Sick Sinus Syndrome diagnosis/Pacemaker questions

Discussion in 'Health and medical' started by Vincent Poy, Mar 12, 2004.

  1. Vincent Poy

    Vincent Poy Guest

    Greetings everyone:

    I've been doing a bit of research on the Sick Sinus Syndrome
    as I could use some input from others concerning my father
    who is 92 years old. I think the easier way to ask the
    question is to actually mention the events leading up to
    today to make it easier. First of all, my father is on a
    Medicare HMO for insurance so he had a March 4, 11:30AM
    office visit with his Primary Care Physician who happens to
    be in Family Practice. I was not with my father on that day
    but my mother was. The Family Practice physician did the
    normal blood pressure test and said he does not have
    hypertension and then I think he did the ECG/EKG which
    caused him to did a immediate referral to the specialist
    Internal Medicine/Cardiologist next door. My father is
    taking the following medications: Glipizide 5mg for diabetes
    and Aricept 10mg for his Alzheimer's disease and Aspirin
    81mg all prescribed by his Primary Care Physician, as well
    Prevacid 30mg which was prescribed by his
    Gastroenterologist. So basically what happened after that is
    my father was sent to the Internal Medicine/Cardiologist
    next door and waited for about 30 minutes. When the
    physician finally saw him, he asked questions but my mom
    answered as he had Alzheimers and the physician was
    basically yelling at my mom and asked what did my father
    went to see him for when the Primary Care Physician sent the
    entire medical record over and he still was asking what
    medications is he taking and refused to look at the medical
    records handed to him. I guess when it came time to check
    for hypertension, he finally realized why my mom was
    answering for him. He claims my father has hypertension. His
    office does not have any equipment besides the blood
    pressure thing. So basically, he did a note and had my
    father goto the hospital for the Holter Monitor for 24 hours
    as his heartbeat was abnormal for diagnosis of the Sick
    Sinus Syndrome. As my father is 92 years old, I wheelchaired
    him to the hospital which is about 1500 feet away from where
    we live and the doctor's office. When we got to the hospital
    in the same afternoon on March 4 at about 1:25PM, the Holter
    Monitor was connected by the hospital department staff and
    the start time was 1:30PM and we were asked to returned
    anytime after 1:30PM to have the Holter Monitor removed. So
    basically, my father did fall twice within that 24 hour
    period due to the weight of the Holter Monitor as he forgot
    about it as well as boxes that were in his way when he was
    trying to use the bathroom.

    So on the next day when I took my father back to the
    hospital to have the Holter Monitor removed, the hospital
    staff told me that the gold necklace he is wearing that was
    directly on top of the taped monitoring area could affect
    the accuracy of the results.

    On March 8 at 11:00AM, my father went to see the
    Gastroenterologist who also did a check for hypertension and
    said he didn't have any. So when we arrived home that same
    day, the office assistant for the Internal
    Medicine/Cardiologist called and said to visit his office
    between 2:30PM-
    3:00PM that same afternoon. At 2:45PM, we were at his
    office and the only thing he said is that my father's
    heart stopped for 6-8 minutes twice during the 24 hour
    period of the Holter Monitor and he had to goto the
    hospital to have some kind of air tubing connected as
    there is a high risk of sudden death he said this in
    Chinese to both myself and my mother. He did not discuss
    the quality of life/surgery benefits or allowed us to
    ask any questions as it seems as if he was in a rush to
    get us out of the office and not giving the patient any
    choice at all of treatment. The next thing he did was he
    took out the HMO providers directory and called another
    physician who is a General/Thoracic Surgeon that I've
    verified on my own research is board certified. When he
    talked to the Surgeon, he said my dad had his heart
    stopped for 6-8 seconds which is the same time as the
    falls and needs to have a pacemaker done. So after that,
    he wrote a note for us to have my dad admitted to the
    hospital the next day at around 2:00PM on March 9, 2004.
    We were not informed at any point that the Cardiologist
    himself would not perform the pacemaker surgery
    procedure and that someone else would perform it. The
    other thing is usually, isn't it necessary for my father
    being the patient to have a office consultation with the
    surgeon prior to determine if the pacemaker or surgery
    is needed in the first place. From my research on the
    Sick Sinus Syndrome, doesn't the patient need to
    experience atleast one of following symptoms: fatigue,
    fainting, confusion, shortness of breath or trouble of
    breathing, weakness, palpitations, or an unusual
    awareness of the heartbeat which can be slow, fast or
    quite strong? As far as I know, my father is not
    experiencing any of those symptoms unless confusion can
    be misundersood as Alzheimer's disease. The other thing
    I am concerned about is the diagnosis since doesn't it
    usually require looking at the medical history and a
    physical exam which includes heart tracing using a ECG
    (Electrocardiogram) to confirm the diagnosis prior to
    the Holter moniter. The Internal Medicine/Cardiologist
    did not do an ECG at all. The other thing is I thought
    it usually would take more than one visit to monitor the
    symptoms but for this physician, it seems to be only one
    visit with the Holter Moniter and that's it. There is a
    chance that the Holter Monitor could be defective or the
    jewelry is affecting the accuracy of the results as
    mentioned by the hospital staff who did the Holter
    Monitor removal. Would the medications: Aspirin 81mg,
    Aricept 10mg, Prevacid 30mg, Glipizide 5mg have any
    effect on the heartbeat rate? From reading this
    newsgroup, I've also learned that usually it's the
    Cardiologist who does the pacemaker procedure and also
    prior to being admitted to any hospital in the US, isn't
    a blood sample needed to check for potassium levels as
    well as the thickness of the blood and other tests to
    see if there are other paths for the blood to flow from
    the heart? At the present time, I've told both the
    Internal Medicine/Cardiologist and the Surgeon to
    postpone the procedure until further notice since I'm
    worry about the risk of my father at his old age. One
    other thing is for the 10 Cardiologists listed in the
    HMO, this is the only one who is not Board Certified in
    either Internal Medicine or Cardiology. Is this
    something to worry about? Sorry for all the questions
    but I hope someone can provide some input. Thanks for
    your help in advance!

    Cheers, Vince Astrophysics, PhD
     
    Tags:


  2. Vincent Poy wrote:

    > Greetings everyone:

    Hi Vincent,

    >
    >
    > I've been doing a bit of research on the Sick Sinus
    > Syndrome as I could use some input from others concerning
    > my father who is 92 years old. I think the easier way to
    > ask the question is to actually mention the events leading
    > up to today to make it easier. First of all, my father is
    > on a Medicare HMO for insurance so he had a March 4,
    > 11:30AM office visit with his Primary Care Physician who
    > happens to be in Family Practice. I was not with my father
    > on that day but my mother was. The Family Practice
    > physician did the normal blood pressure test and said he
    > does not have hypertension and then I think he did the
    > ECG/EKG which caused him to did a immediate referral to
    > the specialist Internal Medicine/Cardiologist next door.
    > My father is taking the following medications: Glipizide
    > 5mg for diabetes and Aricept 10mg for his Alzheimer's
    > disease and Aspirin 81mg all prescribed by his Primary
    > Care Physician, as well Prevacid 30mg which was prescribed
    > by his Gastroenterologist. So basically what happened
    > after that is my father was sent to the Internal
    > Medicine/Cardiologist next door and waited for about 30
    > minutes. When the physician finally saw him, he asked
    > questions but my mom answered as he had Alzheimers and the
    > physician was basically yelling at my mom and asked what
    > did my father went to see him for when the Primary Care
    > Physician sent the entire medical record over and he still
    > was asking what medications is he taking and refused to
    > look at the medical records handed to him. I guess when it
    > came time to check for hypertension, he finally realized
    > why my mom was answering for him. He claims my father has
    > hypertension. His office does not have any equipment
    > besides the blood pressure thing. So basically, he did a
    > note and had my father goto the hospital for the Holter
    > Monitor for 24 hours as his heartbeat was abnormal for
    > diagnosis of the Sick Sinus Syndrome. As my father is 92
    > years old, I wheelchaired him to the hospital which is
    > about 1500 feet away from where we live and the doctor's
    > office. When we got to the hospital in the same afternoon
    > on March 4 at about 1:25PM, the Holter Monitor was
    > connected by the hospital department staff and the start
    > time was 1:30PM and we were asked to returned anytime
    > after 1:30PM to have the Holter Monitor removed. So
    > basically, my father did fall twice within that 24 hour
    > period due to the weight of the Holter Monitor as he
    > forgot about it as well as boxes that were in his way when
    > he was trying to use the bathroom.
    >
    > So on the next day when I took my father back to the
    > hospital to have the Holter Monitor removed, the hospital
    > staff told me that the gold necklace he is wearing that
    > was directly on top of the taped monitoring area could
    > affect the accuracy of the results.
    >
    > On March 8 at 11:00AM, my father went to see the
    > Gastroenterologist who also did a check for hypertension
    > and said he didn't have any. So when we arrived home that
    > same day, the office assistant for the Internal
    > Medicine/Cardiologist called and said to visit his office
    > between 2:30PM-
    > 3:00PM that same afternoon. At 2:45PM, we were at his
    > office and the only thing he said is that my father's
    > heart stopped for 6-8 minutes twice
    >

    You probably meant seconds here.

    (God's gift of truth discernment here :)

    > during the 24 hour period of the Holter Monitor and he had
    > to goto the hospital to have some kind of air tubing
    > connected as there is a high risk of sudden death he said
    > this in Chinese to both myself and my mother. He did not
    > discuss the quality of life/surgery benefits or allowed us
    > to ask any questions as it seems as if he was in a rush to
    > get us out of the office and not giving the patient any
    > choice at all of treatment. The next thing he did was he
    > took out the HMO providers directory and called another
    > physician who is a General/Thoracic Surgeon that I've
    > verified on my own research is board certified. When he
    > talked to the Surgeon, he said my dad had his heart
    > stopped for 6-8 seconds which is the same time as the
    > falls and needs to have a pacemaker done. So after that,
    > he wrote a note for us to have my dad admitted to the
    > hospital the next day at around 2:00PM on March 9, 2004.
    > We were not informed at any point that the Cardiologist
    > himself would not perform the pacemaker surgery procedure
    > and that someone else would perform it. The other thing is
    > usually, isn't it necessary for my father being the
    > patient to have a office consultation with the surgeon
    > prior to determine if the pacemaker or surgery is needed
    > in the first place. From my research on the Sick Sinus
    > Syndrome, doesn't the patient need to experience atleast
    > one of following symptoms: fatigue, fainting, confusion,
    > shortness of breath or trouble of breathing, weakness,
    > palpitations, or an unusual awareness of the heartbeat
    > which can be slow, fast or quite strong?

    Sometimes the symptoms are minimal.

    > As far as I know, my father is not experiencing any of
    > those symptoms unless confusion can be misundersood as
    > Alzheimer's disease.

    Could be. The falls are also a concern.

    > The other thing I am concerned about is the diagnosis
    > since doesn't it usually require looking at the medical
    > history and a physical exam which includes heart tracing
    > using a ECG (Electrocardiogram) to confirm the diagnosis
    > prior to the Holter moniter.

    Few doctors are able to order appropriate testing and
    treatment without interviewing and examining the
    patient first.

    > The Internal Medicine/Cardiologist did not do an ECG at
    > all. The other thing is I thought it usually would take
    > more than one visit to monitor the symptoms but for this
    > physician, it seems to be only one visit with the Holter
    > Moniter and that's it. There is a chance that the Holter
    > Monitor could be defective or the jewelry is affecting
    > the accuracy of the results as mentioned by the hospital
    > staff who did the Holter Monitor removal. Would the
    > medications: Aspirin 81mg, Aricept 10mg, Prevacid 30mg,
    > Glipizide 5mg have any effect on the heartbeat rate?

    Not typically.

    > From reading this newsgroup, I've also learned that
    > usually it's the Cardiologist who does the pacemaker
    > procedure and also prior to being admitted to any
    > hospital in the US, isn't a blood sample needed to check
    > for potassium levels as well as the thickness of the
    > blood and other tests to see if there are other paths for
    > the blood to flow from the heart?

    It is likely that these blood tests would have been
    scheduled and done shortly before the pacemaker
    implantation.

    > At the present time, I've told both the Internal
    > Medicine/Cardiologist and the Surgeon to postpone the
    > procedure until further notice since I'm worry about the
    > risk of my father at his old age. One other thing is for
    > the 10 Cardiologists listed in the HMO, this is the only
    > one who is not Board Certified in either Internal
    > Medicine or Cardiology. Is this something to worry about?

    It may be a concern.

    > Sorry for all the questions but I hope someone can
    > provide some input. Thanks for your help in advance!
    >

    All praises belong to God, Vince :)

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/

    **
    Who is the humblest person in the universe?
    http://makeashorterlink.com/?W1F522557

    What is all this about?
    http://makeashorterlink.com/?J2DB148A7

    Is this spam?
    http://makeashorterlink.com/?N69721867
     
  3. Vincent Poy wrote:

    > Greetings everyone:

    Hi Vincent,

    >
    >
    > I've been doing a bit of research on the Sick Sinus
    > Syndrome as I could use some input from others concerning
    > my father who is 92 years old. I think the easier way to
    > ask the question is to actually mention the events leading
    > up to today to make it easier. First of all, my father is
    > on a Medicare HMO for insurance so he had a March 4,
    > 11:30AM office visit with his Primary Care Physician who
    > happens to be in Family Practice. I was not with my father
    > on that day but my mother was. The Family Practice
    > physician did the normal blood pressure test and said he
    > does not have hypertension and then I think he did the
    > ECG/EKG which caused him to did a immediate referral to
    > the specialist Internal Medicine/Cardiologist next door.
    > My father is taking the following medications: Glipizide
    > 5mg for diabetes and Aricept 10mg for his Alzheimer's
    > disease and Aspirin 81mg all prescribed by his Primary
    > Care Physician, as well Prevacid 30mg which was prescribed
    > by his Gastroenterologist. So basically what happened
    > after that is my father was sent to the Internal
    > Medicine/Cardiologist next door and waited for about 30
    > minutes. When the physician finally saw him, he asked
    > questions but my mom answered as he had Alzheimers and the
    > physician was basically yelling at my mom and asked what
    > did my father went to see him for when the Primary Care
    > Physician sent the entire medical record over and he still
    > was asking what medications is he taking and refused to
    > look at the medical records handed to him. I guess when it
    > came time to check for hypertension, he finally realized
    > why my mom was answering for him. He claims my father has
    > hypertension. His office does not have any equipment
    > besides the blood pressure thing. So basically, he did a
    > note and had my father goto the hospital for the Holter
    > Monitor for 24 hours as his heartbeat was abnormal for
    > diagnosis of the Sick Sinus Syndrome. As my father is 92
    > years old, I wheelchaired him to the hospital which is
    > about 1500 feet away from where we live and the doctor's
    > office. When we got to the hospital in the same afternoon
    > on March 4 at about 1:25PM, the Holter Monitor was
    > connected by the hospital department staff and the start
    > time was 1:30PM and we were asked to returned anytime
    > after 1:30PM to have the Holter Monitor removed. So
    > basically, my father did fall twice within that 24 hour
    > period due to the weight of the Holter Monitor as he
    > forgot about it as well as boxes that were in his way when
    > he was trying to use the bathroom.
    >
    > So on the next day when I took my father back to the
    > hospital to have the Holter Monitor removed, the hospital
    > staff told me that the gold necklace he is wearing that
    > was directly on top of the taped monitoring area could
    > affect the accuracy of the results.
    >
    > On March 8 at 11:00AM, my father went to see the
    > Gastroenterologist who also did a check for hypertension
    > and said he didn't have any. So when we arrived home that
    > same day, the office assistant for the Internal
    > Medicine/Cardiologist called and said to visit his office
    > between 2:30PM-
    > 3:00PM that same afternoon. At 2:45PM, we were at his
    > office and the only thing he said is that my father's
    > heart stopped for 6-8 minutes twice
    >

    You probably meant seconds here.

    (God's gift of truth discernment here :)

    > during the 24 hour period of the Holter Monitor and he had
    > to goto the hospital to have some kind of air tubing
    > connected as there is a high risk of sudden death he said
    > this in Chinese to both myself and my mother. He did not
    > discuss the quality of life/surgery benefits or allowed us
    > to ask any questions as it seems as if he was in a rush to
    > get us out of the office and not giving the patient any
    > choice at all of treatment. The next thing he did was he
    > took out the HMO providers directory and called another
    > physician who is a General/Thoracic Surgeon that I've
    > verified on my own research is board certified. When he
    > talked to the Surgeon, he said my dad had his heart
    > stopped for 6-8 seconds which is the same time as the
    > falls and needs to have a pacemaker done. So after that,
    > he wrote a note for us to have my dad admitted to the
    > hospital the next day at around 2:00PM on March 9, 2004.
    > We were not informed at any point that the Cardiologist
    > himself would not perform the pacemaker surgery procedure
    > and that someone else would perform it. The other thing is
    > usually, isn't it necessary for my father being the
    > patient to have a office consultation with the surgeon
    > prior to determine if the pacemaker or surgery is needed
    > in the first place. From my research on the Sick Sinus
    > Syndrome, doesn't the patient need to experience atleast
    > one of following symptoms: fatigue, fainting, confusion,
    > shortness of breath or trouble of breathing, weakness,
    > palpitations, or an unusual awareness of the heartbeat
    > which can be slow, fast or quite strong?

    Sometimes the symptoms are minimal.

    > As far as I know, my father is not experiencing any of
    > those symptoms unless confusion can be misundersood as
    > Alzheimer's disease.

    Could be. The falls are also a concern.

    > The other thing I am concerned about is the diagnosis
    > since doesn't it usually require looking at the medical
    > history and a physical exam which includes heart tracing
    > using a ECG (Electrocardiogram) to confirm the diagnosis
    > prior to the Holter moniter.

    Few doctors are able to order appropriate testing and
    treatment without interviewing and examining the
    patient first.

    > The Internal Medicine/Cardiologist did not do an ECG at
    > all. The other thing is I thought it usually would take
    > more than one visit to monitor the symptoms but for this
    > physician, it seems to be only one visit with the Holter
    > Moniter and that's it. There is a chance that the Holter
    > Monitor could be defective or the jewelry is affecting
    > the accuracy of the results as mentioned by the hospital
    > staff who did the Holter Monitor removal. Would the
    > medications: Aspirin 81mg, Aricept 10mg, Prevacid 30mg,
    > Glipizide 5mg have any effect on the heartbeat rate?

    Not typically.

    > From reading this newsgroup, I've also learned that
    > usually it's the Cardiologist who does the pacemaker
    > procedure and also prior to being admitted to any
    > hospital in the US, isn't a blood sample needed to check
    > for potassium levels as well as the thickness of the
    > blood and other tests to see if there are other paths for
    > the blood to flow from the heart?

    It is likely that these blood tests would have been
    scheduled and done shortly before the pacemaker
    implantation.

    > At the present time, I've told both the Internal
    > Medicine/Cardiologist and the Surgeon to postpone the
    > procedure until further notice since I'm worry about the
    > risk of my father at his old age. One other thing is for
    > the 10 Cardiologists listed in the HMO, this is the only
    > one who is not Board Certified in either Internal
    > Medicine or Cardiology. Is this something to worry about?

    It may be a concern.

    > Sorry for all the questions but I hope someone can
    > provide some input. Thanks for your help in advance!
    >

    All praises belong to God, Vince :)

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/

    **
    Who is the humblest person in the universe?
    http://makeashorterlink.com/?W1F522557

    What is all this about?
    http://makeashorterlink.com/?J2DB148A7

    Is this spam?
    http://makeashorterlink.com/?N69721867
     
  4. Vincent Poy

    Vincent Poy Guest

    Hi Dr. Chung:

    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote
    in news:[email protected]:

    > Vincent Poy wrote:
    >
    >> Greetings everyone:
    >
    >> I've been doing a bit of research on the Sick Sinus
    >> Syndrome as I could use some input from others concerning
    >> my father who is 92 years old. I think the easier way to
    >> ask the question is to actually mention the events
    >> leading up to today to make it easier. First of all, my
    >> father is on a Medicare HMO for insurance so he had a
    >> March 4, 11:30AM office visit with his Primary Care
    >> Physician who happens to be in Family Practice. I was not
    >> with my father on that day but my mother was. The Family
    >> Practice physician did the normal blood pressure test and
    >> said he does not have hypertension and then I think he
    >> did the ECG/EKG which caused him to did a immediate
    >> referral to the specialist Internal Medicine/Cardiologist
    >> next door. My father is taking the following medications:
    >> Glipizide 5mg for diabetes and Aricept 10mg for his
    >> Alzheimer's disease and Aspirin 81mg all prescribed by
    >> his Primary Care Physician, as well Prevacid 30mg which
    >> was prescribed by his Gastroenterologist. So basically
    >> what happened after that is my father was sent to the
    >> Internal Medicine/Cardiologist next door and waited for
    >> about 30 minutes. When the physician finally saw him, he
    >> asked questions but my mom answered as he had Alzheimers
    >> and the physician was basically yelling at my mom and
    >> asked what did my father went to see him for when the
    >> Primary Care Physician sent the entire medical record
    >> over and he still was asking what medications is he
    >> taking and refused to look at the medical records handed
    >> to him. I guess when it came time to check for
    >> hypertension, he finally realized why my mom was
    >> answering for him. He claims my father has hypertension.
    >> His office does not have any equipment besides the blood
    >> pressure thing. So basically, he did a note and had my
    >> father goto the hospital for the Holter Monitor for 24
    >> hours as his heartbeat was abnormal for diagnosis of the
    >> Sick Sinus Syndrome. As my father is 92 years old, I
    >> wheelchaired him to the hospital which is about 1500 feet
    >> away from where we live and the doctor's office. When we
    >> got to the hospital in the same afternoon on March 4 at
    >> about 1:25PM, the Holter Monitor was connected by the
    >> hospital department staff and the start time was 1:30PM
    >> and we were asked to returned anytime after 1:30PM to
    >> have the Holter Monitor removed. So basically, my father
    >> did fall twice within that 24 hour period due to the
    >> weight of the Holter Monitor as he forgot about it as
    >> well as boxes that were in his way when he was trying to
    >> use the bathroom.
    >>
    >> So on the next day when I took my father back to the
    >> hospital to have the Holter Monitor removed, the hospital
    >> staff told me that the gold necklace he is wearing that
    >> was directly on top of the taped monitoring area could
    >> affect the accuracy of the results.
    >>
    >> On March 8 at 11:00AM, my father went to see the
    >> Gastroenterologist who also did a check for hypertension
    >> and said he didn't have any. So when we arrived home that
    >> same day, the office assistant for the Internal
    >> Medicine/Cardiologist called and said to visit his office
    >> between 2:30PM- 3:00PM that same afternoon. At 2:45PM, we
    >> were at his office and the only thing he said is that my
    >> father's heart stopped for 6-8 minutes twice
    >
    > You probably meant seconds here.

