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Wednesday, November, 11, 2009
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The Future of Health Care: The Changing Doctor-Patient Relationship

HeartHawk
HeartHawk
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HeartHawk is Blogging on HeartCentral
Heart Health Consumer Advocate

I am a numbers guy, an engineer, MBA, and for the real numbers geeks,...

HeartHawk

Thursday, September 04, 2008
View All of HeartHawk's Posts
This blog is being written as I sit in the auditorium of the MaRS Center attending the "Medicine 2.0 Congress" in Toronto. Should there be any doubt, the future of medicine is empowered, self-directed healthcare with the Internet and websites like HealthCentral.com playing a key role.   Spea...
  1. Untitled Comment
    Sue
    Thursday, September 04, 2008 at 04:08 PM

    Thanks Heart Hawk for sharing your thoughts on this with our members.  Seems you are right that there are lots and lots of ways for patients to educate themselves before they head of to the doctor's visit or even the surgical procedure.  Hopefully patients are reading reputable information and managing those expectations.

     

    Hope the rest of your conference was a success.  All the best, sue

     

    Readers might be interested:

     

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    Reply
    re: Untitled Comment
    HeartHawk
    Thursday, September 11, 2008 at 11:13 AM

    Sue:

     

    All I can say is WOW! the web is about to explode with health info and not just in the U.S.  Half the presenters were from Europe and other places outsiode the U.S.  Heck, they are already talking about Web 3.0!

     

    HH

    Reply
  2. PLAVIX
    lennyaeger
    Thursday, September 11, 2008 at 07:13 AM

    Hawk,

    What is your opinion of the so called super aspirin?  I suspect that it is behind all the health problems I have had in the last month and a half.  Been on Plavix for about two years.``Recently had intestinal bleeding, enough for a three unit blood transfusion.  Also had gout and was scanned and found I had  stomach ulcers, negative on H pylori.

    When the bleeding first started I took myself`off aspirin (81mg) and Plavix.  I had no angina and no other heart symptoms after that.  I inquired of my primary physician, who said I should stay on the meds.  I asked why and his reply made no sense it was even given in a guarded mode.  Basically, he said, it is keeping me from clotting and keeping me alive, and I should stay on it.  My heart doctor just said, "I don't reccomend it, but it's your choice."  I am beginning to think there might have been something to the old barber shop, blood letting leech system.  Know where I can get some leeches and a barbershop manual?

     

    Anyway Hawk. what is your opinion.

     

    Thanks

    Lenny

     

     

     

    Reply
    re: PLAVIX
    HeartHawk
    Thursday, September 11, 2008 at 11:10 AM

    Lenny:

     

    LOL! I am not a doctor so I cannot give medical advice but I would stay away from leeches!  All kidding aside, this is a serious problem that should be addressed as soon as possible.  Obviously, I hang around a lot of people with heart disease so I have seen this before.

     

    Aspiring and Plavix work in two different ways to prevent platelet aggregation (clotting) by blocking two of the chemical pathways that cause blood to clot.

     

    Plavix is given for a number of reasons where a patient is at increased risk for blood-clotting (you did not mention why it was prescribed for you).  For example, it is frequently administered as a second anti-clotting agent in addition to aspirin to guard against what is known as "late-stent thrombosis" - essentially a blood clot at the site of the stent.  Some studies suggest this phenomenon is increased when a drug-eluting stent is used.

     

    There is little doubt that aspirin can do a number on your stomach.  I have had similar symptoms to yours but not as severe.  Again, I cannot prescribe to you but I can offer an opinion.  If I were bleeding so much as to require three units of blood I would seek a second opinion from another doctor to treat your condition.  It has been well-established that concomittant administration of clopidogrel (Plavix) and aspirin increase the risk of hemorrhage.  For a doctor to feel comfortable to keep you on your current regimen after a massive hemorrhage seems unconscionable to me.  There are alternative treatments and measures that can be taken to reduce bleeding risk and ulcers (are you on a PPI drug like esomeprazole).  Frankly, I'd find a new, more aggressive doc who isn't willing to "roll the dice" on your health.

     

    Thw CHARISMA study is what started the hullabaloo over Plavix and aspirin.  Here is some additional reading for you on the subject from HealthCentral and other blogs and web sources (disclosure: some I am affiliated with just like HealthCentral). 

     

    CHARISMA: Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance

    Plavix, Aspirin, and the CHARISMA study

    Clopidogrel versus Aspirin and Esomeprazole to Prevent Recurrent Ulcer Bleeding

    Stopping Plavix may carry early clotting risk

    Aspirin: A New Look at an Old Friend 

    New Research, FDA Advisory Focus on Stent Risks

    Headaches over aspirin?

     

    Looking out for your heart health,

     

     

    HeartHawk

    Reply
    re: re: PLAVIX
    lennyaeger
    Monday, September 15, 2008 at 07:47 AM

    Hey Hawk,

    Very helpful information.  Thank you.

     

    I have always believed that we are ultimately responsible for our health and survival and should always seek the knowledge that will empower us to enjoy the finest quality 0f life, (healthwise) that we are capable of.  Doctors in my area (SE LOUISIANA,since Katrina)are overwhelmed with patients and can sometimes mistake you for another patient.  Many competent doctors, nurses and healthcare workers did not return after hurricane Katrina.  I really hesitate to call 911 and do not look forward to hospital stays.  It is a very sad situation.  You can see why I seek and value good info. 

     Many thanks again, Hawk, for your valuable info.

     lenny

    Age 71

    Gonna live til I die.

    Reply
    re: re: re: PLAVIX
    HeartHawk
    Monday, September 15, 2008 at 11:18 AM

    Lenny:

     

    Cool I like the sentiment about "I'm gonna live til I die."  They say you can't win but I am going to put on a heck of show 'til I lose.  Tickets to the show are free right here at HealthCentral!

     

    HeartHawk

     

    P.S. Spent a great deal of my mis-spent youth travelling down to SE LA (mostly Bourbon Street, naturally).  I still remember the restaurants I favored, Visko's, The Steam Room, Commander's Palace in the Garden District, Anything Goes (out of business for sure), and my absolute favorite steak joint was this converted old home right in the middle of a residential neighborhood - huge portions - not far off Canal Street as I recall - I wish I could remember the name (I think it started with a "B")!

    Reply
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