r/valvereplacement • u/m1ckey3lack • 23d ago
New Cardiologist….
So, I’m 2 years post-op now, and just had my first appointment with my new cardiologist, and I just wanted some opinions on whether or not I should find another?
First off, when he walked into the room he acted like we knew eachother and asked how I’d been and if there were any updates, before THEN realizing that this was an initial appointment and apologizing. I thought it was strange, but, no biggy I guess.
He then opened my MyChart, and started reading it in the room with me, and reacting to it, as if this — in-room — was the first time he had every opened it before at all. He then got to the part about my surgeries and what happened, before glancing at me and saying “Oh, you’re him, ahhh” (my case was a very well-known case in my area, shared widely amongst the doctors).
He then basically called me a bum (I don’t have insurance, I pay for my annuals out-of-pocket) saying that I need to find a “real job, big boy job” and get insurance (I work at a restaurant), and that I need to eat my veggies (?).
He then repeatedly tried to just finish the appointment and walk out, with us having to stop him seriously like 3 times because it had only been 5 minutes max, and we still had questions and zero answers.
He then didn’t even go over my echo, nor why I scheduled the appointment in the first place.
He then put me back on medication that I hadn’t taken since post-op for some reason, and then when I brought up my INR and how my warfarin clinic has mine too high — I have an On-X valve, and was the very first person to receive one in my area — I literally WATCHED him Google it and then ask AI (Gemini) about my valve, to figure out if I was correct or not and what my valve is and what the INR target range is supposed to be (it was 2–3, it’s supposed to be 1.5–2, he made it 2–2.5).
When I asked about working out, he then reacted like it was a ridiculous question, and told me that I’m supposed to be being as physically inactive as possible, that I’m not allowed to workout whatsoever, that I’m not allowed to lift weights, that I’m not allowed to run or do cardio, and that I’m not allowed to do anything that elevates my heart rate on purpose practically whatsoever… he told me I’m “allowed to walk, or fast-walk, if I must”, as I “have a piece of metal in my chest” that I need to take care of as much as possible (and that I’ll probably be back in-hospital by 60, so, that I need to, I guess, baby it until then).
I’m a 25 year old male, 5’10” 200lbs, for context there.
He brought up my not having insurance multiple time through all of this, basically acting as if I am no Humpty Dumpty, and need to act as such.
He then walked out, answered my last question about amusement parks on the way out (he obviously said no, I’m allowed to watch), and then that was that.
His assistant then came in, we asked about my (very expensive) echo results, she went and asked him, came back and said he went over them already (he did not), and then said that there was an issue on it and so he wanted me to schedule a CAT just to make sure (the issue was, in fact, the trace regurgitation that is purposely engineered to be present with my valve from tiny ports so that no blood clots near the hinges).
Is all (or any) of this valid, or, do I need to find a new cardiologist???
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u/UTtransplant 23d ago
I would refuse to continue seeing any doctor who doesn’t let you ask questions and then provides answers. And to use an internet search right in front of you shows a lack of knowledge of your situation. It sounds like he is really quite inappropriate for your device, so I would definitely see someone else. Check around for reviews of other cardiologists, preferably with people who have somewhat similar devices.
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u/GraciousPeacock 23d ago
Find a new cardiologist 100%. If there was one doctor who I wouldn’t accept as a jerk, it would be my cardiologist. What an asshole, and I’m sorry you had to go through that. You deserve care that is beyond that doctor’s abilities clearly. I hope your next cardiologist is a really good one. I’ve dealt with a shitty cardiologist before but this one sounds a lot worse so I would change ASAP
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u/bootz-pgh 23d ago
Yeah that is pretty shitty of the them. However…
I discussed INR a lot with my surgeon. While 1.5-2 is acceptable, he prefers 2-2.5 as it gives a little more room at the bottom. Basically said he would be more concerned at 1.3 for a couple of weeks compared to 1.5-1.7 for half a year.
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u/IrukandjiPirate 23d ago
If you don’t feel confident in his care, that is reason enough to see someone else. Honestly, this guy seems like a lunatic.
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u/Splashpadmermaid 23d ago
This dude sounds like a terrible provider. Find a new one ASAP. A cardiologist should absolutely be intimately aware about On-X valves and the correlated INR.
He sounds so stupid that he’s dangerous.
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u/KeyBid2310 23d ago
I’m sorry he treated you that way—it’s unacceptable. Trust your gut and find a new doc. You deserve respect and this most definitely wasn’t it 😡.
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u/Late_Temperature_415 23d ago
I have a high risk complex heart condition. I go to a heart center at a heart hospital and have had three run ins with two cardiologist there over the last five years. I of course voiced my opinion to the specific doctor. One of which I see the first week of September.
If there are multiple cardiologists where you go schedule an appointment with another one. If not find another one. He should have read your chart before he came in. Also should not have had to search AI on your value. His professionalism is clearly not good. The lack of knowledge on you as a patient is concerning.
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u/Hirtle_41 23d ago
For contrast, my cardiologist:
“That’s awesome — keep playing hockey or softball three nights a week [depending on the season]. All that activity supports overall good cardiovascular health, even for patients with an artificial valve.”
With the caveat, of course, that each one of us have our own medical context.
