Thanks!

Selected letters (answers to asked medical questions can be found at this link) from the inbox since 10/9/96:

The latest feedback can be found here:

ABChung.LiveJournal.com

Subject: Re: depression + binge eating
Date: Sun, 15 May 2005 11:22:43 -0500
From: xxxxxx@prodigy.net
To: cardiologist2@heartmdphd.com

I and a friend of mine with diabetes can relate. Have found that talking to a counselor and taking antidepresants really has helped me. You have to understand that depression can be caused by having a chronic illness. Most people with chronic diseases do suffer from depression.
Good Luck
xxxxxx
Subject: RE:Question
Date: Sat, 30 Apr 2005 23:28:15 -0500
From: xxxxxx@LILLY.COM
To: ac1@heartmdphd.com

Dr. Chung,
I am sorry to bother you but I just found a website that posted questions to you. I have a complicated medical history dating back to my late teens, early 20's. I'm 52, a health care professional, who has been in relatively good health except for a long history of illnesses, disorders, and complications that appear to be related to connective tissue disorder. I was diagnosed with MVP in my 20's after being symptomatic for a period of time. Chest pain, fatigue, syncope, PVCs, runs of bigeminy, and trigeminy. I've always been sensitive to sleep deprivation and when forced to work double shifts (grave yard shift), my radial pulse would become very irregular and low (26 bpm). Needless to say, I've battled this for years and have tried to ignore it while getting adequate rest and avoiding exertion.

I developed hypertension while pregnant at age 32. All 3 sons were delivered 3 weeks early. I became hypertensive 4 weeks prior to my due date with my first son. Hypertension occurred at the end of the 2nd trimester during the 2nd pregnancy (also developed severe asthma). Both hypertension and asthma disappeared after delivery but reappeared early in my 3rd pregnancy. I was put on bedrest at the end of 1st trimester for 3rd son. Following delivery, I suffered from both labile hypertension and asthma for years. The labile hypertension is not a white coat phenomenon. ( I also have ADD which may suggest noradrenergic dysfunction.) In any case, I've always felt like I've been in flight or fight.
My MVP was stable with the exception of my normal PVCs. (When I was pregnant I had 26 PVCs a min). Over the years, I've developed many hypersensitivities, including Candida, dairy allergies (asthma), medications (asthma,

Although I have had labile blood pressure for years, I have never tolerated blood pressure medications, except diuretic which doesn't control B/P. My cardiologist put me on several new blood pressure meds last fall because I now have left atrium enlargement and left aortic branch enlargement secondary to severe mitral regurgitation and hypertension.

The big problem is that I don't tolerate the blood pressure meds. I developed asthma with Caduet. I am tolerating Uniretic well. I had to stop Toprol XR because I developed all symptoms of prodromal syncope. I had episodes of syncope (dizzy, whooshing in my head, break out in a sweat, feel cold, difficulty seeing, weak) several times a day. I am on an SNRI and don't know if there may be drug interactions. The episodes of syncope became noticeable in Jan. and continued to worsen through March. I saw my cardiologist in March who said to stop the SNRI but I still had significant symptoms related to syncope. I stopped the Toprol and was better within a few days. I restarted the SNRI (for fibromyalgia, anxiety). The problem is that my base pulse has been running around 40 and irregular since the fall. When I get these episodes, I can't function. Fortunately, my mitral regurgitation in less severe and my lef

I do not doubt that I may need a repair or replacement of my valve in the future. My cardiologist wants me to wait until my blood pressure is under control. I have serious doubts that he will be able to control it because I do think I have underlying autonomic dysregulation that is not easily treatable. New data out suggests that early surgical intervention is associated with better outcomes. Autonomic dysregulation is not associated with good outcomes. Is there a specialist you could recommend that may have experience in this area? I am fairly close to the Cleveland Clinic but I am willing to travel to see someone who can put the whole picture together and get me on the right path.

I very much appreciate any advice or wisdom you can share with me.

Sincerely,
xxxxxx
Subject: Jen Gallagher-Advent Associates
Date: Fri, 22 Apr 2005 13:01:04 -0400 (Eastern Daylight Time)
From: "Jen Gallagher" (jgallagher@adventassociates.com)
To: nospam7@heartmdphd.com

Hello Dr. Chung!

I just wanted you to know that I signed your guestbook on your website and remember working with you several years ago when you first came out of fellowship and were looking for a position in cardiology!

We share your love and belief of Jesus Christ here at Advent Associates, we are all Christians! We also now specialize in cardiology recruiting.

Just wanted to let you know that and I enjoyed your website as well as your personal faith and witness for Jesus.

Sincerely,

Jen Gallagher
888-280-7684
Subject: question
Date: Fri, 22 Apr 2005 01:22:14 EDT
From: xxxxxx@aol.com
To: cardiologist2@heartmdphd.com

Hello,

I am looking to find information regarding the connection, if any, between heart disease and dementia. I have moved in with my 70 year old mother who about 2 years ago had 2 medicated stents put in. I have been noticing some lapses in memory and repeating stories at least 3-4 times in one day to me, ( More than usual ) and has even forgot where a local store was.

I have been on her case a little in regards to going to get assessed for alzheimer's. I know that sounds terrible of me, but I was under the impression there was treatment for it as well as either a gene or something of substance to diagnose it. Maybe an MRI or something.

After researching it, I was thinking it might be something else. Another form of "dementia". My question is, after oxygen is not as well circulated before the stents, could that have caused some dying brain cells and or dementia? Do elderly people not regenerate brain cells like younger people? Do brain cells regenerate? I am way too ahead of myself here. Is it the heart disease that is causing my mother to be a bit loopy? Or am I just over analyzing her, and not taking into account that she is getting older?
Please advise,
Patti xxxxxx
Subject: atrial fib
Date: Mon, 11 Apr 2005 17:57:04 +0100
From: xxxxxx@blueyonder.co.uk
To: cardiologist2@heartmdphd.com

Dear Andrew
Brief history Diag June 03 with atrial fib but have since found out cannot have vein ablation due to damage to center wall left vent and some at front of heart i am 52yr Male they have tried two cardioversions neither lasted long was on amoridine but now on bisoprol furmanate 5mg linsoprol 30mg warfarin 2mg a day can you suggest a way forward from here.
ps i live in uk
Many blessings xxxxxx
Subject: FW: Doctors Without Borders Thanks You!
Date: Fri, 4 Mar 2005 14:13:01 -0500
From: xxxxxx@pechter.com
To: cardiologist2@heartmdphd.com

Dr. Chung,

Thank you for answering my questions regarding my mother’s heart problem. I appreciate your way to serve the society, so I made the donation to Doctors without Borders. Thank you again.
Subject: Hope
Date: Sun, 27 Feb 2005 23:37:52 EST
From: xxxxxx@aol.com
To: ac1@heartmdphd.com

Hi Doctor, I'm a 30 year old women just diagnosed with having 3 leaking valves and an enlarged left ventricle. I was experiencing dizzy spells and I have suffered from migraines. I went for a physical. An echocardiogram and a carotid Doppler was ordered. The carotid Doppler was normal the echocardiogram revealed that my Mitro, bicuspid and aortic valve were leaking. My current Cardiologist has ordered 3 exams. I wore a holter monitor for 24-hrs and I am also going to have a loop test and a stress test. I haven't completed these exams due to the fact that my insurance does not cover any cardiac testing. My blood test was ordered my blood work was normal. I do not suffer from hypertension, nor do I have high cholesterol, tryglecirides or diabetes. My family medical history my dad suffers from hypertension and maternal side my mother had cervical cancer, grandmother had colon cancer, great aunt had breast cancer. May you explain worse case scenario and what procedure would normally be done if any should be.

Thank you for your time
Subject: Unspecific ST-Elevation
Date: Fri, 11 Feb 2005 18:16:28 +0100 (CET)
From: xxxxxx@yahoo.de
To: cardiologist2@heartmdphd.com

Hello,

my last EKG + stress-EKG showed an "unspecific ST-elevation", CK-MB was normal. My MD wasn't concerned, he said he sees this 5 times a week. Shouldn't he be concerned, as my old EKGs do not show that elevation?

I do have chest pain, my MD says it's intercostal-neuralgia because it's sensitive to pressure. Shall I order more tests, if yes which? Btw.: It's not Coronary Heart disease, as I'm just 20 years old and non-smoker, non-drinker, good cholesterol, not overweight etc...

thanks, Michael
Subject: Viagra and WPWS
Date: Mon, 31 Jan 2005 12:21:43 -0700
From: xxxxxx@mms.gov
To: ac1@heartmdphd.com

Is there a problem with having WPWS and taking Viagra?

David xxxxxx
Subject: question
Date: Tue, 18 Jan 2005 03:50:24 EST
From: xxxxxx@aol.com
To: ac1@heartmdphd.com

hello dr. chung,

i have a question for you. i am a healthy 31 year old female. i just got married this month and when i was getting married, my heart was beating very very rapidly. ( i've never experienced this even with nervousness) afterwards, i had chest pain on the left side which was dull and smarting. it lasted for hours and i still feel pain now. do you think this was anxiety? i've had two panic attacks and i do have anxiety. i have also experienced skipped heart beat. my doctor tells me it's because of stress. i had an ekg done in may 2004, all was fine. what do you think is wrong with me?

thank you,
xxxxxx
Subject: RE: Post In Arthritis News Group
Date: Fri, 7 Jan 2005 17:48:28 -0500
From: xxxxxx@bellsouth.net
To: ac1@heartmdphd.com

Hello!
I tried to email you, sir, about your post in this group concerning Limbrel (sorry if I misspelled it!). The whole thread was interesting and your comment spiked my interest in what this product might be. Hopefully, this email will reach you--the first one was deleted by your spam guard... and I was afraid that your reply would be stopped by mine! Thank you for any information you feel free to share. BTW, I live down the river from you in Columbus, GA.
Peace,
xxxxxx
Subject: Re: nadolol, problems -> does it disappear when blood vessels turn to vasodilation
Date: Sat, 18 Dec 2004 10:20:59 +0100
From: xxxxxx@gmx.net
To: cardiologist2@heartmdphd.com

Hi,

I have heard that over long term use of betablockers, the vasoconstriction of peripheral blood vessels would turn into a vasodilation. Perhaps symptoms of erectile disfunction could disappear. But I am not sure, is that true? Does a betablocker result in vasodilation over long term use?

