time
ago. I also lift weights (fairly intensely) ride about 3,000 miles per year, and walk daily
about 2 miles.

http://members.aol.com/foxcondorsrvtns (Colorado rental condo)

http://members.aol.com/dnvrfox (Family Web Page)

 

If I were you I would ask your cardiologist why he does these test annually. Do you know if you have
any arrhythmia or irregular heart beat? I do not believe that the radio-isotope test is used to
detect coronary heart disease. It my be more useful in discerning the flow and turbulence in the
chambers. Turbulence can result in blood clots that may have serious consequences. A developing
prolapsed valve or other mechanical feature may be present creating a sub-optimum flow.. Many
arrhythmias are common and are not life threatening pre beats are very common but may be indicative
of future issues.

Ask him about this.

<[email protected]> wrote in message news:[email protected]...
> Hi all,
>
> For the last 3 years, I have been getting my annual medical checkup from a internist who is also a
> cardiologist. Besides doing the normal lab tests and BP, he insists that I take the echo and the
> stress test. He and his staff give these very expensive and I assume profitable tests.
>
> I'm a 55 yo, male non-smoker with no known heart problems and no family history (my Pop is over 90
> yo). I have been going to gym last 2+ years, lifting medium weights 3x a week. I commute to work
> by bicycle about 20 miles daily and rode over 6000 miles last year. My resting pulse is about 50
> and my last 2 stress tests were normal. My BP has been consistantly "boringly" normal (quote from
> my doctor).
>
> Although these tests are covered by med insurance, I prefer taking these tests once every 2 or 3
> years. This year the new stress test includes ingesting "short 1/2 life" radioactive isotope.
> Since I normally stay away from medicine, I feel uneasy about ingesting these foreign materials. I
> also don't want to take the tests if they are truly unnecessary since they help increase the cost
> of health insurance.
>
> I would appreciate some good common sense opinions.
>
> Thanks

 

<[email protected]> wrote in message news:[email protected]...
> I also don't want to take the tests if they are truly unnecessary since they help increase the
> cost of health insurance.
>
Dear galaxy gazer -

Have similar exercise pattern to you but have a history of elevated LDL and a dad with 4
heart attacks

I consider I do at least one stress test a week (Tuesday is hills day!) but I only do a supervised
one every three years with the ecg and all.

My quack (I think he calls himself a cardiologist but he really has got to do something about that
battered Trek he rides) does this ultrasound thing which displays the heart on screen and will show
significant deposits of the bad stuff (he says) - seriously weird watching your heart pumping away
on TV but he says a great non invasive diagnostic tool.

Otherwise I do a comprehensive blood scan every 6 months which does not cost much and can pick up
many things.

Quite enjoy the intellectual discourse with doctors willing to argue their position so I suggest you
have the debate with a few experienced medical sources - I think we need to be questioning consumers
of this sort of stuff - the maxim 'by good argument shall the truth become known' comes to mind.

But bear in mind newsgroups are not much of a substitute for reliable medical advice ... best Andrew

 

<[email protected]> wrote in message news:[email protected]...
> Hi all,
>
> For the last 3 years, I have been getting my annual medical checkup from a internist who is also a
> cardiologist. Besides doing the normal lab tests and BP, he insists that I take the echo and the
> stress test. He and his staff give these very expensive and I assume profitable tests.

I think you've identified the real reason for the tests there in your last sentence.

I have coronary artery disease. I've had 4 MI's, I've been through the cardiac catheter lab 10
times, I've had 5 stent implantation and a number of angioplasties.

I've never had an abnormal stress test.

If your doctor has a medical rationale for giving you these unusually frequent tests, he should be
forthcoming about what those reasons are. If he can't satisfy you that his reasons are sufficient,
but won't reduce their frequency, it's time to change doctors.

Annual stress tests in a healthy, fit non-smoker with no risk factors are IMO excessive and
unnecessary. And quite profitable for the medical practice, yes indeedy.

