Patient
Sudasena just ended up breaking down and telling me I didn't understand. I'm just asking for an explanation, and when I asked if she had an ABPM or needed a medication adjustment he said "we don't do those here". He wasn't concerned with our concerns... or any his own criteria and guidelines. He said the ECG came back with a 160 bpm, the cuff said 118/88 HR 71 directly before. Run it again, schedule the holter, re-do ecg, ABPM, do anything when I have a valid concern. We need a thorough evidence based approach before a pacemaker, not to be dismissed or uninformed. Not acceptable for him to skip the very first course of action he should take, ruling out any other possibilities before a procedure. It's completely irrelevant how invasive it is.... He isn't recommending to retest, reassess, or reevaluate after medication adjustment, he thought me asking about "split dose" meant I wanted total dosage halved. It might be best for us to wait for next months doctor if you won't explain, and you tell me I don't understand. Get us an actual cardiologist who will at least follow a basic scientific method. Discuss risks, options, and alternatives for any decision they make. The plan seems to be change multiple variables at once and guess which one worked? Or just tell me why NOT rule out the trifecta of unadjusted medications or possible reversible causes first? Make it make sense. We'll get a second opinion, not this procedure pusher in a puffer who shows up late.