Thanks
Subject: Write, that others may read.
Date: Fri, 17 Dec 2004 14:16:46 -0800
From: xxxxxx@excite.com
To: cardiologist2@heartmdphd.com

My friend in words,

In early 2005, a new global, spiritual awakening will begin. You will read about it, see signs of it everywhere. The issues of today will be set aside and a new world vision will come into focus. It is the time you knew was coming. The moment you have waited for:

It is a time to share your thoughts with others...to share your writings. New opportunities will arise. Be mindful and watch for them. The signs may be subtle. But observe them. It will be a time of risks and adventure. But happiness lies not in what you might imagine the future to be, but in the connections you make as you step forth to share your own thoughts with others through your writings.

We are strangers, but I share this vision with you, for that is how realities begin, and you are among those who have something to share with the world.

Many good wishes to you for a joyful New Year.
Mind the signs.

xxxxxx
(one who sees and is humbled)

PS -- a reply is not necessary. I am selling nothing. I felt compelled to share these thoughts and will not write you again.
Subject: Interest in cardiology
Date: Wed, 15 Dec 2004 19:29:15 -0500
From: xxxxxx@bc.edu
To: ac1@heartmdphd.com

Hi Doctor,

I ran into your site online because of your many post on google groups. I think it's a great way to stay informed. I'm currently a junior pre-med/biochem major at Boston College. I was accepted early to Tufts Med and will be attending there in 2006. I have worked as an emt for several years and at home I work for a private company and ride with paramedics. The most common calls I have seen are chest pain and through working many stand-bys I have been able to run two cardiac arrests myself. From what I have seen and read so far, I really love cardiology and really think it's the most direct way to save someone's life. Over last summer I read several books on ekgs for fun since the medics let me try to interpret the rhythms first when I am with them on calls. Also, next semester I am teaching a emt con-ed on sudden cardiac arrest and will be a cpr instructor soon. I know I have a long time before I have to decide what I really want to go into, but I was just wondering what's the best way to find out more about the field and was wondering if maybe you could tell me why you chose this wonderful field. Are there any particular books you would recommend?

Thanks,
xxxxxx
Subject: Dr. Can You help?
Date: Tue, 16 Nov 2004 16:53:10 -0500
From: Pascal Dupuy ext225 (PASCAL@ategra.com)
Organization: Ategra
To: Andrew Chung (ac1@heartmdphd.com)

Dr.Chung - I know I just sent you my nationwide update, but one of my clients just sent me an amazing opportunity and you never know when the next opportunity that is presented to you is the right one. Do you know anyone who would be interested?

My client is seeking TWO Interventional Cardiologist/electrophysiologist ?

Two opportunities: Specialty Clinic-- join a larger multii-specialty group who provides three rotating cardiologists to practice primarily at the Medical Center for 1:4 call. Competitive income guarantee (upper 200+K range). They did 200 interventions, 600EPs, 250 pacemakers, and 50 ICDs last year collectively.

Southeast Cardiology-- Join a group of three interventional cardiologists for a ¼ call schedule on weekends and 1:5 on weekdays. Aggressive group has several remote clinics (Enterprise, Opp, Marianna, Blakely) in which they provide 1 day clinic each week to a specific clinic. GA and FL license a plus. Competitive income guarantee. They did 500 interventions last year collectively. Andreas Muench (UTX-Houston) will join them in August, 2005. Base: 350K

The two groups share call with an interventionalist. All groups perform stenting.

Please pass this to any colleague who you think would be interested in this opportunity or call me as soon as possible at 800 466 9919 x225. To speed things up, please also send me a copy of your resume, (if you haven't already done so). I will keep your resume confidential and will not release it to anyone without your permission. My services are at no charge to you.

Thank You !!
Pascal - 800 466 9919 ext 225

---------------------------------------------------------
Ategra Systems Inc
Specialists in Permanent & Contract Staffing
7085 University Blvd
Winter Park, FL 32792

To Learn More About Ategra:
http://www.ategra.com
Subject: doctor referral
Date: Thu, 4 Nov 2004 04:18:25 -0500
From: xxxxxx@webtv.net
To: ac1@heartmdphd.com

Hi,
I found you through the discussion forums & wish you were my doctor! You are so knowledgable & nice. But since I live too far away, can you please give me a referral of a good cardiologist, internist, or diagnostitian that practices similar to you in my area of Philadelphia, PA?
---Thank you!
Subject: North Carolina Cardiology Opportunity
Date: Mon, 25 Oct 2004 09:26:58 -0400
From: Bill Brochetti To: ac1@heartmdphd.com

Dr. Andrew Benhua Chung, M.D.,Ph.D.,

ESA Medical Group has been retained by a Cardiology Practice in North Carolina to provide a BE/BC Invasive/Non Interventional or a Non-Invasive Cardiologist.

Guaranteed first year salary of $350,000.00 to $400,000.00, plus bonuses, with a full benefit package, short track to partnership, and much more awaits this compassionate and caring Cardiologist.

Location offers an outstanding family oriented community, year round activities for the whole family, plus a host of other amenities.

If you are interested, or know of any Cardiologist that is interested in this opportunity, fax or email your CV to:
FAX: 216-289-1635
EMAIL: bill@execsearchamerica.com

For immediate information call Bill Brochetti, at the ESA Corporate Office, 216-261-7400 ext 226.

ESA MEDICAL GROUP REPRESENTS PHYSICIAN PRACTICE OPPORTUNITIES THROUGHOUT THE WORLD.

Regards,

Bill Brochetti
Vice President
ESA Medical Group
Cleveland, Ohio
Subject: Help in decifering results
Date: Fri, 3 Sep 2004 09:18:06 -0500
From: xxxxxx@logantele.com
To: ac1@heartmdphd.com

Thanks for replying to my problems in the posting in the cariology part of sci.med. Thgought maybe you could help with this:

Got holter monitor test back. He said I had "2 events svt" and "many short run svt". I dont know what that means. He refered me to a cariologist but I cant get in until next week. Under Supraventricular Ectopy it said:
SVE Total: 217
Sve Rub Total: 31
Longest SVE Run: 14 beats at 5:21
Maximum HR sv run: 193 beats at 22:18
sve's per 1000/per hour: 3/10
Total Aberrant Beats: 9
Atrial Flib/Flutter: n/a

Under Conclusions it said:

Average heart rate was 61. The minimum heart rate was 41 at 16:04. The maximum heart rate was 130 at 05:22. Paus greater than 2.5 seconds were 0. Ventricular ectopy was 16, with 0 v-runs and 0 pairs. Supraventricular ectopy was 217, with 31 sv-runs. st episode minutes totaled 0.

Can anyone explain if this is good or bad?

Also, after I got this report yesterday I started having trouble again for about 4 hours. Went to an urgentcare clinic. They did an ekg, bloodwork, checked oxygen. My oxygen was 100. egk was fine with no tarcardia or something like that. I was not anemic but the thyroid and electrolite tests had to be sent out.

She said if these came back fine she would think it was anxiety or panic attacks. I have never had these before. I am not under any stress. These are worse in the afternoon and sometimes just happen if I am sitting on the floor.

Cna you guide me?
Subject: My suicide attemt
Date: Mon, 23 Aug 2004 15:16:55 +0000
From: xxxxxx@hotmail.com
To: nospam7@heartmdphd.com

Dear Doctor,
Two years ago I attemed suicide. I was on alot of cocaine and tried to kill myself. I took 3 tylonal pm. I was almost asleep when a girl came over i was in love with. For some reason her rejection made me want to take my own life. I did a line thinking it whould kill me. Well i didn't. Now I am having lots of problems with my circulation and i think it is because of what i did that day. Am I going to die and at this late in my condition is it posible i could still live?
Subject: Case Review
Date: Mon, 19 Jul 2004 14:38:16 -0400
From: xxxxxx@xxxxxx.com
To: cardiologist@heartmdphd.

Dear Dr. Chung,
My name is Paulette xxxxxx, I work with an insurance defense firm that defends physicians in medical malpractice cases. We have a case at the present time involving a cardiologist and the use of amiodarone. If you review cases and available to review this case, please contact me at the number below.

Thank you for your time and consideration of this matter.

Sincerely,
Paulette xxxxxx
Subject: Hello, Repectively
Date: Fri, 2 Jul 2004 09:00:04 -0700 (PDT)
From: xxxxxx@yahoo.com
To: cardiologist@heartmdphd.com

Hello, my mane is Aprial xxxxxx and I am interested in a career in cardiology. I was looking through your website for more information but I was hoping I could get more in depth with it. If you can please take some time to answer some questions I have, I would really appreciate it. I am doing research for myself and for my High School Careers class.

What are the responsibilities of a Cardiologist?
What are the requirements for college?
What colleges offer it?
How many years of college for a Ph.D or Master's?
What are the requirements for a good job?
What is the salary?
What are the benefits?
What kinds of other professionals do Cardiologists work with?
What sorts of technology do Cardiologists use?
What are the not so good things?

Thank you for taking the time to read and hopefully respond. I know it seems like a lot but it would really help me out. Thank you for your time and patience.