    The cardiologist meant seconds but he kept telling us
    minutes in Chinese.
    :)

    > (God's gift of truth discernment here :)
    >
    >> during the 24 hour period of the Holter Monitor and he
    >> had to goto the hospital to have some kind of air tubing
    >> connected as there is a high risk of sudden death he said
    >> this in Chinese to both myself and my mother. He did not
    >> discuss the quality of life/surgery benefits or allowed
    >> us to ask any questions as it seems as if he was in a
    >> rush to get us out of the office and not giving the
    >> patient any choice at all of treatment. The next thing he
    >> did was he took out the HMO providers directory and
    >> called another physician who is a General/Thoracic
    >> Surgeon that I've verified on my own research is board
    >> certified. When he talked to the Surgeon, he said my dad
    >> had his heart stopped for 6-8 seconds which is the same
    >> time as the falls and needs to have a pacemaker done. So
    >> after that, he wrote a note for us to have my dad
    >> admitted to the hospital the next day at around 2:00PM on
    >> March 9, 2004. We were not informed at any point that the
    >> Cardiologist himself would not perform the pacemaker
    >> surgery procedure and that someone else would perform it.
    >> The other thing is usually, isn't it necessary for my
    >> father being the patient to have a office consultation
    >> with the surgeon prior to determine if the pacemaker or
    >> surgery is needed in the first place. From my research on
    >> the Sick Sinus Syndrome, doesn't the patient need to
    >> experience atleast one of following symptoms: fatigue,
    >> fainting, confusion, shortness of breath or trouble of
    >> breathing, weakness, palpitations, or an unusual
    >> awareness of the heartbeat which can be slow, fast or
    >> quite strong?
    >
    > Sometimes the symptoms are minimal.

    True but doesn't it usually require atleast further
    diagnosis.

    >> As far as I know, my father is not experiencing any of
    >> those symptoms unless confusion can be misundersood as
    >> Alzheimer's disease.
    >
    > Could be. The falls are also a concern.

    That's true but he hasn't fall before or after the
    Holter monitor.

    >> The other thing I am concerned about is the diagnosis
    >> since doesn't it usually require looking at the medical
    >> history and a physical exam which includes heart tracing
    >> using a ECG (Electrocardiogram) to confirm the diagnosis
    >> prior to the Holter moniter.
    >
    > Few doctors are able to order appropriate testing and
    > treatment without interviewing and examining the
    > patient first.

    The interviewing was the part that's missing. He basically
    had the entire medical history file in his hands from the
    Family Practice physician but he had no idea why my father
    was there.

    >> The Internal Medicine/Cardiologist did not do an ECG at
    >> all. The other thing is I thought it usually would take
    >> more than one visit to monitor the symptoms but for this
    >> physician, it seems to be only one visit with the Holter
    >> Moniter and that's it. There is a chance that the Holter
    >> Monitor could be defective or the jewelry is affecting
    >> the accuracy of the results as mentioned by the hospital
    >> staff who did the Holter Monitor removal. Would the
    >> medications: Aspirin 81mg, Aricept 10mg, Prevacid 30mg,
    >> Glipizide 5mg have any effect on the heartbeat rate?
    >
    > Not typically.

    That's true, come to think of it.

    >> From reading this newsgroup, I've also learned that
    >> usually it's the Cardiologist who does the pacemaker
    >> procedure and also prior to being admitted to any
    >> hospital in the US, isn't a blood sample needed to check
    >> for potassium levels as well as the thickness of the
    >> blood and other tests to see if there are other paths
    >> for the blood to flow from the heart?
    >
    > It is likely that these blood tests would have been
    > scheduled and done shortly before the pacemaker
    > implantation.

    Speaking about pacemaker implantation, is the cardiologist
    supposed to be the one who does it or is a surgeon supposed
    to do it? The other thing about Sick Sinus Syndrome and the
    issue of sudden death is from my understanding after doing
    some research on the net, I thought a person with SSS can
    injure themselves during a fainting episode. An individual
    with certain arrhythmias has an increased risk of blood
    clots which can cause a stroke and there is a rare risk of
    sudden death that can occur if the heart stops beating for a
    long period of time. So is it correct that the sudden death
    is a rare risk rather than a high risk like this
    Cardiologist has stated. I mean my father is 92 years old
    and as far as I know, the pacemaker won't prolong life and
    it seems surgery at this age is just a huge risk.

    >> At the present time, I've told both the Internal
    >> Medicine/Cardiologist and the Surgeon to postpone the
    >> procedure until further notice since I'm worry about the
    >> risk of my father at his old age. One other thing is for
    >> the 10 Cardiologists listed in the HMO, this is the only
    >> one who is not Board Certified in either Internal
    >> Medicine or Cardiology. Is this something to worry
    >> about?
    >
    > It may be a concern.

    Yeah, I was just looking at your website and I think I
    know what the certification is about. The MD is more like
    just to certify that one has completed Medical School and
    can practice Family/General Practice assuming they are
    licensed in the State they are practicing in. Then for
    things like Surgery, Internal Medicine, Cardiology, they
    require certification in each of those areas practice to
    atleast show that the person in question is actually
    qualified in those areas. I guess if they aren't
    certified, then it's almost like someone trying to be a
    doctor when they are a engineer.
    :) So while on the subject, I am in California and believe
    :it or not,
    this Internal Medicine/Cardiology physician does have the
    last name of Chung as well but on the AMA, he lists himself
    as follows:

    Primary Specialty: Internal Medicine Major Professional
    Activity: Office Based Practice Medical School: UNIV OF THE
    EAST, RAMON MAGSAYSAY MEM MED CTR, QUEZON CITY Graduated
    1984 Residency Training: UNIV CA SF SCH OF MED,
    CARDIOVASCULAR DISEASES ST LUKE'S MED CTR, INTERNAL MEDICINE

    but when one goes to ABMS or ABIM, it shows him as Not
    certified. California's Board of Medicine shows his original
    license issued in 1992 and it'll expire next year. So
    basically for someone who claims to be in Internal
    Medicine/Cardiology that completed their MD in the
    Philippines and then did their residency at UCSF School of
    Medicine as well as St Luke's Medical Center in San
    Francisco and has been private practice after being licensed
    in California for the last 12 years, he is not board
    certified for anything he claims to specialize in. It does
    raise a great concern as he doesn't seem to have any
    credentials other than the MD and the residency training or
    atleast he's not board certified in the areas of his
    residency training.

    >> Sorry for all the questions but I hope someone can
    >> provide some input. Thanks for your help in advance!
    >
    > All praises belong to God, Vince :)

    Heh, and to you too Andrew! :)

    Cheers, Vince Astrophysics PhD
     
  5. Vincent Poy

    Vincent Poy Guest

    Hi Dr. Chung:

    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote
    in news:[email protected]:

    > Vincent Poy wrote:
    >
    >> Greetings everyone:
    >
    >> I've been doing a bit of research on the Sick Sinus
    >> Syndrome as I could use some input from others concerning
    >> my father who is 92 years old. I think the easier way to
    >> ask the question is to actually mention the events
    >> leading up to today to make it easier. First of all, my
    >> father is on a Medicare HMO for insurance so he had a
    >> March 4, 11:30AM office visit with his Primary Care
    >> Physician who happens to be in Family Practice. I was not
    >> with my father on that day but my mother was. The Family
    >> Practice physician did the normal blood pressure test and
    >> said he does not have hypertension and then I think he
    >> did the ECG/EKG which caused him to did a immediate
    >> referral to the specialist Internal Medicine/Cardiologist
    >> next door. My father is taking the following medications:
    >> Glipizide 5mg for diabetes and Aricept 10mg for his
    >> Alzheimer's disease and Aspirin 81mg all prescribed by
    >> his Primary Care Physician, as well Prevacid 30mg which
    >> was prescribed by his Gastroenterologist. So basically
    >> what happened after that is my father was sent to the
    >> Internal Medicine/Cardiologist next door and waited for
    >> about 30 minutes. When the physician finally saw him, he
    >> asked questions but my mom answered as he had Alzheimers
    >> and the physician was basically yelling at my mom and
    >> asked what did my father went to see him for when the
    >> Primary Care Physician sent the entire medical record
    >> over and he still was asking what medications is he
    >> taking and refused to look at the medical records handed
    >> to him. I guess when it came time to check for
    >> hypertension, he finally realized why my mom was
    >> answering for him. He claims my father has hypertension.
    >> His office does not have any equipment besides the blood
    >> pressure thing. So basically, he did a note and had my
    >> father goto the hospital for the Holter Monitor for 24
    >> hours as his heartbeat was abnormal for diagnosis of the
    >> Sick Sinus Syndrome. As my father is 92 years old, I
    >> wheelchaired him to the hospital which is about 1500 feet
    >> away from where we live and the doctor's office. When we
    >> got to the hospital in the same afternoon on March 4 at
    >> about 1:25PM, the Holter Monitor was connected by the
    >> hospital department staff and the start time was 1:30PM
    >> and we were asked to returned anytime after 1:30PM to
    >> have the Holter Monitor removed. So basically, my father
    >> did fall twice within that 24 hour period due to the
    >> weight of the Holter Monitor as he forgot about it as
    >> well as boxes that were in his way when he was trying to
    >> use the bathroom.
    >>
    >> So on the next day when I took my father back to the
    >> hospital to have the Holter Monitor removed, the hospital
    >> staff told me that the gold necklace he is wearing that
    >> was directly on top of the taped monitoring area could
    >> affect the accuracy of the results.
    >>
    >> On March 8 at 11:00AM, my father went to see the
    >> Gastroenterologist who also did a check for hypertension
    >> and said he didn't have any. So when we arrived home that
    >> same day, the office assistant for the Internal
    >> Medicine/Cardiologist called and said to visit his office
    >> between 2:30PM- 3:00PM that same afternoon. At 2:45PM, we
    >> were at his office and the only thing he said is that my
    >> father's heart stopped for 6-8 minutes twice
    >
    > You probably meant seconds here.

    The cardiologist meant seconds but he kept telling us
    minutes in Chinese.
    :)

    > (God's gift of truth discernment here :)
    >
    >> during the 24 hour period of the Holter Monitor and he
    >> had to goto the hospital to have some kind of air tubing
    >> connected as there is a high risk of sudden death he said
    >> this in Chinese to both myself and my mother. He did not
    >> discuss the quality of life/surgery benefits or allowed
    >> us to ask any questions as it seems as if he was in a
    >> rush to get us out of the office and not giving the
    >> patient any choice at all of treatment. The next thing he
    >> did was he took out the HMO providers directory and
    >> called another physician who is a General/Thoracic
    >> Surgeon that I've verified on my own research is board
    >> certified. When he talked to the Surgeon, he said my dad
    >> had his heart stopped for 6-8 seconds which is the same
    >> time as the falls and needs to have a pacemaker done. So
    >> after that, he wrote a note for us to have my dad
    >> admitted to the hospital the next day at around 2:00PM on
    >> March 9, 2004. We were not informed at any point that the
    >> Cardiologist himself would not perform the pacemaker
    >> surgery procedure and that someone else would perform it.
    >> The other thing is usually, isn't it necessary for my
    >> father being the patient to have a office consultation
    >> with the surgeon prior to determine if the pacemaker or
    >> surgery is needed in the first place. From my research on
    >> the Sick Sinus Syndrome, doesn't the patient need to
    >> experience atleast one of following symptoms: fatigue,
    >> fainting, confusion, shortness of breath or trouble of
    >> breathing, weakness, palpitations, or an unusual
    >> awareness of the heartbeat which can be slow, fast or
    >> quite strong?
    >
    > Sometimes the symptoms are minimal.

    True but doesn't it usually require atleast further
    diagnosis.

    >> As far as I know, my father is not experiencing any of
    >> those symptoms unless confusion can be misundersood as
    >> Alzheimer's disease.
    >
    > Could be. The falls are also a concern.

    That's true but he hasn't fall before or after the
    Holter monitor.

    >> The other thing I am concerned about is the diagnosis
    >> since doesn't it usually require looking at the medical
    >> history and a physical exam which includes heart tracing
    >> using a ECG (Electrocardiogram) to confirm the diagnosis
    >> prior to the Holter moniter.
    >
    > Few doctors are able to order appropriate testing and
    > treatment without interviewing and examining the
    > patient first.

    The interviewing was the part that's missing. He basically
    had the entire medical history file in his hands from the
    Family Practice physician but he had no idea why my father
    was there.

    >> The Internal Medicine/Cardiologist did not do an ECG at
    >> all. The other thing is I thought it usually would take
    >> more than one visit to monitor the symptoms but for this
    >> physician, it seems to be only one visit with the Holter
    >> Moniter and that's it. There is a chance that the Holter
    >> Monitor could be defective or the jewelry is affecting
    >> the accuracy of the results as mentioned by the hospital
    >> staff who did the Holter Monitor removal. Would the
    >> medications: Aspirin 81mg, Aricept 10mg, Prevacid 30mg,
    >> Glipizide 5mg have any effect on the heartbeat rate?
    >
    > Not typically.

    That's true, come to think of it.

    >> From reading this newsgroup, I've also learned that
    >> usually it's the Cardiologist who does the pacemaker
    >> procedure and also prior to being admitted to any
    >> hospital in the US, isn't a blood sample needed to check
    >> for potassium levels as well as the thickness of the
    >> blood and other tests to see if there are other paths
    >> for the blood to flow from the heart?
    >
    > It is likely that these blood tests would have been
    > scheduled and done shortly before the pacemaker
    > implantation.

    Speaking about pacemaker implantation, is the cardiologist
    supposed to be the one who does it or is a surgeon supposed
    to do it? The other thing about Sick Sinus Syndrome and the
    issue of sudden death is from my understanding after doing
    some research on the net, I thought a person with SSS can
    injure themselves during a fainting episode. An individual
    with certain arrhythmias has an increased risk of blood
    clots which can cause a stroke and there is a rare risk of
    sudden death that can occur if the heart stops beating for a
    long period of time. So is it correct that the sudden death
    is a rare risk rather than a high risk like this
    Cardiologist has stated. I mean my father is 92 years old
    and as far as I know, the pacemaker won't prolong life and
    it seems surgery at this age is just a huge risk.

    >> At the present time, I've told both the Internal
    >> Medicine/Cardiologist and the Surgeon to postpone the
    >> procedure until further notice since I'm worry about the
    >> risk of my father at his old age. One other thing is for
    >> the 10 Cardiologists listed in the HMO, this is the only
    >> one who is not Board Certified in either Internal
    >> Medicine or Cardiology. Is this something to worry
    >> about?
    >
    > It may be a concern.

    Yeah, I was just looking at your website and I think I
    know what the certification is about. The MD is more like
    just to certify that one has completed Medical School and
    can practice Family/General Practice assuming they are
    licensed in the State they are practicing in. Then for
    things like Surgery, Internal Medicine, Cardiology, they
    require certification in each of those areas practice to
    atleast show that the person in question is actually
    qualified in those areas. I guess if they aren't
    certified, then it's almost like someone trying to be a
    doctor when they are a engineer.
    :) So while on the subject, I am in California and believe
    :it or not,
    this Internal Medicine/Cardiology physician does have the
    last name of Chung as well but on the AMA, he lists himself
    as follows:

    Primary Specialty: Internal Medicine Major Professional
    Activity: Office Based Practice Medical School: UNIV OF THE
    EAST, RAMON MAGSAYSAY MEM MED CTR, QUEZON CITY Graduated
    1984 Residency Training: UNIV CA SF SCH OF MED,
    CARDIOVASCULAR DISEASES ST LUKE'S MED CTR, INTERNAL MEDICINE

    but when one goes to ABMS or ABIM, it shows him as Not
    certified. California's Board of Medicine shows his original
    license issued in 1992 and it'll expire next year. So
    basically for someone who claims to be in Internal
    Medicine/Cardiology that completed their MD in the
    Philippines and then did their residency at UCSF School of
    Medicine as well as St Luke's Medical Center in San
    Francisco and has been private practice after being licensed
    in California for the last 12 years, he is not board
    certified for anything he claims to specialize in. It does
    raise a great concern as he doesn't seem to have any
    credentials other than the MD and the residency training or
    atleast he's not board certified in the areas of his
    residency training.

    >> Sorry for all the questions but I hope someone can
    >> provide some input. Thanks for your help in advance!
    >
    > All praises belong to God, Vince :)

    Heh, and to you too Andrew! :)

    Cheers, Vince Astrophysics PhD
     
  6. "Vincent Poy" <[email protected]> wrote in message
    news:[email protected]...

    > Speaking about pacemaker implantation, is the cardiologist
    > supposed to be the one who does it or is a surgeon
    > supposed to do it? The other thing about Sick Sinus
    > Syndrome and the issue of sudden death is from my
    > understanding after doing some research on the net, I
    > thought a person
    with
    > SSS can injure themselves during a fainting episode. An
    > individual with certain arrhythmias has an increased risk
    > of blood clots which can cause a stroke and there is a
    > rare risk of sudden death that can occur if the
    heart
    > stops beating for a long period of time. So is it correct
    > that the sudden death is a rare risk rather than a high
    > risk like this Cardiologist has stated. I mean my father
    > is 92 years old and as far as I know, the pacemaker won't
    > prolong life and it seems surgery at this age is just a
    > huge risk.
    >

    Some surgeons and some cardiologists implant pacemakers. It
    depends largely on the nature of the practice in the
    particular location and customs vary widely from region to
    region. Years ago, cardiologists, recognizing reimbursement
    rates for this procedure, have largely learned how to
    implant them and since most cardiac disease in urban areas
    is seen by cardiologists, they tend to take care of the
    pacemaker implantation themselves rather than referring them
    to surgeons. In rural areas, cardiac disease may be seen by
    internists, who may in turn refer the patients to a surgeon
    if a pacemaker is required.

    Pacemaker implantation is generally not a difficult
    procedure. Learning the technique is usually a part of
    cardiology fellowship training and cardiologists are
    generally quite competent at doing it. In this particular
    case, I wouldn't get too hung up on titles or specialty and
    pay more attention to the qualifications of the implanting
    physician your doctor recommends.

    HMc
     
  7. "Vincent Poy" <[email protected]> wrote in message
    news:[email protected]...

    > Speaking about pacemaker implantation, is the cardiologist
    > supposed to be the one who does it or is a surgeon
    > supposed to do it? The other thing about Sick Sinus
    > Syndrome and the issue of sudden death is from my
    > understanding after doing some research on the net, I
    > thought a person
    with
    > SSS can injure themselves during a fainting episode. An
    > individual with certain arrhythmias has an increased risk
    > of blood clots which can cause a stroke and there is a
    > rare risk of sudden death that can occur if the
    heart
    > stops beating for a long period of time. So is it correct
    > that the sudden death is a rare risk rather than a high
    > risk like this Cardiologist has stated. I mean my father
    > is 92 years old and as far as I know, the pacemaker won't
    > prolong life and it seems surgery at this age is just a
    > huge risk.
    >

    Some surgeons and some cardiologists implant pacemakers. It
    depends largely on the nature of the practice in the
    particular location and customs vary widely from region to
    region. Years ago, cardiologists, recognizing reimbursement
    rates for this procedure, have largely learned how to
    implant them and since most cardiac disease in urban areas
    is seen by cardiologists, they tend to take care of the
    pacemaker implantation themselves rather than referring them
    to surgeons. In rural areas, cardiac disease may be seen by
    internists, who may in turn refer the patients to a surgeon
    if a pacemaker is required.

    Pacemaker implantation is generally not a difficult
    procedure. Learning the technique is usually a part of
    cardiology fellowship training and cardiologists are
    generally quite competent at doing it. In this particular
    case, I wouldn't get too hung up on titles or specialty and
    pay more attention to the qualifications of the implanting
    physician your doctor recommends.

