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Inverted T-waves and surgery

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beth1954

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I went to my family doctor Friday to get some blood work ordered for my surgeon. While I was there he decided to do an EKG which was fine with me--as a precaution because of the upcoming surgery.

As usual, he flipped out and made it sound like I would die on the operating table.

History of this: In 1992 I had an EKG in his office and it showed inverted t-waves. He said I had heart disease, etc. and had me so upset....he faxed over a copy of the EKG print out to a cardiologist. That doctor said that there is nothing wrong, but that the inverted t-waves were just "normal" for me. In 2000 I had another EKG in his office and it turned out the same way. He flipped out again. Same resolution.

Friday SAME THING. He said that this would probably put off the surgery and had me at my wit's end. So he made an appointment with a cardiologist for me. I don't really have a problem with that, but it makes me so mad that he freaks out like that when that has been "normal" for me for 17 years. I have had 5 different surgeries since then, and no one has even mentioned it and nothing has gone wrong. I got copies of all the EKGs and I'm going to take them with me to my pre-op and show them to the surgeon.

(In case you are wondering, the reason for the EKG's in the past were no because of any symptoms of heart problems, but because at that time I was using a lot of Imitrex for migraine headaches, and he would make me occasionally have an EKG to make sure everything was OK. Imitrex can be hard on the heart)
 
Oh Beth I'm sorry maybe your right bring your EKG's and show him you have had surgeries since then and have been fine. I understand that he is worried but if the Cardiologist says its OK then I'm with you . I'm confused. Just state your case in the nicest , firmest way , I think you get more being calm. But tell him your really need this done and this is the time you have to do it....I sure hope it works out for you. I hate to see you sit in pain it the Cardiologist says its fine. Maybe have the Cardiologist call him and speak with him or send a letter.....Best wishes to you....Please keep us posted I would be interseted to find out what he says.
 
Oh gosh, Beth! SO sorry you have to deal with this latest blip! Talk about your doctor having no bedside manner....:shk: Get yourself checked......this may be a blessing in disguise!:pzld:Good luck and let us know how you are doing!
:p
 
Oh doncha just love these drama queens! I've met a bunch of them in my time.

All of the waves are evaluated, not just one in particular and since the rest of the trace appeared to be normal, that's most likely why the cardiologist reported that it was a fine. There are many reasons for inverted T waves but they can include hyperventilation, anxiety, certain medications.
 
Geez Jo really every time you post I look at it. You really know alot, I mean alot. I learn every time you make a post......I guess 50 yrs paid off. I know there are other nurse out there just as dedicated but I know they hated to lose you.....You should take a bow, you really deserve it !!!!
 
YAY JO!!! You really take dedication to a new level!:flwr::yrk:
 
Beth
Why even listen to your family doctor. Your cardiologist said it was nothing. He is the heard doctor. You have had 5 surgeries you said and no problem and no one said anything.

Glad you are taking copies of the EKG to new OS. If he says it is nothing then don't worry about it.

Jo is the one to listen to.

Good luck on the surgery coming up and I am sure you will be able
to have.
 
Beth,

Not sure about everyone else, but my OS required me be cleared by the cardiologist and dentist. This was his standard procedure. Seems to me if the cardiologistic says it's fine the OS will not have any problems.

Just wondering why you still go to the drama doctor after all these years? Must have other good qualities to make up for his poor bedside manner.

Wish you the best and hope your OS has a calm nature!

Blessings,
 
Beth,
Just like you I have always had inverted T waves and it's been that way since I was 21 years old and first EKG. There are a lot of congenital heart problems in my family. Subsequently I've had to have several echocardiograms and stress tests through the years. They are always completely normal. I've had different primary care physicians over the last 10 years (they keep moving away) and every time they see my EKG, they flip out too. And then I march to the cardiologist to have him listen and say it's perfectly fine. My last OS demanded a stress test before surgery- perfectly normal as the cardiologist said it would be.

