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Message
Doctor referrals, cardiologist, & other stuff
Posted on 10/18/16 at 7:57 pm
Posted on 10/18/16 at 7:57 pm
OK, so I go into get a yearly health checkup, basically a blood test.
For the most part everything checks out decent.
Blood pressure a tad high(117/83), LDL cholesterol a little too high(117), Serum Creatinine(.70) a little low and Testosterone low(312).
My NP suggests I take a testosterone shot every now & then to boost my energy levels back up. I have been feeling a lil sluggish.
What say the OT Dr's, nutritionalists, RNs...?
Are T-shots legit? What else?
Now I would like to get a good check-up on the ole heart, stuff like an EKG, stress test, maybe an echo cardiograph. Heart conditions do run in my family so I want to check this out.
I call my doctors office about this and they say I need come to them to do a 'referral' to see a cardiologist, so I have to take time out my busy schedule and come seem them just to have them 'refer' me to cardiologist.
To me this seems like a waste of time, effort AND my money.
Can't I just schedule a cardiologist and skip my primary doctor? Who is a good cardiologist in the Monroe/West Monroe area?
BTW, a little background, I am 5'10", 220 lbs(over weight and need to drop about 25 lbs), middle 40s, white male. I used to a gym rat but I have stopped going to the gym all-together, I do a little physical activity but not much. I eat an above average diet,nutritionally speaking.
I have BlueCross/BlueShield insurance.
Sorry if TL or Germans...
TIA
For the most part everything checks out decent.
Blood pressure a tad high(117/83), LDL cholesterol a little too high(117), Serum Creatinine(.70) a little low and Testosterone low(312).
My NP suggests I take a testosterone shot every now & then to boost my energy levels back up. I have been feeling a lil sluggish.
What say the OT Dr's, nutritionalists, RNs...?
Are T-shots legit? What else?
Now I would like to get a good check-up on the ole heart, stuff like an EKG, stress test, maybe an echo cardiograph. Heart conditions do run in my family so I want to check this out.
I call my doctors office about this and they say I need come to them to do a 'referral' to see a cardiologist, so I have to take time out my busy schedule and come seem them just to have them 'refer' me to cardiologist.
To me this seems like a waste of time, effort AND my money.
Can't I just schedule a cardiologist and skip my primary doctor? Who is a good cardiologist in the Monroe/West Monroe area?
BTW, a little background, I am 5'10", 220 lbs(over weight and need to drop about 25 lbs), middle 40s, white male. I used to a gym rat but I have stopped going to the gym all-together, I do a little physical activity but not much. I eat an above average diet,nutritionally speaking.
I have BlueCross/BlueShield insurance.
Sorry if TL or Germans...
TIA
This post was edited on 10/18/16 at 8:16 pm
Posted on 10/18/16 at 8:03 pm to Reubaltaich
You must have a HMO, which requires a PCP, so if you don't get a PCP referall the insurance will say we won't pay.
Posted on 10/18/16 at 8:05 pm to Reubaltaich
quote:
Blood pressure a tad high(117/22
Are you 7?
Posted on 10/18/16 at 8:05 pm to t00f
yeah my doctor said he could refer me but said it would be over 2k in tests they would run on me.
i would call the cardiologist and see if they require one
i would call the cardiologist and see if they require one
Posted on 10/18/16 at 8:05 pm to Reubaltaich
I think most medical specialization offices require a referral before accepting a new patient.
I've always assumed it was so they didn't have to sift through the hypochondriacs themselves and let the general practitioners deal with them
I've always assumed it was so they didn't have to sift through the hypochondriacs themselves and let the general practitioners deal with them
This post was edited on 10/18/16 at 8:06 pm
Posted on 10/18/16 at 8:08 pm to Reubaltaich
The BP you listed can't be correct.
You posted nothing suggesting you need to visit a cardiologist or get a stress test. Any good PCP should be able to risk stratify basic cardiac issues.
You posted nothing suggesting you need to visit a cardiologist or get a stress test. Any good PCP should be able to risk stratify basic cardiac issues.
Posted on 10/18/16 at 8:10 pm to Reubaltaich
I'm not sure if that's BP reading is correct. 22?
Posted on 10/18/16 at 8:13 pm to windshieldman
quote:
Blood pressure a tad high(117/22
Are you 7?
Opps, should've been 117/83. Gonna fix in the OP
Posted on 10/18/16 at 8:14 pm to Reubaltaich
In what world is 117/22 high? Maybe the lowest diastolic I have ever seen other than someone on the verge of coding
ETA: nm I see the correction
ETA: nm I see the correction
This post was edited on 10/18/16 at 8:17 pm
Posted on 10/18/16 at 8:15 pm to Reubaltaich
quote:
Can't I just schedule a cardiologist and skip my primary doctor?