    HMc
     
  8. Vincent Poy wrote:

    > Hi Dr. Chung:
    >
    > "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    > wrote in news:[email protected]:
    >
    > > Vincent Poy wrote:
    > >
    > >> Greetings everyone:
    > >
    > >> I've been doing a bit of research on the Sick Sinus
    > >> Syndrome as I could use some input from others
    > >> concerning my father who is 92 years old. I think the
    > >> easier way to ask the question is to actually mention
    > >> the events leading up to today to make it easier. First
    > >> of all, my father is on a Medicare HMO for insurance so
    > >> he had a March 4, 11:30AM office visit with his Primary
    > >> Care Physician who happens to be in Family Practice. I
    > >> was not with my father on that day but my mother was.
    > >> The Family Practice physician did the normal blood
    > >> pressure test and said he does not have hypertension
    > >> and then I think he did the ECG/EKG which caused him to
    > >> did a immediate referral to the specialist Internal
    > >> Medicine/Cardiologist next door. My father is taking
    > >> the following medications: Glipizide 5mg for diabetes
    > >> and Aricept 10mg for his Alzheimer's disease and
    > >> Aspirin 81mg all prescribed by his Primary Care
    > >> Physician, as well Prevacid 30mg which was prescribed
    > >> by his Gastroenterologist. So basically what happened
    > >> after that is my father was sent to the Internal
    > >> Medicine/Cardiologist next door and waited for about 30
    > >> minutes. When the physician finally saw him, he asked
    > >> questions but my mom answered as he had Alzheimers and
    > >> the physician was basically yelling at my mom and asked
    > >> what did my father went to see him for when the Primary
    > >> Care Physician sent the entire medical record over and
    > >> he still was asking what medications is he taking and
    > >> refused to look at the medical records handed to him. I
    > >> guess when it came time to check for hypertension, he
    > >> finally realized why my mom was answering for him. He
    > >> claims my father has hypertension. His office does not
    > >> have any equipment besides the blood pressure thing. So
    > >> basically, he did a note and had my father goto the
    > >> hospital for the Holter Monitor for 24 hours as his
    > >> heartbeat was abnormal for diagnosis of the Sick Sinus
    > >> Syndrome. As my father is 92 years old, I wheelchaired
    > >> him to the hospital which is about 1500 feet away from
    > >> where we live and the doctor's office. When we got to
    > >> the hospital in the same afternoon on March 4 at about
    > >> 1:25PM, the Holter Monitor was connected by the
    > >> hospital department staff and the start time was 1:30PM
    > >> and we were asked to returned anytime after 1:30PM to
    > >> have the Holter Monitor removed. So basically, my
    > >> father did fall twice within that 24 hour period due to
    > >> the weight of the Holter Monitor as he forgot about it
    > >> as well as boxes that were in his way when he was
    > >> trying to use the bathroom.
    > >>
    > >> So on the next day when I took my father back to the
    > >> hospital to have the Holter Monitor removed, the
    > >> hospital staff told me that the gold necklace he is
    > >> wearing that was directly on top of the taped
    > >> monitoring area could affect the accuracy of the
    > >> results.
    > >>
    > >> On March 8 at 11:00AM, my father went to see the
    > >> Gastroenterologist who also did a check for
    > >> hypertension and said he didn't have any. So when we
    > >> arrived home that same day, the office assistant for
    > >> the Internal Medicine/Cardiologist called and said to
    > >> visit his office between 2:30PM- 3:00PM that same
    > >> afternoon. At 2:45PM, we were at his office and the
    > >> only thing he said is that my father's heart stopped
    > >> for 6-8 minutes twice
    > >
    > > You probably meant seconds here.
    >
    > The cardiologist meant seconds but he kept telling us
    > minutes in Chinese.
    > :)
    >

    :)

    >
    > > (God's gift of truth discernment here :)
    > >
    > >> during the 24 hour period of the Holter Monitor and he
    > >> had to goto the hospital to have some kind of air
    > >> tubing connected as there is a high risk of sudden
    > >> death he said this in Chinese to both myself and my
    > >> mother. He did not discuss the quality of life/surgery
    > >> benefits or allowed us to ask any questions as it seems
    > >> as if he was in a rush to get us out of the office and
    > >> not giving the patient any choice at all of treatment.
    > >> The next thing he did was he took out the HMO providers
    > >> directory and called another physician who is a
    > >> General/Thoracic Surgeon that I've verified on my own
    > >> research is board certified. When he talked to the
    > >> Surgeon, he said my dad had his heart stopped for 6-8
    > >> seconds which is the same time as the falls and needs
    > >> to have a pacemaker done. So after that, he wrote a
    > >> note for us to have my dad admitted to the hospital the
    > >> next day at around 2:00PM on March 9, 2004. We were not
    > >> informed at any point that the Cardiologist himself
    > >> would not perform the pacemaker surgery procedure and
    > >> that someone else would perform it. The other thing is
    > >> usually, isn't it necessary for my father being the
    > >> patient to have a office consultation with the surgeon
    > >> prior to determine if the pacemaker or surgery is
    > >> needed in the first place. From my research on the Sick
    > >> Sinus Syndrome, doesn't the patient need to experience
    > >> atleast one of following symptoms: fatigue, fainting,
    > >> confusion, shortness of breath or trouble of breathing,
    > >> weakness, palpitations, or an unusual awareness of the
    > >> heartbeat which can be slow, fast or quite strong?
    > >
    > > Sometimes the symptoms are minimal.
    >
    > True but doesn't it usually require atleast further
    > diagnosis.
    >

    The holter can be enough to cinch the diagnosis.

    >
    > >> As far as I know, my father is not experiencing any of
    > >> those symptoms unless confusion can be misundersood as
    > >> Alzheimer's disease.
    > >
    > > Could be. The falls are also a concern.
    >
    > That's true but he hasn't fall before or after the Holter
    > monitor.
    >

    That is certainly reassuring.

    >
    > >> The other thing I am concerned about is the diagnosis
    > >> since doesn't it usually require looking at the
    > >> medical history and a physical exam which includes
    > >> heart tracing using a ECG (Electrocardiogram) to
    > >> confirm the diagnosis prior to the Holter moniter.
    > >
    > > Few doctors are able to order appropriate testing and
    > > treatment without interviewing and examining the patient
    > > first.
    >
    > The interviewing was the part that's missing. He basically
    > had the entire medical history file in his hands from the
    > Family Practice physician but he had no idea why my father
    > was there.
    >

    That is a concern.

    >
    > >> The Internal Medicine/Cardiologist did not do an ECG
    > >> at all. The other thing is I thought it usually would
    > >> take more than one visit to monitor the symptoms but
    > >> for this physician, it seems to be only one visit with
    > >> the Holter Moniter and that's it. There is a chance
    > >> that the Holter Monitor could be defective or the
    > >> jewelry is affecting the accuracy of the results as
    > >> mentioned by the hospital staff who did the Holter
    > >> Monitor removal. Would the medications: Aspirin 81mg,
    > >> Aricept 10mg, Prevacid 30mg, Glipizide 5mg have any
    > >> effect on the heartbeat rate?
    > >
    > > Not typically.
    >
    > That's true, come to think of it.
    >

    I work at being truthful :)

    >
    > >> From reading this newsgroup, I've also learned that
    > >> usually it's the Cardiologist who does the pacemaker
    > >> procedure and also prior to being admitted to any
    > >> hospital in the US, isn't a blood sample needed to
    > >> check for potassium levels as well as the thickness of
    > >> the blood and other tests to see if there are other
    > >> paths for the blood to flow from the heart?
    > >
    > > It is likely that these blood tests would have been
    > > scheduled and done shortly before the pacemaker
    > > implantation.
    >
    > Speaking about pacemaker implantation, is the cardiologist
    > supposed to be the one who does it or is a surgeon
    > supposed to do it?

    Whoever is able to do it best is the one who should do it
    :)

    > The other thing about Sick Sinus Syndrome and the issue
    > of sudden death is from my understanding after doing some
    > research on the net, I thought a person with SSS can
    > injure themselves during a fainting episode.

    Yes.

    Falling can result in severe injuries recalling the recent
    demise of Dr. Bob Atkins.

    > An individual with certain arrhythmias has an increased
    > risk of blood clots which can cause a stroke and there is
    > a rare risk of sudden death that can occur if the heart
    > stops beating for a long period of time. So is it correct
    > that the sudden death is a rare risk rather than a high
    > risk like this Cardiologist has stated.

    Sudden death from sick sinus syndrome (SSS) is rare.

    > I mean my father is 92 years old and as far as I know, the
    > pacemaker won't prolong life and it seems surgery at this
    > age is just a huge risk.

    I would not say it is *huge* but there is a
    significant risk.

    > >> At the present time, I've told both the Internal
    > >> Medicine/Cardiologist and the Surgeon to postpone the
    > >> procedure until further notice since I'm worry about
    > >> the risk of my father at his old age. One other thing
    > >> is for the 10 Cardiologists listed in the HMO, this is
    > >> the only one who is not Board Certified in either
    > >> Internal Medicine or Cardiology. Is this something to
    > >> worry about?
    > >
    > > It may be a concern.
    >
    > Yeah, I was just looking at your website and I think I
    > know what the certification is about. The MD is more like
    > just to certify that one has completed Medical School and
    > can practice Family/General Practice assuming they are
    > licensed in the State they are practicing in. Then for
    > things like Surgery, Internal Medicine, Cardiology, they
    > require certification in each of those areas practice to
    > atleast show that the person in question is actually
    > qualified in those areas. I guess if they aren't
    > certified, then it's almost like someone trying to be a
    > doctor when they are a engineer.
    > :) So while on the subject, I am in California and
    > :believe it or not,
    > this Internal Medicine/Cardiology physician does have the
    > last name of Chung as well but on the AMA, he lists
    > himself as follows:
    >
    > Primary Specialty: Internal Medicine Major Professional
    > Activity: Office Based Practice Medical School: UNIV OF
    > THE EAST, RAMON MAGSAYSAY MEM MED CTR, QUEZON CITY
    > Graduated 1984 Residency Training: UNIV CA SF SCH OF MED,
    > CARDIOVASCULAR DISEASES ST LUKE'S MED CTR, INTERNAL
    > MEDICINE
    >
    > but when one goes to ABMS or ABIM, it shows him as Not
    > certified. California's Board of Medicine shows his
    > original license issued in 1992 and it'll expire next
    > year. So basically for someone who claims to be in
    > Internal Medicine/Cardiology that completed their MD in
    > the Philippines and then did their residency at UCSF
    > School of Medicine as well as St Luke's Medical Center in
    > San Francisco and has been private practice after being
    > licensed in California for the last 12 years, he is not
    > board certified for anything he claims to specialize in.
    > It does raise a great concern as he doesn't seem to have
    > any credentials other than the MD and the residency
    > training or atleast he's not board certified in the areas
    > of his residency training.
    >
    > >> Sorry for all the questions but I hope someone can
    > >> provide some input. Thanks for your help in advance!
    > >
    > > All praises belong to God, Vince :)
    >
    > Heh, and to you too Andrew! :)
    >

    I wouldn't be here if it were not for God's grace.

    >
    > Cheers, Vince Astrophysics PhD

    May God watch over you and your mom, in Christ's name.

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/

    **
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    Is this spam?
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  9. Vincent Poy wrote:

    > Hi Dr. Chung:
    >
    > "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    > wrote in news:[email protected]:
    >
    > > Vincent Poy wrote:
    > >
    > >> Greetings everyone:
    > >
    > >> I've been doing a bit of research on the Sick Sinus
    > >> Syndrome as I could use some input from others
    > >> concerning my father who is 92 years old. I think the
    > >> easier way to ask the question is to actually mention
    > >> the events leading up to today to make it easier. First
    > >> of all, my father is on a Medicare HMO for insurance so
    > >> he had a March 4, 11:30AM office visit with his Primary
    > >> Care Physician who happens to be in Family Practice. I
    > >> was not with my father on that day but my mother was.
    > >> The Family Practice physician did the normal blood
    > >> pressure test and said he does not have hypertension
    > >> and then I think he did the ECG/EKG which caused him to
    > >> did a immediate referral to the specialist Internal
    > >> Medicine/Cardiologist next door. My father is taking
    > >> the following medications: Glipizide 5mg for diabetes
    > >> and Aricept 10mg for his Alzheimer's disease and
    > >> Aspirin 81mg all prescribed by his Primary Care
    > >> Physician, as well Prevacid 30mg which was prescribed
    > >> by his Gastroenterologist. So basically what happened
    > >> after that is my father was sent to the Internal
    > >> Medicine/Cardiologist next door and waited for about 30
    > >> minutes. When the physician finally saw him, he asked
    > >> questions but my mom answered as he had Alzheimers and
    > >> the physician was basically yelling at my mom and asked
    > >> what did my father went to see him for when the Primary
    > >> Care Physician sent the entire medical record over and
    > >> he still was asking what medications is he taking and
    > >> refused to look at the medical records handed to him. I
    > >> guess when it came time to check for hypertension, he
    > >> finally realized why my mom was answering for him. He
    > >> claims my father has hypertension. His office does not
    > >> have any equipment besides the blood pressure thing. So
    > >> basically, he did a note and had my father goto the
    > >> hospital for the Holter Monitor for 24 hours as his
    > >> heartbeat was abnormal for diagnosis of the Sick Sinus
    > >> Syndrome. As my father is 92 years old, I wheelchaired
    > >> him to the hospital which is about 1500 feet away from
    > >> where we live and the doctor's office. When we got to
    > >> the hospital in the same afternoon on March 4 at about
    > >> 1:25PM, the Holter Monitor was connected by the
    > >> hospital department staff and the start time was 1:30PM
    > >> and we were asked to returned anytime after 1:30PM to
    > >> have the Holter Monitor removed. So basically, my
    > >> father did fall twice within that 24 hour period due to
    > >> the weight of the Holter Monitor as he forgot about it
    > >> as well as boxes that were in his way when he was
    > >> trying to use the bathroom.
    > >>
    > >> So on the next day when I took my father back to the
    > >> hospital to have the Holter Monitor removed, the
    > >> hospital staff told me that the gold necklace he is
    > >> wearing that was directly on top of the taped
    > >> monitoring area could affect the accuracy of the
    > >> results.
    > >>
    > >> On March 8 at 11:00AM, my father went to see the
    > >> Gastroenterologist who also did a check for
    > >> hypertension and said he didn't have any. So when we
    > >> arrived home that same day, the office assistant for
    > >> the Internal Medicine/Cardiologist called and said to
    > >> visit his office between 2:30PM- 3:00PM that same
    > >> afternoon. At 2:45PM, we were at his office and the
    > >> only thing he said is that my father's heart stopped
    > >> for 6-8 minutes twice
    > >
    > > You probably meant seconds here.
    >
    > The cardiologist meant seconds but he kept telling us
    > minutes in Chinese.
    > :)
    >

    :)

    >
    > > (God's gift of truth discernment here :)
    > >
    > >> during the 24 hour period of the Holter Monitor and he
    > >> had to goto the hospital to have some kind of air
    > >> tubing connected as there is a high risk of sudden
    > >> death he said this in Chinese to both myself and my
    > >> mother. He did not discuss the quality of life/surgery
    > >> benefits or allowed us to ask any questions as it seems
    > >> as if he was in a rush to get us out of the office and
    > >> not giving the patient any choice at all of treatment.
    > >> The next thing he did was he took out the HMO providers
    > >> directory and called another physician who is a
    > >> General/Thoracic Surgeon that I've verified on my own
    > >> research is board certified. When he talked to the
    > >> Surgeon, he said my dad had his heart stopped for 6-8
    > >> seconds which is the same time as the falls and needs
    > >> to have a pacemaker done. So after that, he wrote a
    > >> note for us to have my dad admitted to the hospital the
    > >> next day at around 2:00PM on March 9, 2004. We were not
    > >> informed at any point that the Cardiologist himself
    > >> would not perform the pacemaker surgery procedure and
    > >> that someone else would perform it. The other thing is
    > >> usually, isn't it necessary for my father being the
    > >> patient to have a office consultation with the surgeon
    > >> prior to determine if the pacemaker or surgery is
    > >> needed in the first place. From my research on the Sick
    > >> Sinus Syndrome, doesn't the patient need to experience
    > >> atleast one of following symptoms: fatigue, fainting,
    > >> confusion, shortness of breath or trouble of breathing,
    > >> weakness, palpitations, or an unusual awareness of the
    > >> heartbeat which can be slow, fast or quite strong?
    > >
    > > Sometimes the symptoms are minimal.
    >
    > True but doesn't it usually require atleast further
    > diagnosis.
    >

    The holter can be enough to cinch the diagnosis.

    >
    > >> As far as I know, my father is not experiencing any of
    > >> those symptoms unless confusion can be misundersood as
    > >> Alzheimer's disease.
    > >
    > > Could be. The falls are also a concern.
    >
    > That's true but he hasn't fall before or after the Holter
    > monitor.
    >

    That is certainly reassuring.

    >
    > >> The other thing I am concerned about is the diagnosis
    > >> since doesn't it usually require looking at the
    > >> medical history and a physical exam which includes
    > >> heart tracing using a ECG (Electrocardiogram) to
    > >> confirm the diagnosis prior to the Holter moniter.
    > >
    > > Few doctors are able to order appropriate testing and
    > > treatment without interviewing and examining the patient
    > > first.
    >
    > The interviewing was the part that's missing. He basically
    > had the entire medical history file in his hands from the
    > Family Practice physician but he had no idea why my father
    > was there.
    >

    That is a concern.

    >
    > >> The Internal Medicine/Cardiologist did not do an ECG
    > >> at all. The other thing is I thought it usually would
    > >> take more than one visit to monitor the symptoms but
    > >> for this physician, it seems to be only one visit with
    > >> the Holter Moniter and that's it. There is a chance
    > >> that the Holter Monitor could be defective or the
    > >> jewelry is affecting the accuracy of the results as
    > >> mentioned by the hospital staff who did the Holter
    > >> Monitor removal. Would the medications: Aspirin 81mg,
    > >> Aricept 10mg, Prevacid 30mg, Glipizide 5mg have any
    > >> effect on the heartbeat rate?
    > >
    > > Not typically.
    >
    > That's true, come to think of it.
    >

    I work at being truthful :)

    >
    > >> From reading this newsgroup, I've also learned that
    > >> usually it's the Cardiologist who does the pacemaker
    > >> procedure and also prior to being admitted to any
    > >> hospital in the US, isn't a blood sample needed to
    > >> check for potassium levels as well as the thickness of
    > >> the blood and other tests to see if there are other
    > >> paths for the blood to flow from the heart?
    > >
    > > It is likely that these blood tests would have been
    > > scheduled and done shortly before the pacemaker
    > > implantation.
    >
    > Speaking about pacemaker implantation, is the cardiologist
    > supposed to be the one who does it or is a surgeon
    > supposed to do it?

    Whoever is able to do it best is the one who should do it
    :)

    > The other thing about Sick Sinus Syndrome and the issue
    > of sudden death is from my understanding after doing some
    > research on the net, I thought a person with SSS can
    > injure themselves during a fainting episode.

    Yes.

    Falling can result in severe injuries recalling the recent
    demise of Dr. Bob Atkins.

    > An individual with certain arrhythmias has an increased
    > risk of blood clots which can cause a stroke and there is
    > a rare risk of sudden death that can occur if the heart
    > stops beating for a long period of time. So is it correct
    > that the sudden death is a rare risk rather than a high
    > risk like this Cardiologist has stated.

    Sudden death from sick sinus syndrome (SSS) is rare.

    > I mean my father is 92 years old and as far as I know, the
    > pacemaker won't prolong life and it seems surgery at this
    > age is just a huge risk.

    I would not say it is *huge* but there is a
    significant risk.

    > >> At the present time, I've told both the Internal
    > >> Medicine/Cardiologist and the Surgeon to postpone the
    > >> procedure until further notice since I'm worry about
    > >> the risk of my father at his old age. One other thing
    > >> is for the 10 Cardiologists listed in the HMO, this is
    > >> the only one who is not Board Certified in either
    > >> Internal Medicine or Cardiology. Is this something to
    > >> worry about?
    > >
    > > It may be a concern.
    >
    > Yeah, I was just looking at your website and I think I
    > know what the certification is about. The MD is more like
    > just to certify that one has completed Medical School and
    > can practice Family/General Practice assuming they are
    > licensed in the State they are practicing in. Then for
    > things like Surgery, Internal Medicine, Cardiology, they
    > require certification in each of those areas practice to
    > atleast show that the person in question is actually
    > qualified in those areas. I guess if they aren't
    > certified, then it's almost like someone trying to be a
    > doctor when they are a engineer.
    > :) So while on the subject, I am in California and
    > :believe it or not,
    > this Internal Medicine/Cardiology physician does have the
    > last name of Chung as well but on the AMA, he lists
    > himself as follows:
    >
    > Primary Specialty: Internal Medicine Major Professional
    > Activity: Office Based Practice Medical School: UNIV OF
    > THE EAST, RAMON MAGSAYSAY MEM MED CTR, QUEZON CITY
    > Graduated 1984 Residency Training: UNIV CA SF SCH OF MED,
    > CARDIOVASCULAR DISEASES ST LUKE'S MED CTR, INTERNAL
    > MEDICINE
    >
    > but when one goes to ABMS or ABIM, it shows him as Not
    > certified. California's Board of Medicine shows his
    > original license issued in 1992 and it'll expire next
    > year. So basically for someone who claims to be in
    > Internal Medicine/Cardiology that completed their MD in
    > the Philippines and then did their residency at UCSF
    > School of Medicine as well as St Luke's Medical Center in
    > San Francisco and has been private practice after being
    > licensed in California for the last 12 years, he is not
    > board certified for anything he claims to specialize in.
    > It does raise a great concern as he doesn't seem to have
    > any credentials other than the MD and the residency
    > training or atleast he's not board certified in the areas
    > of his residency training.
    >
    > >> Sorry for all the questions but I hope someone can
    > >> provide some input. Thanks for your help in advance!
    > >
    > > All praises belong to God, Vince :)
    >
    > Heh, and to you too Andrew! :)
    >

    I wouldn't be here if it were not for God's grace.