Aprial xxxxxx
Subject: Please help me!
Date: Wed, 9 Jun 2004 21:43:36 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

My mother is a 74 yr old WF. She has had heart disease for over 35 yrs. First, caths. and angioplasty, followed by bypass surgery 19 yrs. ago. She has had numerous caths, and currently had 3 stents. She had an MI about 5 yrs. ago. She is a diabetic, which is currently controlled by Glucotrol-XL 5 mg. She was diagnosed with CA of the lung 2 1/2 yrs ago. (She also had breast CA 18 yrs. ago). Her CA is under control. She has rheumatoid arthritis. In Feb. she had a positive stress test. She had a Cath and her stents were open . Her heart damage is on the back of her heart. She was put of Zebeta, 10 mg and had multiple symptoms such as low pulse, headaches, dizzy, no energy, etc. She started to have angina with any activity. Was sent back to cardiac rehab. on Friday. She only lasted 10 minutes, had severe angina and was taken to the ER. Admitted 8 hrs. later. Put on blood thinners and doubled her Imdur from 120 to 240 mg. Discharged Sunday. Her angina now is terrible. I feel like the Drs. here are blowing her off because she has "cancer".I am not sure what are the correct questions to ask the Drs. I feel like she has symptoms of CHF, but she has never been told that. I'm not looking for a miracle, just some respect. If they feel they can do no more for her, then say that or tell us what her choices are. I'm in Maryland (Salisbury), which is about 3 hrs. away from Hopkins. Could you please advise me on what to ask the Drs. or where I should take her? I sincerely appreciate your time, and thank you for listening to me. xxxxxx
Subject: My mother is in the hospital
Date: Wed, 02 Jun 2004 10:33:56 -0400
From: xxxxxx@dhr.state.ga.us
To: cardiologist@heartmdphd.com

and she needs another opinion about her CHF Treatment (very Bad) Do you have any suggestions in the Northlake/ Dekalb Hospital Corridor? Thanks
Subject: Re: what's your diagnosis?
Date: Fri, 7 May 2004 15:35:11 -0700
From: xxxxxx@mailaka.net
To: "Dr. Andrew B. Chung, MD/PhD" (nospam5@heartmdphd.com)

Dr. Chung:

This is probably off-thread at least. But, regarding your 2lb diet, it seems that further directions are needed. Supposing that for week x I dedide to eat two pounds of walnuts per day. The next week: two pounds of celery per day. I guess you are assuming that any user of the diet is sophistacated enough to know better. Shouldn't there be an addendum describing the permissable foods for a daily diet?
Subject: MVP, AF, CARDIOVERSION
Date: Sat, 24 Apr 2004 14:38:01 EDT
From: xxxxxx@cs.com
To: cardiologist@heartmdphd.com

I have been diagnosed with AF and Mitral Valve Prolapse, 3 valves of the 4 leaking and "mild congestive heart failure." I was prescribed first Tropol XL twice daily, with 40 mg of Norvasc twice daily, and coumadin twice daily. I had been taking 20 mg of Norvasc for the last 5 year in conjunction with Atacand for hypertension. When I started the Tropol XL, it caused extreme adverse reactions--overall swelling, shortness of breath, and more severe AF. When I called the cardiologist, he changed it to Atenolol 40 mg, and the problems disappeared. However, the heavy dosage of Norvasc caused my lower legs and feet to swell, as well as other parts of my body, causing aches and pains and fatigue. The cardiologist said the benefits outweighed the side effects, and I would just have to put up with that. My family doctor felt he was over medicating, but would not interfere. However, both doctors were skeptical of my reaction to the Tropol xl, which was witnessed by my husband and family, not to mention the frightening discomfort I endured. The fact that the reaction subsided after stopping Tropol xl, to me, seems to speak for itself, so why the skepticism. I have always been sensitive to drugs (allergic to penicillin, codeine, sulfa, etc.). The doctors I had before I retired to Florida, told me I was difficult to treat because of the limitations, but never did they insult my intelligence by doubting my reported reactions. It would be to my advantage not to have adverse reactions.

My last visit, April 21, the cardiologist recommended strongly that I have the electrical cardioversion, saying I still had AF (though I thought it was gone) and the mild congestive heart failure would be worsened unless the AF was stopped. He changed the Norvasc to Lotensin, and I can't believe the relief from the swelling--I am taking prescribed Lasix daily with a potassium supplement. I see my endocrinologist (Dr. xxxxxxx, Ocala, FL--I am hypothyroid) Monday, April 26, who has not been apprised of this condition, and I am taking him requested copies of the extensive tests performed by the cardiologist. I wish to get his opinion.

I would like your opinion on the above.

xxxxxxx
Subject: FW: ECG Consultation
Date:Mon, 19 Apr 2004 14:50:37 +0100
From: xxxxxx@tiscali.co.uk
To: andrew@heartmdphd.com
CC: cardiologist@heartmdphd.com

Dear Dr Chung,
I sent you an e-mail about 2 weeks ago inquiring if you could help me with an ECG problem. As I have got no reply I was wondering if you had not received it. I just noted you have a different address on the discussion groups.

I would very much appreciate your advice on the problem. If you cannot help kindly advise on where I could go. Please find below the old message.

xxxxxx
Subject: Personal from Dr. Klatz
Date:Mon, 12 Apr 2004 22:04:01 -0400 (EDT)
From: Dr.Klatz To: cardiologist@heartmdphd.com

Dear Colleague,

I read of your work on the Internet and I believe you will have interest in advanced biotechnology for the intervention of disorders of human aging. Our medical society will be hosting the International medical events of the year with the 12th Annual World Congress on Anti-Aging Medicine in Chicago, August 20-23, at the Hyatt Regency, and again in Las Vegas at the Mandalay Bay Resort, December 3-5. This is my personal invitation to you.

The A4M is a nonprofit organization of physicians and scientists from over 70 countries worldwide and have grown from just 12 members in 1993 to over 12,500 members today. Our reach is wide as we now provide educational seminars, training, and advanced biotech information to over 100,000 healthcare professionals.

For your convenience I've included links to the following important resources

12th Annual World Congress on Anti-Aging Medicine flier, speakers, topics, and registration. http://www.worldhealth.net/event/
Our latest Biotech E-Newsletter of breakthrough technologies for aging interventions. http://www.worldhealth.net/ebn/a4m_040406.html
Our Society's official web site, www.worldhealth.net: The #1 source for anti-aging medical information. You can find application information for our society as well as board certification information and requirements for the American Board of Anti-Aging Medicine.

Thanks for taking the time to review this correspondence. We look forward to working with you, and hope you will join us at our August conference in Chicago. If you have no interest check here and I will remove you from my personal private mailing list.

Best Professional Regards,
Dr. Ronald Klatz MD, DO, FAOASM
President of the American Academy of Anti-Aging Medicine
Subject: no where to turn
Date: Mon, 12 Apr 2004 19:47:33 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

Dr. Chung, I was searching for information on the net and had seen some of the responses that you made to others and decided to take a shot. October of 2002 my father a healthy 65 year old had triple bypass surgery. Immediately after surgery he began to have complications. after numerous visits to doctors we hospitalized my father in January. We found out that he had Phrenic nerve palsy. I have tried everything including two trips to New York to see a neurologist and thoracic surgeon with not much help. My father is on a ventilator and will probably remain on a trach for the rest of his life. We have come to accept this, but have yet to find a doctor that can explain to us how this happened and what steps we can take to make my father more comfortable. He has been int the hospital 15 times in the last year and seems not to be comfortable. If there is anything you can tell me to help us understand his condition or tools we can use to make him live a healthier life I would appreciate it.

Thank you
Amanda xxxxxx
Subject: Breast Mass
Date: Mon, 12 Apr 2004 06:36:17 -0400
From: xxxxxx@mac.com
To: cardiologist@heartmdphd.com

Dr. Chung,

I am writing you to avoid panic.

After a MIDCAB in May 2003, I have developed a very painful mass in my left breast. I am male so I can’t imagine this to be anything but a normal result of the surgery. Should I see my cardio or my surgeon or someone else? I am rather embarrassed and don’t want to embarrass anyone needlessly.

Regards,

Glenn xxxxxx
Subject: Zocor
Date: Sun, 21 Mar 2004 21:59:28 -0800 (Pacific Standard Time)
From: xxxxxx@earthlink.net
To: cardiologist@heartmdphd.com

I see there are many questions regarding the use and also the problems with Zocor. There is much information that is faulty and some good. What is you opinion of taking a patient off Statins without several weeks of downward titration.
Thanks,
xxxxxx
Subject: None
Date: Mon, 8 Mar 2004 20:44:31 -0500
From: xxxxxx@prodigy.net
To: cardiologist@heartmdphd.com

Doc,
I am concerned about a sharp shooting pain in my heart region, it feels like a shard of glass. I am 18 years old very active and eat relitively healthy. I have asked my friends if they have this condition and they all have told me that they also have these pains. I was wondering if this is any thing to be concerned about and what might cause this?
Subject: Question
Date: Tue, 2 Mar 2004 16:50:31 -0600
From: xxxxxx@mindspring.com
To: "Dr. Andrew B. Chung, MD/PhD" (cardiologist@heartmdphd.com)

Hi Andrew

Sorry to bother you, but I wondered if you might have a recommendation. I have had chronic (daily) headaches since 1990. I have had many doctors, and eventually ended up at Shepherd Center for Spine Care (formally Shepherd Pain Center), where they determined that the headaches are caused by a head injury in 1980. After an auto accident the headaches didn't start immediately, but after 10 years, arthritis built up and is pressing on the nerves.

I now had headaches everyday since 1990, with some days being unbearable. My doctor has done some procedures like destroying the pain fibers of the nerves, but I am still in pain everyday, particularly behind the eyes. Some days, especially lately, I have had to go to the ER for a shot or strong pain killers to diminish the pain level (It never completely goes away, but I have learned to set a goal of just getting it down to tolerable). My doctor has told me that I will be in pain for the rest of my life.

My doctor is on the leading edge of new procedures and recently tried implanting a T.E.N.'s unit on the occipital nerves (which was just approved for the neck). It helped in the back of my neck, but not behind the eyes. He even placed a needle through my jaw to do a nerve block on the nerves behind the nose, but it didn't stop the pain behind my eyes. All of these procedures are guided by x-ray (I'm sure you've heard of them).

Most recently, I have been told at the ER that one of my eyes (the one that hurt that night) was dilated different from the other eye. Also, my face was swollen on one side during another ER visit with a severe headache. These symptoms are new in the last 6 months. The ER doctor did a Cat Scan, but it was normal.

I have previously been to neurologists, but am wondering if I should go to another Neurologist for these new symptoms. I guess my question to you (after boring you with this) is do you know of a good neurologist that I could try. Years ago, I went to Jerome Walker, who a lot of people consider the Atlanta Guru of headaches, but did not care for his treatment, demeanor, or office staff.

I appreciate your time and advice.

By the way, I became a christian late in high school as well and enjoy a genuine relationship with Christ as well. I have played in a contemporary christian band for about 13 years (on the side). Thanks for your witness in your emails. And just to let you know, I have prayed for relief and healing for years, including having the elders of my church anoint me with oil and pray. So far, God has other plans. I have told him that I would rather have pain everyday and be connected with him than healing and missing his plan. I have to believe that there is a bigger purpose for my pain, but on the worst days, it's hard to see (you know what I mean?).