RichC

 

On Sat, 26 Apr 2003 15:10:58 -0700, "waxxer" <[email protected]> wrote:

>If I were you I would ask your cardiologist why he does these test annually. Do you know if you
>have any arrhythmia or irregular heart beat? I do not believe that the radio-isotope test is used
>to detect coronary heart disease. It my be more useful in discerning the flow and turbulence in the
>chambers. Turbulence can result in blood clots that may have serious consequences. A developing
>prolapsed valve or other mechanical feature may be present creating a sub-optimum flow.. Many
>arrhythmias are common and are not life threatening pre beats are very common but may be indicative
>of future issues.
>
>Ask him about this.
>
><[email protected]> wrote in message news:[email protected]...
>> Hi all,
>>
>> For the last 3 years, I have been getting my annual medical checkup from a internist who is also
>> a cardiologist. Besides doing the normal lab tests and BP, he insists that I take the echo and
>> the stress test. He and his staff give these very expensive and I assume profitable tests.
>>
>> I'm a 55 yo, male non-smoker with no known heart problems and no family history (my Pop is over
>> 90 yo). I have been going to gym last 2+ years, lifting medium weights 3x a week. I commute to
>> work by bicycle about 20 miles daily and rode over 6000 miles last year. My resting pulse is
>> about 50 and my last 2 stress tests were normal. My BP has been consistantly "boringly" normal
>> (quote from my doctor).
>>
>> Although these tests are covered by med insurance, I prefer taking these tests once every 2 or 3
>> years. This year the new stress test includes ingesting "short 1/2 life" radioactive isotope.
>> Since I normally stay away from medicine, I feel uneasy about ingesting these foreign materials.
>> I also don't want to take the tests if they are truly unnecessary since they help increase the
>> cost of health insurance.
>>
>> I would appreciate some good common sense opinions.
>>
>> Thanks
>>

fwiw - my brother, though he has a variety of other health issues, had never been diagnosed with any
particular heart ailment. Diabetes, obesity, panic attacks yes - but a heart like a draft horse.

During his last panic attack he went in to the emergency room and a doctor there thought to do some
sort of additional, unusual testing. They discovered that in addition to the two normally present
nerve bundles which govern contractions of the heart, he had a third which occasionally piped up and
threw the whole mess into confusion. Hence the panic attacks - racing heartbeats.

This is apparently not an unusual condition, but it is uncommon. There is a surgical treatment, but
by limiting caffeine he has eliminated his symptoms and is currently safe, according to his doctor.
Ironically, it's a congenital thing, and had nothing to do with his other health issues.

This doesn't have much to do with your particular situation - but it does illustrate that
sometimes conscientiousness on the part of a doctor can uncover real issues that can then be
addressed. Sure, maybe this is a spurious test. On the other hand, perhaps you should consider
yourself lucky that you've got an additional opportunity to be evaluated in such a way. The body
is a complicated device.

BLink Brian Link in St. Paul, Minnesota

 

Hi,

For those who have asked what is he reasoning.

He says that since I am over 50 and doing extensive regular excercising (weightlifting, cycling), he
feels it is a way of catching future irregularities or problems that do not yet exist.

I guess using that reasoning, I should get a stress test quarterly if not monthly.

Again, I want to remind you that the last 2 annual stress tests were normal and he has not indicated
to me that I have anything abnormal.

He also gives me an echo test as well.

Does anyone have any strong opinions about stress test that require you to ingest radioactive
isotopes? This makes me a bit nervous. I don't know what effect it will have on my body in
the future.

Thanks again for your input.

Maurice

Charlie wrote:

>What does your doc give as a reason for this test being necessary?
>
>Charlie
>
><[email protected]> wrote in message news:[email protected]...
>
>
>> Hi all,
>>
>>For the last 3 years, I have been getting my annual medical checkup from a internist who is also a
>>cardiologist. Besides doing the normal lab tests and BP, he insists that I take the echo and the
>>stress test. He and his staff give these very expensive and I assume profitable tests.
>>
>>I'm a 55 yo, male non-smoker with no known heart problems and no family history (my Pop is over 90
>>yo). I have been going to gym last 2+ years, lifting medium weights 3x a week. I commute to work
>>by bicycle about 20 miles daily and rode over 6000 miles last year. My resting pulse is about 50
>>and my last 2 stress tests were normal. My BP has been consistantly "boringly" normal (quote from
>>my doctor).
>>
>>Although these tests are covered by med insurance, I prefer taking these tests once every 2 or 3
>>years. This year the new stress test includes ingesting "short 1/2 life" radioactive isotope.
>>Since I normally stay away from medicine, I feel uneasy about ingesting these foreign materials. I
>>also don't want to take the tests if they are truly unnecessary since they help increase the cost
>>of health insurance.
>>
>>I would appreciate some good common sense opinions.
>>
>>Thanks
>>
>>
>>
>
>

 

Regarding the radiosotopes; if the test is warranted, then the risk from the radioisotopes is
warranted. The risks are really quite small.