    >
    > Cheers, Vince Astrophysics PhD

    May God watch over you and your mom, in Christ's name.

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/

    **
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    http://makeashorterlink.com/?W1F522557

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    http://makeashorterlink.com/?J2DB148A7

    Is this spam?
    http://makeashorterlink.com/?N69721867
     
  10. Vincent Poy

    Vincent Poy Guest

    "Howard McCollister" <[email protected]> wrote in
    news:[email protected]:

    > "Vincent Poy" <[email protected]> wrote in
    > message
    > news:[email protected]...
    >
    >> Speaking about pacemaker implantation, is the
    >> cardiologist supposed to be the one who does it or is a
    >> surgeon supposed to do it? The other thing about Sick
    >> Sinus Syndrome and the issue of sudden death is from my
    >> understanding after doing some research on the net, I
    >> thought a person
    > with
    >> SSS can injure themselves during a fainting episode. An
    >> individual with certain arrhythmias has an increased risk
    >> of blood clots which can cause a stroke and there is a
    >> rare risk of sudden death that can occur if the
    > heart
    >> stops beating for a long period of time. So is it correct
    >> that the sudden death is a rare risk rather than a high
    >> risk like this Cardiologist has stated. I mean my father
    >> is 92 years old and as far as I know, the pacemaker won't
    >> prolong life and it seems surgery at this age is just a
    >> huge risk.
    >>
    >
    > Some surgeons and some cardiologists implant pacemakers.
    > It depends largely on the nature of the practice in the
    > particular location and customs vary widely from region to
    > region. Years ago, cardiologists, recognizing
    > reimbursement rates for this procedure, have largely
    > learned how to implant them and since most cardiac disease
    > in urban areas is seen by cardiologists, they tend to take
    > care of the pacemaker implantation themselves rather than
    > referring them to surgeons. In rural areas, cardiac
    > disease may be seen by internists, who may in turn refer
    > the patients to a surgeon if a pacemaker is required.
    >
    > Pacemaker implantation is generally not a difficult
    > procedure. Learning the technique is usually a part of
    > cardiology fellowship training and cardiologists are
    > generally quite competent at doing it. In this particular
    > case, I wouldn't get too hung up on titles or specialty
    > and pay more attention to the qualifications of the
    > implanting physician your doctor recommends.
    >
    > HMc

    I do trust the implanting physician though since he's board
    certified as a general surgeon as well as other surgery
    subspecialties in the chest area. It's just the internal
    medicine/cardiologist who is the one I'm wondering about who
    is non-board certified since it would seem a second opinion
    from a certified cardiologist is in order to determine
    atleast if the diagnostic results are the similar since the
    lack of discussion with the patient or family members of the
    patient is a primary concern.

    Vince Astrophysics, PhD
     
  11. Vincent Poy

    Vincent Poy Guest

    "Howard McCollister" <[email protected]> wrote in
    news:[email protected]:

    > "Vincent Poy" <[email protected]> wrote in
    > message
    > news:[email protected]...
    >
    >> Speaking about pacemaker implantation, is the
    >> cardiologist supposed to be the one who does it or is a
    >> surgeon supposed to do it? The other thing about Sick
    >> Sinus Syndrome and the issue of sudden death is from my
    >> understanding after doing some research on the net, I
    >> thought a person
    > with
    >> SSS can injure themselves during a fainting episode. An
    >> individual with certain arrhythmias has an increased risk
    >> of blood clots which can cause a stroke and there is a
    >> rare risk of sudden death that can occur if the
    > heart
    >> stops beating for a long period of time. So is it correct
    >> that the sudden death is a rare risk rather than a high
    >> risk like this Cardiologist has stated. I mean my father
    >> is 92 years old and as far as I know, the pacemaker won't
    >> prolong life and it seems surgery at this age is just a
    >> huge risk.
    >>
    >
    > Some surgeons and some cardiologists implant pacemakers.
    > It depends largely on the nature of the practice in the
    > particular location and customs vary widely from region to
    > region. Years ago, cardiologists, recognizing
    > reimbursement rates for this procedure, have largely
    > learned how to implant them and since most cardiac disease
    > in urban areas is seen by cardiologists, they tend to take
    > care of the pacemaker implantation themselves rather than
    > referring them to surgeons. In rural areas, cardiac
    > disease may be seen by internists, who may in turn refer
    > the patients to a surgeon if a pacemaker is required.
    >
    > Pacemaker implantation is generally not a difficult
    > procedure. Learning the technique is usually a part of
    > cardiology fellowship training and cardiologists are
    > generally quite competent at doing it. In this particular
    > case, I wouldn't get too hung up on titles or specialty
    > and pay more attention to the qualifications of the
    > implanting physician your doctor recommends.
    >
    > HMc

    I do trust the implanting physician though since he's board
    certified as a general surgeon as well as other surgery
    subspecialties in the chest area. It's just the internal
    medicine/cardiologist who is the one I'm wondering about who
    is non-board certified since it would seem a second opinion
    from a certified cardiologist is in order to determine
    atleast if the diagnostic results are the similar since the
    lack of discussion with the patient or family members of the
    patient is a primary concern.

    Vince Astrophysics, PhD
     
  12. Vincent Poy

    Vincent Poy Guest

    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in
    news:[email protected]:

    > Vincent Poy wrote:
    >
    >> Hi Dr. Chung:
    >>
    >> "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    >> wrote in news:[email protected]:
    >>
    >> > Vincent Poy wrote:
    >> >
    >> >> Greetings everyone:
    >> >
    >> >> I've been doing a bit of research on the Sick Sinus
    >> >> Syndrome as I could use some input from others
    >> >> concerning my father who is 92 years old. I think the
    >> >> easier way to ask the question is to actually mention
    >> >> the events leading up to today to make it easier.
    >> >> First of all, my father is on a Medicare HMO for
    >> >> insurance so he had a March 4, 11:30AM office visit
    >> >> with his Primary Care Physician who happens to be in
    >> >> Family Practice. I was not with my father on that day
    >> >> but my mother was. The Family Practice physician did
    >> >> the normal blood pressure test and said he does not
    >> >> have hypertension and then I think he did the ECG/EKG
    >> >> which caused him to did a immediate referral to the
    >> >> specialist Internal Medicine/Cardiologist next door.
    >> >> My father is taking the following medications:
    >> >> Glipizide 5mg for diabetes and Aricept 10mg for his
    >> >> Alzheimer's disease and Aspirin 81mg all prescribed by
    >> >> his Primary Care Physician, as well Prevacid 30mg
    >> >> which was prescribed by his Gastroenterologist. So
    >> >> basically what happened after that is my father was
    >> >> sent to the Internal Medicine/Cardiologist next door
    >> >> and waited for about 30 minutes. When the physician
    >> >> finally saw him, he asked questions but my mom
    >> >> answered as he had Alzheimers and the physician was
    >> >> basically yelling at my mom and asked what did my
    >> >> father went to see him for when the Primary Care
    >> >> Physician sent the entire medical record over and he
    >> >> still was asking what medications is he taking and
    >> >> refused to look at the medical records handed to him.
    >> >> I guess when it came time to check for hypertension,
    >> >> he finally realized why my mom was answering for him.
    >> >> He claims my father has hypertension. His office does
    >> >> not have any equipment besides the blood pressure
    >> >> thing. So basically, he did a note and had my father
    >> >> goto the hospital for the Holter Monitor for 24 hours
    >> >> as his heartbeat was abnormal for diagnosis of the
    >> >> Sick Sinus Syndrome. As my father is 92 years old, I
    >> >> wheelchaired him to the hospital which is about 1500
    >> >> feet away from where we live and the doctor's office.
    >> >> When we got to the hospital in the same afternoon on
    >> >> March 4 at about
    >> >> 1:25PM, the Holter Monitor was connected by the
    >> >> hospital department staff and the start time was
    >> >> 1:30PM and we were asked to returned anytime after
    >> >> 1:30PM to have the Holter Monitor removed. So
    >> >> basically, my father did fall twice within that 24
    >> >> hour period due to the weight of the Holter Monitor
    >> >> as he forgot about it as well as boxes that were in
    >> >> his way when he was trying to use the bathroom.
    >> >>
    >> >> So on the next day when I took my father back to the
    >> >> hospital to have the Holter Monitor removed, the
    >> >> hospital staff told me that the gold necklace he is
    >> >> wearing that was directly on top of the taped
    >> >> monitoring area could affect the accuracy of the
    >> >> results.
    >> >>
    >> >> On March 8 at 11:00AM, my father went to see the
    >> >> Gastroenterologist who also did a check for
    >> >> hypertension and said he didn't have any. So when we
    >> >> arrived home that same day, the office assistant for
    >> >> the Internal Medicine/Cardiologist called and said to
    >> >> visit his office between 2:30PM- 3:00PM that same
    >> >> afternoon. At 2:45PM, we were at his office and the
    >> >> only thing he said is that my father's heart stopped
    >> >> for 6-8 minutes twice
    >> >
    >> > You probably meant seconds here.
    >>
    >> The cardiologist meant seconds but he kept telling us
    >> minutes in Chinese.
    >> :)
    >
    >:)

    But you're right since if it was even 5 minutes, I think the
    person would be dead already. :)

    >> > (God's gift of truth discernment here :)
    >> >
    >> >> during the 24 hour period of the Holter Monitor and he
    >> >> had to goto the hospital to have some kind of air
    >> >> tubing connected as there is a high risk of sudden
    >> >> death he said this in Chinese to both myself and my
    >> >> mother. He did not discuss the quality of life/surgery
    >> >> benefits or allowed us to ask any questions as it
    >> >> seems as if he was in a rush to get us out of the
    >> >> office and not giving the patient any choice at all of
    >> >> treatment. The next thing he did was he took out the
    >> >> HMO providers directory and called another physician
    >> >> who is a General/Thoracic Surgeon that I've verified
    >> >> on my own research is board certified. When he talked
    >> >> to the Surgeon, he said my dad had his heart stopped
    >> >> for 6-8 seconds which is the same time as the falls
    >> >> and needs to have a pacemaker done. So after that, he
    >> >> wrote a note for us to have my dad admitted to the
    >> >> hospital the next day at around 2:00PM on March 9,
    >> >> 2004. We were not informed at any point that the
    >> >> Cardiologist himself would not perform the pacemaker
    >> >> surgery procedure and that someone else would perform
    >> >> it. The other thing is usually, isn't it necessary for
    >> >> my father being the patient to have a office
    >> >> consultation with the surgeon prior to determine if
    >> >> the pacemaker or surgery is needed in the first place.
    >> >> From my research on the Sick Sinus Syndrome, doesn't
    >> >> the patient need to experience atleast one of
    >> >> following symptoms: fatigue, fainting, confusion,
    >> >> shortness of breath or trouble of breathing, weakness,
    >> >> palpitations, or an unusual awareness of the heartbeat
    >> >> which can be slow, fast or quite strong?
    >> >
    >> > Sometimes the symptoms are minimal.
    >>
    >> True but doesn't it usually require atleast further
    >> diagnosis.
    >
    > The holter can be enough to cinch the diagnosis.

    That is probably true. I just hope the results were accurate
    and is not because of the holter actually failing and
    providing false results since things do break as I've seen
    ECG/EKG not working correctly before.

    >> >> As far as I know, my father is not experiencing any of
    >> >> those symptoms unless confusion can be misundersood as
    >> >> Alzheimer's disease.
    >> >
    >> > Could be. The falls are also a concern.
    >>
    >> That's true but he hasn't fall before or after the Holter
    >> monitor.
    >
    > That is certainly reassuring.

    Yep, let's just say that the only time he has fallen within
    the past 5 years was with the holter moniter on. In 1999, he
    did have a ingenial hernia repair done by the surgeon
    originally for same day discharge who said his heart was
    beating abnormally so they kept him at the Cardiology floor
    of the hospital for further monitoring for 2 days and had
    referred to a board certified cardiologist who did a check
    up at both the hospital and then after my father was
    discharged without issues, visited his office where he had 2
    holter monitors and had one sent home with my father for 24
    hours and there were no problems either. Ofcourse that was 5
    years ago and his memory as well as his strength in walking
    has gone downhill over the years.

    >> >> The other thing I am concerned about is the diagnosis
    >> >> since doesn't it usually require looking at the
    >> >> medical history and a physical exam which includes
    >> >> heart tracing using a ECG (Electrocardiogram) to
    >> >> confirm the diagnosis prior to the Holter moniter.
    >> >
    >> > Few doctors are able to order appropriate testing and
    >> > treatment without interviewing and examining the
    >> > patient first.
    >>
    >> The interviewing was the part that's missing. He
    >> basically had the entire medical history file in his
    >> hands from the Family Practice physician but he had no
    >> idea why my father was there.
    >
    > That is a concern.

    And I guess the office assistant of the Family Practice
    Physician told him off. =)

    >> >> The Internal Medicine/Cardiologist did not do an ECG
    >> >> at all. The other thing is I thought it usually would
    >> >> take more than one visit to monitor the symptoms but
    >> >> for this physician, it seems to be only one visit
    >> >> with the Holter Moniter and that's it. There is a
    >> >> chance that the Holter Monitor could be defective or
    >> >> the jewelry is affecting the accuracy of the results
    >> >> as mentioned by the hospital staff who did the Holter
    >> >> Monitor removal. Would the medications: Aspirin 81mg,
    >> >> Aricept 10mg, Prevacid 30mg, Glipizide 5mg have any
    >> >> effect on the heartbeat rate?
    >> >
    >> > Not typically.
    >>
    >> That's true, come to think of it.
    >
    > I work at being truthful :)

    I just thought the Aspirin might have a effect but that
    couldn't be it. He used to have Hypertension up to about 3
    years ago and was taking Atenolol which is a drug that does
    something to the heart.

    >> >> From reading this newsgroup, I've also learned that
    >> >> usually it's the Cardiologist who does the pacemaker
    >> >> procedure and also prior to being admitted to any
    >> >> hospital in the US, isn't a blood sample needed to
    >> >> check for potassium levels as well as the thickness
    >> >> of the blood and other tests to see if there are
    >> >> other paths for the blood to flow from the heart?
    >> >
    >> > It is likely that these blood tests would have been
    >> > scheduled and done shortly before the pacemaker
    >> > implantation.
    >>
    >> Speaking about pacemaker implantation, is the
    >> cardiologist supposed to be the one who does it or is a
    >> surgeon supposed to do it?
    >
    > Whoever is able to do it best is the one who should
    > do it :)

    That's true too. My only real concern is the diagnosis
    portion and from reading everything anyone has said, it
    seems a board certified cardiologist for a second opinion
    is in order.

    >> The other thing about Sick Sinus Syndrome and the issue
    >> of sudden death is from my understanding after doing
    >> some research on the net, I thought a person with SSS
    >> can injure themselves during a fainting episode.
    >
    > Yes.
    >
    > Falling can result in severe injuries recalling the recent
    > demise of
    > Dr. Bob Atkins.

    If I'm not mistaken, falling seems to be bad even without
    SSS if one had hypertension or a stroke.

    >> An individual with certain arrhythmias has an increased
    >> risk of blood clots which can cause a stroke and there
    >> is a rare risk of sudden death that can occur if the
    >> heart stops beating for a long period of time. So is it
    >> correct that the sudden death is a rare risk rather than
    >> a high risk like this Cardiologist has stated.
    >
    > Sudden death from sick sinus syndrome (SSS) is rare.

    This non-board certified cardiologist made it sound like it
    was a high risk.

    >> I mean my father is 92 years old and as far as I know,
    >> the pacemaker won't prolong life and it seems surgery at
    >> this age is just a huge risk.
    >
    > I would not say it is *huge* but there is a
    > significant risk.

    Yep, seems like anything related to the organs, heart or
    even brain has some significant risk.

    >> >> At the present time, I've told both the Internal
    >> >> Medicine/Cardiologist and the Surgeon to postpone the
    >> >> procedure until further notice since I'm worry about
    >> >> the risk of my father at his old age. One other thing
    >> >> is for the 10 Cardiologists listed in the HMO, this
    >> >> is the only one who is not Board Certified in either
    >> >> Internal Medicine or Cardiology. Is this something to
    >> >> worry about?
    >> >
    >> > It may be a concern.
    >>
    >> Yeah, I was just looking at your website and I think I
    >> know what the certification is about. The MD is more like
    >> just to certify that one has completed Medical School and
    >> can practice Family/General Practice assuming they are
    >> licensed in the State they are practicing in. Then for
    >> things like Surgery, Internal Medicine, Cardiology, they
    >> require certification in each of those areas practice to
    >> atleast show that the person in question is actually
    >> qualified in those areas. I guess if they aren't
    >> certified, then it's almost like someone trying to be a
    >> doctor when they are a engineer.
    >> :) So while on the subject, I am in California and
    >> :believe it or
    >> :not, this Internal Medicine/Cardiology physician does
    >> have the last name of Chung as well but on the AMA, he
    >> lists himself as follows:
    >>
    >> Primary Specialty: Internal Medicine Major Professional
    >> Activity: Office Based Practice Medical School: UNIV OF
    >> THE EAST, RAMON MAGSAYSAY MEM MED CTR, QUEZON CITY
    >> Graduated 1984 Residency Training: UNIV CA SF SCH OF MED,
    >> CARDIOVASCULAR DISEASES ST LUKE'S MED CTR, INTERNAL
    >> MEDICINE
    >>
    >> but when one goes to ABMS or ABIM, it shows him as Not
    >> certified. California's Board of Medicine shows his
    >> original license issued in 1992 and it'll expire next
    >> year. So basically for someone who claims to be in
    >> Internal Medicine/Cardiology that completed their MD in
    >> the Philippines and then did their residency at UCSF
    >> School of Medicine as well as St Luke's Medical Center in
    >> San Francisco and has been private practice after being
    >> licensed in California for the last 12 years, he is not
    >> board certified for anything he claims to specialize
    >> in. It does raise a great concern as he doesn't seem to
    >> have any credentials other than the MD and the
    >> residency training or atleast he's not board
    >> certified in the areas of his residency training.
    >>
    >> >> Sorry for all the questions but I hope someone can
    >> >> provide some input. Thanks for your help in advance!
    >> >
    >> > All praises belong to God, Vince :)
    >>
    >> Heh, and to you too Andrew! :)
    >
    > I wouldn't be here if it were not for God's grace.

    Yeah, and the world is better when there are more people
    like you out there .

    > May God watch over you and your mom, in Christ's name.

    Thanks.