Listen, I appreciate your insight and recommendation and your time to read this.

Thanks Again Andrew,

xxxxx
Subject: Research Questions
Date: Sun, 29 Feb 2004 22:02:32 -0500
From: xxxxxx@athensacademy.org
To: cardiologist@heartmdphd.com

Hi, I am a 9th grader at Athens Academy doing research on the profession of Cardiology. I was wondering if maybe in your spare time, you might be able to answer just a few (and I promise it will only be a few)questions. I do not need great detail just a brief answer. I am not in desperate need but if you could answer these questions it would be greatly appreciated. Thank you so much.


xxxxxx (Athens Academy - 9th Grade)
Email: xxxxxx@athensacademy.org or just reply to this message

Questions: (Here are a few questions and you don't need to answer all of them. Whatever you can write is helpful. Thank you so much.

1. What drew you to becoming a Cardiologist?

2. How long did you go to school to become a Cardiologist?

3. What did you major in college and what courses did you take to become a Cardiologist?

4. What is the hardest part of being a Cardiologist?

5. What kind of vacation time and off time do Cardiologists normally get?

6. What do you dislike about being a Cardiologist and do you have any regrets?

Subject: A message from xxxxxx from the Cardiology Listserv
Date: Wed, 18 Feb 2004 18:41:28 -0800 (PST)
From:xxxxxx@yahoo.com
To: cardiologist@heartmdphd.com

Andrew:

It occurred to me that you might be interested in this piece I received via email. I have done little to verify it's authenticity but the writing seems to speak for itself.

I have yet to decide if I will see the film. My beliefs are firm. Do I need to watch hours of endless suffering to be convicted? I don't think so. However, I must admit that over the past several months, I have gained enormous respect for Mel Gibson.

Since this is very off topic, I chose to send it to your private email. Please forgive me if I overstepped boundaries to your privacy.

xxxxxx

THE PASSION OF THE CHRIST"

Below are Paul Harvey's stirring comments concerning Mel Gibson's new movie, "The Passion of the Christ," due to be released on February 25, 2004.

For more information abut the film, see http://www.passion-movie.com.

Note that Harvey says the movie is "a kind of art that is a rarity in life."

I really did not know what to expect. I was thrilled to have been invited to a private viewing of Mel Gibson's film "The Passion," but I had also read all the cautious articles and spin. I grew up in a Jewish town and owe much of my own faith journey to this influence. I have a life long, deeply held aversion to anything that might even indirectly encourage any form of anti-Semitic thought, language or actions.

I arrived at the private viewing for "The Passion", held in Washington DC and greeted some familiar faces. The environment was typically Washingtonian, with people greeting you with a smile but seeming to look beyond you, having an agenda beyond the words. The film was very briefly introduced, without fanfare, and then the room darkened. From the gripping opening scene in the Garden of Gethsemane, to the very human and tender portrayal of the earthly ministry of Jesus, through the betrayal, the arrest, the scourging, the way of the cross, the encounter with the thieves, the surrender on the Cross, until the final scene in the empty tomb, this was not simply a movie; it was an encounter, unlike anything I have ever experienced.

In addition to being a masterpiece of film-making and an artistic triumph, "The Passion" evoked more deep reflection, sorrow and emotional reaction within me than anything since my wedding, my ordination or the birth of my children. Frankly, I will never be the same. When the film concluded, this "invitation only" gathering of "movers and shakers" in Washington, DC were shaking indeed, but this time from sobbing. I am not sure there was a dry eye in the place. The crowd that had been glad-handing before the film was now eerily silent. No one could speak because words were woefully inadequate. We had experienced a kind of art that is a rarity in life, the kind that makes heaven touch earth.

One scene in the film has now been forever etched in my mind. A brutalized, wounded Jesus was soon to fall again under the weight of the cross. His mother had made her way along the Via Della Rosa. As she ran to him, she flashed back to a memory of Jesus as a child, falling in the dirt road outside of their home. Just as she reached to protect him from the fall, she was now reaching to touch his wounded adult face. Jesus looked at her with intensely probing and passionately loving eyes (and at all of us through the screen) and said "Behold I make all things new." These are words taken from the last Book of the New Testament, the Book of Revelations. Suddenly, the purpose of the pain was so clear and the wounds, that earlier in the film had been so difficult to see in His face, His back, indeed all over His body, became intensely beautiful! . They had been borne voluntarily for love.

At the end of the film, after we had all had a chance to recover, a question and answer period ensued. The unanimous praise for the film, from a rather diverse crowd, was as astounding as the compliments were effusive. The questions included the one question that seems to follow this film, even though it has not yet even been released. "Why is this film considered by some to be "anti-Semitic?" Frankly, having now experienced (you do not "view" this film) "the Passion" it is a question that is impossible to answer. A law professor whom I admire sat in front of me. He raised his hand and responded "After watching this film, I do not understand how anyone can insinuate that it even remotely presents that the Jews killed Jesus. It doesn't." He continued "It made me realize that my sins killed Jesus" I agree. There is not a scintilla of anti-Semitism to be found anywhere in this powerful film. If there were, I would be among the first to decry it. It faithfully tells the Gospel story in a dramatically beautiful, sensitive and profoundly engaging way.

Those who are alleging otherwise have either not seen the film or have another agenda behind their protestations. This is not a "Christian" film, in the sense that it will appeal only to those who identify themselves as followers of Jesus Christ. It is a deeply human, beautiful story that will deeply touch all men and women. It is a profound work of art. Yes, its producer is a Catholic Christian and thankfully has remained faithful to the Gospel text; if that is no longer acceptable behavior than we are all in trouble. History demands that we remain faithful to the story and Christians have a right to tell it. After all, we believe that it is the greatest story ever told and that its message is for all men and women. The greatest right is the right to hear the truth.

We would all be well advised to remember that the Gospel narratives to which "The Passion" is so faithful were written by Jewish men who followed a Jewish Rabbi whose life and teaching have forever changed the history of the world. The problem is not the message but those who have distorted it and used it for hate rather than love. The solution is not to censor the message, but rather to promote the kind of gift of love that is Mel Gibson's filmmaking masterpiece, "The Passion."

It should be seen by as many people as possible. I intend to do everything I can to make sure that is the case. I am passionate about "The Passion." You will be as well. Don't miss it! This is a commentary by DAVID LIMBAUGH about Mel Gibson's very controversial movie regarding Christ's crucifixion. It, too, is well worth reading.
Subject: Not angina?
Date: Mon, 16 Feb 2004 16:02:21 EST
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

Hello heart doc.
I have had noticiable ectopic heart beats since last easter time, they started soon after i had an accident at work in which i had some fragments of glass get in my throat which caused an infection (the infection comes and goes and is signified by a yellow spot that appears in the back of my throat) went to the local hospital to get the ectopic beats checked out and had an ECG test. the cardiologist there said the ectopic beats were nothing to worry about, however he did say that one of the traces showed an abnormality that may be angina. I went for another ECG test this time whilst walking on a treadmill. This test showed that i do not have angina but no mention was made of what the abnormality might really be and no further appointments or tests were suggested. My question is could the throat infection i have be causing some abnormality in my heart beats? Could it perhaps have spread to my heart? Could bacteria from it be causing the ectopic beats? Lots of questions i know, but sitting in the doctors office i always seem to forget to ask them home here i have the time to think about it.
Thanks for your time and i hope you are able to reply.
xxxxxx

Subject: Interventional Cardiology - Florida
Date: Fri, 23 Jan 2004 14:18:44 -0500
From: Peter Luciano (pluciano@fgp.com)
Organization: Find Great People, Inc.
To: cardiologist@heartmdphd.com

I represent a Heart Specialist practice in Ft. Lauderdale, Florida that is wholly owned by the local multi-hospital system. They have an excellent opportunity for an experienced interventional cardiologist. The practice currently has five cardiologists and seeks to expand.

Because of the structure of the practice, this is an employed opportunity with salary, benefits, fully paid malpractice insurance, and retirement.

The range of salary is mid $300's to mid $400's depending on experience with an additional bonus potential of up to $100K. This is an excellent package given there are no expenses to the physician.

Ft. Lauderdale is a lovely community offering a wide range of lifestyles, beautiful gated communities, waterfront living and excellent schooling opportunities for family.

I would encourage you to share this opportunity with colleagues. Interested individuals should email me your CV and to contact me at your convenience. Best Regards,

Peter R. Luciano SPHR
Consultant
FGP International
www.findgreatpeople.com or www.fgp.com

"I Find Great People in healthcare"

150 Executive Center Drive, B82
Greenville, SC 29615

e-mail: pluciano@fgp.com
(800) 638-1661
Subject: Questions about Dr. Wallace
Date: Mon, 5 Jan 2004 11:21:20 -0800 (PST)
From: xxxxxx@yahoo.com
To: cardiologist@heartmdphd.com

Dear Dr. Chung,

I found your name and background information after conducting a search for past students from Dr. Douglas Wallace's lab. I am a first-year grad student in a Ph.D. program at the University of California, Irvine and will be starting a rotation soon in his lab (he recently moved here from Atlanta).

Because he is so new, there are only post-docs in his lab and I was hoping to gain the perspective of some of his former grad students before I make a decision about my thesis lab. Could you tell me what it was like to have him as an advisor? Did you like working in his lab? How long did it take you to finish your Ph.D. work? What did you feel were his strengths and weaknesses?

I understand that you are very busy and appreciate very much your time in this matter. If you also know of anyone else that was in his lab and could give me some feedback, that would also be very helpful.

Thank you again (and congratulations for all your successes in life)!

Sincerely,

xxxxxx
From: xxxxxx@surfmore.net
To: cardiologist@heartmdphd.com
Subject: pulse rates
Date: Thu, 1 Jan 2004 21:15:13 -0600

Hello, I am a 51 yr old lady petite always had a low blood pressure. Lately , my pulse rate has gone up to 137. Which is far from normal for me. My whole body will turn red from head to toe. And , stay that way. for a while it takes 2-3 days for it to slowly come down. It has only happened twice. But, right now it is 100 and it has been doing rather good for 2weeks. My doctor took urine for 24 hours and put in acid for that time in refregerator. Then I turned it in . The first one something was wrong . But, my urine was very dark , you could say black. The second was ok. and normal clear. now he wants me to wear a monitor for 24 hours and turn it back in.
What is my problem?
xxxxxx
From: xxxxxx@xxxxxx.co.uk
To: cardiologist@heartmdphd.com
Subject: FW: Thank you for your donation - Information about Cardiac Revascularisation options
Date: Tue, 30 Dec 2003 13:01:59 -0000

-----Original Message-----
From: donations@efundraising.org [mailto:donations@efundraising.org
Sent: Tuesday, December 30, 2003 12:47 PM
To: xxxxxx@xxxxxx.co.uk
Subject: Thank you for your donation

Dear Donor

On behalf of Medecins Sans Frontieres [UK], we would like to thank you for your kind donation of USD 35.00.

