Fear and Trepidation - Pace Maker

[MargaritaMike]

I just had an EKG where the Dr. told me to find a cardiologist. I asked if I should do this immediately and he said yes. I asked why and he said that over the last 7 months my heart rate has gone from 82 in January to 46 today (August 28). I live in the boonies so there are no cardiologists readily available. I don't know whether to drive 40 miles to a medium-small town (Huntsville, TX), 55 miles to a medium town (The Woodlands, TX), or 85 miles to a large city (Houston, TX). How does one find a diving Cardiologist? If I don't get a pacemaker, I don't have to worry about diving with one, but my diving days may be limited. I'm planning to dive in October.

Cheers (not so cheery) -

 

[Duke Dive Medicine]

Hi Mike,

There are several layers to your question. I would first make an effort to find a good cardiologist. Absolutely nothing against cardiologists who practice in small towns, but you're likely to find a higher concentration of them in an academic medical center in a larger city.

Once you find the cardiologist and are evaluated for a pacemaker (assuming they plan on placing one), you can have the conversation about whether he/she thinks that you'll be able to return to diving afterwards. If it's looking like you'll be able to dive again, you'll want to try to select a device with a maximum recommended pressure that most closely meets your anticipated diving needs. Pressure tolerance can differ considerably between brands and devices.

You might get lucky and find an interventional cardiologist in Texas like @Dr. Doug Ebersole who also specializes in diving; if not, you'll need to seek out a diving medicine specialist for clearance to dive as well. Fortunately you have Memorial Hermann Hospital in Houston; they have a robust hyperbaric program and have several physicians who should be able to do that for you. They may also have a cardiologist they work with, so it might be worth a call to their clinic to see.

Best regards,
DDM

 

[MargaritaMike]

Thanks for your input. I am VERY familiar with MHH in Houston. I've had 7 back surgeries there, as well as a medial meniscus repair. I had a cardiologist there but it has been over 3 years since I've seen him, and I am not sure I want to go back. He was nearing retirement and had a weird attitude IMHO . I'm not sure how to research an interventional cardiologist in Houston or surrounding area, but will make the attempt. I will reach out to the hyperbaric program at MHH. My mother-in-law had hyperbaric treatment for some wound treatment at MMH in The Woodlands which is closer than Houston. I'll call there first.
Thanks again. I now have a couple of buzz words to possibly get better answers. I really appreciate your response.

Cheers - Michael aka Margarita Mike

 

[Bubblesong]

My suggestion is to bring someone with you to appointments, who has a good ear for details, bring a pen and paper and write details down. Even bring a list of questions related to the type of diving that you do. That way you will get the most out of your short time with the doctor.
Also, consider asking about new technology, experimental tech, that may allow you to keep diving. I am wishing you the very best!

 

[MargaritaMike]

@Duke Dive Medicine
Why an "interventional" cardiologist? After MANY phone calls I'm no further along than I was when I started this thread. You can't talk to a human anymore - at least one who knows anything.
The first appointment I can get with anyone is after I have a dive trip planned, so maybe it will be a non-issue. I have agonized over this to where I am now afraid to go to sleep because of the fact that the heart slows down when a person is asleep.
I would like to just talk with someone knowledgeable for 5 minutes to get some peace. But when Doctors get their M.D. they must have to swear an oath not to use the telephone.

 

[billbb]

Looking at your profile pic I would see a doctor immediately

 

[Duke Dive Medicine]

@Duke Dive Medicine
Why an "interventional" cardiologist? After MANY phone calls I'm no further along than I was when I started this thread. You can't talk to a human anymore - at least one who knows anything.
The first appointment I can get with anyone is after I have a dive trip planned, so maybe it will be a non-issue. I have agonized over this to where I am now afraid to go to sleep because of the fact that the heart slows down when a person is asleep.
I would like to just talk with someone knowledgeable for 5 minutes to get some peace. But when Doctors get their M.D. they must have to swear an oath not to use the telephone.

Let me qualify that. An electrophysiologist is the more appropriate term for a cardiologist who performs pacemaker placements.

Re the diving, understand that the immersed exercise associated with diving places a strain on the heart that's not the same as being on the surface. If you've been advised to see a cardiologist for a low heart rate (were they any more specific as to the exact type of rhythm?) then I'd recommend you avoid diving until it's corrected and/or you're cleared by a physician with training and experience in examining divers. I wouldn't hold my breath on getting any concrete information on the phone, especially from a physician who hasn't examined you in person.

Best regards,
DDM

 

[MargaritaMike]

Looking at your profile pic I would see a doctor immediately

The receptionists often ask me to leave and then I remind them that I have an appointment.

Cheers -

 

[MargaritaMike]

were they any more specific as to the exact type of rhythm?

The doctor and I looked at the ekg printout together. He said it looked fine except for the heart beat rate. He said there was a very small block on the front (while showing me the blip).
When I had back surgeries I learned everything I could about the spinal area. I guess it's time for the heart and EKG's.
Thanks -

 

[MargaritaMike]

avoid diving until it's corrected and/or you're cleared by a physician with training and experience in examining divers.

How do I find this physician. They're not listed in the yellow pages under "Doctors with training and experience in examining divers". When is your next available appointment?