Noel

"Stargazer" <[email protected]_email_address.com> wrote in message
news:[email protected]_email_address.com...
> Hi,
>
> For those who have asked what is he reasoning.
>
> He says that since I am over 50 and doing extensive regular excercising (weightlifting, cycling),
> he feels it is a way of catching future irregularities or problems that do not yet exist.
>
> I guess using that reasoning, I should get a stress test quarterly if not monthly.
>
> Again, I want to remind you that the last 2 annual stress tests were normal and he has not
> indicated to me that I have anything abnormal.
>
> He also gives me an echo test as well.
>
> Does anyone have any strong opinions about stress test that require you to ingest radioactive
> isotopes? This makes me a bit nervous. I don't know what effect it will have on my body in
> the future.
>
> Thanks again for your input.
>
> Maurice
>
>
> Charlie wrote:
>
> >What does your doc give as a reason for this test being necessary?
> >
> >Charlie
> >
> ><[email protected]> wrote in message news:[email protected]...
> >
> >
> >> Hi all,
> >>
> >>For the last 3 years, I have been getting my annual medical checkup from a internist who is also
> >>a cardiologist. Besides doing the normal lab tests and BP, he insists that I take the echo and
> >>the stress test. He and his staff give these very expensive and I assume profitable
tests.
> >>
> >>I'm a 55 yo, male non-smoker with no known heart problems and no family history (my Pop is over
> >>90 yo). I have been going to gym last 2+ years, lifting medium weights 3x a
week.
> >>I commute to work by bicycle about 20 miles daily and rode over 6000 miles last year. My resting
> >>pulse is about 50 and my last 2 stress tests were normal. My BP has been consistantly "boringly"
> >>normal (quote from my doctor).
> >>
> >>Although these tests are covered by med insurance, I prefer taking these tests once every 2 or 3
> >>years. This year the new stress test includes ingesting "short 1/2 life" radioactive isotope.
> >>Since I normally stay away from medicine, I feel uneasy about ingesting these foreign materials.
> >>I also don't want to take the tests if they are truly unnecessary since they help increase the
> >>cost of health insurance.
> >>
> >>I would appreciate some good common sense opinions.
> >>
> >>Thanks
> >>
> >>
> >>
> >
> >
> >

 

In article <[email protected]_email_address.com>, [email protected]_email_address.com says...
> Hi, The reason he iis giving is that since I am over 50 and doing extensive regular excercising
> (weightlifting, cycling), he feels it is a way of catching future irregularities or problems that
> do not currently exist. I guess using that reason, I should get a stress test quarterly if not
> monthly.
>
> Does anyone have any strong opinions about ingesting radioactive isotopes?

Yes. I would call it borderline malpractice if they don't have a specific condition they are testing
for, and doing it annually is absurd.

--
Dave Kerber Fight spam: remove the ns_ from the return address before replying!

REAL programmers write self-modifying code.

 

In article <[email protected]_email_address.com>, [email protected]_email_address.com says...

...

> Does anyone have any strong opinions about stress test that require you to ingest radioactive
> isotopes? This makes me a bit nervous. I don't know what effect it will have on my body in
> the future.

I worked for several years in the nuclear power field, two of them as a radiological controls
officer. The cumulative effect of small doses of radiation (those which don't produce any symptoms
at the time) is largely unknown because the effects are known to be small, but the damage is
normally assumed to be cumulative throughout your life. This will include any x-rays you might have,
the radon in your basement, radio-isotope medical tests, flying in commercial jetliners (at high
altitude) and living at high altitudes.