[Details snipped]
----------------------------------

Dr Chung

I wonder if I might seek some information from you about possible treatment options for cardiac revascularisation.

I am a 52 year old architect living in the UK. I had angioplasty and stent in July 2002 and am being referred back to the Cardiology Dept by my GP (Primary Care Physician) due to deteriorating angina. The problem I have is getting information about treatment options which are not constrained by the limitations of our National Health Service in order that I might discuss these with my cardiologist when I see him on 7 January.

I travelled to Belgium for my angioplasty, as the waiting list in the UK was nearly 2 years. My UK cardiologist was supportive of my decision to go abroad for treatment and willingly provided a letter of introduction providing full medical details of my condition. In return the belgian cardiologist provided details of the treatment to my UK cardiologist for follow-up care.

I had a 90% blockage of the LAD at the trifurcation of the first septal branch and intermediate diagonal branch. After the treatment I was free of symptoms but ETT at 8 weeks was positive. Subsequent ETT at 12 weeks showed 2mm ST depression and an angiogram showed mild neointimal hyperplasia of the stent and narrowing of the first diagonal and moderate to severe ostial stenosis of the diagonal branch at the base of the stent. It also showed normal LV with normal RCA, left circumflex and left marginal. I was advised that they wanted to treat this with drugs only as it would be very difficult to repair by angioplasty and CABG was not an option for single vessel disease. I was also warned that I might lose one or both of the arteries.

It is now 15 months since this angiogram. My medication has progressively been increased and my tolerance of exercise has decreased. The deterioration has been slow but relentless. My current medication is Diltiazem 240mg, Isosorbide Mononitrate 20mg twice a day, Propranolol 160mg, Valsartan 80mg, Atorvastatin 20mg, Aspirin 75mg. General health good but 20kg overweight which I am working on. Blood tests, Cholesterol, BP etc are all normal except kidney function (creatinine).

To date I have not had a heart attack and I am concerned about the prospect of "losing" one of these coronary arteries and presumably the consequent loss of heart muscle. Is it normal just to allow coronary arteries to infarct or should I be considering seeking treatment outside the UK as I did before? I suspect that as I have not already had a heart attack I am low priority so far as our National Health Service is concerned, but I am sure my cardiologist would support another trip abroad if other treatment options were available.

xxxxxx
xxxxxx
xxxxxx, UK
Date: Tue, 23 Dec 2003 21:50:20 +1300 (New Zealand Standard Time)
From:xxxxxx@paradise.net.nz
Subject: Dilated Cardiomyopathy
To: cardiologist@heartmdphd.com

Dear Dr Chung, My name is xxxxxx and I live in New Zealand. I recently had a mild heart attack and from there it was discovered that I had Dilated Cardiomyopathy but the medical staff did not tell me that or explain the problems that I would face with it.
As I work in a hospital I was quite stunned that many staff members could not explain it to me so I started surfing the net and found many interesting articles written in America and I understand a little more about heart muscle disease.
It seems to me Americans are better informed on heart disease than us Kiwis.
A question can this disease be reversed, what harm does high blood pressure play when after six months pills have not brought it down and also infections are they harmful.
As a group of us are interested in making people more aware of this disease is there good material you can recommend.

Kind regards
xxxxxx
Date: Fri, 5 Dec 2003 12:02:24 -0800 (PST)
From: xxxxxx@yahoo.com
Subject: Big Change in Cholesterol
To: cardiologist@heartmdphd.com

Hi Dr. Chung.
I found your name on a Google Group list and thought I might ask you a question. I recently had a cholesterol test that showed my total count as 317, which of course is ridiculously high. I had a test 11 months ago that had my total count at 235, which is borderline high but certainly much better than 317. My diet hasn't changed much in those 11 months, I haven't gained any weight, though I am a bit less active (I walk more but get rigorous exercise less). Is an 82 point jump in cholesterol in 11 months possible or at least reasonable? I'm being retested, but I'm still shocked at the result. I'm a 30 years male and otherwise in excellent health. Hope to hear from you. Thanks.

Regards,
David xxxxxx
xxxxxx, NY
From: xxxxxx@singnet.com.sg
To: cardiologist@heartmdphd.com
Subject: help
Date: Fri, 5 Dec 2003 21:00:37 +0800

Dear doctor,
I am from Singapore. I came to your webpage accidentally and find it really informative. I am wondering whether can I get some advice from you. Recently my grandmother has been diagnose with Ischemic heart disease. Doctors here said that her blood vessels (coronary artery) are very occluded. Her ECG is still normal but her cardiac ultrasound is showing atherosclerosis everywhere. She got carotid bruit also. In addition her kidney function is estimated to be only 10% though she has not had sign of kidney failure like vomiting yet.

May I know what treatment can be offered tor her to treat or prolong her life. I really love my grandmother. Hope you can enlighten me. In Singapore, the cardiologist seems unable to help. His plan to do a coronary angiogram was cancelled because of the kidney failure.
Oh yes, she has isolated systolic hypertension of 170-180/70mmHg

I would really appreciate if you can give me some advice.

xxxxxx
Dentist (oral maxillofacial surgeon)
Singapore
xxxxxx@singnet.com.sg
Date: Sun, 23 Nov 2003 04:59:19 -0000
xxxxx@msn.com
To: cardiologist@heartmdphd.com
Subject: Omega 3

Dear Dr. C,

What is your opinion about omega 3 supplements? I take them daily. I believe that a significant part of mental and cardio health problems are due to this fat not being a part of most people's diets. I have read about Scandanavians that adopt an American style diet start to have higher incidents of depression and heart/cardiovascular disease than Scands that maintain a traditional diet.

Your friend and classmate,

Paul xxxxxx
From: xxxxxx@hotmail.com
To: cardiologist@heartmdphd.com
Subject: help for our essay on dextrocardia
Date: Wed, 12 Nov 2003 17:04:22 +0000


Dear Sir/ Madam,

We are three students from the Netherlands who are writing an essay on dextrocardia (situs inversus). As this disorder is quite rare, we have not been able to find more information than provided on the Internet. We would like to ask you, if you would be so kind as to give us some extra information on this subject. Our most important question is if you could tell us in which population group this disorder is most common. But any help is welcome, such as recommending particular literature etcetera. It would mean a lot to us, since this essay is quite important for our final exam. We would very much appreciate it if you would be able to answer us as soon as possible.

Yours sincerely,

Saphira xxxxxx, Arthur xxxxxx and Irini xxxxxx.
Subject: Pressing heart problem for 25 y/o
Date: Fri, 7 Nov 2003 13:45:38 -0500
From: xxxxxx@adelphia.net
To: cardiologist@heartmdphd.com

Dr Chung,

Thank you for reading my email, I have several questions for you. I have been having the following symptoms over the past three months: difficulty breathing, cold hands and feet, shooting shocking like pain in the left arm, and at times chest, feeling as if arms and other extremities have fallen asleep, nausea, increased coughing with brownish and white milky phlegm, dizziness, jaw pain, as well as dull to severe pain the left chest area, dried blood in left nostril, snoring and extreme tiredness. I have had an EKG, Enzyme blood test, echo, cardiolite stress test; all appeared normal per the cardiologist. I have also seen a lung specialist, who did nothing, telling me that I have postnasal drip. I have been to the emergency room several times regarding this, however they are at a loss. My mother as well as aunt have mitro value prolapse, however the cardiologist has said no, might their be any other tests that could be run. I know my own body, pain in a specific area is med school 101, and it is not in my head, I’m rather tired of physicians telling me, that 25 is too young to have a heart problem. I also have requested but not had a cholesterol test, per all the physicians I have asked. I have drank several years while in college seven to be exact, also my blood pressure is rather high 130-140/80, however my GP thinks this is normal, I disagree. Any additional ideas, because this is scarring the hell out of me, and is seems as if the Dr’s are brushing me off. I will gladly send a $35.00 donation for an objective response, towards this pressing problem.


Sincerely,


xxxxxx
From: xxxxxx@xxxxxx.com
To: cardiologist@heartmdphd.com
Subject: Quick question on your two pound diet
Date: Tue, 28 Oct 2003 00:39:35 -0800

Hi,

I'm really looking forward to going on your diet. I read your page and what you are saying makes a lot of sense.

When you say, "Sugar free drinks", what do you mean? I thought you meant diet soda. Instruction 3 seems to treat skim milk as a sugar free drink. I have always thought carbs and sugars were pretty much the same. Are there other "free" drinks? What about "Sugar free" fruit juices? (Sugar free cranberry juice -- YUCK. Its full of carbs, no doubt.)

I'm planning to succeed on your diet and look forward to writing a testimonial. And by the way, I really liked your FAQ. It really cut to the chase.

Thanks & Regards,

xxxxxx
From: xxxxxx@earthlink.net
To: cardiologist@heartmdphd.com
Subject: May I pose a question?
Date: Sat, 11 Oct 2003 23:29:18 -0400

Dear Dr. Chung,
I appreciate your website and your participation with the cardiology news group,however I have become leary of some of the posters and would not care to post there.
May I ask a question of you at this address.
If so thank you, if no I apologize.