Trust the cardiologist. They listen to a lot of hearts! And know if there is a problem. I see a lot of flipped T waves working in surgery. Agree with Jo, no big deal- it's normal for you.
 
I forgot to mention - I had a period of inverted T-waves as a result of taking the antihistamine, Clarytin. I also had to have a stress test and was normal.

Funny story - when I was being kitted up for the ST, the machine took my blood pressure and it was 210/110! :shk: Well, hardly surprising - I had first appt of the day and while I was sitting in the waiting room, the fire alarm went off. All the staff trooped out and left me there. After a minute or two, one of them popped back and said for me not to worry it was 'just' a fire alarm and they'd be back in a tick! Well, I worked in the hospital so I knew they were having false alarms almost every day but I couldn't help thinking what if this time it's not! So by the time they got me wired up, that BP wasn't all that surprising.

But. as protocol dictates, they said they'd have to postpone the test so I said 'no, give me a few minutes quiet and I'll get it down'. Well, I tried to go into an hypnotic trance to do bio-feedback but they were chatting about a relative who was dying of cancer which didn't exactly help! I asked them to quiet down and then was able to get into a good trance. As a result, got my BP down to 140/100 which is pretty near my normal. Yay for self-hypnosis!!
 
I would igore your family doctor and talk to your surgeon. Its his ego if you die on the table (not minimizing this but I think as a surgeon that's how he would look at it). I have heart disease (2 heart attacks, bypass, pacemaker/defibrilator implanted). The orthopod said your cardiologist is 150 miles away I want you familiar to a cardiologist in the hospital here just in case I need to call somone. So I did a workup with a cardiologist he picked. The cardiolgist OK'ed the surgery and was never called.
 
Well, when I remember all the patients I've nursed who've had hip and knee replacements and been just fine throught the surgery. Conditions would include

~ heart problems such as history of heart attacks,
arrhythmias, pacemakers, stents, valve replacements, medicated high blood pressure etc.
~ diabetes, asthma and other lung disorders, sleep apnoea, epilepsy
~ obese, elderly, young, frail

All patients are closely monitored throughout the procedure with constant EKG monitors, oxygenation levels probe on finger, blood pressure every 3/5 minutes, respirations recorded all with a constant display and record kept on a machine like this

[Bonesmart.org] Inverted T-waves and surgery

So the anaesthetist has a constantly updating display on your health on a minute by minute basis plus his own observation to monitor the patient's health. Nothing catches him unawares, that I can promise you.

 
I started this answer and then lost it.
In my heart (diseased or not) I feel like everything is OK. If my OS wants me to see a cardiologist, I will. It might be nice to know that my heart is healthy which it has been for so long. You would think my 60 lb weight loss would help that a little bit too.
The reason I got so upset on Friday was because of frustration more than anything.
Just wondering.......why do you need an OK from a dentist? Just curious. As a matter of fact, I am going to see the dentist about a week before I see my OS for the pre-op visit. I'm afraid that since my family doctor sent off all kind of alarms, bells, whistles, that I might need to see a cardiologist just because maybe everyone is scared about it.
I was also frustrated because of all the surgeries I've had with the SAME EXACT EKG and nothing has happened. No one even said anything to me afterwards.
Oh--I go to this doctor because he knows me so well (at least I thought he did.) I started going to another doctor for awhile, but when I had the neck problems (pain at level 7 on a scale of 1-10) she would not prescribe anything for pain stronger than Advil. Dr. Rogers knows me well and knows that I don't abuse those types of drugs. There are alot of things I like about him, but I think I'm going to have to stop going to him again.
Like one of you said, it's just another "blip" (or as my Doc said--a hiccup) in my journey to the surgery. Something I didn't need, and as a diagnosed "major depressant" person with a "Mood disorder" I didn't need this now. Fought with my daughter all weekend about how to proceed. REALLY rough weekend. IF I did abuse those drugs, I would have been in a stupor all weekend.
A kind of funny note:
I know this forum is all about no bad language, etc. But I just have to tell you this. I was crying, mad, practically yelling at my doctor. He started asking about family history. The only one with heart problems was my Dad, and he had had at least two heart attacks-one ending in a triple bypass. I have one sibling that is so cruel to me that I have dis-owned him for a lack of a better description. SO, he asked me about my brother and if has and heart problems. I said "The only wrong with my brother is that he's an a**hole." Doc's response was--with a slight pause......."Well, has the a**hole had any heart problems?"
 