If I were you and the doctor didn't have a specific convincing reason for the test, I would refuse
to take it. Stick with the echocardiogram if you want to err on the safe side; ultrasound has no
known damaging effects on the body.

--
Dave Kerber Fight spam: remove the ns_ from the return address before replying!

REAL programmers write self-modifying code.

 

Based on what you've said, an annual stress test and echo seem excessive.

It's tempting - as you previously suggested - to believe that the doc is just doing these tests for
the money, but I think that you owe it to both yourself and your doc to voice those concerns
explicitly. See if he/she comes up with an alternative explanation that satisfies you. If not, you
might consider talking with another cardiologist.

Charlie

"Stargazer" <[email protected]_email_address.com> wrote in message
news:[email protected]_email_address.com...
> Hi,
>
> For those who have asked what is he reasoning.
>
> He says that since I am over 50 and doing extensive regular excercising (weightlifting, cycling),
> he feels it is a way of catching future irregularities or problems that do not yet exist.
>
> I guess using that reasoning, I should get a stress test quarterly if not monthly.
>
> Again, I want to remind you that the last 2 annual stress tests were normal and he has not
> indicated to me that I have anything abnormal.
>
> He also gives me an echo test as well.
>
> Does anyone have any strong opinions about stress test that require you to ingest radioactive
> isotopes? This makes me a bit nervous. I don't know what effect it will have on my body in
> the future.
>
> Thanks again for your input.
>
> Maurice
>
>
> Charlie wrote:
>
> >What does your doc give as a reason for this test being necessary?
> >
> >Charlie
> >
> ><[email protected]> wrote in message news:[email protected]...
> >
> >
> >> Hi all,
> >>
> >>For the last 3 years, I have been getting my annual medical checkup from a internist who is also
> >>a cardiologist. Besides doing the normal lab tests and BP, he insists that I take the echo and
> >>the stress test. He and his staff give these very expensive and I assume profitable
tests.
> >>
> >>I'm a 55 yo, male non-smoker with no known heart problems and no family history (my Pop is over
> >>90 yo). I have been going to gym last 2+ years, lifting medium weights 3x a
week.
> >>I commute to work by bicycle about 20 miles daily and rode over 6000 miles last year. My resting
> >>pulse is about 50 and my last 2 stress tests were normal. My BP has been consistantly "boringly"
> >>normal (quote from my doctor).
> >>
> >>Although these tests are covered by med insurance, I prefer taking these tests once every 2 or 3
> >>years. This year the new stress test includes ingesting "short 1/2 life" radioactive isotope.
> >>Since I normally stay away from medicine, I feel uneasy about ingesting these foreign materials.
> >>I also don't want to take the tests if they are truly unnecessary since they help increase the
> >>cost of health insurance.
> >>
> >>I would appreciate some good common sense opinions.
> >>
> >>Thanks
> >>
> >>
> >>
> >
> >
> >

 

On Sun, 27 Apr 2003 00:24:44 -0400, "Rich Clark" <[email protected]> wrote:

>
><[email protected]> wrote in message news:[email protected]...
>> Hi all,
>>
>> For the last 3 years, I have been getting my annual medical checkup from a internist who is also
>> a cardiologist. Besides doing the normal lab tests and BP, he insists that I take the echo and
>> the stress test. He and his staff give these very expensive and I assume profitable tests.
>
>I think you've identified the real reason for the tests there in your last sentence.
>
>I have coronary artery disease. I've had 4 MI's, I've been through the cardiac catheter lab 10
>times, I've had 5 stent implantation and a number of angioplasties.
>
>I've never had an abnormal stress test.

How on earth could you have 4MIs and normal stress tests?

--

We are stardust.

 

On Sun, 27 Apr 2003 17:31:57 -0400, Stargazer <[email protected]_email_address.com> wrote:

>Hi, The reason he iis giving is that since I am over 50 and doing extensive regular excercising
>(weightlifting, cycling), he feels it is a way of catching future irregularities or problems
>that do not currently exist. I guess using that reason, I should get a stress test quarterly if
>not monthly.
>
>Does anyone have any strong opinions about ingesting radioactive isotopes?
>
>Thanks again.
>
>Maurice

Wait a minute, he is doing a thallium stress test EVERY year in the absence of any heart condition
and no family history of heart disease? Something is amiss my friend.