Depends on your insurance. If you plan requires specialist referrals and your PCP is going to request a referral, he needs to supply documentation as to why he is referring you to a specialist who will undoubtedly run numerous expensive tests on you.
Posted on 10/18/16 at 8:20 pm to LakeViewLSU
Some Cardiologists take patients without referrals. Some insurance requires a referral. Do some leg work and see what your plan specifies. Be sure you ask how appropriate a test is before you have it done. Gone are the days of 'routine' stress tests on asymptomatic individuals - the so called 'executive physical'.
As for testosterone: everyone's levels fall with age. It's natural. The low-T industry is making a killing off of some questionable science. In some folks it can actually increase your risk of a heart attack.
As for testosterone: everyone's levels fall with age. It's natural. The low-T industry is making a killing off of some questionable science. In some folks it can actually increase your risk of a heart attack.
Posted on 10/18/16 at 8:23 pm to Reubaltaich
So much to respond to:
Focus on cleaning up you diet. Weight /girth reduction should bring BP and testosterone back in range.
Optimize sleep/stress management
Get back in the gym 2 to 3 days/week (progressive strength training)
Read this book for details and minimize the need for meds.
Do not focus on total LDL (very limited study). Triglyceride to HDL ratio along with your waist size are more important/practical. If question remains, ask your cardiologist specifically about particle number/size (NMR study)
You want Cr to be low/normal (it is)
T shot work, but use them only if above fails
The DIY approach....
Eight Highly Effective Testosterone Boosting Tips
LINK
The Testosterone/Estrogen Balance in Men
LINK
I may "know" a professional in the BR area who could help you with what you are describing....
Focus on cleaning up you diet. Weight /girth reduction should bring BP and testosterone back in range.
Optimize sleep/stress management
Get back in the gym 2 to 3 days/week (progressive strength training)
Read this book for details and minimize the need for meds.
Do not focus on total LDL (very limited study). Triglyceride to HDL ratio along with your waist size are more important/practical. If question remains, ask your cardiologist specifically about particle number/size (NMR study)
You want Cr to be low/normal (it is)
T shot work, but use them only if above fails
The DIY approach....
Eight Highly Effective Testosterone Boosting Tips
LINK
The Testosterone/Estrogen Balance in Men
LINK
I may "know" a professional in the BR area who could help you with what you are describing....
Posted on 10/18/16 at 8:23 pm to Reubaltaich
Uh... is that stuff what the NP told you? Gracious, you know, some PAs and NPs are pretty good, some are... opposite of that. Without looking reference ranges up, I can tell you that a 117 LDL is pretty good. And a low creatinine? Seriously? That's an excellent creatinine and in general, the lower the better.
Posted on 10/18/16 at 8:26 pm to Crimson
quote:
n some folks it can actually increase your risk of a heart attack.
In the overwhelming majority of folks and the vast majority of peer reviewed studies, it does just the opposite...
Along with reducing diabetes / metabolic syndrome
This post was edited on 10/18/16 at 8:28 pm
Posted on 10/18/16 at 8:27 pm to ThinePreparedAni
Believe what you want. I've seen it multiple times first hand. That's why I said "In some individuals..."
This post was edited on 10/18/16 at 8:29 pm
Posted on 10/18/16 at 8:29 pm to Crimson
Believe what you want.
You are not the only one who has "first hand experience"
Take a look at all the literature on this topic. I have...
You are not the only one who has "first hand experience"
Take a look at all the literature on this topic. I have...
Posted on 10/18/16 at 8:39 pm to ThinePreparedAni
I have as well. No clear consensus of benefit or harm. There are no randomized controlled trials showing benefit. You are right - there may be some surrogate benefit by helping reduce traditional risks factors in the setting of optimal lifestyle interventions. Again, this has not been formally evaluated with an RCT.
If you have a study with proven prospective data please share. I'm eager to learn. Observational and retrospective data are just that - correlation does not prove causation.
If you have a study with proven prospective data please share. I'm eager to learn. Observational and retrospective data are just that - correlation does not prove causation.
This post was edited on 10/18/16 at 8:53 pm
Posted on 10/18/16 at 8:39 pm to Reubaltaich
Call your insurance rep and ask if they do cardio wellness checks.
Posted on 10/18/16 at 8:54 pm to Reubaltaich
quote:
Blood pressure a tad high(117/83)
120/80 is target BP so whoever told you yours was high is a dumbass
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