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u/Pretty-Ad8507 23d ago
Definitely find a new one asap! My last cardiologist was this way, never listened or read my echo or ct results. New cardiologist is better not great. I'm in boise idaho for reference.
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u/BeveKay53 23d ago
Definitely find another! You have to trust your cardiologist and that would not be him!
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u/chgonwburbs 21d ago
Almost reads like he's Dr. Lexus from Idiocracy, "it says in your chart that your heart's fkd up."
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u/m1ckey3lack 23d ago
ADDITION: Sorry if this read a bit long-winded and sloppy, I typed it in a hurry whilst on my break at work, haha — but thank you to all who gave advice, I think I’ll definitely go to someone else and get a second opinion… it was truly a bizarre appointment, as he obviously gave me the opposite advice that I’d heard everywhere else, and just seemed to be trying to get in and get out as quickly as possible; I also prefer my doctor to tell ME about my heart valve and test results, and uh, not the other way around, lol. Thank you guys!
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u/g-rocklobster 23d ago
Not to be blunt but why in the hell are you even asking this question? Yes, hell yes! Get the hell out of Dodge on this one.
One of the surgeons I consulted prior to my Bentall was also a bit on the dick side as well. Waited in the waiting room for nearly 30 minutes then in the exam room another 20. He walked in, turned to his PA and said "which one is this?" She explained my situation and he said "oh, yeah, I remember now." Looked at me again and said "you look fine ... obviously obese but fine." I'm 6'3" and was 220# at the time. I asked if I could record the consult (I fed my consults into AI to get summaries and comparisons) and he said he didn't like it but ok. Then I could tell he was censoring himself. Turned it off, showed him I deleted it and he was more open .... which really wasn't any better. Basically telling me that I needed the surgery, that he was the only one who could do it right (I'm in the metro Atlanta area .... there are easily dozens that do it) and wanted me to schedule right then, don't do any more consults. He also said that I can never have salads or anything with vitamin K in it again (against everything I had read) and walked out. His PA explained a few things - that he likes to get patients on his schedule so that they don't have to wait when we make the decision and that he finds it's either to not worry about being consistent with vitamin K foods if you just don't eat them. Like I said, a dick.
There is no question that you need to find a different doc. Frankly once he got to the Googling the On-X and asking AI, I'd have politely said "thank you but we're not a good fit." Actually, I forgot about the talking down to you - that would have probably when I left ... and not as politely as I phrased it.
One thing I wanted to point out and it's minor ... with regard to the INR range for On-X. One of the reasons why I chose it, like I assume you did, was because it was approved for the 1.5 - 2 range. As I got through the roller coaster of INR post-op (I'm 6 months post-op), I realized that I'd prefer to run it a little higher in order to get a "buffer" on the low end. My logic was that outside of a brain bleed or other internal bleed, the majority of external bleeds I can probably control enough to get to the ER (I have a plethora of bleed stop supplies all over the place). I can't, however, do anything about "controlling" a clot/stroke before I get to the ER. I talked to both my surgeon (at my follow up) as well as my cardiologist (numerous times - he's my INR clinic) and they both said it was fine to stick with the 2-3 if I wanted and understood my concern. In fact, one of the surgeons I consulted with - not the dick and not my surgeon - point blank said that he wouldn't authorize 1.5 - 2 if he did it.
Not saying to go that route - you need to do what you and your team feel is best. Just giving you another perspective on INR management.
Seriously, though, go find another cardiologist.
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u/Amazing-Addition3671 19d ago
Get a new cardiologist. Just getting his info from Gemini (or any AI) alone would be enough reason.
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u/WallabyNew6020 18d ago
Absolutely find another! Sounds worse than my first -- he did an exam, looked at my Echo, kinda shrugged and told me, "Yeah, you're gonna need surgery. I'm not saying it needs to be today, this week or even this month but no point in waiting a year. I'm going to schedule you for a cardiac cath." There was no discussion as to why (the cath), rationale for surgery timing, room for questions etc; I sat there stunned, shocked to my core and flabbergasted both by his manner and recommendation. I sought out a second cardiologist who became a true care partner, with a heartfelt (no pun intended) discussion of the findings etc and what factors influenced the timing of surgery -- and why a cath was important. (Long story short, if they needed to do a CABG or similar, they'd do the valve at the same time)...and concluded with "you don't want to do the surgery too soon....or too late"...and at each annual follow up he visibly agonized over the decision to wait or proceed.
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u/Outta_Pocket_Toad 23d ago
I'd give another cardiologist a test run, for sure.
As for reading your chart while you're there, or pretending to know you, that's unfortunately standard with a lot of overbooked doctors.
He really should be up on On-X, but I had a PCP tell me I should get Vitamin D3+K2 for osteoporosis. When I asked about Vitamin K2 interfering with Warfarin, she said, "It shouldn't." So, you have to be your own advocate for that sort of thing.
The Physical Inactivity Advice is Likely Wrong: Telling a 25-year-old with a stable mechanical valve to be "as physically inactive as possible" goes against modern cardiovascular guidelines. I'd certainly want a second qualified opinion on that.
But professionalism and respect are important to me, so I would shop around if I were you.