[HSF] angiogram and Denying CABG

[Tea Acuff]

Bravo. I agree with most of your clinical points. It is one thing to take it on the chin from time to time, another to lay on the floor like a door mat. The door mat does get more traffic, however.

tea


----- Original Message ----
From: "Jbflegejr at aol.com" <Jbflegejr at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Wednesday, October 10, 2007 8:01:57 PM
Subject: Re: [HSF] angiogram and Denying CABG


Michael, I turned him down because he didn't have what I would consider  
critical stenoses in his major vessels, his LV was bad and his symptoms  suggested 
heart failure rather than ischemia, his mitral insufficiency I think  is 
secondary to his bad LV rather than the cause of it, I did not think that  
operation was likely to improve his situation, and I thought his prognosis from  his 
cancer was not as good as the one to five year survival that his oncologist  
estimated. 
I have long since alienated most of the cardiolgists by differing with  their 
surgical judgement and there are a few around that respect my decision  
making based solely on the patient's characteristics. From that point of view I  am 
fortunate to be near the end of my career. I really feel sorry for those of  
you who have to suck up to the cardiologists to survive and I do understand. I 
was lucky to get my start before that was necessary and managed to eke out 
the  last few years in a hostile enviroment.
On another subject. I saw three new patients today with coronary disease  
that I am sure would have had stents a year ago and now have been referred for  
surgery. At least one of them has good commercial insurance and another  
medicare. I sense a changing attitude about stents in our cardiologists.  What are 
others seeing.
John Flege



************************************** See what's new at http://www.aol.com
_______________________________________________
OpenHeart-L mailing list

Send postings to:
OpenHeart-L at lists.hsforum.com

To UNSUBSCRIBE, to CHANGE email address, or to view archives:
http://mmp.cjp.com/mailman/listinfo/openheart-l

All messages transmitted by the OpenHeart-L are subject to the policies and 
disclaimers posted at:
http://www.hsforum.com/listdisclaim
-----------------------------------------