    Cheers, Vince Astrophysics PhD
     
  13. Vincent Poy

    Vincent Poy Guest

    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in
    news:[email protected]:

    > Vincent Poy wrote:
    >
    >> Hi Dr. Chung:
    >>
    >> "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    >> wrote in news:[email protected]:
    >>
    >> > Vincent Poy wrote:
    >> >
    >> >> Greetings everyone:
    >> >
    >> >> I've been doing a bit of research on the Sick Sinus
    >> >> Syndrome as I could use some input from others
    >> >> concerning my father who is 92 years old. I think the
    >> >> easier way to ask the question is to actually mention
    >> >> the events leading up to today to make it easier.
    >> >> First of all, my father is on a Medicare HMO for
    >> >> insurance so he had a March 4, 11:30AM office visit
    >> >> with his Primary Care Physician who happens to be in
    >> >> Family Practice. I was not with my father on that day
    >> >> but my mother was. The Family Practice physician did
    >> >> the normal blood pressure test and said he does not
    >> >> have hypertension and then I think he did the ECG/EKG
    >> >> which caused him to did a immediate referral to the
    >> >> specialist Internal Medicine/Cardiologist next door.
    >> >> My father is taking the following medications:
    >> >> Glipizide 5mg for diabetes and Aricept 10mg for his
    >> >> Alzheimer's disease and Aspirin 81mg all prescribed by
    >> >> his Primary Care Physician, as well Prevacid 30mg
    >> >> which was prescribed by his Gastroenterologist. So
    >> >> basically what happened after that is my father was
    >> >> sent to the Internal Medicine/Cardiologist next door
    >> >> and waited for about 30 minutes. When the physician
    >> >> finally saw him, he asked questions but my mom
    >> >> answered as he had Alzheimers and the physician was
    >> >> basically yelling at my mom and asked what did my
    >> >> father went to see him for when the Primary Care
    >> >> Physician sent the entire medical record over and he
    >> >> still was asking what medications is he taking and
    >> >> refused to look at the medical records handed to him.
    >> >> I guess when it came time to check for hypertension,
    >> >> he finally realized why my mom was answering for him.
    >> >> He claims my father has hypertension. His office does
    >> >> not have any equipment besides the blood pressure
    >> >> thing. So basically, he did a note and had my father
    >> >> goto the hospital for the Holter Monitor for 24 hours
    >> >> as his heartbeat was abnormal for diagnosis of the
    >> >> Sick Sinus Syndrome. As my father is 92 years old, I
    >> >> wheelchaired him to the hospital which is about 1500
    >> >> feet away from where we live and the doctor's office.
    >> >> When we got to the hospital in the same afternoon on
    >> >> March 4 at about
    >> >> 1:25PM, the Holter Monitor was connected by the
    >> >> hospital department staff and the start time was
    >> >> 1:30PM and we were asked to returned anytime after
    >> >> 1:30PM to have the Holter Monitor removed. So
    >> >> basically, my father did fall twice within that 24
    >> >> hour period due to the weight of the Holter Monitor
    >> >> as he forgot about it as well as boxes that were in
    >> >> his way when he was trying to use the bathroom.
    >> >>
    >> >> So on the next day when I took my father back to the
    >> >> hospital to have the Holter Monitor removed, the
    >> >> hospital staff told me that the gold necklace he is
    >> >> wearing that was directly on top of the taped
    >> >> monitoring area could affect the accuracy of the
    >> >> results.
    >> >>
    >> >> On March 8 at 11:00AM, my father went to see the
    >> >> Gastroenterologist who also did a check for
    >> >> hypertension and said he didn't have any. So when we
    >> >> arrived home that same day, the office assistant for
    >> >> the Internal Medicine/Cardiologist called and said to
    >> >> visit his office between 2:30PM- 3:00PM that same
    >> >> afternoon. At 2:45PM, we were at his office and the
    >> >> only thing he said is that my father's heart stopped
    >> >> for 6-8 minutes twice
    >> >
    >> > You probably meant seconds here.
    >>
    >> The cardiologist meant seconds but he kept telling us
    >> minutes in Chinese.
    >> :)
    >
    >:)

    But you're right since if it was even 5 minutes, I think the
    person would be dead already. :)

    >> > (God's gift of truth discernment here :)
    >> >
    >> >> during the 24 hour period of the Holter Monitor and he
    >> >> had to goto the hospital to have some kind of air
    >> >> tubing connected as there is a high risk of sudden
    >> >> death he said this in Chinese to both myself and my
    >> >> mother. He did not discuss the quality of life/surgery
    >> >> benefits or allowed us to ask any questions as it
    >> >> seems as if he was in a rush to get us out of the
    >> >> office and not giving the patient any choice at all of
    >> >> treatment. The next thing he did was he took out the
    >> >> HMO providers directory and called another physician
    >> >> who is a General/Thoracic Surgeon that I've verified
    >> >> on my own research is board certified. When he talked
    >> >> to the Surgeon, he said my dad had his heart stopped
    >> >> for 6-8 seconds which is the same time as the falls
    >> >> and needs to have a pacemaker done. So after that, he
    >> >> wrote a note for us to have my dad admitted to the
    >> >> hospital the next day at around 2:00PM on March 9,
    >> >> 2004. We were not informed at any point that the
    >> >> Cardiologist himself would not perform the pacemaker
    >> >> surgery procedure and that someone else would perform
    >> >> it. The other thing is usually, isn't it necessary for
    >> >> my father being the patient to have a office
    >> >> consultation with the surgeon prior to determine if
    >> >> the pacemaker or surgery is needed in the first place.
    >> >> From my research on the Sick Sinus Syndrome, doesn't
    >> >> the patient need to experience atleast one of
    >> >> following symptoms: fatigue, fainting, confusion,
    >> >> shortness of breath or trouble of breathing, weakness,
    >> >> palpitations, or an unusual awareness of the heartbeat
    >> >> which can be slow, fast or quite strong?
    >> >
    >> > Sometimes the symptoms are minimal.
    >>
    >> True but doesn't it usually require atleast further
    >> diagnosis.
    >
    > The holter can be enough to cinch the diagnosis.

    That is probably true. I just hope the results were accurate
    and is not because of the holter actually failing and
    providing false results since things do break as I've seen
    ECG/EKG not working correctly before.

    >> >> As far as I know, my father is not experiencing any of
    >> >> those symptoms unless confusion can be misundersood as
    >> >> Alzheimer's disease.
    >> >
    >> > Could be. The falls are also a concern.
    >>
    >> That's true but he hasn't fall before or after the Holter
    >> monitor.
    >
    > That is certainly reassuring.

    Yep, let's just say that the only time he has fallen within
    the past 5 years was with the holter moniter on. In 1999, he
    did have a ingenial hernia repair done by the surgeon
    originally for same day discharge who said his heart was
    beating abnormally so they kept him at the Cardiology floor
    of the hospital for further monitoring for 2 days and had
    referred to a board certified cardiologist who did a check
    up at both the hospital and then after my father was
    discharged without issues, visited his office where he had 2
    holter monitors and had one sent home with my father for 24
    hours and there were no problems either. Ofcourse that was 5
    years ago and his memory as well as his strength in walking
    has gone downhill over the years.

    >> >> The other thing I am concerned about is the diagnosis
    >> >> since doesn't it usually require looking at the
    >> >> medical history and a physical exam which includes
    >> >> heart tracing using a ECG (Electrocardiogram) to
    >> >> confirm the diagnosis prior to the Holter moniter.
    >> >
    >> > Few doctors are able to order appropriate testing and
    >> > treatment without interviewing and examining the
    >> > patient first.
    >>
    >> The interviewing was the part that's missing. He
    >> basically had the entire medical history file in his
    >> hands from the Family Practice physician but he had no
    >> idea why my father was there.
    >
    > That is a concern.

    And I guess the office assistant of the Family Practice
    Physician told him off. =)

    >> >> The Internal Medicine/Cardiologist did not do an ECG
    >> >> at all. The other thing is I thought it usually would
    >> >> take more than one visit to monitor the symptoms but
    >> >> for this physician, it seems to be only one visit
    >> >> with the Holter Moniter and that's it. There is a
    >> >> chance that the Holter Monitor could be defective or
    >> >> the jewelry is affecting the accuracy of the results
    >> >> as mentioned by the hospital staff who did the Holter
    >> >> Monitor removal. Would the medications: Aspirin 81mg,
    >> >> Aricept 10mg, Prevacid 30mg, Glipizide 5mg have any
    >> >> effect on the heartbeat rate?
    >> >
    >> > Not typically.
    >>
    >> That's true, come to think of it.
    >
    > I work at being truthful :)

    I just thought the Aspirin might have a effect but that
    couldn't be it. He used to have Hypertension up to about 3
    years ago and was taking Atenolol which is a drug that does
    something to the heart.

    >> >> From reading this newsgroup, I've also learned that
    >> >> usually it's the Cardiologist who does the pacemaker
    >> >> procedure and also prior to being admitted to any
    >> >> hospital in the US, isn't a blood sample needed to
    >> >> check for potassium levels as well as the thickness
    >> >> of the blood and other tests to see if there are
    >> >> other paths for the blood to flow from the heart?
    >> >
    >> > It is likely that these blood tests would have been
    >> > scheduled and done shortly before the pacemaker
    >> > implantation.
    >>
    >> Speaking about pacemaker implantation, is the
    >> cardiologist supposed to be the one who does it or is a
    >> surgeon supposed to do it?
    >
    > Whoever is able to do it best is the one who should
    > do it :)

    That's true too. My only real concern is the diagnosis
    portion and from reading everything anyone has said, it
    seems a board certified cardiologist for a second opinion
    is in order.

    >> The other thing about Sick Sinus Syndrome and the issue
    >> of sudden death is from my understanding after doing
    >> some research on the net, I thought a person with SSS
    >> can injure themselves during a fainting episode.
    >
    > Yes.
    >
    > Falling can result in severe injuries recalling the recent
    > demise of
    > Dr. Bob Atkins.

    If I'm not mistaken, falling seems to be bad even without
    SSS if one had hypertension or a stroke.

    >> An individual with certain arrhythmias has an increased
    >> risk of blood clots which can cause a stroke and there
    >> is a rare risk of sudden death that can occur if the
    >> heart stops beating for a long period of time. So is it
    >> correct that the sudden death is a rare risk rather than
    >> a high risk like this Cardiologist has stated.
    >
    > Sudden death from sick sinus syndrome (SSS) is rare.

    This non-board certified cardiologist made it sound like it
    was a high risk.

    >> I mean my father is 92 years old and as far as I know,
    >> the pacemaker won't prolong life and it seems surgery at
    >> this age is just a huge risk.
    >
    > I would not say it is *huge* but there is a
    > significant risk.

    Yep, seems like anything related to the organs, heart or
    even brain has some significant risk.

    >> >> At the present time, I've told both the Internal
    >> >> Medicine/Cardiologist and the Surgeon to postpone the
    >> >> procedure until further notice since I'm worry about
    >> >> the risk of my father at his old age. One other thing
    >> >> is for the 10 Cardiologists listed in the HMO, this
    >> >> is the only one who is not Board Certified in either
    >> >> Internal Medicine or Cardiology. Is this something to
    >> >> worry about?
    >> >
    >> > It may be a concern.
    >>
    >> Yeah, I was just looking at your website and I think I
    >> know what the certification is about. The MD is more like
    >> just to certify that one has completed Medical School and
    >> can practice Family/General Practice assuming they are
    >> licensed in the State they are practicing in. Then for
    >> things like Surgery, Internal Medicine, Cardiology, they
    >> require certification in each of those areas practice to
    >> atleast show that the person in question is actually
    >> qualified in those areas. I guess if they aren't
    >> certified, then it's almost like someone trying to be a
    >> doctor when they are a engineer.
    >> :) So while on the subject, I am in California and
    >> :believe it or
    >> :not, this Internal Medicine/Cardiology physician does
    >> have the last name of Chung as well but on the AMA, he
    >> lists himself as follows:
    >>
    >> Primary Specialty: Internal Medicine Major Professional
    >> Activity: Office Based Practice Medical School: UNIV OF
    >> THE EAST, RAMON MAGSAYSAY MEM MED CTR, QUEZON CITY
    >> Graduated 1984 Residency Training: UNIV CA SF SCH OF MED,
    >> CARDIOVASCULAR DISEASES ST LUKE'S MED CTR, INTERNAL
    >> MEDICINE
    >>
    >> but when one goes to ABMS or ABIM, it shows him as Not
    >> certified. California's Board of Medicine shows his
    >> original license issued in 1992 and it'll expire next
    >> year. So basically for someone who claims to be in
    >> Internal Medicine/Cardiology that completed their MD in
    >> the Philippines and then did their residency at UCSF
    >> School of Medicine as well as St Luke's Medical Center in
    >> San Francisco and has been private practice after being
    >> licensed in California for the last 12 years, he is not
    >> board certified for anything he claims to specialize
    >> in. It does raise a great concern as he doesn't seem to
    >> have any credentials other than the MD and the
    >> residency training or atleast he's not board
    >> certified in the areas of his residency training.
    >>
    >> >> Sorry for all the questions but I hope someone can
    >> >> provide some input. Thanks for your help in advance!
    >> >
    >> > All praises belong to God, Vince :)
    >>
    >> Heh, and to you too Andrew! :)
    >
    > I wouldn't be here if it were not for God's grace.

    Yeah, and the world is better when there are more people
    like you out there .

    > May God watch over you and your mom, in Christ's name.

    Thanks.

    Cheers, Vince Astrophysics PhD
     
  14. Vincent Poy wrote:
    >
    > "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    > wrote in news:[email protected]:
    >
    <snip>
    > > The holter can be enough to cinch the diagnosis.
    >
    > That is probably true. I just hope the results were
    > accurate and is not because of the holter actually failing
    > and providing false results since things do break as I've
    > seen ECG/EKG not working correctly before.

    The holter monitor typically has multiple leads. It would be
    unusual for *all* of the leads to malfunction (disconnect)
    for 5-6 seconds to create an artefactual sinus pause.

    > >> >> As far as I know, my father is not experiencing any
    > >> >> of those symptoms unless confusion can be
    > >> >> misundersood as Alzheimer's disease.
    > >> >
    > >> > Could be. The falls are also a concern.
    > >>
    > >> That's true but he hasn't fall before or after the
    > >> Holter monitor.
    > >
    > > That is certainly reassuring.
    >
    > Yep, let's just say that the only time he has fallen
    > within the past 5 years was with the holter moniter on. In
    > 1999, he did have a ingenial hernia repair done by the
    > surgeon originally for same day discharge who said his
    > heart was beating abnormally so they kept him at the
    > Cardiology floor of the hospital for further monitoring
    > for 2 days and had referred to a board certified
    > cardiologist who did a check up at both the hospital and
    > then after my father was discharged without issues,
    > visited his office where he had 2 holter monitors and had
    > one sent home with my father for 24 hours and there were
    > no problems either. Ofcourse that was 5 years ago and his
    > memory as well as his strength in walking has gone
    > downhill over the years.

    Alzheimer's is not a forgiving disease.

    > >> >> The other thing I am concerned about is the
    > >> >> diagnosis since doesn't it usually require looking
    > >> >> at the medical history and a physical exam which
    > >> >> includes heart tracing using a ECG
    > >> >> (Electrocardiogram) to confirm the diagnosis prior
    > >> >> to the Holter moniter.
    > >> >
    > >> > Few doctors are able to order appropriate testing and
    > >> > treatment without interviewing and examining the
    > >> > patient first.
    > >>
    > >> The interviewing was the part that's missing. He
    > >> basically had the entire medical history file in his
    > >> hands from the Family Practice physician but he had no
    > >> idea why my father was there.
    > >
    > > That is a concern.
    >
    > And I guess the office assistant of the Family Practice
    > Physician told him off. =)

    That certainly does not help.

    > >> >> The Internal Medicine/Cardiologist did not do an
    > >> >> ECG at all. The other thing is I thought it usually
    > >> >> would take more than one visit to monitor the
    > >> >> symptoms but for this physician, it seems to be
    > >> >> only one visit with the Holter Moniter and that's
    > >> >> it. There is a chance that the Holter Monitor could
    > >> >> be defective or the jewelry is affecting the
    > >> >> accuracy of the results as mentioned by the
    > >> >> hospital staff who did the Holter Monitor removal.
    > >> >> Would the medications: Aspirin 81mg, Aricept 10mg,
    > >> >> Prevacid 30mg, Glipizide 5mg have any effect on the
    > >> >> heartbeat rate?
    > >> >
    > >> > Not typically.
    > >>
    > >> That's true, come to think of it.
    > >
    > > I work at being truthful :)
    >
    > I just thought the Aspirin might have a effect but that
    > couldn't be it.

    Correct.

    > He used to have Hypertension up to about 3 years ago and
    > was taking Atenolol which is a drug that does something
    > to the heart.

    Yes, atenolol can exacerabate SSS.

    > >> >> From reading this newsgroup, I've also learned that
    > >> >> usually it's the Cardiologist who does the
    > >> >> pacemaker procedure and also prior to being
    > >> >> admitted to any hospital in the US, isn't a blood
    > >> >> sample needed to check for potassium levels as well
    > >> >> as the thickness of the blood and other tests to
    > >> >> see if there are other paths for the blood to flow
    > >> >> from the heart?
    > >> >
    > >> > It is likely that these blood tests would have been
    > >> > scheduled and done shortly before the pacemaker
    > >> > implantation.
    > >>
    > >> Speaking about pacemaker implantation, is the
    > >> cardiologist supposed to be the one who does it or is a
    > >> surgeon supposed to do it?
    > >
    > > Whoever is able to do it best is the one who should do
    > > it :)
    >
    > That's true too. My only real concern is the diagnosis
    > portion and from reading everything anyone has said, it
    > seems a board certified cardiologist for a second opinion
    > is in order.

    I don't believe anyone would argue against second opinions
    in general.

    > >> The other thing about Sick Sinus Syndrome and the
    > >> issue of sudden death is from my understanding after
    > >> doing some research on the net, I thought a person
    > >> with SSS can injure themselves during a fainting
    > >> episode.
    > >
    > > Yes.
    > >
    > > Falling can result in severe injuries recalling the
    > > recent demise of
    > > Dr. Bob Atkins.
    >
    > If I'm not mistaken, falling seems to be bad even without
    > SSS if one had hypertension or a stroke.

    Especially for the elderly.

    > >> An individual with certain arrhythmias has an
    > >> increased risk of blood clots which can cause a stroke
    > >> and there is a rare risk of sudden death that can
    > >> occur if the heart stops beating for a long period of
    > >> time. So is it correct that the sudden death is a rare
    > >> risk rather than a high risk like this Cardiologist
    > >> has stated.
    > >
    > > Sudden death from sick sinus syndrome (SSS) is rare.
    >
    > This non-board certified cardiologist made it sound like
    > it was a high risk.

    It may not have been intentional.

    > >> I mean my father is 92 years old and as far as I know,
    > >> the pacemaker won't prolong life and it seems surgery
    > >> at this age is just a huge risk.
    > >
    > > I would not say it is *huge* but there is a
    > > significant risk.
    >
    > Yep, seems like anything related to the organs, heart or
    > even brain has some significant risk.

    All invasive procedures have significant risk.

    > >> >> At the present time, I've told both the Internal
    > >> >> Medicine/Cardiologist and the Surgeon to postpone
    > >> >> the procedure until further notice since I'm worry
    > >> >> about the risk of my father at his old age. One
    > >> >> other thing is for the 10 Cardiologists listed in
    > >> >> the HMO, this is the only one who is not Board
    > >> >> Certified in either Internal Medicine or
    > >> >> Cardiology. Is this something to worry about?
    > >> >
    > >> > It may be a concern.
    > >>
    > >> Yeah, I was just looking at your website and I think I
    > >> know what the certification is about. The MD is more
    > >> like just to certify that one has completed Medical
    > >> School and can practice Family/General Practice
    > >> assuming they are licensed in the State they are
    > >> practicing in. Then for things like Surgery, Internal
    > >> Medicine, Cardiology, they require certification in
    > >> each of those areas practice to atleast show that the
    > >> person in question is actually qualified in those
    > >> areas. I guess if they aren't certified, then it's
    > >> almost like someone trying to be a doctor when they are
    > >> a engineer.
    > >> :) So while on the subject, I am in California and
    > >> :believe it or
    > >> :not, this Internal Medicine/Cardiology physician does
    > >> have the last name of Chung as well but on the AMA, he
    > >> lists himself as follows:
    > >>
    > >> Primary Specialty: Internal Medicine Major Professional
    > >> Activity: Office Based Practice Medical School: UNIV OF
    > >> THE EAST, RAMON MAGSAYSAY MEM MED CTR, QUEZON CITY
    > >> Graduated 1984 Residency Training: UNIV CA SF SCH OF
    > >> MED, CARDIOVASCULAR DISEASES ST LUKE'S MED CTR,
    > >> INTERNAL MEDICINE
    > >>
    > >> but when one goes to ABMS or ABIM, it shows him as Not
    > >> certified. California's Board of Medicine shows his
    > >> original license issued in 1992 and it'll expire next
    > >> year. So basically for someone who claims to be in
    > >> Internal Medicine/Cardiology that completed their MD in
    > >> the Philippines and then did their residency at UCSF
    > >> School of Medicine as well as St Luke's Medical Center
    > >> in San Francisco and has been private practice after
    > >> being licensed in California for the last 12 years, he
    > >> is not board certified for anything he claims to
    > >> specialize
    > >> in. It does raise a great concern as he doesn't seem
    > >> to have any credentials other than the MD and the
    > >> residency training or atleast he's not board
    > >> certified in the areas of his residency training.
    > >>
    > >> >> Sorry for all the questions but I hope someone can
    > >> >> provide some input. Thanks for your help in
    > >> >> advance!
    > >> >
    > >> > All praises belong to God, Vince :)
    > >>
    > >> Heh, and to you too Andrew! :)
    > >
    > > I wouldn't be here if it were not for God's grace.
    >
    > Yeah, and the world is better when there are more people
    > like you out there.

    That seems to be His plan at the moment.

    >
    > > May God watch over you and your mom, in Christ's name.
    >
    > Thanks.
    >
    > Cheers, Vince Astrophysics PhD

    You and your family will be in my prayers, Vince.

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/

    **
    Who is the humblest person in the universe?
    http://makeashorterlink.com/?W1F522557

    What is all this about?
    http://makeashorterlink.com/?A26B16397

    Is this spam?
    http://makeashorterlink.com/?N69721867
     
  15. Vincent Poy wrote:
    >
    > "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    > wrote in news:[email protected]:
    >
    <snip>
    > > The holter can be enough to cinch the diagnosis.
    >
    > That is probably true. I just hope the results were
    > accurate and is not because of the holter actually failing
    > and providing false results since things do break as I've
    > seen ECG/EKG not working correctly before.

    The holter monitor typically has multiple leads. It would be
    unusual for *all* of the leads to malfunction (disconnect)
    for 5-6 seconds to create an artefactual sinus pause.