--

We are stardust.

 

On Sun, 27 Apr 2003 17:50:40 -0400 in rec.bicycles.misc, Stargazer
<[email protected]_email_address.com> wrote:

> He says that since I am over 50 and doing extensive regular excercising (weightlifting, cycling),
> he feels it is a way of catching future irregularities or problems that do not yet exist.
>
> I guess using that reasoning, I should get a stress test quarterly if not monthly.
>
Either he's trying to milk your insurance company, or he's one of those folks who when he has a
hammer every problem looks like a nail. In either case, if it was me, I would have already changed
doctors. I don't have any patience with unnecessary tests, and if you regularly exercising and the
first test was regular, any more would be unneccesary as long as I had no symptoms, at least for 5
to 10 years.

 

I was wondering the same thing.
>
>How on earth could you have 4MIs and normal stress tests?

 

"Stargazer" <[email protected]_email_address.com> wrote in message
news:[email protected]_email_address.com...
> Hi, The reason he iis giving is that since I am over 50 and doing extensive regular excercising
> (weightlifting, cycling), he feels it is a way of catching future irregularities or problems that
> do not currently exist. I guess using that reason, I should get a stress test quarterly if not
> monthly.
>
> Does anyone have any strong opinions about ingesting radioactive isotopes?
>
> Thanks again.
>
> Maurice

Well, unless he's alarmed by something, my doctor likes to rule out as much as possible before
suggesting that I do any test involving radioactive anything. That shit is filtered by your liver,
and as we all know, there's only so much a liver can take. Transplants are hard to find.

I'd get a 2nd opinion about those tests.

 

In article <[email protected]>, George says...
>
>I was wondering the same thing.
>>
>>How on earth could you have 4MIs and normal stress tests?
>

I can understand having CAD missed by a stress test but once that CAD has resulted in an MI, that
should show up on even just a plain old "lie on your back" electrocardiogram I would think.

I don't think a stress test done by a cardiologist could miss the damage from 4
MIs.

--

"No Roger....no Rerun....no RENT!"

 

"Doug Kanter" <[email protected]> wrote in message
news:[email protected]...
> "Stargazer" <[email protected]_email_address.com> wrote in message
> news:[email protected]_email_address.com...
> > Hi, The reason he iis giving is that since I am over 50 and doing extensive regular excercising
> > (weightlifting, cycling), he feels it is a way of catching future irregularities or problems
> > that do not currently exist. I guess using that reason, I should get a stress test quarterly if
> > not monthly.
> >
> > Does anyone have any strong opinions about ingesting radioactive
isotopes?
> >
> > Thanks again.
> >
> > Maurice
>
> Well, unless he's alarmed by something, my doctor likes to rule out as
much
> as possible before suggesting that I do any test involving radioactive anything. That shit is
> filtered by your liver, and as we all know, there's only so much a liver can take. Transplants are
> hard to find.
>
> I'd get a 2nd opinion about those tests.

Dont worry. Get the test. Its more important to get the test. Way more people die from what your
getting the test for than from any complications that could result from the substance used. Chronic
low dose exposure is more dangerous than acute moderate/high dose anyway. Plus, your getting a tiny
tiny tiny dose. One so low that an expensive computer driven machine is needed to even register the
results. Different reason, but Im getting a MUGA on my heart in the next few weeks using the same
method. Tis no big deal compared to whats being tested for.

Rob

 

> I can understand having CAD missed by a stress test but once that CAD has resulted in an MI, that
> should show up on even just a plain old "lie on your back" electrocardiogram I would think.
>
> I don't think a stress test done by a cardiologist could miss the damage from 4
> MIs.
>

The resting EKG will show the damage from old MI's, but won't show if anything new is about to
happen- for that, you need a stress test. The old MI scars are fixed, not getting better or worse;
your concern is whether any new area is being deprived of blood and facing a new MI.

Stress tests come in several types, not all requiring radioactive tracers- your doctor can tell you
which one you need to get the best accuracy.

Go ahead and do it, then ride. Its amazing how many people do not get or notice typical chest pain
before having a heart attack.