NEW THREAD CARDIOVASCULAR PROBLEMS

[Mary63]

Just seen cardiologist. He says I do not have angina, but something to do with the chest wall related to my PMR.

He could not understand me, and I could not understand him.

Despite the fact that I no longer have pain at rest, but when I go to the loo or try to get something out of my locker or transfer from bed to chair the pain comes...three times today so far. He says it is a chest wall problem related to my PMR. I asked what I should do. He didn’t really answer. I asked why the GTN spray helped he said I should not use it too much. I was getting tearful so was not able to fight my corner. What now?

[Rugger]

Is there a junior doctor on the team who will sit and explain things to you?

Wishing you well.

[MrsNails]

Mary, ask to speak to your Named Nurse, should be above your bed or the Ward Sister and ask for a further explanation.

Did he mean Costochondritis?.....

nhs.uk/conditions/costochon...

Angela 🌸

[Mary63 in reply to MrsNails]

Thanks Angela. I have had costochondritis in the past and this is nothing like that.

When I can speak without tears I will try to get an explanation from the junior sister or another doctor.

[MrsNails in reply to Mary63]

That’s helpful (in an odd way) did he show you the ECG? Is it normal & what are the bloods showing?.....

[Mary63 in reply to MrsNails]

ECG is now ok though I was told on Saturday there were small changes. Bloods normal. He only started saying it wasn’t angina when he was examining me ,and it was uncomfortable when he was pressing on my chest. I said that is not where Polymyalgia gives you pain. I think he may be confusing poly with Fibro.

[MrsNails in reply to Mary63]

How can he tell it’s not Angina without having a Heart Scan/Angiogram? Pro is right about communication/language difficulties....

[123-go in reply to Mary63]

Tears come so easily for a lot of us but nothing to be ashamed of. You do need someone to be present if communications between you and the specialist aren't clear. Please ask. 💐

[PMRpro Ambassador]

Wonder if he means costochondritis? Which people with PMR have but so do lots of people without and it isn't associated with PMR.

At the risk of being accused of being racist, I really don't find it acceptable that patients are expected to see a doctor who doesn't understand them and they don't understand. I do know a bit about that - I used to teach medical English in Germany. Being able to write English does NOT mean you can communicate in it - even if colleagues know what you are saying. Especially when the patient is (understandably) anxious because of suspected cardiac issues. The other way round, the hospital would be rushing around to find an interpreter - as a legal requirement.

uptodate.com/contents/chest...

may help - it is easy enough to read I think.

All you can do really is get your GP to follow it up and find out what the thinking is.

This may be a place to get PALS involved - the department may not realise how difficult it is for patients to communicate with this doctor.

[Mary63 in reply to PMRpro]

Thanks. I really just feel like getting home now, and start again with my (mostly useless) GP.

[PMRpro Ambassador in reply to Mary63]

You should get a discharge talk - maybe the doctor (or nurse) who does that might help? Doesn't here, the junior bunnies who put the bits together are often useless ...

[Mary63 in reply to PMRpro]

Yes waiting for that. Maybe everything will be much clearer then. Not sure whether I will stay on all the hollow they’ve given me since admission, beta blockers, platelet stuff etc etc

Thanks Eileen

[ChinaWuntoo in reply to PMRpro]

As I have hinted here before....it's difficult to refer to language / accents without seeeming to be racist. In my part of London it is most unusual to see a doctor who is white/AngloSaxon and most are difficult to understand in my experience. As I have hearing challenges I can 'hide' behind that to some extent by explaining that I have a hearing problem, they need to speak slowly and I keep asking them to repeat what they are saying. My own GP falls into this bracket and he also mumbles. But he does know that I need to see his face when we are talking (remember those days?).

My ex-rheumy (who thinks he is still my rheumy!) also falls within this bracket.

On the other hand, I have to say that the two locums who diagnosed my PMR fell into the same bracket and there was no language or accent difficulty - young and trained in UK.