    > >> >> As far as I know, my father is not experiencing any
    > >> >> of those symptoms unless confusion can be
    > >> >> misundersood as Alzheimer's disease.
    > >> >
    > >> > Could be. The falls are also a concern.
    > >>
    > >> That's true but he hasn't fall before or after the
    > >> Holter monitor.
    > >
    > > That is certainly reassuring.
    >
    > Yep, let's just say that the only time he has fallen
    > within the past 5 years was with the holter moniter on. In
    > 1999, he did have a ingenial hernia repair done by the
    > surgeon originally for same day discharge who said his
    > heart was beating abnormally so they kept him at the
    > Cardiology floor of the hospital for further monitoring
    > for 2 days and had referred to a board certified
    > cardiologist who did a check up at both the hospital and
    > then after my father was discharged without issues,
    > visited his office where he had 2 holter monitors and had
    > one sent home with my father for 24 hours and there were
    > no problems either. Ofcourse that was 5 years ago and his
    > memory as well as his strength in walking has gone
    > downhill over the years.

    Alzheimer's is not a forgiving disease.

    > >> >> The other thing I am concerned about is the
    > >> >> diagnosis since doesn't it usually require looking
    > >> >> at the medical history and a physical exam which
    > >> >> includes heart tracing using a ECG
    > >> >> (Electrocardiogram) to confirm the diagnosis prior
    > >> >> to the Holter moniter.
    > >> >
    > >> > Few doctors are able to order appropriate testing and
    > >> > treatment without interviewing and examining the
    > >> > patient first.
    > >>
    > >> The interviewing was the part that's missing. He
    > >> basically had the entire medical history file in his
    > >> hands from the Family Practice physician but he had no
    > >> idea why my father was there.
    > >
    > > That is a concern.
    >
    > And I guess the office assistant of the Family Practice
    > Physician told him off. =)

    That certainly does not help.

    > >> >> The Internal Medicine/Cardiologist did not do an
    > >> >> ECG at all. The other thing is I thought it usually
    > >> >> would take more than one visit to monitor the
    > >> >> symptoms but for this physician, it seems to be
    > >> >> only one visit with the Holter Moniter and that's
    > >> >> it. There is a chance that the Holter Monitor could
    > >> >> be defective or the jewelry is affecting the
    > >> >> accuracy of the results as mentioned by the
    > >> >> hospital staff who did the Holter Monitor removal.
    > >> >> Would the medications: Aspirin 81mg, Aricept 10mg,
    > >> >> Prevacid 30mg, Glipizide 5mg have any effect on the
    > >> >> heartbeat rate?
    > >> >
    > >> > Not typically.
    > >>
    > >> That's true, come to think of it.
    > >
    > > I work at being truthful :)
    >
    > I just thought the Aspirin might have a effect but that
    > couldn't be it.

    Correct.

    > He used to have Hypertension up to about 3 years ago and
    > was taking Atenolol which is a drug that does something
    > to the heart.

    Yes, atenolol can exacerabate SSS.

    > >> >> From reading this newsgroup, I've also learned that
    > >> >> usually it's the Cardiologist who does the
    > >> >> pacemaker procedure and also prior to being
    > >> >> admitted to any hospital in the US, isn't a blood
    > >> >> sample needed to check for potassium levels as well
    > >> >> as the thickness of the blood and other tests to
    > >> >> see if there are other paths for the blood to flow
    > >> >> from the heart?
    > >> >
    > >> > It is likely that these blood tests would have been
    > >> > scheduled and done shortly before the pacemaker
    > >> > implantation.
    > >>
    > >> Speaking about pacemaker implantation, is the
    > >> cardiologist supposed to be the one who does it or is a
    > >> surgeon supposed to do it?
    > >
    > > Whoever is able to do it best is the one who should do
    > > it :)
    >
    > That's true too. My only real concern is the diagnosis
    > portion and from reading everything anyone has said, it
    > seems a board certified cardiologist for a second opinion
    > is in order.

    I don't believe anyone would argue against second opinions
    in general.

    > >> The other thing about Sick Sinus Syndrome and the
    > >> issue of sudden death is from my understanding after
    > >> doing some research on the net, I thought a person
    > >> with SSS can injure themselves during a fainting
    > >> episode.
    > >
    > > Yes.
    > >
    > > Falling can result in severe injuries recalling the
    > > recent demise of
    > > Dr. Bob Atkins.
    >
    > If I'm not mistaken, falling seems to be bad even without
    > SSS if one had hypertension or a stroke.

    Especially for the elderly.

    > >> An individual with certain arrhythmias has an
    > >> increased risk of blood clots which can cause a stroke
    > >> and there is a rare risk of sudden death that can
    > >> occur if the heart stops beating for a long period of
    > >> time. So is it correct that the sudden death is a rare
    > >> risk rather than a high risk like this Cardiologist
    > >> has stated.
    > >
    > > Sudden death from sick sinus syndrome (SSS) is rare.
    >
    > This non-board certified cardiologist made it sound like
    > it was a high risk.

    It may not have been intentional.

    > >> I mean my father is 92 years old and as far as I know,
    > >> the pacemaker won't prolong life and it seems surgery
    > >> at this age is just a huge risk.
    > >
    > > I would not say it is *huge* but there is a
    > > significant risk.
    >
    > Yep, seems like anything related to the organs, heart or
    > even brain has some significant risk.

    All invasive procedures have significant risk.

    > >> >> At the present time, I've told both the Internal
    > >> >> Medicine/Cardiologist and the Surgeon to postpone
    > >> >> the procedure until further notice since I'm worry
    > >> >> about the risk of my father at his old age. One
    > >> >> other thing is for the 10 Cardiologists listed in
    > >> >> the HMO, this is the only one who is not Board
    > >> >> Certified in either Internal Medicine or
    > >> >> Cardiology. Is this something to worry about?
    > >> >
    > >> > It may be a concern.
    > >>
    > >> Yeah, I was just looking at your website and I think I
    > >> know what the certification is about. The MD is more
    > >> like just to certify that one has completed Medical
    > >> School and can practice Family/General Practice
    > >> assuming they are licensed in the State they are
    > >> practicing in. Then for things like Surgery, Internal
    > >> Medicine, Cardiology, they require certification in
    > >> each of those areas practice to atleast show that the
    > >> person in question is actually qualified in those
    > >> areas. I guess if they aren't certified, then it's
    > >> almost like someone trying to be a doctor when they are
    > >> a engineer.
    > >> :) So while on the subject, I am in California and
    > >> :believe it or
    > >> :not, this Internal Medicine/Cardiology physician does
    > >> have the last name of Chung as well but on the AMA, he
    > >> lists himself as follows:
    > >>
    > >> Primary Specialty: Internal Medicine Major Professional
    > >> Activity: Office Based Practice Medical School: UNIV OF
    > >> THE EAST, RAMON MAGSAYSAY MEM MED CTR, QUEZON CITY
    > >> Graduated 1984 Residency Training: UNIV CA SF SCH OF
    > >> MED, CARDIOVASCULAR DISEASES ST LUKE'S MED CTR,
    > >> INTERNAL MEDICINE
    > >>
    > >> but when one goes to ABMS or ABIM, it shows him as Not
    > >> certified. California's Board of Medicine shows his
    > >> original license issued in 1992 and it'll expire next
    > >> year. So basically for someone who claims to be in
    > >> Internal Medicine/Cardiology that completed their MD in
    > >> the Philippines and then did their residency at UCSF
    > >> School of Medicine as well as St Luke's Medical Center
    > >> in San Francisco and has been private practice after
    > >> being licensed in California for the last 12 years, he
    > >> is not board certified for anything he claims to
    > >> specialize
    > >> in. It does raise a great concern as he doesn't seem
    > >> to have any credentials other than the MD and the
    > >> residency training or atleast he's not board
    > >> certified in the areas of his residency training.
    > >>
    > >> >> Sorry for all the questions but I hope someone can
    > >> >> provide some input. Thanks for your help in
    > >> >> advance!
    > >> >
    > >> > All praises belong to God, Vince :)
    > >>
    > >> Heh, and to you too Andrew! :)
    > >
    > > I wouldn't be here if it were not for God's grace.
    >
    > Yeah, and the world is better when there are more people
    > like you out there.

    That seems to be His plan at the moment.

    >
    > > May God watch over you and your mom, in Christ's name.
    >
    > Thanks.
    >
    > Cheers, Vince Astrophysics PhD

    You and your family will be in my prayers, Vince.

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/

    **
    Who is the humblest person in the universe?
    http://makeashorterlink.com/?W1F522557

    What is all this about?
    http://makeashorterlink.com/?A26B16397

    Is this spam?
    http://makeashorterlink.com/?N69721867
     
  16. Vincent Poy

    Vincent Poy Guest

    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in
    news:[email protected]:

    > Vincent Poy wrote:
    >>
    >> "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    >> wrote in news:[email protected]:
    >>
    > <snip>
    >> > The holter can be enough to cinch the diagnosis.
    >>
    >> That is probably true. I just hope the results were
    >> accurate and is not because of the holter actually
    >> failing and providing false results since things do break
    >> as I've seen ECG/EKG not working correctly before.
    >
    > The holter monitor typically has multiple leads. It would
    > be unusual for *all* of the leads to malfunction
    > (disconnect) for 5-6 seconds to create an artefactual
    > sinus pause.

    When I mean malfunction, I don't mean disconnect since
    holter monitors do have electronics inside and sometimes,
    weird things happen. In science, nothing is really ever
    fully 100%. It's always 99% followed by 9's after the
    decimal place.

    >> >> >> As far as I know, my father is not experiencing any
    >> >> >> of those symptoms unless confusion can be
    >> >> >> misundersood as Alzheimer's disease.
    >> >> >
    >> >> > Could be. The falls are also a concern.
    >> >>
    >> >> That's true but he hasn't fall before or after the
    >> >> Holter monitor.
    >> >
    >> > That is certainly reassuring.
    >>
    >> Yep, let's just say that the only time he has fallen
    >> within the past 5 years was with the holter moniter on.
    >> In 1999, he did have a ingenial hernia repair done by the
    >> surgeon originally for same day discharge who said his
    >> heart was beating abnormally so they kept him at the
    >> Cardiology floor of the hospital for further monitoring
    >> for 2 days and had referred to a board certified
    >> cardiologist who did a check up at both the hospital and
    >> then after my father was discharged without issues,
    >> visited his office where he had 2 holter monitors and had
    >> one sent home with my father for 24 hours and there were
    >> no problems either. Ofcourse that was 5 years ago and his
    >> memory as well as his strength in walking has gone
    >> downhill over the years.
    >
    > Alzheimer's is not a forgiving disease.
    >
    >> >> >> The other thing I am concerned about is the
    >> >> >> diagnosis since doesn't it usually require looking
    >> >> >> at the medical history and a physical exam which
    >> >> >> includes heart tracing using a ECG
    >> >> >> (Electrocardiogram) to confirm the diagnosis prior
    >> >> >> to the Holter moniter.
    >> >> >
    >> >> > Few doctors are able to order appropriate testing
    >> >> > and treatment without interviewing and examining the
    >> >> > patient first.
    >> >>
    >> >> The interviewing was the part that's missing. He
    >> >> basically had the entire medical history file in his
    >> >> hands from the Family Practice physician but he had no
    >> >> idea why my father was there.
    >> >
    >> > That is a concern.
    >>
    >> And I guess the office assistant of the Family Practice
    >> Physician told him off. =)
    >
    > That certainly does not help.
    >
    >> >> >> The Internal Medicine/Cardiologist did not do an
    >> >> >> ECG at all. The other thing is I thought it
    >> >> >> usually would take more than one visit to monitor
    >> >> >> the symptoms but for this physician, it seems to
    >> >> >> be only one visit with the Holter Moniter and
    >> >> >> that's it. There is a chance that the Holter
    >> >> >> Monitor could be defective or the jewelry is
    >> >> >> affecting the accuracy of the results as mentioned
    >> >> >> by the hospital staff who did the Holter Monitor
    >> >> >> removal. Would the medications: Aspirin 81mg,
    >> >> >> Aricept 10mg, Prevacid 30mg, Glipizide 5mg have
    >> >> >> any effect on the heartbeat rate?
    >> >> >
    >> >> > Not typically.
    >> >>
    >> >> That's true, come to think of it.
    >> >
    >> > I work at being truthful :)
    >>
    >> I just thought the Aspirin might have a effect but that
    >> couldn't be
    >> it.
    >
    > Correct.
    >
    >> He used to have Hypertension up to about 3 years ago and
    >> was taking Atenolol which is a drug that does something
    >> to the heart.
    >
    > Yes, atenolol can exacerabate SSS.

    Would that be even if he stopped taking it 3 years ago
    though?

    >> >> >> From reading this newsgroup, I've also learned
    >> >> >> that usually it's the Cardiologist who does the
    >> >> >> pacemaker procedure and also prior to being
    >> >> >> admitted to any hospital in the US, isn't a blood
    >> >> >> sample needed to check for potassium levels as
    >> >> >> well as the thickness of the blood and other tests
    >> >> >> to see if there are other paths for the blood to
    >> >> >> flow from the heart?
    >> >> >
    >> >> > It is likely that these blood tests would have been
    >> >> > scheduled and done shortly before the pacemaker
    >> >> > implantation.
    >> >>
    >> >> Speaking about pacemaker implantation, is the
    >> >> cardiologist supposed to be the one who does it or is
    >> >> a surgeon supposed to do it?
    >> >
    >> > Whoever is able to do it best is the one who should do
    >> > it :)
    >>
    >> That's true too. My only real concern is the diagnosis
    >> portion and from reading everything anyone has said, it
    >> seems a board certified cardiologist for a second opinion
    >> is in order.
    >
    > I don't believe anyone would argue against second opinions
    > in general.

    Wouldn't the physician who gave the first opinion be one of
    the primary opponents?

    >> >> The other thing about Sick Sinus Syndrome and the
    >> >> issue of sudden death is from my understanding after
    >> >> doing some research on the net, I thought a person
    >> >> with SSS can injure themselves during a fainting
    >> >> episode.
    >> >
    >> > Yes.
    >> >
    >> > Falling can result in severe injuries recalling the
    >> > recent demise of Dr. Bob Atkins.
    >>
    >> If I'm not mistaken, falling seems to be bad even without
    >> SSS if one had hypertension or a stroke.
    >
    > Especially for the elderly.

    Just as I thought.

    >> >> An individual with certain arrhythmias has an
    >> >> increased risk of blood clots which can cause a
    >> >> stroke and there is a rare risk of sudden death that
    >> >> can occur if the heart stops beating for a long
    >> >> period of time. So is it correct that the sudden
    >> >> death is a rare risk rather than a high risk like
    >> >> this Cardiologist has stated.
    >> >
    >> > Sudden death from sick sinus syndrome (SSS) is rare.
    >>
    >> This non-board certified cardiologist made it sound like
    >> it was a high risk.
    >
    > It may not have been intentional.

    It wouldn't if he did it once but he did it over the phone
    and even on e- mail when I didn't even mention it.

    >> >> I mean my father is 92 years old and as far as I know,
    >> >> the pacemaker won't prolong life and it seems surgery
    >> >> at this age is just a huge risk.
    >> >
    >> > I would not say it is *huge* but there is a significant
    >> > risk.
    >>
    >> Yep, seems like anything related to the organs, heart or
    >> even brain has some significant risk.
    >
    > All invasive procedures have significant risk.

    True.

    >> >> >> At the present time, I've told both the Internal
    >> >> >> Medicine/Cardiologist and the Surgeon to postpone
    >> >> >> the procedure until further notice since I'm worry
    >> >> >> about the risk of my father at his old age. One
    >> >> >> other thing is for the 10 Cardiologists listed in
    >> >> >> the HMO, this is the only one who is not Board
    >> >> >> Certified in either Internal Medicine or
    >> >> >> Cardiology. Is this something to worry about?
    >> >> >
    >> >> > It may be a concern.
    >> >>
    >> >> Yeah, I was just looking at your website and I think I
    >> >> know what the certification is about. The MD is more
    >> >> like just to certify that one has completed Medical
    >> >> School and can practice Family/General Practice
    >> >> assuming they are licensed in the State they are
    >> >> practicing in. Then for things like Surgery, Internal
    >> >> Medicine, Cardiology, they require certification in
    >> >> each of those areas practice to atleast show that the
    >> >> person in question is actually qualified in those
    >> >> areas. I guess if they aren't certified, then it's
    >> >> almost like someone trying to be a doctor when they
    >> >> are a engineer.
    >> >> :) So while on the subject, I am in California and
    >> >> :believe it or
    >> >> :not, this Internal Medicine/Cardiology physician does
    >> >> have the last name of Chung as well but on the AMA, he
    >> >> lists himself as follows:
    >> >>
    >> >> Primary Specialty: Internal Medicine Major
    >> >> Professional Activity: Office Based Practice Medical
    >> >> School: UNIV OF THE EAST, RAMON MAGSAYSAY MEM MED CTR,
    >> >> QUEZON CITY Graduated 1984 Residency Training: UNIV CA
    >> >> SF SCH OF MED, CARDIOVASCULAR DISEASES ST LUKE'S MED
    >> >> CTR, INTERNAL MEDICINE
    >> >>
    >> >> but when one goes to ABMS or ABIM, it shows him as Not
    >> >> certified. California's Board of Medicine shows his
    >> >> original license issued in 1992 and it'll expire next
    >> >> year. So basically for someone who claims to be in
    >> >> Internal Medicine/Cardiology that completed their MD
    >> >> in the Philippines and then did their residency at
    >> >> UCSF School of Medicine as well as St Luke's Medical
    >> >> Center in San Francisco and has been private practice
    >> >> after being licensed in California for the last 12
    >> >> years, he is not board certified for anything he
    >> >> claims to specialize in. It does raise a great concern
    >> >> as he doesn't seem to have any credentials other than
    >> >> the MD and the residency training or atleast he's not
    >> >> board certified in the areas of his residency
    >> >> training.
    >> >>
    >> >> >> Sorry for all the questions but I hope someone can
    >> >> >> provide some input. Thanks for your help in
    >> >> >> advance!
    >> >> >
    >> >> > All praises belong to God, Vince :)
    >> >>
    >> >> Heh, and to you too Andrew! :)
    >> >
    >> > I wouldn't be here if it were not for God's grace.
    >>
    >> Yeah, and the world is better when there are more people
    >> like you out there.
    >
    > That seems to be His plan at the moment.
    >
    >> > May God watch over you and your mom, in Christ's name.
    >>
    >> Thanks.
    >
    > You and your family will be in my prayers, Vince.

    Thanks as always, Dr. Chung. =)

    Cheers, Vince Astrophysics PhD
     
  17. Vincent Poy

    Vincent Poy Guest

    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in
    news:[email protected]:

    > Vincent Poy wrote:
    >>
    >> "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    >> wrote in news:[email protected]:
    >>
    > <snip>
    >> > The holter can be enough to cinch the diagnosis.
    >>
    >> That is probably true. I just hope the results were
    >> accurate and is not because of the holter actually
    >> failing and providing false results since things do break
    >> as I've seen ECG/EKG not working correctly before.
    >
    > The holter monitor typically has multiple leads. It would
    > be unusual for *all* of the leads to malfunction
    > (disconnect) for 5-6 seconds to create an artefactual
    > sinus pause.

    When I mean malfunction, I don't mean disconnect since
    holter monitors do have electronics inside and sometimes,
    weird things happen. In science, nothing is really ever
    fully 100%. It's always 99% followed by 9's after the
    decimal place.

    >> >> >> As far as I know, my father is not experiencing any
    >> >> >> of those symptoms unless confusion can be
    >> >> >> misundersood as Alzheimer's disease.
    >> >> >
    >> >> > Could be. The falls are also a concern.
    >> >>
    >> >> That's true but he hasn't fall before or after the
    >> >> Holter monitor.
    >> >
    >> > That is certainly reassuring.
    >>
    >> Yep, let's just say that the only time he has fallen
    >> within the past 5 years was with the holter moniter on.
    >> In 1999, he did have a ingenial hernia repair done by the
    >> surgeon originally for same day discharge who said his
    >> heart was beating abnormally so they kept him at the
    >> Cardiology floor of the hospital for further monitoring
    >> for 2 days and had referred to a board certified
    >> cardiologist who did a check up at both the hospital and
    >> then after my father was discharged without issues,
    >> visited his office where he had 2 holter monitors and had
    >> one sent home with my father for 24 hours and there were
    >> no problems either. Ofcourse that was 5 years ago and his
    >> memory as well as his strength in walking has gone
    >> downhill over the years.
    >
    > Alzheimer's is not a forgiving disease.
    >
    >> >> >> The other thing I am concerned about is the
    >> >> >> diagnosis since doesn't it usually require looking
    >> >> >> at the medical history and a physical exam which
    >> >> >> includes heart tracing using a ECG
    >> >> >> (Electrocardiogram) to confirm the diagnosis prior
    >> >> >> to the Holter moniter.
    >> >> >
    >> >> > Few doctors are able to order appropriate testing
    >> >> > and treatment without interviewing and examining the
    >> >> > patient first.
    >> >>
    >> >> The interviewing was the part that's missing. He
    >> >> basically had the entire medical history file in his
    >> >> hands from the Family Practice physician but he had no
    >> >> idea why my father was there.
    >> >
    >> > That is a concern.
    >>
    >> And I guess the office assistant of the Family Practice
    >> Physician told him off. =)
    >
    > That certainly does not help.
    >
    >> >> >> The Internal Medicine/Cardiologist did not do an
    >> >> >> ECG at all. The other thing is I thought it
    >> >> >> usually would take more than one visit to monitor
    >> >> >> the symptoms but for this physician, it seems to
    >> >> >> be only one visit with the Holter Moniter and
    >> >> >> that's it. There is a chance that the Holter
    >> >> >> Monitor could be defective or the jewelry is
    >> >> >> affecting the accuracy of the results as mentioned
    >> >> >> by the hospital staff who did the Holter Monitor
    >> >> >> removal. Would the medications: Aspirin 81mg,
    >> >> >> Aricept 10mg, Prevacid 30mg, Glipizide 5mg have
    >> >> >> any effect on the heartbeat rate?
    >> >> >
    >> >> > Not typically.
    >> >>
    >> >> That's true, come to think of it.
    >> >
    >> > I work at being truthful :)
    >>
    >> I just thought the Aspirin might have a effect but that
    >> couldn't be
    >> it.
    >
    > Correct.
    >
    >> He used to have Hypertension up to about 3 years ago and
    >> was taking Atenolol which is a drug that does something
    >> to the heart.
    >
    > Yes, atenolol can exacerabate SSS.

