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Author: Subject: Cardio- versions in La Paz ?
EnsenadaDr
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[*] posted on 5-10-2014 at 08:58 PM


Blanca you only do Cardioversion with a doctor's order. You can't order a doctor to give your husband a Cardioversion. They have to hook him up to a monitor and see what he has. Go to the ER and have them put him on a monitor. A cardioversion is not like getting an enema, it is a very serious procedure that needs to be monitored closely. It is essentially an emergency procedure. It is only done when medications and other options do not work. I wouldn't chance it in Mexico unless no other treatments have worked. Sometimes an injection of Diltiazem will slow the atrial fibrillation down to an acceptable level till you can get him back to the US. Most likely you got this answer from the Cardiologist because it isn't an option in his hospital. Get back to the United States if you absolutely insist on a cardioversion. Make sure he is well hydrated and is not drinking alcohol and stays out of the heat. Guaranteed Les' doctor in San Diego would advise the ER as well.

[Edited on 5-11-2014 by EnsenadaDr]
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mtgoat666
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[*] posted on 5-10-2014 at 09:11 PM


What are you waiting for?!?!?!?
Fly to San Diego!!!!
Crikey! Use common sense! Get to a real hospital!
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DENNIS
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[*] posted on 5-11-2014 at 06:28 AM


Quote:
Originally posted by EnsenadaDr
Blanca you only do Cardioversion with a doctor's order.


But they'll sell a de-fib machine to any kid who walks in off the street?




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DENNIS
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[*] posted on 5-11-2014 at 06:35 AM


Blanca and Les are showing all of us the importance of MediVac insurance.



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[*] posted on 5-11-2014 at 07:16 AM


Quote:
Originally posted by mtgoat666
What are you waiting for?!?!?!?
Fly to San Diego!!!!
Crikey! Use common sense! Get to a real hospital!


Sheesh, Blanca isn't an idiot.

Chances are she's looking at flights while at the same time posting here to see if anybody has found an expeditious way to have the procedure done locally. They're in La Paz, so think about it- she has to consider landing in TJ and taxi to the border, walking across the border, and a taxi on the other side... Maybe Les' CA cardiologist told her if they flew up there they couldn't get him on the schedule for elective cardioversion (see below) for a few more days so in the meantime she's looking at possible local options.

She's never said what his heart rate or rhythm is, or what his normal rhythm is. His normal rhythm could possibly be atrial fib which is why his doctors are recommending optimizing the conditions before cardioverting due to the increased potential for dislodging blood clots. He could have been in atrial fib for the past 20 years and be tolerating it fine, but has switched to a different rhythm which is causing his symptoms. Without obtaining Les' complete past history along with all his present signs and symptoms, there are too many variables to give her responsible input.

There is emergent cardioversion for life threatening conditions, and elective cardioversion for situations where the heart has kicked in to a rapid rhythm, but the patient is tolerating it fairly well and there would be risks to start shocking the heart. Of course his rapid rhythm needs to be treated but it's always best to have as many facts and as much control as you can before performing a procedure that has it's own inherent risks.
They can't just grab the paddles.

It sounds like his doctors are being cautious before proceeding and she is trying to figure out the logistics and wondered if anyone has already been through this and could offer advice. I'm sorry Blanca, wish i could help.
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rts551
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[*] posted on 5-11-2014 at 08:20 AM


Quit YELLING you guys...sounds like dinner and drinks went just fine.

http://forums.bajanomad.com/viewthread.php?tid=73372&pag...
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EnsenadaDr
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[*] posted on 5-11-2014 at 08:35 AM


The doctors shouldn't be deciding anything before hooking him up to a monitor. They don't know if he has SVT, PVC's,PAC's. uncontrolled atrial fibrillation, or Ventricular tachycardia. Doubt he has Ventricular fibirillation because he only would last a few minutes with that. Just because cardioversion has worked in the past doesn't mean he's a candidate for it each time. I have seen it done dozens of times in the US but never once in all the facilities I have been in Mexico. How could the doctors be deciding what to do when they don't even know what they're dealing with.

[Edited on 5-11-2014 by EnsenadaDr]
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[*] posted on 5-11-2014 at 08:46 AM


Quote:
Originally posted by rts551
Quit YELLING you guys...sounds like dinner and drinks went just fine.

http://forums.bajanomad.com/viewthread.php?tid=73372&pag...



You OK, Ralph? Are you having a bad dream? :lol:




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BajaBlanca
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[*] posted on 5-11-2014 at 09:00 AM


Thanks, Oladulce.


