Monday, July 23, 2007

Informed consent?

My husband has a cardiac cath scheduled for Wednesday to check a couple of relatively small areas with decreased perfusion after exercise. 9 minutes on the treadmill and he was having no chest pain or shortness of breath when they did the scan. If he was less active, he'd never have known he needed to get this checked out. His only symptoms were some dizziness and shortness of breath when he spent 20 minutes on a stair climber at the gym last month. That and if he mows the lawn when the temperature in the 90's he gets a little winded. I'm glad he's paying attention. Lots of people would think that was normal.

It sounds like he may need a couple of stents, but that there hasn't been any damage done - yet. I listened as the cardiologist explained the procedure - in very simple language. I watched as he explained the risks and asked if we had any questions. I was the only one asking questions and those were mostly "When and where?" As soon as the cardiologist left the room, my husband looked at me and said, "So is there any danger that the procedure could trigger something?"

Well, yes, but not much and it's safer than not doing it.

The interventional cardiologist will review all this with him again on Wednesday, but I expect that the conversation will be the same. He will have no questions for the doctor and lots for me as soon as the cardiologist walks out of the room. Good thing these cardiologists explain things so clearly. I know the vocabulary, but this sure isn't my area of expertise.


Chris and Vic said...

So, Judy, what is your explanation for your husband's asking YOU the questions as soon as the doc walks out the door? Do you think your husband's reasons are like those of NICU parents who do the same?

How worried are YOU? Sometimes those stats are just NOT comforting, seems to me. It is too personal when it is a family member.

Chris and Vic

Judy said...

I need to ask him why he waits until the doctor leaves. I have some suspicions, but I shouldn't assume. I think that people - including my husband - don't want to "waste the doctor's time"

I also think that he's pretty sure I'll phrase things the way he wants to hear them. The cardiologist said that there was a 1-2 in 10,000 chance of an adverse event (in English, though). I also think he wants to hear how worried I am.

I'm really glad that my husband knows his body well and doesn't ignore symptoms so any problems can be dealt with before they get worse. Worried? A little, but really not so much. I'm very confident that his cardiologists know what they're doing. The risks really are very low - especially compared to the risks of ignoring the symptoms.

The first time I was really scared. He'd scheduled the cath at a local community hospital. I called the cardiologist right back and had it moved to a hospital with a cardiac surgery center -- where the cardiologist had wanted to take him in the first place.

The second was much more frightening. He went by ambulance with unstable angina. This is just not in the same league. To make a NICU analogy,I'd compare it to the parents who have a 34 weeker who needs an oxygen cannula for a couple of days after having had a 25 weeker who was hospitalized for months.