Nice response! I like it!

Never heard of anyone have to have an actual ok from the dentist before but the reason your surgeon may wish it is because any root canal or extractions after the replacement can have repercussion vis a vis infection. We know that any such procedures do dump a whole load of very active bacteria into the blood system. There is a body of opinion, as yet unproven, that it is possible for such bacteria to affix themselves to the surface of the prosthesis which, being an inert material, hides them from the immune system. Thus they are able to live there and multiply, causing trouble.

As I said, this theory is unproven except for the fact that sometimes the bacteria found in infected replacements are similar to those found in the oral flora but this could as easily be a coincidence. Urinary tract infections are also suspected as a source.

After a joint replacement, some surgeons require their patients to have profylactic antibiotics before root canal or extractions. This will be the reason he wants you to have a check-up so if any such procedures are required you can get them done beforehand.

 
Before my surgery, my OS wanted an okay from a cardiologist and dentist too, Beth. I don't think it's that unusual ... especially here in the USA. As for your GP, why don't you just make a deal with yourself that if you ever need an EKG again, you'll not have him do it. Find yourself a good cardiologist and get them there. It's better that way anyway, since they are the experts in interpreting the results.

Try not to let all this get to you....you'll be on the recovery side soon and it will all be just a great fireside story. (((HUGS))))
 
I was wondering about the dentist thing because I'm pretty sure I'm going to need a root canal. So it would be best to do it before the surgery??
 
having the root canal before surgery would be best you dont really have to worry about the antibiotics after,with the thr you would have to take them. .. i've been the nurse for the cardiologist we've had to see people before giving viagra, any kind of surgery with any kind of abnomal ekg. if it dosent say normal they sent them. the t wave can be inverted most times just a low potassium can cause it. if they arent finding anything that might be the only reason eat a banana, it can also be a very benign thing because the meds they use to put you to sleep increases potassium when i do dialysis that is one of the surgical considerations we have. high potassium causes peaked twaves low causes inverted. there are alot of meds that fool with potassium those meds are monitored for ekg changes. as long as the interval isnt changed its usually benign... anyhow i said all this to say most surgeons are going to get the ok just to be sure and i wouldnt worry about it. its more protocal then anything
best of luck.
monique
 
Thanks Monique, that was very informative.

I was wondering about the dentist thing because I'm pretty sure I'm going to need a root canal. So it would be best to do it before the surgery??

Oh yes! For sure, get it done first. Root canal can risk infection around the prosthesis.
 
All your responses have been so helpful. I am going to the endodontist today to have my tooth looked at. He has done 3 root canals on me before, so he is just going to do one x-ray in the area that hurts. I found out the hard way sometimes you think it's one tooth that hurts when really it's the one behind or in front of it that is bad. Then he usually blows REALLY cold air on the tooth, and if it hurts, that seals the deal!

I hope he can get me in really fast. It never has been a problem in the past, but you never know. He is the only endodontist in town. Other dentists do root canals also, but he is the best. If he can't get me in, I might try one of the dentists here in the town that I work in. One in particular has been recommended by my co-workers over and over again.

Potassium, huh? That's very interesting. I'll keep that in mind.

I've stopped fighting going to the cardiologist. I'm 55, have NEVER really taken care of myself, just lost 60 pounds, but am still overweight and have been overweight for the better part of 30 years. So I should take advantage of this "opportunity" to find out everything about my heart. Hopefully it's all good.....or at least not TOO bad.
 
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