Best Regards
xxxxxx
From: xxxxxx@webtv.net
Date: Tue, 16 Sep 2003 23:13:15 -0400 (EDT)
To: cardiologist@heartmdphd.com
Subject: temporary password and username

Would you send me temporary password and username?
Thanks

xxxxxx
From: xxxxxx@aol.com
Date: Sat, 6 Sep 2003 22:52:25 EDT
Subject: 2lb diet
To: cardiologist@heartmdphd.com

I enjoyed your website and the theory behind the "2lb diet". It makes sense...............years ago people lost weight on diets based on eating rice and pasta. Then along came the no fat/low fat diets. Again people lost weight. Adkins no carb diet....people lost weight.
Several years ago one of the doctors at the hospital where I worked was constantly on some fad diet or another. Finally he went on MediFast and lost the weight. After he lost the weight he merely cut back what he ate. Being divorced and in his late 50's he ate out most of the time. He would tell the server to cut everything on his plate in half BEFORE bringing it to the table and put it in a take out container (or often times throw it away). This worked for him..............if he didn't see it, he didn't crave it and he didn't eat it.
Kind of like the 2lb diet.........eat less therefore weigh less.
Date: Sat, 06 Sep 2003 16:38:46 -0600
To: cardiologist@heartmdphd.com
From: xxxxxx@xxxxxx.com
Subject: s.m.c, etc

Dr. Chung,

I have been enjoying your contributions to sci.med.cardiology for quite a while now. What brought me to this newsgroup in the first place is that I have had paroxysmal atrial fibrillation for about six years now.

I have greatly appreciated the care and concern with which you have answered people's questions about their medical conditions. I also really appreciate that you are witnessing your faith in such a public way. I'm sure that this causes a lot of the darts and arrows that have been launched in your direction.

I would like to suggest that you consider a different approach to the fools and idiots that have plagued the newsgroup. I would suggest that you apply the wisdom of Matt 10:14 and Luke 9:5 to this problem. I.e., ignore them. Use your killfile if you have one, or your self control if you don't. You have patiently explained the issues to these people over and over. They don't want to know the truth. Jesus has taught us to leave these people behind and concentrate on those who do want to hear the message.

If you can't resist arguing with these people could you please leave s.m.c out of the groups you post your replies to? This will allow me and others to killfile the idiots and never see their posts as long as we confine ourselves to s.m.c. Every time you respond to them in s.m.c, I am forced to see their blather. Unless you change your approach, the only way I can let my filters work for me is to kill file you too. I do not want to do this. But I am sometimes tempted to do so.

Please consider this.

God bless,
xxxxxx
From: simone@zacorpinc.com
To: cardiologist@heartmdphd.com
Subject: Exchange Links
Date: Tue, 2 Sep 2003 20:02:16 -0400

Hello,

My name is Simone. I discovered your website http://www.heartmdphd.com on Google and found it to be very informative. I was wondering if you wanted to exchange links with 4 of our sites? If so please add the following information and send us your link information and your site will be added within 24 hours. If you require that we link first we will do so. Just let us know.

Thank you for your consideration.

Simone
Webmaster
ZACORP INC.

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Title Links To: http://www.propecia-hair-growth.com
Date: Fri, 29 Aug 2003 17:04:04 -0400
To: cardiologist@heartmdphd.com
From: Erik Grissom (erik@polarishealth.com)
Subject: link suggestion

Hello. I am writing to suggest our company, Polaris Health Directions, as a possible link from your page at http://www.heartmdphd.com/

Our organization has recently won a major grant from NIH to study depression and anxiety in patients receiving cardiovascular treatment.

You can visit our web site at http://www.polarishealth.com

Thank you.

Erik
From: xxxxxx@telus.net
To: cardiologist@heartmdphd.com
Date: Thu, 28 Aug 2003 10:06:03 -0600
Subject: when to take statins


Hi again Dr. Chung

Endocrinologist told me to take them at night ie) supper or after because liver makes most cholesterol at night.

Why don't you post the AMA page with your creds? Why do you put up with the b.s. on the board. Makes me sad to go there.

xxxxx
From: xxxxxx@mountain.net
To: "Dr. Andrew B. Chung, MD/PhD" (cardiologist@heartmdphd.com)
Subject: Re: Anti Atkins
Date: Sat, 23 Aug 2003 13:39:43 -0400

thanks Dr. Chung. . Saved me for starting this diet. Will stick with the walking and lower fat.
Subject: Fw: Your Online Donation to Doctors Without Borders
Date: Fri, 15 Aug 2003 16:27:08 -0700
From: xxxxxx@juno.com
To: cardiologist@heartmdphd.com

Dear Dr. Chung::

I had stress test and thallium test few months ago, my cardiologist recommended an angiogram. Out of fear for another bypass surgery ( I had a bypass surgery 4 years ago), I opted for medication. I am taking nitroglycerin 5mg twice a day. I learn there is a non-invasive therapy called EECP (Enhanced External Counterpulsation). Is it effective?

Thank you.

----- Forwarded Message -----
From: "Donor Services at Doctors Without Borders" (donations@newyork.msf.org)
To: xxxxxx@juno.com
Date: Fri, 15 Aug 2003 19:03:51 -0400
Subject: Your Online Donation to Doctors Without Borders
Message-ID: (OAKTREE17FRaqbC8wSA00000003@relay.com)


Thank you for your online donation to Doctors Without Borders/Médecins Sans Frontières (MSF).
Subject: thanks for the chat
Date: Wed, 18 Jun 2003 17:19:38 -0700 (PDT)
From: xxxxxx@yahoo.com
To: cardiologist@heartmdphd.com

Andrew, so good to find you. I have lots to discuss with you about the genetics study regarding WPW and the electron CT scan. Gonna go for a walk, may log back on later. Take care, xxxxxx
Subject: Christ's Healing
Date: Sat, 14 Jun 2003 23:31:11 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

Dr. Chung,
It is wonderful to see a physician give credit to OUR LORD'S marvelous works while HE was on earth. I believe that more and more of the medical community are recognizing the POWER of OUR LORD & SAVIOR!!

Dr. Chung, you are truly one in a million! Wish I had you as my cardiologist !!!

My GOD watch over you and your practice.

xxxxxx
Subject: Website Suggestion for http://www.heartmdphd.com/research.asp
Date: Thu, 12 Jun 2003 23:02:04 +0530
From: xxxxxx@rediffmail.com
To: cardiologist@heartmdphd.com

Hi,

I came across your site and found it very informative and nice. Thank you for putting up this wonderful site. It really helped me in my research.

I would like to suggest a website for inclusion on your page at http://www.heartmdphd.com/research.asp [Research Links:] and other such related appropriate pages.

You could find the below information useful to link to the site:

Url: http://www.1upinfo.com/

Title: 1Up Info - Encyclopedia

Description:

Browse articles in all areas of topics within Earth & Environment, History, Literature & Arts, Health & Medicine, People, Philosophy & Religion, Places, Plants & Animals, Science & Technology, Social Science, Law, Sports, Everyday Life, and more.

Thanks and I would really love to recommend your wonderful site to a lots of my friends. In facts, I already suggested it to many of them :)

Regards,
xxxxxx
Subject: Best MDs
Date: Thu, 12 Jun 2003 09:26:58 -0400
From: xxxxxx@mac.com
To: cardiologist@heartmdphd.com

I would like to nominate my cardiac surgeon, Dr. L. Wei of UPMC, Pittsburgh, to your “best” list. He was very professional, had tremendous patience for my questions, and performed an exceptional job of performing an MIDCAB. His ability to transfer knowledge and calm with confidence was exceptional.

xxxxxx

P.S. Dr. Chung — thanks for your efforts with the website and your participation in the sci.med.cardiology newsgroup. It’s been a great source of practical information.

Subject: The Best MDs
Date: Mon, 9 Jun 2003 23:12:10 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

I can give you my Dr's name for your list, just don't ask me how to pronounce it, Chukwudi Uchegbu,M.D. Adult Medicine / Primary Care . he has an office in Tucker and one in Alpharetta
Subject: Research Nurse Needed
Date: Wed, 4 Jun 2003 10:24:45 -0400
From: "Caroline Diamond" (CarolineDiamond@MSNHealth.com)
To: cardiologist@heartmdphd.com

Dr. Chung,

I was wondering if you may know anyone looking for a Clinical position in Atlanta Georgia. Your experience in cardiology is very extensive so I thought you may know someone looking for a position as a Research Nurse in the cardio field. I also have an opening for someone in Regulatory affairs. This is a great opportunity for someone looking to get into the pharma research field. Any help you could give me would be greatly appreciated.

Caroline Diamond
Account Manager
Clinical Resources,
a Medical Staffing Network, Inc. Company
6110 Executive Blvd. Suite 905
Rockville, MD 20852
(301) 468-2500 Ext. 129
(301) 770-2253 fax
carolinediamond@msnhealth.com
http://www.msnhealth.com/
Subject: Dr. Recommendation
Date: Tue, 20 May 2003 22:10:07 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

Robert Albee, MD. He is a GYN, but specializes in Endometriosis. He is in Atlanta, GA. His website is http://www.centerforendo.com.

He is one of the top in the world for this disease.

xxxxxx
Subject: heart question
Date: Tue, 20 May 2003 16:02:36 EDT
From: xxxxxx@aol.com
To: cardiologist@heartmdphd.com

Hi, I found your information on the internet and hope you don't mind me contacting you...

I work for a film director who wants to know something specific for a film. Basically, fake medics are trying to sneak a prisoner out of prison in an ambulance, saying he is having a heart attack. Something has to go on so the guard knows they are lying - something the guy is doing wrong in faking the attack, something about the pulse, I don't know... do you have any ideas?

Thank you!!!

xxxxxx
From: xxxxxx@cs.jhu.edu
To: drchung@heartmdphd.com
Subject: Mitral Valve Prolapse
Date: Thu, 24 Apr 2003 19:35:37 -0400

Dear Dr. Chung,

Viewed your webiste, and I now have a few questions about mitral valve prolapse:

What is a rough estimate of the chance that somebody with mitral valve prolapse will develop mitral regurgitation?

What are the symptomps of mitral valve prolapse with mitral regurgitation?

Do people with mitral valve prolapse without mitral regurgitation need to see a cardiologist every few years if they do not experience any symptoms?

