(bryanism on: Reposted Intuitive Experiences --> Medical Intuition Is Consciously Willed) Medical Intuition Is Consciously Willed (Story) This is not an easy story to tell, because it hits so close to home, and although I had plenty of practice showing medical concern for those I'd filled prescriptions, I still wasn't prepared to be a health advocate for my father, who had noticed a rapid heart beat that persisted over a month. I filled in for my mom by going to all my dad's doctor appointments starting with the one when we went over the cardiac imaging taken during his stress test. I rememember my father looking uncertain and a bit vulnerable, and I remember asking the cardiologist the condition of my dad's left ventricle (an important heart chamber). The doctor told me the muscle was slightly dilated, which to me was great news. The doctor also described which of the heart's blood vessels had become narrow, reducing the flow of oxygen to vital parts of the cardiac muscle. With that I conveyed to my, "There is no hypertrophy, dad, meaning you didn't let the symptoms progress to the point where your heart is irreversibly damaged. A dilated muscle can regain some of its normal tone, provided you get surgical stints to open the blood vessels like the doctor suggests and use meds to moderate the stress your heart may encounter from this point onward. Days later, successful stint surgery coupled with meds put my dad on a fast track to recovery. As health professional, I'd become aware of how people suffering cardiac events get the wind taken from their sails, so to speak, for fear that things go down hill, and although my dad's physician was relatively positive, he appeared to prepare my dad for the worst scenario, a subtle strategy some health professionals use (even I) from time to time to relay the seriousness of the matter and why it's important to stay compliant; but I didn't want to play that mind game with my dad, because he was astute when it came to his health. Upon subsequent visits and clinical tests, we discovered that my dad's ejection fraction rate hadn't improved enough, based on the cardiologist's expectation, so a new drug was implemented -- a long acting beta-blocker, meant to slow the heart in order to allow more blood into its chambers between beats. I was okay with that, but unfortunately my dad's cardiac output hadn't responded to this long-acting drug, which is why the doctor began increasing the dosage over time, finally reaching the maximum dosage allowed. I and the doctor had discussed the target he wanted my dad to meet, which is when I'd decided that his objective was too ideal for a man with my father's health and stamina, considering his other healthy organ systems could compensate in maintaining quality life with few interventions. I also deduced that he should back off the beta-blocker, since it provided no therapeutic benefit, i.e. my dads ejection rate remained unchanged. Beta-blockers at too high a dose may eventually suppress cardiac function in a heart that's already challenged. I mentioned my concern of the long-acting beta-blocker to mom (a former cardiac nurse) and dad, but it didn't register, and I knew I couldn't bring it up with the doctor, because I'd already sensed he wasn't open to outside advice, even though my input could be valid. I didn't want to be the relative with clinical information challenging the doctor at every turn. I had experienced that before related to my job. In any event, this was a waiting game I did not want to play, because I knew what was going to happen and a life was at stake. Several months later my dad calls complaining he had not slept for three straight nights, unable to lay flat on his back because of a drowining feeling or not able to walk a short flight of steps without stopping half-way to catch his breath. He hadn't even told my mother yet. Immediately I said, "Call your physician. You'll be hospitalized and put on another drug to strengthen your heart beat and they'll reduce the one drug causing the problem. Remember that drug I told you about?" He said, "No." So I said, "Never mind. Just tell mom and call the doctor. I'll be coming to the hospital as you stabilize," then we hung up. My mom called back an hour later -- frantic -- and then I asked, "Remember that drug I told you about?" She said, "No." So I said, "When you get to the hospital tell the admitting physician that it's the beta-blocker! DO NOT FORGET!" As expected, my dad was hospitalized and I was relieved that the admitting physician ended up reducing the dosage of the long acting beta-blocker by one-half, and I summed up that the dose should remain there. Yet for some reason I would not go in to visit in person until he was really stabilized and until I knew when his regular physician was coming in to consult. I knew I and the doctor needed to have a serious talk, and that it could be confrontational. ( Honestly, I dreaded it) When that day came, I and my dad's sister, were in the hospital room visiting, waiting for the physician. I asked my dad how he felt, and he said, "Fine," as if he was amazed at his quick turnaround -- I knew he thought he was going to die and later he admitted it. Also, my dad brought something up that his regular cardiologist (the one who had him on the beta-blocker) had mentioned about surgery to put in a device to jump-start his heart in case it stopped beating. I remember getting mad, thinking that wasn't necessary, if the dosage of the beta-blocker stayed where it was (reduced by one-half at least). Finally my dad's regular cardiologist came to the hospital room to inform that my dad needed the device I just described above, because his heart function had seriously deteriorated as he had expected (?), which is when I asserted... "Doctor, my dad was suffering acute congestive heart failure due to the high dose of beta-blocker. He has no left ventricular hypertrophy, no swelling of the extremeties, and his symptoms dissapeared altogether when the dosage was reduced. So, I don't think he needs that surgery." The doctor fired back with some medical statistics, as if I'd be intimidated, not able to compete with his clinical knowledge, finally insisting that he intended to raise the dose back up to the maximum and that surgery was inevitable, concluding, "I don't know why I'm arguing with you over this anyway." I calmly replied, ready to bring the confrontation to a quick end, by agreeing, "You're right, doctor. We don't need to argue, but why don't you go check the computer just outside this room to see what the admitting physician had to say," as if I'd already known what was documented -- and I did know this, even though I'd never met or spoken with any hospital staff about it. "I will," he said as he spun out the room. Because the partition was tinted glass where they stood, my dad, auntie, and I could see the doctor at the computer flanked by medical students glaring into the computer screen. I remember telling my dad and aunt, "Oh no you won't do more surgeries or raise the dose of the damn drug, because YOU'RE FIRED!" not loud enough for the doctor to overhear, of course. After five minutes at the computer the doctor literally waltzed back in singing, "Bryan, how about we do this? We leave your dad at the present dose, and I won't dare raise it unless I get your consent! How does that sound?" Although I couldn't believe my ears, I responded, "Why, doctor, that'll be fine," I said no longer acting like a health professional or medical intuitive, but a care taker, the role I prefered playing.