You hit it on the nail. Absolutely brilliant and I could not have said it better. Les is elective as the docs sayhe could live forever just like he is. He does not want to. Hence, elective.


Les has checked into flights and San Diego doc is indeed calling us Monday with a date.

I simply wanted a future plan B for La Paz. This is bound to happen again.

We did find a local place that does ECGs for 100 pesos, right around the corner and have done them consistently the last couple days.

Les is on blood thinners in preparation for San Diego. We have been around the block, folks, no one is playing around. The heart rate is high but not that high.

Dinner and drinks were fabulous, that was right on the nail too (((:

All that being said: the doc here, before we heard back from our san diego cardiologist (who said it would not work in Les's case) suggested Les try to control the arrythmia (sp) with meds. It was horrible. Terrible. Beyond scary. He could not take 2 steps without being winded. We wish we had never started this option. I would not wish it on my worst enemy.

[Edited on 5-11-2014 by BajaBlanca]





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EnsenadaDr
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[*] posted on 5-11-2014 at 09:20 AM


Alcohol after a scare like that? Anyone knows that alcohol exacerbates atrial fibrillation. and a huge dinner should be avoided as well.

http://www.everydayhealth.com/health-report/atrial-fibrillat...
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rts551
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[*] posted on 5-11-2014 at 09:27 AM


Quote:
Originally posted by DENNIS
Quote:
Originally posted by rts551
Quit YELLING you guys...sounds like dinner and drinks went just fine.

http://forums.bajanomad.com/viewthread.php?tid=73372&pag...



You OK, Ralph? Are you having a bad dream? :lol:



Between internet sleuthing for missing people, forum medical diagnosis, and a continuing theme of economic downsizing I think it was a night mare. But I have a remedy....cooler full of beer, couple of burritos, the boat and a fishing pole.
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EnsenadaDr
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[*] posted on 5-11-2014 at 09:38 AM


If that is all you have to do with your time, have at it. Remember the beer might just jumpstart atrial fibrillation though!! Have a great Mother's Day! OH yeah watch out for the lard laden burritos as well.
Quote:
Originally posted by rts551
Quote:
Originally posted by DENNIS
Quote:
Originally posted by rts551
Quit YELLING you guys...sounds like dinner and drinks went just fine.

http://forums.bajanomad.com/viewthread.php?tid=73372&pag...



You OK, Ralph? Are you having a bad dream? :lol:



Between internet sleuthing for missing people, forum medical diagnosis, and a continuing theme of economic downsizing I think it was a night mare. But I have a remedy....cooler full of beer, couple of burritos, the boat and a fishing pole.


[Edited on 5-11-2014 by EnsenadaDr]
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EnsenadaDr
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[*] posted on 5-11-2014 at 09:52 AM


Another thing I would like to mention is shortness of breath. Many might want to relate it to being medicine induced but it is the actual atrial fibrillation that causes shortness of breath especially when it isn't controlled. Your heart is pumping ineffectively therefore not enough oxygen is being distributed to the tissues hence shortness of breath. Get the rhythm and rate controlled and you will not have problems feeling short of breath!
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rts551
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[*] posted on 5-11-2014 at 09:53 AM


Quote:
Originally posted by EnsenadaDr
If that is all you have to do with your time, have at it. Remember the beer might just jumpstart atrial fibrillation though!! Have a great Mother's Day! OH yeah watch out for the lard laden burritos as well.
Quote:
Originally posted by rts551
Quote:
Originally posted by DENNIS
Quote:
Originally posted by rts551
Quit YELLING you guys...sounds like dinner and drinks went just fine.

http://forums.bajanomad.com/viewthread.php?tid=73372&pag...



You OK, Ralph? Are you having a bad dream? :lol:



Between internet sleuthing for missing people, forum medical diagnosis, and a continuing theme of economic downsizing I think it was a night mare. But I have a remedy....cooler full of beer, couple of burritos, the boat and a fishing pole.


[Edited on 5-11-2014 by EnsenadaDr]


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[*] posted on 5-11-2014 at 04:02 PM


Blanca do you have a good blood pressure gauge? John kept his blood pressure daily, weighed himself, and definitely was aware of shortness of breath and swelling. Our BP gauge also has a AFib alert on it so that helped if he was unsure. After 3, week long stays in ICU, 2 heart ablations, 4 or 5 cardioversions, many ECGs, 24hr heart monitors, stress tests etc. several medications for arrhythmia including amioderone (which should be avoided) I feel I am a minor expert. We were also schooled and prepped for a study group for efficacy of ablations + or - medication support.
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