Sincerely,
xxxxxx


----- Original Message -----
From: Donor Services at Doctors Without Borders
To: xxxxxx@cs.jhu.edu
Sent: Thursday, April 24, 2003 7:27 PM
Subject: Your Online Donation to Doctors Without Borders


Thank you for your online donation to Doctors Without Borders/Médecins Sans Frontières (MSF).
From: xxxxxx@xxxxxx.com
To: drchung@heartmdphd.com
Date: Fri, 4 Apr 2003 14:24:36 -0600
Subject: Recommendation of Dr. Van C. Reeder

Dr. Chung,

We have never met but I understand you publish a "Best Doctors List" and I would like for you to consider Dr. Van C. Reeder for this list. Dr. Reeder has been my cardiologist for almost 3 years and without his excellent medical care, I don't believe I'd be alive today. Dr. Reeder always takes time to answer my questions and is willing to go "the extra mile" to ensure I receive the best medical care possible. Dr. Reeder practices medicine at Birmingham Heart Clinic in Birmingham, Alabama.

Choosing a physician is an important decision and I believe good physicians should be recognized for their contribution to society. I truly believe references such as your "Best Doctors List" assist in this selection process and I believe Dr. Reeder is deserving of this special recognition.

Please don't hesitate to contact me should you have any questions.

Regards,

xxxxxx

Subject: Fwd: Your Online Donation to Doctors Without Borders
Date: Wed, 26 Mar 2003 14:08:43 +0000
From: xxxxxx@hotmail.com
To: drchung@heartmdphd.com

Dr. Chung - I am a 33 year old male. I used to be quite athletic, mainly running until about 6 moths ago. I have generally felt in poor health - mainly tired and started getting skipped beats. The doctor said pvc's. He referred me to a caridologist three weeks ago (I still need to wait one more week for my appt). My symptoms have gotten worse with sometimes several pvc's per minute. I also have begun to feel my heart racing when I sleep. From the best I can tell this is Atrial Fibrillation. It happened for a few seconds several times per night and would always stop when I moved. Now it happens almost continuously during the night and does not go away until I move quite a bit. Is this something that could wait another week?What medicine would be the safest to take? Could an artery blocakge cause this? Could something with my stomach cause this? What might other causes be?

I appreciate you providing this service and helping a worthy cause through donations

>From: "Donor Services at Doctors Without Borders"
>Reply-To: donations@newyork.msf.org
>To: xxxxxx@hotmail.com
>Subject: Your Online Donation to Doctors Without Borders
>Date: Wed, 26 Mar 2003 08:54:03 -0500
>

Thank you for your online donation to Doctors Without Borders/Médecins Sans Frontières (MSF).

In a world where the need for Doctors Without Borders' work is greater than ever, your support is the fuel that drives us to reach the most vulnerable, to raise issues that are not popular, and to demand - and help bring about - an end to suffering. Without you, our work simply would not be possible.

If you have any questions about the processing of your donation, please feel free to send an email to donations@newyork.msf.org or call Katie Lane, our Donor Services Assistant, at (212) 655-3757.

You will also be receiving a thank you letter in the mail, which will serve as your legal receipt.

Please find below your donation information as it appears in our records.

-----------------------------------------------------

E-mail address: xxxxxx@hotmail.com

xxxxxx,
xxxxxx
www.heartmdphd.com
xxxxxx
Donation Amount: $35.00

-----------------------------------------------------

Subject: Fw: Your Online Donation to Doctors Without Borders
Date: Tue, 18 Feb 2003 19:08:04 -0500
From: xxxxxxx@lanshop.com
To: drchung@heartmdphd.com

See the donation information below.

My father was admitted to xxxxxx xxxxxxxon December 24th with congestive heart failure.

He was released eight days after that and since that time has had a case of persistent hiccups. Dr. xxxxxx, his cardiologist referred him to a neurologist.

The hiccups still persist to this date, even though four different medications have been tried – metaclopramide first, then novochlopromazine, clonazepam and lastly novodivalproex.

As the hiccups are quite debilitating for my father, I am looking to evaluate alternative treatment plans. Both he and my mother are becoming quite distressed.

Despite the medication, the hiccups which have abated for some periods, still persist.

Other medications and treatments show up in the medical literature as effective combating hiccups. These include the muscle relaxant Baclofen, Benztropine and Lidocaine. I have not performed an exhaustive search but certainly chlorpromazine and baclofen show up consistently. Treatment of the phrenic nerve with medicine or surgical procedure is also indicated, but as a last resort.

Most articles discuss the need to determine the underlying cause for the hiccups and then plan the treatment accordingly. I’m not sure what the cause is but could guess it was a direct result of his heart failure/attack – possibly irritation of the phrenic and/or vagus nerve.

I am not a doctor and my information is strictly from what I’ve gathered on the Internet. I have no idea what side affect or interactions certain drugs have.

What I do believe, however, is that a definitive plan of attack has to be implemented to address my father’s hiccups.

Doctor Chung, what would you recommend? Should we see another neurologist for a second opinion, or perhaps a GI guy or even an anesthesiologist?

----- Original Message ----- From: Donor Services at Doctors Without Borders
To: xxxxxx@lanshop.com
Sent: Tuesday, February 18, 2003 7:03 PM
Subject: Your Online Donation to Doctors Without Borders

Thank you for your online donation to Doctors Without Borders/Médecins Sans Frontières (MSF).

In a world where the need for Doctors Without Borders' work is greater than ever, your support is the fuel that drives us to reach the most vulnerable, to raise issues that are not popular, and to demand - and help bring about - an end to suffering. Without you, our work simply would not be possible.

If you have any questions about the processing of your donation, please feel free to send an email to donations@newyork.msf.org or call Katie Lane, our Donor Services Assistant, at (212) 655-3757.

You will also be receiving a thank you letter in the mail, which will serve as your legal receipt.

Please find below your donation information as it appears in our records.

-------------------------- ---------------------------

E-mail address: xxxxxx@lanshop.com

Mr. xxxxxxx,
xxxxxx xxxxxx
www.heartmdphd.com
xxxxxx, xxxxxx
Donation Amount: $35.00

-----------------------------------------------------
Subject: Excellent CARDIOLOGY practice opportunities
Date: Fri, 14 Feb 2003 09:13:54 -0500
From: Kathy Avers (kavers@stjohnjobs.com)
Organization: St John Associates
To: "Andrew Chung, MD" (drchung@heartmdphd.com)

Dear Dr. Chung,

I can use your help.

Please review the following practice parameters and forward this message to any colleagues for whom you feel this may be appropriate. I believe these will be great practices for the right physicians. Thanks for passing it along.

DALLAS EP: Join a single specialty cardiology group in Dallas with more than 20 members including 4 electrophysiologists. The senior EP member will be retiring this fall and they want another EP to start before he retires for a seamless transition. This well-established group has offices affiliated with several large Dallas hospitals and offers the chance to be involved in clinical research trials in their private research facility. The electrophysiologists practice EP exclusively including 1:4 EP call. With a population of over 1 million, Dallas is a hub for banking, high tech industry, and corporate headquarters.

CHARLOTTE INTERVENTIONAL: A Charlotte NC group has been asked by a local hospital to be the practice to start an interventional program. The new interventionalist will be joining a group of 9 cardiologists with 3 interventional members to share call. The community hospital has just completed a renovation project and added a new digital cath lab, emergency department and MRI and CT scanner. The office has echo and nuclear cameras. If you like golf, this is the place to be! Drive west and you're in the Blue Ridge Mountains or head east to the Atlantic beaches.

PHOENIX NON-INTERVENTIONAL: A Phoenix group with 11 cardiologists needs another non-interventional cardiologist to cath and help with their quickly expanding nuclear program. Unlike many Phoenix area groups, this one covers only a couple of offices and hospitals so you don't run around all day between locations. Anticipate great compensation and a short trip to partnership! With more than 300 days of sunshine and a robust economy this group enjoys the best of the Southwest.

Dr. Chung, please forward this message to any physicians for whom you believe this practice may be of interest or call me to confidentially discuss their qualifications.
Have a great day!

Kathy

Kathy Avers
St. John Associates, Inc.
(800)737-2001
kavers@stjohnjobs.com
http://www.stjohnjobs.com
Subject: electrophysiologist
Date: Sat, 11 Jan 2003 08:53:52 -0800 (PST
From: xxxxxx@yahoo.com
To: drchung@heartmdphd.com

Dr. Chung.

Can you or an assistant review a legal case.

The scenario: patient went in for an ablation in an attempt to cure arrhythmia. She was told there was a 99% chance it would cure her.

Unfortunately, there was an accidental puncture of the heart before the device was in position. The patient was coded but survived after emergency surgery to address the puncture.
The ablation was accordingly never performed and the patient has been told she is no longer a candidate for the procedure. She still has the arrhythmia.

This procedure was performed in Tennessee.

If you can help provide legal assistance regarding this unfortunate complication please respond to the email.

Thanks xxxxxx
Subject: Cardiac Questions
Date: Wed, 8 Jan 2003 22:16:21 -0000
From: xxxxxx@tesco.net
To: drchung@heartmdphd.com

Dear Dr Chung,

Thank you very much for your excellent website and the help that you dispense through sci.med.cardiology on the internet. I am writing for advice for my Wife. Before I start I should point out that I am in the UK and have been unable to make a donation to any of the organisations that you list from here. Are there any international medical or christian organisations that you know of active in the UK which I would be able to donate to from here. Can I suggest a charity called The Leprosy Mission which works to bring medical relief and christian teaching to leprosy sufferers world-wide?

My wife is 38 years old, in otherwise good health and not taking any medication of any kind. I would like to ask for information/advice on two matters (1) Ventricular Ectopic Beats and (2) Adverse reactions to cardiac medication

In April 2001 she was diagnosed with Ventricular Tachycardia which was occouring several times a day. This was treated by giving her a drug called Flecainide (Tambocor). She had an extrme adverse reaction to this drug (more details below) and so it was replaced by Beta-blockers - first Metoprolol and later Nebivolol. She was unable to tolerate these drugs either and so her cardiologist agreed to a Radiofrequency ablation which he did in July 2001.

(1)
Since the ablation she has had maybe a dozen occurances of something which felt to her like VT (although we have not been able to prove this as none have occoured when she had a holter monitor on). However, she does have lots and lots of ventricular ectopic beats. These will occour randomly - sometimes very few in a day, at other times they will go all day. Sometimes every third of fourth beat will be a VEB for hours on end. She has recorded runs of bigeminy on the holter monitor too.

Often the ectopics worson about half-an-hour after she has eaten a meal for about an hour or so.

Her cardiologist has said that they are benign and that the only available treatment is medication - which her body can't tolerate.

