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Discussion:
A pain in my clavicle
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I know pains are weird for women, and today I have had several episodes of pain on the left side of my chest, up high under my clavicle. I have done nothing strenuous, and it brings tears to my eyes, but only lasts a few moments, then it is gone for awhile. I tried to make myself belch...no sense it did anything to improve the situation. I have that cath coming on the 19th of August and believe my main cardiologist doesn't place a great deal of significance on my issues since the cath of last year was only blockages in the 40-50% range. But, how long does it take to go from 40-50% to the 70% or more when they would act on it? I mean, I had one in '06..then another in '08...so, they grow. Well, either thry grow or they stented me when I didn't need it.

See? The issue of when to complain messes me up so much. I will end up dying, and they will say....."Why didn't she say anything?"

Maybe someone will recall, and remind them, that when I did, they downplayed it.
Posted on 07/22/10, 07:35 pm
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Reply #1 - 07/22/10  7:39pm
" Oh, the issue of the 40-50% gets me concerned, because, my lipids do not respond to medication. I take so much only to end up with a 429 total...a 311 LDL....an elevated CRP....homocysteine out the roof, but...he made me feel like I was over-anxious about the prospect of dying from heart disease.

Ya' think?! "
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Reply #2 - 07/23/10  5:21am
" What an awful game we have to play, waiting for reassurance in regards to the left sided pains that plague us. My husband and I see a cardio that laughs with his assistant when you complain. They somehow embarrass you, and I wonder if they don't do this to avoid cardiac cripples from developing. "
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Reply #3 - 07/23/10  8:12am
" I wonder if they just see so much of it that they become sort of immune to the impact it has on the lives of the people living with it. The pain isn't crushing...never has been. So, I end up feeling like I am SUPPOSED to wait for a heart attack. But, am I also supposed to be willing to trust that will happen where I will be likely to get help? When 3% of people who have a heart attack die...no heroic-made-for-TV lifesaving happens...am I supposed to be willing to take the gamble? When 67% of women who die from sudden cardiac death had zero symptoms...and it ranks number one as the greatest killer of American women...well, you see where this is going. If I called and dropped by and worried over every tiny aspect of my care...then I would get it. I literally call them maybe twice a year. Then, it is for appointments (routine) and prescriptions. I don't get it.

If they actually laughed at me, I would be so upset. I mean, if they don't take you seriously enough to listen...the prospects are sure scary. I hope you have options Scottish....I hope there are other physicians whom you can go to. Here...it is a monopoly. Plus, once electronic medical records gets in full swing...never again will you have an opinion not jaded by the ones already in your record. "
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Reply #4 - 07/23/10  11:12am
" Hey Doc, are you reading this…

After a less than satisfactory appointment, I was deeply troubled to come to this site and read reports of poor relationships between doctors and patients. When did we lose the relationship between us that is so necessary, especially to the successful treatment of long term illnesses, such as heart disease?

I recognize there are deficiencies on both ends of the stethoscope and doctors are not totally at fault for the breakdown between us. However, the days of doctor worship and unquestioning acquiescence that our parents showered on your profession have ended thanks to a more educated public. I cannot comprehend a professional ignoring critical warning signs without even a cursory inspection, and arbitrarily designating the symptoms as nothing to worry about. Hey, those symptoms are on the very list you provide us as danger signals!

You sir, or Madame, are our employees, and the very reason for your profession’s existence is care and treatment of us. This statement is not made in arrogance, just fact. Some of you complain that patients use the internet as a diagnostic and treatment tool, but has it occurred to you that perhaps this has become so prolific because we can’t get answers from you? So many doctors just don’t have, and won’t take, time for patients.

Many of you are exemplary doctors, and yet you don’t fully utilize those skills, do you really believe a 5 minute office visit for a patient with issues is adequate for proper diagnosis and treatment? Assembly line practices only work when the individual parts and procedures are identical, unfortunately, humans are not all alike.

Quality of service is what we are looking for, not necessarily time. Explain, listen, answer, I believe those three words sum up what we’d like. When a patient identifies a symptom to you, at least take time to explain why you feel it’s nothing to worry about.

Personally, I have a high degree of respect for my Cardiologist, I’m just very disappointed. I guess after rescheduling my appointment multiple times, for his convenience, he still didn't really have time to worry about insignificant details like my heart.

I’m glad I got that off my chest; I’ve already got far too much to deal with in that region.
Not a patient man "
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Reply #5 - 07/23/10  8:24pm
" I so want to copy and take this 'letter' to my Cardiologist. I am a Nurse...we have our own reputations to live down as far as medical care is concerned (we tie with doctors for the "worst patient" award). Then, I have the added deficience of Post Traumatic Stress Disorder. If you met me, I guarantee you wouldn't know it. But, I try not to lie about it and leave it off of my registration papers. But, I am no basket case...no cardiac cripple...I am reasonable and...I listen to my body. The point you make about the very danger signs they gavce us to trigger a trip to the ER, that is so very, very accurate! How dare they tell us what to look for as a warning sign, only to later downplay the very thing as inconsequential or insignificant?! I have billions of little hiccup issues they never, ever hear about. I don't call and whine about my ankles turning the size of my calves...I deal with it. My face and eyes swell making me look odd, even to myself...and, I deal with it. Today, I had the pain again...under my clavicle. I tried to move my arm around to see if it was affected by it...nope. I made myself belch...no change. I hadn't eaten yet, so I don't believe it was associated with my gastrointestinal system. I used two squirts of Nitro and voila! It was gone. It has returned on a couple of occassions since then.