I suppose time will sort it out but I'll be long gone to the steroid-making factory in the sky.

I do try to write stuff down and give it to my GP / Rheumy before an appointment as I think that should be a great help. (Unfortunately I have caught both out when I refer to it!)

[Mary63 in reply to ChinaWuntoo]

Thanks for your comments. I too have hearing difficulties. I wear two hearing aids, and realise since Covid and masks how much I usually lip read. Accents are extremely difficult for me to get a grip on. The cardiologist’s accent was very difficult and he was irritated (with me) that he couldn’t understand exactly what I meant. But I was very clear. I don’t have a problem with clarity really. Anyway I am now waiting a bit longer and I expect someone will come along to explain a plan. If they don’t I will approach someone. I’m not tearful any more so have a better chance of a sane ish conversation!

[123-go in reply to Mary63]

Good for you! You will have left the hospital by now, I imagine. I hope all went well.

[PMRpro Ambassador in reply to ChinaWuntoo]

Worst I had was when Vodafone shifted their call centre from the west of Scotland (easy peasy, beautiful English) to Yorkshire! The guy I got in Yorkshire was just speaking scribble!

[ChinaWuntoo in reply to PMRpro]

norf o' watford does me in - and I mean Watford Herts. [BTW some of my best friends are ..... ]

[Longtimer in reply to PMRpro]

Horrible problem, stressed, ill and can`t understand the medics!, even find wearing a mask you can`t always understand someone.....even in English!......I always say, sorry, can`t understand what you said.....

[tangocharlie]

I have no idea if it is the same, but I get chest pains when I am not on a high enough dose of Pred, or written another way, high enough doses of Pred takes away my chest pains. I wouldn't say I have difficulty breathing so much, it's more like a constant tightness or weight on my chest, a bit like having cramp. Pred takes it away. I have been throroughly investigated for heart and lung problems and given the all clear. I first noticed it when trying to get below 5mg years ago. I also have oedema in my legs which is alleviated by higher doses of Pred. I keep searching for answers but nobody knows why. My guess is it is some kind of vasculitis thing, which PMR essentially is. Like I say, I have no idea if yours is the same.

[Mary63]

Interesting!

[Rache]

I really feel for you, Mary. I spent a long time in A&E recently due to a couple of episodes of feeling chest pressure and pain between shoulder blades. The doctor who dealt with me (who was wearing his mask under his nose) didn’t seem to take it seriously at all. My troponin level had still been slightly raised about a week after the incidents, 17 instead of under 14, and my pulse level was stuck at over 100 when my GP had phoned me at home and told me to go to A&E. He frightened me. I was just glad to get home in the end. I thought all the stress was not helping. You’ve had some good advice here which I hope will help x

[Mary63 in reply to Rache]

Thanks

[Rose54]

Hi Mary

Are thay still saying you had a mild HA ?

If so the HC Nurse will be around before you are discharged to talk you through meds and Life Style changes .

If you see them maybe thay will be able to tell you more .

[Mary63 in reply to Rose54]

No they’ve changed their mind about that!

[Mary63]

Final comment on this thread!

Thanks to all of you for your input and supportive comments. Just been seen by the lovely SHO who explained everything beautifully.

Followed by the consultant, alerted by someone, who tried to explain but was not clear. What he did say was that he thought it might be costochondritis or something to do with FIBROmyalgia. Put him straight on that.

But he and the SHO both said I would keep on whatever has been controlling my BP well and a statin which I’m not sure about but didn’t have the energy to argue.

I will be having an exercise stress test in the near future. He now says that he never said I hadn’t got angina, just felt it was not the right thing in the circs to perform an angiogram, as I may not have angina. So the stress test will provide some extra information.

[ChinaWuntoo in reply to Mary63]

Pleased you seem to be getting somewhere.

[Rache]

Glad you’ve had some clarification