    Would that be even if he stopped taking it 3 years ago
    though?

    >> >> >> From reading this newsgroup, I've also learned
    >> >> >> that usually it's the Cardiologist who does the
    >> >> >> pacemaker procedure and also prior to being
    >> >> >> admitted to any hospital in the US, isn't a blood
    >> >> >> sample needed to check for potassium levels as
    >> >> >> well as the thickness of the blood and other tests
    >> >> >> to see if there are other paths for the blood to
    >> >> >> flow from the heart?
    >> >> >
    >> >> > It is likely that these blood tests would have been
    >> >> > scheduled and done shortly before the pacemaker
    >> >> > implantation.
    >> >>
    >> >> Speaking about pacemaker implantation, is the
    >> >> cardiologist supposed to be the one who does it or is
    >> >> a surgeon supposed to do it?
    >> >
    >> > Whoever is able to do it best is the one who should do
    >> > it :)
    >>
    >> That's true too. My only real concern is the diagnosis
    >> portion and from reading everything anyone has said, it
    >> seems a board certified cardiologist for a second opinion
    >> is in order.
    >
    > I don't believe anyone would argue against second opinions
    > in general.

    Wouldn't the physician who gave the first opinion be one of
    the primary opponents?

    >> >> The other thing about Sick Sinus Syndrome and the
    >> >> issue of sudden death is from my understanding after
    >> >> doing some research on the net, I thought a person
    >> >> with SSS can injure themselves during a fainting
    >> >> episode.
    >> >
    >> > Yes.
    >> >
    >> > Falling can result in severe injuries recalling the
    >> > recent demise of Dr. Bob Atkins.
    >>
    >> If I'm not mistaken, falling seems to be bad even without
    >> SSS if one had hypertension or a stroke.
    >
    > Especially for the elderly.

    Just as I thought.

    >> >> An individual with certain arrhythmias has an
    >> >> increased risk of blood clots which can cause a
    >> >> stroke and there is a rare risk of sudden death that
    >> >> can occur if the heart stops beating for a long
    >> >> period of time. So is it correct that the sudden
    >> >> death is a rare risk rather than a high risk like
    >> >> this Cardiologist has stated.
    >> >
    >> > Sudden death from sick sinus syndrome (SSS) is rare.
    >>
    >> This non-board certified cardiologist made it sound like
    >> it was a high risk.
    >
    > It may not have been intentional.

    It wouldn't if he did it once but he did it over the phone
    and even on e- mail when I didn't even mention it.

    >> >> I mean my father is 92 years old and as far as I know,
    >> >> the pacemaker won't prolong life and it seems surgery
    >> >> at this age is just a huge risk.
    >> >
    >> > I would not say it is *huge* but there is a significant
    >> > risk.
    >>
    >> Yep, seems like anything related to the organs, heart or
    >> even brain has some significant risk.
    >
    > All invasive procedures have significant risk.

    True.

    >> >> >> At the present time, I've told both the Internal
    >> >> >> Medicine/Cardiologist and the Surgeon to postpone
    >> >> >> the procedure until further notice since I'm worry
    >> >> >> about the risk of my father at his old age. One
    >> >> >> other thing is for the 10 Cardiologists listed in
    >> >> >> the HMO, this is the only one who is not Board
    >> >> >> Certified in either Internal Medicine or
    >> >> >> Cardiology. Is this something to worry about?
    >> >> >
    >> >> > It may be a concern.
    >> >>
    >> >> Yeah, I was just looking at your website and I think I
    >> >> know what the certification is about. The MD is more
    >> >> like just to certify that one has completed Medical
    >> >> School and can practice Family/General Practice
    >> >> assuming they are licensed in the State they are
    >> >> practicing in. Then for things like Surgery, Internal
    >> >> Medicine, Cardiology, they require certification in
    >> >> each of those areas practice to atleast show that the
    >> >> person in question is actually qualified in those
    >> >> areas. I guess if they aren't certified, then it's
    >> >> almost like someone trying to be a doctor when they
    >> >> are a engineer.
    >> >> :) So while on the subject, I am in California and
    >> >> :believe it or
    >> >> :not, this Internal Medicine/Cardiology physician does
    >> >> have the last name of Chung as well but on the AMA, he
    >> >> lists himself as follows:
    >> >>
    >> >> Primary Specialty: Internal Medicine Major
    >> >> Professional Activity: Office Based Practice Medical
    >> >> School: UNIV OF THE EAST, RAMON MAGSAYSAY MEM MED CTR,
    >> >> QUEZON CITY Graduated 1984 Residency Training: UNIV CA
    >> >> SF SCH OF MED, CARDIOVASCULAR DISEASES ST LUKE'S MED
    >> >> CTR, INTERNAL MEDICINE
    >> >>
    >> >> but when one goes to ABMS or ABIM, it shows him as Not
    >> >> certified. California's Board of Medicine shows his
    >> >> original license issued in 1992 and it'll expire next
    >> >> year. So basically for someone who claims to be in
    >> >> Internal Medicine/Cardiology that completed their MD
    >> >> in the Philippines and then did their residency at
    >> >> UCSF School of Medicine as well as St Luke's Medical
    >> >> Center in San Francisco and has been private practice
    >> >> after being licensed in California for the last 12
    >> >> years, he is not board certified for anything he
    >> >> claims to specialize in. It does raise a great concern
    >> >> as he doesn't seem to have any credentials other than
    >> >> the MD and the residency training or atleast he's not
    >> >> board certified in the areas of his residency
    >> >> training.
    >> >>
    >> >> >> Sorry for all the questions but I hope someone can
    >> >> >> provide some input. Thanks for your help in
    >> >> >> advance!
    >> >> >
    >> >> > All praises belong to God, Vince :)
    >> >>
    >> >> Heh, and to you too Andrew! :)
    >> >
    >> > I wouldn't be here if it were not for God's grace.
    >>
    >> Yeah, and the world is better when there are more people
    >> like you out there.
    >
    > That seems to be His plan at the moment.
    >
    >> > May God watch over you and your mom, in Christ's name.
    >>
    >> Thanks.
    >
    > You and your family will be in my prayers, Vince.

    Thanks as always, Dr. Chung. =)

    Cheers, Vince Astrophysics PhD
     
  18. Vincent Poy wrote:

    > "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    > wrote in news:[email protected]:
    >
    > > Vincent Poy wrote:
    > >>
    > >> "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    > >> wrote in news:[email protected]:
    > >>
    > > <snip>
    > >> > The holter can be enough to cinch the diagnosis.
    > >>
    > >> That is probably true. I just hope the results were
    > >> accurate and is not because of the holter actually
    > >> failing and providing false results since things do
    > >> break as I've seen ECG/EKG not working correctly
    > >> before.
    > >
    > > The holter monitor typically has multiple leads. It
    > > would be unusual for *all* of the leads to malfunction
    > > (disconnect) for 5-6 seconds to create an artefactual
    > > sinus pause.
    >
    > When I mean malfunction, I don't mean disconnect since
    > holter monitors do have electronics inside and sometimes,
    > weird things happen. In science, nothing is really ever
    > fully 100%. It's always 99% followed by 9's after the
    > decimal place.
    >

    For medical devices, short of lead failure, there are a lot
    of 9's after the decimal place for device failure. If the
    holter device had failed internally, a discerning eye should
    be able to detect it when studying the collected data.

    >
    > >> >> >> As far as I know, my father is not experiencing
    > >> >> >> any of those symptoms unless confusion can be
    > >> >> >> misundersood as Alzheimer's disease.
    > >> >> >
    > >> >> > Could be. The falls are also a concern.
    > >> >>
    > >> >> That's true but he hasn't fall before or after the
    > >> >> Holter monitor.
    > >> >
    > >> > That is certainly reassuring.
    > >>
    > >> Yep, let's just say that the only time he has fallen
    > >> within the past 5 years was with the holter moniter on.
    > >> In 1999, he did have a ingenial hernia repair done by
    > >> the surgeon originally for same day discharge who said
    > >> his heart was beating abnormally so they kept him at
    > >> the Cardiology floor of the hospital for further
    > >> monitoring for 2 days and had referred to a board
    > >> certified cardiologist who did a check up at both the
    > >> hospital and then after my father was discharged
    > >> without issues, visited his office where he had 2
    > >> holter monitors and had one sent home with my father
    > >> for 24 hours and there were no problems either.
    > >> Ofcourse that was 5 years ago and his memory as well as
    > >> his strength in walking has gone downhill over the
    > >> years.
    > >
    > > Alzheimer's is not a forgiving disease.
    > >
    > >> >> >> The other thing I am concerned about is the
    > >> >> >> diagnosis since doesn't it usually require
    > >> >> >> looking at the medical history and a physical
    > >> >> >> exam which includes heart tracing using a ECG
    > >> >> >> (Electrocardiogram) to confirm the diagnosis
    > >> >> >> prior to the Holter moniter.
    > >> >> >
    > >> >> > Few doctors are able to order appropriate testing
    > >> >> > and treatment without interviewing and examining
    > >> >> > the patient first.
    > >> >>
    > >> >> The interviewing was the part that's missing. He
    > >> >> basically had the entire medical history file in his
    > >> >> hands from the Family Practice physician but he had
    > >> >> no idea why my father was there.
    > >> >
    > >> > That is a concern.
    > >>
    > >> And I guess the office assistant of the Family Practice
    > >> Physician told him off. =)
    > >
    > > That certainly does not help.
    > >
    > >> >> >> The Internal Medicine/Cardiologist did not do an
    > >> >> >> ECG at all. The other thing is I thought it
    > >> >> >> usually would take more than one visit to
    > >> >> >> monitor the symptoms but for this physician, it
    > >> >> >> seems to be only one visit with the Holter
    > >> >> >> Moniter and that's it. There is a chance that
    > >> >> >> the Holter Monitor could be defective or the
    > >> >> >> jewelry is affecting the accuracy of the results
    > >> >> >> as mentioned by the hospital staff who did the
    > >> >> >> Holter Monitor removal. Would the medications:
    > >> >> >> Aspirin 81mg, Aricept 10mg, Prevacid 30mg,
    > >> >> >> Glipizide 5mg have any effect on the heartbeat
    > >> >> >> rate?
    > >> >> >
    > >> >> > Not typically.
    > >> >>
    > >> >> That's true, come to think of it.
    > >> >
    > >> > I work at being truthful :)
    > >>
    > >> I just thought the Aspirin might have a effect but that
    > >> couldn't be
    > >> it.
    > >
    > > Correct.
    > >
    > >> He used to have Hypertension up to about 3 years ago
    > >> and was taking Atenolol which is a drug that does
    > >> something to the heart.
    > >
    > > Yes, atenolol can exacerabate SSS.
    >
    > Would that be even if he stopped taking it 3 years
    > ago though?
    >

    No.

    >
    > >> >> >> From reading this newsgroup, I've also learned
    > >> >> >> that usually it's the Cardiologist who does the
    > >> >> >> pacemaker procedure and also prior to being
    > >> >> >> admitted to any hospital in the US, isn't a
    > >> >> >> blood sample needed to check for potassium
    > >> >> >> levels as well as the thickness of the blood and
    > >> >> >> other tests to see if there are other paths for
    > >> >> >> the blood to flow from the heart?
    > >> >> >
    > >> >> > It is likely that these blood tests would have
    > >> >> > been scheduled and done shortly before the
    > >> >> > pacemaker implantation.
    > >> >>
    > >> >> Speaking about pacemaker implantation, is the
    > >> >> cardiologist supposed to be the one who does it or
    > >> >> is a surgeon supposed to do it?
    > >> >
    > >> > Whoever is able to do it best is the one who should
    > >> > do it :)
    > >>
    > >> That's true too. My only real concern is the diagnosis
    > >> portion and from reading everything anyone has said, it
    > >> seems a board certified cardiologist for a second
    > >> opinion is in order.
    > >
    > > I don't believe anyone would argue against second
    > > opinions in general.
    >
    > Wouldn't the physician who gave the first opinion be one
    > of the primary opponents?
    >

    In truth, they may not like it, but it would be unusual for
    them to openly oppose your seeking a second opinion.

    >
    > >> >> The other thing about Sick Sinus Syndrome and the
    > >> >> issue of sudden death is from my understanding
    > >> >> after doing some research on the net, I thought a
    > >> >> person with SSS can injure themselves during a
    > >> >> fainting episode.
    > >> >
    > >> > Yes.
    > >> >
    > >> > Falling can result in severe injuries recalling the
    > >> > recent demise of Dr. Bob Atkins.
    > >>
    > >> If I'm not mistaken, falling seems to be bad even
    > >> without SSS if one had hypertension or a stroke.
    > >
    > > Especially for the elderly.
    >
    > Just as I thought.
    >
    > >> >> An individual with certain arrhythmias has an
    > >> >> increased risk of blood clots which can cause a
    > >> >> stroke and there is a rare risk of sudden death
    > >> >> that can occur if the heart stops beating for a
    > >> >> long period of time. So is it correct that the
    > >> >> sudden death is a rare risk rather than a high risk
    > >> >> like this Cardiologist has stated.
    > >> >
    > >> > Sudden death from sick sinus syndrome (SSS) is rare.
    > >>
    > >> This non-board certified cardiologist made it sound
    > >> like it was a high risk.
    > >
    > > It may not have been intentional.
    >
    > It wouldn't if he did it once but he did it over the phone
    > and even on e- mail when I didn't even mention it.
    >

    Hmmmm. I would still try not to judge.

    >
    > >> >> I mean my father is 92 years old and as far as I
    > >> >> know, the pacemaker won't prolong life and it seems
    > >> >> surgery at this age is just a huge risk.
    > >> >
    > >> > I would not say it is *huge* but there is a
    > >> > significant risk.
    > >>
    > >> Yep, seems like anything related to the organs, heart
    > >> or even brain has some significant risk.
    > >
    > > All invasive procedures have significant risk.
    >
    > True.
    >
    > >> >> >> At the present time, I've told both the Internal
    > >> >> >> Medicine/Cardiologist and the Surgeon to
    > >> >> >> postpone the procedure until further notice
    > >> >> >> since I'm worry about the risk of my father at
    > >> >> >> his old age. One other thing is for the 10
    > >> >> >> Cardiologists listed in the HMO, this is the
    > >> >> >> only one who is not Board Certified in either
    > >> >> >> Internal Medicine or Cardiology. Is this
    > >> >> >> something to worry about?
    > >> >> >
    > >> >> > It may be a concern.
    > >> >>
    > >> >> Yeah, I was just looking at your website and I think
    > >> >> I know what the certification is about. The MD is
    > >> >> more like just to certify that one has completed
    > >> >> Medical School and can practice Family/General
    > >> >> Practice assuming they are licensed in the State
    > >> >> they are practicing in. Then for things like
    > >> >> Surgery, Internal Medicine, Cardiology, they require
    > >> >> certification in each of those areas practice to
    > >> >> atleast show that the person in question is actually
    > >> >> qualified in those areas. I guess if they aren't
    > >> >> certified, then it's almost like someone trying to
    > >> >> be a doctor when they are a engineer.
    > >> >> :) So while on the subject, I am in California and
    > >> >> :believe it or
    > >> >> :not, this Internal Medicine/Cardiology physician
    > >> >> does have the last name of Chung as well but on the
    > >> >> AMA, he lists himself as follows:
    > >> >>
    > >> >> Primary Specialty: Internal Medicine Major
    > >> >> Professional Activity: Office Based Practice Medical
    > >> >> School: UNIV OF THE EAST, RAMON MAGSAYSAY MEM MED
    > >> >> CTR, QUEZON CITY Graduated 1984 Residency Training:
    > >> >> UNIV CA SF SCH OF MED, CARDIOVASCULAR DISEASES ST
    > >> >> LUKE'S MED CTR, INTERNAL MEDICINE
    > >> >>
    > >> >> but when one goes to ABMS or ABIM, it shows him as
    > >> >> Not certified. California's Board of Medicine shows
    > >> >> his original license issued in 1992 and it'll expire
    > >> >> next year. So basically for someone who claims to be
    > >> >> in Internal Medicine/Cardiology that completed their
    > >> >> MD in the Philippines and then did their residency
    > >> >> at UCSF School of Medicine as well as St Luke's
    > >> >> Medical Center in San Francisco and has been private
    > >> >> practice after being licensed in California for the
    > >> >> last 12 years, he is not board certified for
    > >> >> anything he claims to specialize in. It does raise a
    > >> >> great concern as he doesn't seem to have any
    > >> >> credentials other than the MD and the residency
    > >> >> training or atleast he's not board certified in the
    > >> >> areas of his residency training.
    > >> >>
    > >> >> >> Sorry for all the questions but I hope someone
    > >> >> >> can provide some input. Thanks for your help in
    > >> >> >> advance!
    > >> >> >
    > >> >> > All praises belong to God, Vince :)
    > >> >>
    > >> >> Heh, and to you too Andrew! :)
    > >> >
    > >> > I wouldn't be here if it were not for God's grace.
    > >>
    > >> Yeah, and the world is better when there are more
    > >> people like you out there.
    > >
    > > That seems to be His plan at the moment.
    > >
    > >> > May God watch over you and your mom, in Christ's
    > >> > name.
    > >>
    > >> Thanks.
    > >
    > > You and your family will be in my prayers, Vince.
    >
    > Thanks as always, Dr. Chung. =)
    >

    Always let what you do glorify God.

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/

    **
    Who is the humblest person in the universe?
    http://makeashorterlink.com/?W1F522557

    What is all this about?
    http://makeashorterlink.com/?J2DB148A7

    Is this spam?
    http://makeashorterlink.com/?N69721867
     
  19. Vincent Poy wrote:

    > "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    > wrote in news:[email protected]:
    >
    > > Vincent Poy wrote:
    > >>
    > >> "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    > >> wrote in news:[email protected]:
    > >>
    > > <snip>
    > >> > The holter can be enough to cinch the diagnosis.
    > >>
    > >> That is probably true. I just hope the results were
    > >> accurate and is not because of the holter actually
    > >> failing and providing false results since things do
    > >> break as I've seen ECG/EKG not working correctly
    > >> before.
    > >
    > > The holter monitor typically has multiple leads. It
    > > would be unusual for *all* of the leads to malfunction
    > > (disconnect) for 5-6 seconds to create an artefactual
    > > sinus pause.
    >
    > When I mean malfunction, I don't mean disconnect since
    > holter monitors do have electronics inside and sometimes,
    > weird things happen. In science, nothing is really ever
    > fully 100%. It's always 99% followed by 9's after the
    > decimal place.
    >

    For medical devices, short of lead failure, there are a lot
    of 9's after the decimal place for device failure. If the
    holter device had failed internally, a discerning eye should
    be able to detect it when studying the collected data.