This is the most ridiculous and perhaps bordering on stupid things I could say, but...it leaves me almost wishing I would have an event (survivable of course), just to make him realize..in the years since I have been diagnosed, not one time have I complained that they didn't find a cause for it. Once it was really low potassium, and the other times it was cardiac and I was stented. There was two occassions where it was digestive issues, but I have "silent GERD" meaning, I do not have heartburn. I have a moderately eroded esophagus...but had no symptoms. Now, since the heart and the esophagus share the vagus nerve...how can we ever be held responsible that we complain, but it was esophageal? The brain knows what the brain is told...period.

Thank you so uch for your perfect letter. I wish all our physicians could read it...better yet, I wish they all could be moved by it. "
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Reply #6 - 08/13/10  3:55pm
" mockingbird,

Pain under the left clavicle was almost the only symptom of angina (the other one was blood taste in the mouth) that I had for 3 years before my MI.

The angina was clearly shown in the effort test.

Jesus. "
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Reply #7 - 08/17/10  3:07pm
" I ready to give up I feel as a women it's like having a baby...I never know which pain is real any more?
So yes they want us to wait...my own GP told me it's got to feel like very hard pressure on my chest? Why? Because that is what they tell us and if it isn't then we stay home and die because it felt like something besides this great pressure on my chest?

I throw my hands up and tell myself now I will wait and see. Am I sealing my self to death?

I had chest pains this pass weekend...I watch myself it hurt bad not unlike I felt before....I did the 3 pills and wait...I was laying down the pain was terrible....I told myself this isn't real...It's in my head and stay home.
Then a while latter the pain kept coming back this time it went up into my neck....oh it was most painful pain I have ever had...
I had trouble walking and thinking. I still stay home.
I stay in bed most of the day...
I woke up the next morning this is the thrid day....all the pain was gone.
Oh for got to add I took a pain pill the night before for the pain.
I didn't want to eat I felt like throwing up that night...And I felt all day like shit.
Then I almost said I wanted to go....but remember to check my blood pressure it's was a little high but not too bad...the bottom number was low....but not low enough as per my doctor.
So I stay home...
If by that 3rd day I was still feeling sick I told myself I will go.
And that way in my own mind I did whatever I been told to do.
I feeling bad now...but it is my lungs and that is another different story.

So how does a women really know yes I would of told anyone but myself to go to the ER....it is just hard to tell me myself to go.

Thank you for letting me jump on and tell you my story too.
Good post thank you "
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Reply #8 - 08/18/10  8:49am
" I ended up in the ER this past week. I had the heart cath and it was actually good news. But, Jesus, you are right about the angina. I am responding well to the Nitroglycerine patch they have me on. I am even managing the headache from it.

I wish this was simpler...like some reading, not unlike blood pressure, that would be an absolute indicator for heart attack. Even EKGs and the blood tests aren't failsafe. All we can do is go. It shouldn't be up to us to diagnose the pain. It is up to us to react to it - let the doctors rule it out. In an ER, they are hard-pressed to ignore your symptoms when you have known disease. desertbee...next time...just go. "
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Reply #9 - 08/18/10  1:49pm
" mockingbird,

Sorry to know that I was right, this time. But it seems that you are very well controlled, so you have not to worry to much, by the way, your case is the first that I know where they use periodic cath, just to check the status of your arteries.

In fact you do not have to suffer a MI, I did because for more than 3 years I was refusing the cath.

Just in case.... the initial symptom of my MI was extreme tiredness, not even able to walk with stick more that 10 steps.

Jesus "
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Reply #10 - 08/18/10  9:47pm
" Jesus, they didn't really want to do the cath as much as they fear doing nothing when I have symptoms they cannot explain. I work in the medical field and my cardiologist is a friend to one of my employers, so...I imagine he does things a bit to "make sure". But, I suppose they can never really be...sure that is.

I too was fatigued, but that can have so many other causes that I almost never include it. I have asthma, but hardly ever have issues with it, and if I have difficulty breathing, that is the first thing I blame.

I just didn't want to take a chance at harming cardiac muscle with an MI if I could avoid it. But, there is a downside to them listening to my complaints and it being actually an improved cath. Next time I have pain, will they listen.ooor remember this time?

I hope you are feeling well. I hope you continue to improve and have fewer and fewer symptoms and can get some of your own strength back. "

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