1.346 cardiologist, exercise

Thursday 11/12/2020

First up did the morning aerobics zoom class. Why do people not come to these on time? At 7:30 I was the only person signed in other than Veronica. We started on time. Michelle showed up five minutes later, a couple others logged in ten minutes on. That’s dumb. You miss ten minutes of a 30 minute exercise class, you might as well not come. But my opinion was not requested.

Ten AM brought my video appointment with Dr. Dibiase. Regarding nosebleed prevention she recommends Aquafor ointment to keep the membranes soft. About my relatively high blood pressure evenings, she decides to change my meds, taking the Metopropol 2x, morning and evening.

She looks at the writeup from yesterday’s CT (which is not yet accessible to me under Stanford MyHealth), commenting it shows “no fluid around the heart, arteries to kidneys are open, that’s good.” Later she mentions that it says something about “a mass” on the aortic valve, which might account for the regurgitation. What could it be? Hard to say, and she says it is hard to image with the normal echo, and she doesn’t feel inclined to order the more invasive TEE (where the echo emitter is put down your esophagus under anesthesia) as it “doesn’t resolve the aorta that well anyway”.

“The problem with these old valves is,” she remarks, “they deteriorate in an unpredictable way”. So orders another echo for six months on. If I get any symptoms she’ll order an echo right away.

She orders some blood work to check kidney function in a couple of weeks, which reminds me that Dr. Marx ordered some labs too, and I haven’t done them yet.

We discuss the TAVR procedure at length. I’m to bring it up with Dr. Watkins tomorrow. She may say that the stents she placed may be absorbed by the body so that they are less of an obstacle with time. In any case, would the surgical team please send her (Dibiase) a letter describing the stents and their long-term prognosis.

However (and this may be the most significant item from this conversation) she will message a specialist she knows, Dr. Daniels, “who probably does more TAVR than whole Stanford team in 6 months… Practices at Mills/CPMC/Santa Rosa…” This is what I’ve been wanting, a pointer to real expert in this field. I will google this dude for sure. Later: I think this Sutter Health commercial is him: https://www.youtube.com/watch?v=oUXKwEDfJ8w Besides the testimonials, this video has two things that stand out: a better animation of TAVR than I had before; and multiple comments about very quick recovery time (discharged the next day, etc.)

Dibiase also comments that “Given your age and condition, it is still possible to replace the valve the old fashioned way. We’d like to avoid such an invasive operation, but it is an option.”


Appointment over I had plenty of time for a walk before lunch, and I walked my 3-mile exercise route. This was difficult because I am getting a lot of back pain from walking. But I got it done. This was also DIY linen-change day, so I got another five minutes of exercise remaking my bed. Three exercise sessions in the day, yay me.

Evening I listen to two online concerts, the SF Boogie Woogie festival one during supper, and an SF Jazz special at 7.

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