Confused AGAIN….

[camiboxer]

My dad went to see his cardiologist this week and also had his yearly carotid artery ultrasound done.
He had a quadruple bypass in 2000 and a pacemaker in 2001. It was during this time that his carotids were found to have some blockage. It wasn’t enough to require surgery but it would need to be monitored yearly and of course if any symptoms presented another plan of attack would occur.
He was put on Plavix and asprin therapy (325mg) along with another heart med. and cholestrol meds.
His oncologist knows about his meds but has never said anything about them in reference to his MDS.
This week we again mentioned his MDS to his cardiologist along with the fact that dad has had some nasty looking bruises on occasion (rarely) and he bleeds pretty severely with the smallest cut, (shaving, small cuts, etc).
The cardiologist suggested that if the oncologist wanted him to stop taking the Plavix that he would be fine with it but he needed to stay on something, (asprin adult dose).
His explanation was that some MDS patients have problems with bleeding and others with clotting.
I was unaware of this since it’s never been brought up before. We were told to find out what type dad has and let the oncologist make the decision.
Dads platelets are well within normal range.
This disease makes treating other things so very confusing. If the Plavix has been keeping the arteries from getting worse WHY would it be ok to take a chance on him having a stroke or worse?
Is it really more along the lines of you fight the most evil issues and hope for the best with the rest?

[marlene]

Why won’t these specialist talk to one another? This is very frustrating I’m sure. I would assume your dad’s cardiologist has various goal established around cholesteral and clotting rate and uses the meds to achieve that. One would assume that he would be the one to play with reducing or stopping meds to balance the risk/benefit. The plavix and cholesteral meds can effect one or all three blood lines so you have to ask the question, for those that have BM/blood count side effects, can you find another med to replace it, keep it at the lowest dose possible and still achieve those goals. This takes time and requires the doctor to be engaged at a more thorough and thoughtful level. You got to wonder if it’s ok to stop the plavix, why does he still have him on it? Is it overkill? And do you stop it cold turkey, or reduce it slowly to prevent any rebound effects.

And then, you wonder why the oncologist doesn’t take the meds into consideration as to how they are effecting his bone marrow.

rxlist.com is great place to look up meds.

Does your dad have good GP who can help him sort all of this out and look at the entire picture. Unfortunately, specialist only look at a narrow aspect of ones health. You cannot mess with part of your body without effect the entire being. There are more natural methods for managing coronary risks that are less harmful, but you would need to work with a doc who’s skilled in this at this point. They center around reducing the various risk factors like inflammation, homocystiene levels, improved blood flow, arterial health, etc with diet, exercise and nutrients.

You can spend some time on the http://www.lef.org website to research cardiac disease to help facilitate your conversation with the doctors.

Marlene

[camiboxer]

Marlene thanks for the info.
Dad has done everything in his power to get his heart issues under control. Sadly for him he has a terribly bad family history of heart issues and he is actually the only male to have made it past age 45 (he just turned 68). He is at a healthy weight, his cholestrol is wonderful. He eats all the right foods, takes his various supplements and meds on schedule. The only thing lacking is exercise. He has problems with his feet that require surgery but he refuses to go thru more surgeries (I don’t blame him). The surgeries can’t give a guarantee of success. He is the only driver in the house and lives in a very rural area. He doesn’t want to be homebound for 3-4 months which is what the recovery time would be *if* all went well.
He is active, he just doesn’t follow an exercise routine like he should.
His GP is probably not the best….more along the line of “You look good and you say you feel good so that is good for ME”.
His cardio is sending off a letter to this oncologist with his thoughts on the Plavix so that will be helpful.
Thanks again for the info.

[marlene]

I understand about the feet….John ended up with nerve damage (peripheral neuropathy) from the drugs during his treatment and it really does impact exercise. He came a across one doc who said sugery could fix this but we’ve been able to improve it with non-invasive treatments so much so that I don’t think it’s worth the risk at this point. And the operative word is “could” and always the risk that it’s worse afterwards is a strong possibility.

I hope this gets resolved for you guy.

Marlene

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