    >
    > >> >> >> As far as I know, my father is not experiencing
    > >> >> >> any of those symptoms unless confusion can be
    > >> >> >> misundersood as Alzheimer's disease.
    > >> >> >
    > >> >> > Could be. The falls are also a concern.
    > >> >>
    > >> >> That's true but he hasn't fall before or after the
    > >> >> Holter monitor.
    > >> >
    > >> > That is certainly reassuring.
    > >>
    > >> Yep, let's just say that the only time he has fallen
    > >> within the past 5 years was with the holter moniter on.
    > >> In 1999, he did have a ingenial hernia repair done by
    > >> the surgeon originally for same day discharge who said
    > >> his heart was beating abnormally so they kept him at
    > >> the Cardiology floor of the hospital for further
    > >> monitoring for 2 days and had referred to a board
    > >> certified cardiologist who did a check up at both the
    > >> hospital and then after my father was discharged
    > >> without issues, visited his office where he had 2
    > >> holter monitors and had one sent home with my father
    > >> for 24 hours and there were no problems either.
    > >> Ofcourse that was 5 years ago and his memory as well as
    > >> his strength in walking has gone downhill over the
    > >> years.
    > >
    > > Alzheimer's is not a forgiving disease.
    > >
    > >> >> >> The other thing I am concerned about is the
    > >> >> >> diagnosis since doesn't it usually require
    > >> >> >> looking at the medical history and a physical
    > >> >> >> exam which includes heart tracing using a ECG
    > >> >> >> (Electrocardiogram) to confirm the diagnosis
    > >> >> >> prior to the Holter moniter.
    > >> >> >
    > >> >> > Few doctors are able to order appropriate testing
    > >> >> > and treatment without interviewing and examining
    > >> >> > the patient first.
    > >> >>
    > >> >> The interviewing was the part that's missing. He
    > >> >> basically had the entire medical history file in his
    > >> >> hands from the Family Practice physician but he had
    > >> >> no idea why my father was there.
    > >> >
    > >> > That is a concern.
    > >>
    > >> And I guess the office assistant of the Family Practice
    > >> Physician told him off. =)
    > >
    > > That certainly does not help.
    > >
    > >> >> >> The Internal Medicine/Cardiologist did not do an
    > >> >> >> ECG at all. The other thing is I thought it
    > >> >> >> usually would take more than one visit to
    > >> >> >> monitor the symptoms but for this physician, it
    > >> >> >> seems to be only one visit with the Holter
    > >> >> >> Moniter and that's it. There is a chance that
    > >> >> >> the Holter Monitor could be defective or the
    > >> >> >> jewelry is affecting the accuracy of the results
    > >> >> >> as mentioned by the hospital staff who did the
    > >> >> >> Holter Monitor removal. Would the medications:
    > >> >> >> Aspirin 81mg, Aricept 10mg, Prevacid 30mg,
    > >> >> >> Glipizide 5mg have any effect on the heartbeat
    > >> >> >> rate?
    > >> >> >
    > >> >> > Not typically.
    > >> >>
    > >> >> That's true, come to think of it.
    > >> >
    > >> > I work at being truthful :)
    > >>
    > >> I just thought the Aspirin might have a effect but that
    > >> couldn't be
    > >> it.
    > >
    > > Correct.
    > >
    > >> He used to have Hypertension up to about 3 years ago
    > >> and was taking Atenolol which is a drug that does
    > >> something to the heart.
    > >
    > > Yes, atenolol can exacerabate SSS.
    >
    > Would that be even if he stopped taking it 3 years
    > ago though?
    >

    No.

    >
    > >> >> >> From reading this newsgroup, I've also learned
    > >> >> >> that usually it's the Cardiologist who does the
    > >> >> >> pacemaker procedure and also prior to being
    > >> >> >> admitted to any hospital in the US, isn't a
    > >> >> >> blood sample needed to check for potassium
    > >> >> >> levels as well as the thickness of the blood and
    > >> >> >> other tests to see if there are other paths for
    > >> >> >> the blood to flow from the heart?
    > >> >> >
    > >> >> > It is likely that these blood tests would have
    > >> >> > been scheduled and done shortly before the
    > >> >> > pacemaker implantation.
    > >> >>
    > >> >> Speaking about pacemaker implantation, is the
    > >> >> cardiologist supposed to be the one who does it or
    > >> >> is a surgeon supposed to do it?
    > >> >
    > >> > Whoever is able to do it best is the one who should
    > >> > do it :)
    > >>
    > >> That's true too. My only real concern is the diagnosis
    > >> portion and from reading everything anyone has said, it
    > >> seems a board certified cardiologist for a second
    > >> opinion is in order.
    > >
    > > I don't believe anyone would argue against second
    > > opinions in general.
    >
    > Wouldn't the physician who gave the first opinion be one
    > of the primary opponents?
    >

    In truth, they may not like it, but it would be unusual for
    them to openly oppose your seeking a second opinion.

    >
    > >> >> The other thing about Sick Sinus Syndrome and the
    > >> >> issue of sudden death is from my understanding
    > >> >> after doing some research on the net, I thought a
    > >> >> person with SSS can injure themselves during a
    > >> >> fainting episode.
    > >> >
    > >> > Yes.
    > >> >
    > >> > Falling can result in severe injuries recalling the
    > >> > recent demise of Dr. Bob Atkins.
    > >>
    > >> If I'm not mistaken, falling seems to be bad even
    > >> without SSS if one had hypertension or a stroke.
    > >
    > > Especially for the elderly.
    >
    > Just as I thought.
    >
    > >> >> An individual with certain arrhythmias has an
    > >> >> increased risk of blood clots which can cause a
    > >> >> stroke and there is a rare risk of sudden death
    > >> >> that can occur if the heart stops beating for a
    > >> >> long period of time. So is it correct that the
    > >> >> sudden death is a rare risk rather than a high risk
    > >> >> like this Cardiologist has stated.
    > >> >
    > >> > Sudden death from sick sinus syndrome (SSS) is rare.
    > >>
    > >> This non-board certified cardiologist made it sound
    > >> like it was a high risk.
    > >
    > > It may not have been intentional.
    >
    > It wouldn't if he did it once but he did it over the phone
    > and even on e- mail when I didn't even mention it.
    >

    Hmmmm. I would still try not to judge.

    >
    > >> >> I mean my father is 92 years old and as far as I
    > >> >> know, the pacemaker won't prolong life and it seems
    > >> >> surgery at this age is just a huge risk.
    > >> >
    > >> > I would not say it is *huge* but there is a
    > >> > significant risk.
    > >>
    > >> Yep, seems like anything related to the organs, heart
    > >> or even brain has some significant risk.
    > >
    > > All invasive procedures have significant risk.
    >
    > True.
    >
    > >> >> >> At the present time, I've told both the Internal
    > >> >> >> Medicine/Cardiologist and the Surgeon to
    > >> >> >> postpone the procedure until further notice
    > >> >> >> since I'm worry about the risk of my father at
    > >> >> >> his old age. One other thing is for the 10
    > >> >> >> Cardiologists listed in the HMO, this is the
    > >> >> >> only one who is not Board Certified in either
    > >> >> >> Internal Medicine or Cardiology. Is this
    > >> >> >> something to worry about?
    > >> >> >
    > >> >> > It may be a concern.
    > >> >>
    > >> >> Yeah, I was just looking at your website and I think
    > >> >> I know what the certification is about. The MD is
    > >> >> more like just to certify that one has completed
    > >> >> Medical School and can practice Family/General
    > >> >> Practice assuming they are licensed in the State
    > >> >> they are practicing in. Then for things like
    > >> >> Surgery, Internal Medicine, Cardiology, they require
    > >> >> certification in each of those areas practice to
    > >> >> atleast show that the person in question is actually
    > >> >> qualified in those areas. I guess if they aren't
    > >> >> certified, then it's almost like someone trying to
    > >> >> be a doctor when they are a engineer.
    > >> >> :) So while on the subject, I am in California and
    > >> >> :believe it or
    > >> >> :not, this Internal Medicine/Cardiology physician
    > >> >> does have the last name of Chung as well but on the
    > >> >> AMA, he lists himself as follows:
    > >> >>
    > >> >> Primary Specialty: Internal Medicine Major
    > >> >> Professional Activity: Office Based Practice Medical
    > >> >> School: UNIV OF THE EAST, RAMON MAGSAYSAY MEM MED
    > >> >> CTR, QUEZON CITY Graduated 1984 Residency Training:
    > >> >> UNIV CA SF SCH OF MED, CARDIOVASCULAR DISEASES ST
    > >> >> LUKE'S MED CTR, INTERNAL MEDICINE
    > >> >>
    > >> >> but when one goes to ABMS or ABIM, it shows him as
    > >> >> Not certified. California's Board of Medicine shows
    > >> >> his original license issued in 1992 and it'll expire
    > >> >> next year. So basically for someone who claims to be
    > >> >> in Internal Medicine/Cardiology that completed their
    > >> >> MD in the Philippines and then did their residency
    > >> >> at UCSF School of Medicine as well as St Luke's
    > >> >> Medical Center in San Francisco and has been private
    > >> >> practice after being licensed in California for the
    > >> >> last 12 years, he is not board certified for
    > >> >> anything he claims to specialize in. It does raise a
    > >> >> great concern as he doesn't seem to have any
    > >> >> credentials other than the MD and the residency
    > >> >> training or atleast he's not board certified in the
    > >> >> areas of his residency training.
    > >> >>
    > >> >> >> Sorry for all the questions but I hope someone
    > >> >> >> can provide some input. Thanks for your help in
    > >> >> >> advance!
    > >> >> >
    > >> >> > All praises belong to God, Vince :)
    > >> >>
    > >> >> Heh, and to you too Andrew! :)
    > >> >
    > >> > I wouldn't be here if it were not for God's grace.
    > >>
    > >> Yeah, and the world is better when there are more
    > >> people like you out there.
    > >
    > > That seems to be His plan at the moment.
    > >
    > >> > May God watch over you and your mom, in Christ's
    > >> > name.
    > >>
    > >> Thanks.
    > >
    > > You and your family will be in my prayers, Vince.
    >
    > Thanks as always, Dr. Chung. =)
    >

    Always let what you do glorify God.

    Servant to the humblest person in the universe,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/

    **
    Who is the humblest person in the universe?
    http://makeashorterlink.com/?W1F522557

    What is all this about?
    http://makeashorterlink.com/?J2DB148A7

    Is this spam?
    http://makeashorterlink.com/?N69721867
     
  20. Vincent Poy

    Vincent Poy Guest

    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in
    news:[email protected]:

    > Vincent Poy wrote:
    >
    >> "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    >> wrote in news:[email protected]:
    >>
    >> > Vincent Poy wrote:
    >> >>
    >> >> "Dr. Andrew B. Chung, MD/PhD" <[email protected]>
    >> >> wrote in news:[email protected]:
    >> >>
    >> > <snip>
    >> >> > The holter can be enough to cinch the diagnosis.
    >> >>
    >> >> That is probably true. I just hope the results were
    >> >> accurate and is not because of the holter actually
    >> >> failing and providing false results since things do
    >> >> break as I've seen ECG/EKG not working correctly
    >> >> before.
    >> >
    >> > The holter monitor typically has multiple leads. It
    >> > would be unusual for *all* of the leads to malfunction
    >> > (disconnect) for 5-6 seconds to create an artefactual
    >> > sinus pause.
    >>
    >> When I mean malfunction, I don't mean disconnect since
    >> holter monitors do have electronics inside and sometimes,
    >> weird things happen. In science, nothing is really ever
    >> fully 100%. It's always 99% followed by 9's after the
    >> decimal place.
    >
    > For medical devices, short of lead failure, there are a
    > lot of 9's after the decimal place for device failure.
    > If the holter device had failed internally, a discerning
    > eye should be able to detect it when studying the
    > collected data.

    That's true too.

    >> >> >> >> As far as I know, my father is not experiencing
    >> >> >> >> any of those symptoms unless confusion can be
    >> >> >> >> misundersood as Alzheimer's disease.
    >> >> >> >
    >> >> >> > Could be. The falls are also a concern.
    >> >> >>
    >> >> >> That's true but he hasn't fall before or after the
    >> >> >> Holter monitor.
    >> >> >
    >> >> > That is certainly reassuring.
    >> >>
    >> >> Yep, let's just say that the only time he has fallen
    >> >> within the past 5 years was with the holter moniter
    >> >> on. In 1999, he did have a ingenial hernia repair done
    >> >> by the surgeon originally for same day discharge who
    >> >> said his heart was beating abnormally so they kept him
    >> >> at the Cardiology floor of the hospital for further
    >> >> monitoring for 2 days and had referred to a board
    >> >> certified cardiologist who did a check up at both the
    >> >> hospital and then after my father was discharged
    >> >> without issues, visited his office where he had 2
    >> >> holter monitors and had one sent home with my father
    >> >> for 24 hours and there were no problems either.
    >> >> Ofcourse that was 5 years ago and his memory as well
    >> >> as his strength in walking has gone downhill over the
    >> >> years.
    >> >
    >> > Alzheimer's is not a forgiving disease.
    >> >
    >> >> >> >> The other thing I am concerned about is the
    >> >> >> >> diagnosis since doesn't it usually require
    >> >> >> >> looking at the medical history and a physical
    >> >> >> >> exam which includes heart tracing using a ECG
    >> >> >> >> (Electrocardiogram) to confirm the diagnosis
    >> >> >> >> prior to the Holter moniter.
    >> >> >> >
    >> >> >> > Few doctors are able to order appropriate testing
    >> >> >> > and treatment without interviewing and examining
    >> >> >> > the patient first.
    >> >> >>
    >> >> >> The interviewing was the part that's missing. He
    >> >> >> basically had the entire medical history file in
    >> >> >> his hands from the Family Practice physician but he
    >> >> >> had no idea why my father was there.
    >> >> >
    >> >> > That is a concern.
    >> >>
    >> >> And I guess the office assistant of the Family
    >> >> Practice Physician told him off. =)
    >> >
    >> > That certainly does not help.
    >> >
    >> >> >> >> The Internal Medicine/Cardiologist did not do
    >> >> >> >> an ECG at all. The other thing is I thought it
    >> >> >> >> usually would take more than one visit to
    >> >> >> >> monitor the symptoms but for this physician, it
    >> >> >> >> seems to be only one visit with the Holter
    >> >> >> >> Moniter and that's it. There is a chance that
    >> >> >> >> the Holter Monitor could be defective or the
    >> >> >> >> jewelry is affecting the accuracy of the
    >> >> >> >> results as mentioned by the hospital staff who
    >> >> >> >> did the Holter Monitor removal. Would the
    >> >> >> >> medications: Aspirin 81mg, Aricept 10mg,
    >> >> >> >> Prevacid 30mg, Glipizide 5mg have any effect on
    >> >> >> >> the heartbeat rate?
    >> >> >> >
    >> >> >> > Not typically.
    >> >> >>
    >> >> >> That's true, come to think of it.
    >> >> >
    >> >> > I work at being truthful :)
    >> >>
    >> >> I just thought the Aspirin might have a effect but
    >> >> that couldn't be it.
    >> >
    >> > Correct.
    >> >
    >> >> He used to have Hypertension up to about 3 years ago
    >> >> and was taking Atenolol which is a drug that does
    >> >> something to the heart.
    >> >
    >> > Yes, atenolol can exacerabate SSS.
    >>
    >> Would that be even if he stopped taking it 3 years ago
    >> though?
    >
    > No.

    Exactly as I suspected.

    >> >> >> >> From reading this newsgroup, I've also learned
    >> >> >> >> that usually it's the Cardiologist who does the
    >> >> >> >> pacemaker procedure and also prior to being
    >> >> >> >> admitted to any hospital in the US, isn't a
    >> >> >> >> blood sample needed to check for potassium
    >> >> >> >> levels as well as the thickness of the blood
    >> >> >> >> and other tests to see if there are other paths
    >> >> >> >> for the blood to flow from the heart?
    >> >> >> >
    >> >> >> > It is likely that these blood tests would have
    >> >> >> > been scheduled and done shortly before the
    >> >> >> > pacemaker implantation.
    >> >> >>
    >> >> >> Speaking about pacemaker implantation, is the
    >> >> >> cardiologist supposed to be the one who does it or
    >> >> >> is a surgeon supposed to do it?
    >> >> >
    >> >> > Whoever is able to do it best is the one who should
    >> >> > do it :)
    >> >>
    >> >> That's true too. My only real concern is the diagnosis
    >> >> portion and from reading everything anyone has said,
    >> >> it seems a board certified cardiologist for a second
    >> >> opinion is in order.
    >> >
    >> > I don't believe anyone would argue against second
    >> > opinions in general.
    >>
    >> Wouldn't the physician who gave the first opinion be one
    >> of the primary opponents?
    >
    > In truth, they may not like it, but it would be unusual
    > for them to openly oppose your seeking a second opinion.

    True but if I did that, I might end up being on their
    blacklist. ;)

    >> >> >> The other thing about Sick Sinus Syndrome and the
    >> >> >> issue of sudden death is from my understanding
    >> >> >> after doing some research on the net, I thought a
    >> >> >> person with SSS can injure themselves during a
    >> >> >> fainting episode.
    >> >> >
    >> >> > Yes.
    >> >> >
    >> >> > Falling can result in severe injuries recalling the
    >> >> > recent demise of Dr. Bob Atkins.
    >> >>
    >> >> If I'm not mistaken, falling seems to be bad even
    >> >> without SSS if one had hypertension or a stroke.
    >> >
    >> > Especially for the elderly.
    >>
    >> Just as I thought.
    >>
    >> >> >> An individual with certain arrhythmias has an
    >> >> >> increased risk of blood clots which can cause a
    >> >> >> stroke and there is a rare risk of sudden death
    >> >> >> that can occur if the heart stops beating for a
    >> >> >> long period of time. So is it correct that the
    >> >> >> sudden death is a rare risk rather than a high
    >> >> >> risk like this Cardiologist has stated.
    >> >> >
    >> >> > Sudden death from sick sinus syndrome (SSS) is rare.
    >> >>
    >> >> This non-board certified cardiologist made it sound
    >> >> like it was a high risk.
    >> >
    >> > It may not have been intentional.
    >>
    >> It wouldn't if he did it once but he did it over the
    >> phone and even on e- mail when I didn't even mention it.
    >
    > Hmmmm. I would still try not to judge.

    Yeah, it's hard to judge really.

    >> >> >> I mean my father is 92 years old and as far as I
    >> >> >> know, the pacemaker won't prolong life and it seems
    >> >> >> surgery at this age is just a huge risk.
    >> >> >
    >> >> > I would not say it is *huge* but there is a
    >> >> > significant risk.
    >> >>
    >> >> Yep, seems like anything related to the organs, heart
    >> >> or even brain has some significant risk.
    >> >
    >> > All invasive procedures have significant risk.
    >>
    >> True.
    >>
    >> >> >> >> At the present time, I've told both the
    >> >> >> >> Internal Medicine/Cardiologist and the Surgeon
    >> >> >> >> to postpone the procedure until further notice
    >> >> >> >> since I'm worry about the risk of my father at
    >> >> >> >> his old age. One other thing is for the 10
    >> >> >> >> Cardiologists listed in the HMO, this is the
    >> >> >> >> only one who is not Board Certified in either
    >> >> >> >> Internal Medicine or Cardiology. Is this
    >> >> >> >> something to worry about?
    >> >> >> >
    >> >> >> > It may be a concern.
    >> >> >>
    >> >> >> Yeah, I was just looking at your website and I
    >> >> >> think I know what the certification is about. The
    >> >> >> MD is more like just to certify that one has
    >> >> >> completed Medical School and can practice
    >> >> >> Family/General Practice assuming they are licensed
    >> >> >> in the State they are practicing in. Then for
    >> >> >> things like Surgery, Internal Medicine, Cardiology,
    >> >> >> they require certification in each of those areas
    >> >> >> practice to atleast show that the person in
    >> >> >> question is actually qualified in those areas. I
    >> >> >> guess if they aren't certified, then it's almost
    >> >> >> like someone trying to be a doctor when they are a
    >> >> >> engineer.
    >> >> >> :) So while on the subject, I am in California and
    >> >> >> :believe it
    >> >> >> :eek:r not, this Internal Medicine/Cardiology
    >> >> >> physician does have the last name of Chung as well
    >> >> >> but on the AMA, he lists himself as follows:
    >> >> >>
    >> >> >> Primary Specialty: Internal Medicine Major
    >> >> >> Professional Activity: Office Based Practice
    >> >> >> Medical School: UNIV OF THE EAST, RAMON MAGSAYSAY
    >> >> >> MEM MED CTR, QUEZON CITY Graduated 1984 Residency
    >> >> >> Training: UNIV CA SF SCH OF MED, CARDIOVASCULAR
    >> >> >> DISEASES ST LUKE'S MED CTR, INTERNAL MEDICINE
    >> >> >>
    >> >> >> but when one goes to ABMS or ABIM, it shows him as
    >> >> >> Not certified. California's Board of Medicine shows
    >> >> >> his original license issued in 1992 and it'll
    >> >> >> expire next year. So basically for someone who
    >> >> >> claims to be in Internal Medicine/Cardiology that
    >> >> >> completed their MD in the Philippines and then did
    >> >> >> their residency at UCSF School of Medicine as well
    >> >> >> as St Luke's Medical Center in San Francisco and
    >> >> >> has been private practice after being licensed in
    >> >> >> California for the last 12 years, he is not board
    >> >> >> certified for anything he claims to specialize in.
    >> >> >> It does raise a great concern as he doesn't seem to
    >> >> >> have any credentials other than the MD and the
    >> >> >> residency training or atleast he's not board
    >> >> >> certified in the areas of his residency training.
    >> >> >>
    >> >> >> >> Sorry for all the questions but I hope someone
    >> >> >> >> can provide some input. Thanks for your help in
    >> >> >> >> advance!
    >> >> >> >
    >> >> >> > All praises belong to God, Vince :)
    >> >> >>
    >> >> >> Heh, and to you too Andrew! :)
    >> >> >
    >> >> > I wouldn't be here if it were not for God's grace.
    >> >>
    >> >> Yeah, and the world is better when there are more
    >> >> people like you out there.
    >> >
    >> > That seems to be His plan at the moment.
    >> >
    >> >> > May God watch over you and your mom, in Christ's
    >> >> > name.
    >> >>
    >> >> Thanks.
    >> >
    >> > You and your family will be in my prayers, Vince.
    >>
    >> Thanks as always, Dr. Chung. =)
    >
    > Always let what you do glorify God.

    Cheers, Vince Astrophysics, PhD
     
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