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Post by librarylady on Oct 6, 2017 2:13:47 GMT
About 10 years ago, my DH had an angiogram--while they had him sedated, it was discovered he needed a stent--so dr. put it in. DH had been told ahead of time that this would happen, if they found blockage. Next week my brother has angiogram scheduled--he told dr. if you find blockage, put stent in so I don't have to be sedated again. His dr. says, "That is not how it is done now."
So--Is the dr. goofy or is there some reason to sedate a 75 year old twice?
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Post by Zee on Oct 6, 2017 2:32:39 GMT
It might depend on the facility, unless they were at the same place. Where I worked stents were placed at time of cath if needed, but we also got transfers from other hospitals that performed cath only (no intervention) because they didn't have a CVOR team to perform open heart surgery if needed in emergency.
This is less common as stenting is not as risky as it used to be, plus who wants to do that twice? So, many patients would travel from outlying areas to our facility when feasible so they didn't have to transfer post-cath.
Also, occasionally a doctor who does routine caths is not an interventionalist (one who does stenting, etc) and would need to refer to a dr who does. That's not too common but is possible.
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Post by Zee on Oct 6, 2017 2:37:34 GMT
Another question is of that's not how it's done "now", then what is the plan? What reason was given for a second procedure? I need more information. Plus I worked at a hospital with a strong cardio program known for its high PTCA low open heart program so naturally we were more prone to put stents in people, because that was one of the specialties.
I probably sound like I'm rambling because I'm falling asleep, better sign off before I type something goofy. I'm interested in hearing "how it's done now" as if two procedures would be a more desirable and modern approach? Maybe someone else has other insight.
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Post by librarylady on Oct 6, 2017 3:17:44 GMT
...since I posted, another person has suggested it is because Medicare will only pay for one procedure per day.
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Post by jcm28 on Oct 6, 2017 6:46:27 GMT
Maybe he was talking about the sedation part. People are not "out" during routine heart catheterizations. Or perhaps the dr. Is not an interventionalist and only does diagnostic procedures. Why not ask him to clarify? Seems easy enough.
Janet
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Post by jerseystampinguy on Oct 6, 2017 11:55:58 GMT
I would definitely question the doctor about why he won't do the stenting the same time as the cath and if he resists answering the question outright I would strongly urge your brother to find another cardiologist or a facility that has a complete heart health center.
My brother (who is 57) just had a cardiac cath done a month ago and the doctor decided he needed a stent, so he placed it while my brother was still on the table. I hate saying this but I'm doing too anyway, it sounds like your brother's doctor may be the type that likes to overcharge the insurance. Instead of placing the stent at the time of the cath he would rather your brother come back again so he can double tap the insurance company. I'm not saying this is the case with that particular doctor but it is very shady that he not place the stent at the same time as the cath.
As I said, I would question the doctor and if the hospital your brother is going too doesn't have a heart center I'd inquire about going to one that does and seeing an interventional cardiologist who can do procedures at the same time.
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Post by dazeepetals on Oct 6, 2017 12:51:50 GMT
It might depend on the facility, unless they were at the same place. Where I worked stents were placed at time of cath if needed, but we also got transfers from other hospitals that performed cath only (no intervention) because they didn't have a CVOR team to perform open heart surgery if needed in emergency. This is less common as stenting is not as risky as it used to be, plus who wants to do that twice? So, many patients would travel from outlying areas to our facility when feasible so they didn't have to transfer post-cath. Also, occasionally a doctor who does routine caths is not an interventionalist (one who does stenting, etc) and would need to refer to a dr who does. That's not too common but is possible. This! Our hospital can do routine angiograms, but if a stent is needed they have to transfer to another hospital. This is because we don't have the surgery team to be able to do open-heart (i.e. by pass) at our hospital if needed. I would consider seeing another interventional cardiologist who can do same day procedure if needed if the thought of having 2 procedures worries you or your brother. |
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Post by dazeepetals on Oct 6, 2017 12:52:57 GMT
...since I posted, another person has suggested it is because Medicare will only pay for one procedure per day. Not correct. Medicare will pay for both in the same day. |
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Post by Patter on Oct 6, 2017 12:55:51 GMT
You have gotten great responses here. I know they did them at the same time where my daughter had her open heart surgery but teams were available if there was an emergency.
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