My questions are:
:-Is there any other way to treat VEBS?
:-Are there any natural ways to combat them?
:-Can they be cured by ablation in the same way that VT is?
:-Are there any lifestyle changes which my wife can make which might reduce the number of VEBS that she gets? (She does not smoke, drink lots of alcohol or tea or coffee)


(2)
The extreme reaction my wife had to the Flecainide consists of the following symptoms:
:-continual pre-syncopal lightheadedness, a feeling of everything 'fading away' and looking distant (Sometimes to the point where she feels sedated)
:-Unnatural tiredness (She often sleeps until noon and still has no energy)
:- 'fizzy', tingling feelings in her arms and legs
:-Continual Tinnitus (mostly buzzing in the left ear)
:-Sounds resonating in her head
:-Diverse pains in various parts of her head and up and down her neck
:-Diminished vision (especially in poor light)

We expected these to go away when she stopped taking the drugs but they have not. They came on within 5 days of starting to take Flecainide and have been constant ever since. She feels the same way 24 hours a day, 7 days a week and has done for 20 months. Her cardiologist will not accept that the drugs he gave her could have had these effects on her.
:- Are you aware of anyone else having a similar reaction to cardiac medications?
:- Do you know if it is possible for overdoses of cardiac medication to cause long-term damage which might cause these symptoms?
:- Any advise or suggestions as to the cause or treatment of these symptoms would be very welcome.


Thank you very much for taking the time to read this and reply.

God Bless you in your work and ministry,

xxxxxx
Subject: Rythmol Versus Propafenone
Date: Sat, 21 Dec 2002 18:30:28 -0800
From: xxxxxx@verizon.net
To: drchung@heartmdphd.com

Greetings and Happy Holidays!

My mother-in law has been taking Rythmol (150 mg.) for the last 2 years as a result of a stroke. Due to the fact that the cost is so expensive, we are wondering what your opinion of the generic version propafenone is.

Thanks for your time,

xxxxxx
Subject: Dr. Chung -- I REALLY like your approach!
Date: Wed, 11 Dec 2002 16:15:53 -0800
From: xxxxxx@teleport.com
To: drchung@heartmdphd.com

Dr. Chung:

I'm a psychologist in Portland, Oregon and I like things simple. Your approach is very simple, and it seems to accomplish those things you want it to -- that is, reduce the volume of the food. (Also refreshing is your attitude towards the foolishness of three meals a day when obesity is so rampant here in the U.S.)

As a psychologist, I keep track of numbers on my watch of the days on diet and the pounds I have lost. This keeps me focused on my goal of being "good enough for long enough."

Also I have an different way to use a balance beam scale. (That is, when I am reducing my calories greatly to lose weight, I do not let the indicator go higher. Therefore, when I get on the scale, I know there is no way I will be demotivated by fluctuations in weight due to water retention.)

I'd be interested in your reactions to these two approaches. I stuck a manual on the web at http://www.teleport.com/~xxxxxx and you can see how the numbers and balance beam work.

Again, I REALLY like your approach! Neat! Easy to follow!

Excellent!

Yours,

xxxxxx, PhD
Portland, OR
Subject: A cholesterol spike
Date: Wed, 11 Dec 2002 13:46:33 -0500
From: xxxxxx@scrtc.com
To: andrew@heartmdphd.com

Hi Dr. Chung,

I post under the nickname of "xxxxxx" and in the past have expressed my appreciation for your participation in the cardiology newsgroup.

One very quick question if you don't mind. My cholesterol has (under recently)always been below 200. This spring and summer I had readings of 185, 186, and 175. One month ago it was 213. Today it was 217. My diet, exercise regimen, and weight hasn't changed. The only change was a few months ago I went on thyroid medication for an underactive thyroid. I've had this underactive thyroid for a few years now so thought maybe I should go on the medication. This was in spite of having no symptoms of being hypo.

My question is, have you ever heard of anyone having their cholesterol elevate because they were taking thyroid medication?
Thanks,

xxxxxxx
Subject:
Date: Wed, 27 Nov 2002 19:57:58 -0500 (Eastern Standard Time)
From: xxxxxx@bulloch.k12.ga.us
To: drchung@heartmdphd.com

Dr. Chung,

I am taking a chance that you will actually respond to this e-mail. My mother is a 59 year old white female who was diagnosed with (an ?) idiopathic cardiomyopathy last December. Recently, her heart was "operating" at 10-15 percent (efficiency ?).

She has an initial visit scheduled with a specialist at Emory in January (Local physicians have failed to regulate her heart through medication thus far). Although you know nothing about her situation, are their options other than a transplant (i.e. experimental treatments)? And if a transplant is required, can you give us some guidance on success rates, etc?

As you, I am a Ph.D. and, more importantly, a Believer. I assume you are very busy, but she is the only mother I will ever have. Any help or guidance you are willing to offer would be very, very appreciated.

xxxxxx
Subject: worried about my heart.
Date: Sat, 23 Nov 2002 17:39:16 -0700
From: xxxxxx@hotmail.com
To: drchung@heartmdphd.com

Dear Dr. Chung,
I am worried about my heart. Lately is has been hurting and beating very hard and rapid. I'm not sure if I have heart disease or high blood pressure, but in the past my doctor told me I had a high white count and for me to come back in. I never did.
I'm not sure how I can tell or what I can do. Any advice or information you can guve woulf be greatly appreciated

xxxxxx
Subject: ECG vs ECHO
Date: Wed, 13 Nov 2002 20:27:31 -0800
From: xxxxxx@tiscali.co.uk
To: andrew@heartmdphd.com

Hello Andrew,

Thanks for posting your reaction. There were a few replies to my query and some people suggested I hadnt given enough information. Here it is.

The initial BP assessment was incidental to a general visit to the doctor.

My age. 39, non smoker, total cholesterol. 5.2. HDL 1.6. LDL 2.9 renal function normal. not overweight.

No chest pain or exertional problems but suffer from some sort of symptoms like missed beats and palpitations which no no one has seen fit to investigate so far, Most days and sometimes if I wake at night.

Often BP seems normal at home. Not persistently over 90 even without treatment. Varies. If am very busy/concentrating hard then a measurement is higher, if I am relaxed reading a book, perfectly normal In Doctors surgery, 150/102 to 150/110 quite usual. I measured it in the car once having come from the surgerym and it dropped from 150/102 in surgery to 130/83

24 hr average ambulatory was 125/87 and even white coat like factors could apply there. I mean the artificiality of it, the awareness of the measurement procedure especially in company, people are aware of the auto inflation. I would knock a few points off the measurement for that although this is a unscientific approach !

I think that the 125/87 (which was without medication) was not an alarming result. But maybe the doctor ought to have paid attention to the daytime average as more relevant than the 24 hr because the night time period distorts the picture. The night time would be (I think) more relevant if it showed a failure to lower.

No questions were asked about my lifestyle or diet. I wasnt encouraged to consider any non drug strategy

I suffer from anxiety and I think my BP is consequentially labile.

The doctor asked for an echo but the hospital just did a repeat ECG If I would have preferred the echo the doc asked for. he said it would be more reliable and it seems most people or sources do. I really want that echo just to be sure I havent got anything nasty

Best regards xxxxxx
Subject: Need Help in Tallahassee
Date: Sun, 10 Nov 2002 13:46:39 EST
From: xxxxxx@aol.com
To: andrew@heartmdphd.com

Dear Dr. Chung,

We are in desperate need of some medical advice. My 35 year girlfriend xxxxxx was in the ER last Sat with pulmonary edema. The edema has manifested over the last 9 mths culminating with the hospital visit last week. The hospital internist recocognized her symptons as nightime syncope and scheduled her for an ECG. The results of that test were severe mitral valve regurgitation. She has been scheduled for a cardiac catheteritization on Wedsnday this week, without even a consultation with a cardiologist. I find this to be ludricous for such an invasive test, without even a consult. I do not understand why she has not been sceduled for a stress echo or transesophigal echo. Please...your input is invaluable to us. We would like to get the best advice from the best cardiologists available.

We can be reached at 850-xxx-xxxx, xxx-xxxx, or xxx-xxxx
xxxxxx
From: xxxxxx@slingo.com
To: andrew@heartmdphd.com
Subject: Your SCI.MED posts
Date: Mon, 28 Oct 2002 15:02:08 -0500

Hey -

I asked you a couple of questions previously about Toprol XL - i'm 24 and take it for NMH/Vaso-vagal episodes (2 this year). Failed the tilt table after 2 mins and got 50MG daily.\

Anyway - would you recommend this med for this purpose? I notice that i get a significant "brain fog" and am having difficulty losing weight. Would another BB reduce these side effects?

All in all i'm happy with the toprol, but the brain fog and slow thinking is really becoming difficult to deal with.

Thanks,

xxxxxx

From: xxxxxx@lvcm.com
To: andrew@heartmdphd.com
Subject: Greetings...
Date: Sun, 27 Oct 2002 19:48:51 -0800

Dear Dr. Chung:
Hello. I am a freshman at the Academy of Allied Heath in the Medical Program at Rancho Highschool. I am doing a research paper on being a cardiologist. I was wondering if you can aide me in these subjects:
1.Any information that has to do with LICENSING: Where do you go to get this? Any exams that have to be taken? How many? How many times do you have to take it? etc.
2.Where do you get education in a cardiology subspecialty?
3.What is the salary range and potential outlook?
4.Any other interesting information about this career you would like to share? (Do you prescibe laughter as a prescription???)

Thank you sir. I would appreciate it if you would respond by October 31, 2002. Thank you again.

Sincerely,
xxxxxx
Date: Sun, 27 Oct 2002 19:20:13 -0700
To: andrew@heartmdphd.com
From: xxxxxx@direcway.com
Subject: you may want to know that my

homepage was moved from crosswinds.net to different server and currently has an address : http://dradam.polscy-lekarze.net

You may want to update your listing.Soon I will have English language version.

Dr. Adam Poradzisz
Edmonton, Alberta, Canada
From: xxxxxx@worldnet.att.net
To: andrew@heartmdphd.com
Subject: Full-Body CT Health Scan Results
Date: Wed, 23 Oct 2002 16:57:33 -0700

Hello, Dr. Chung --

Appreciate your response received a few months ago.

My husband and I have just undergone complimentary full-body CT scans in connection with my audio program on Oregon Public Broadcasting. I interviewed a staff radiologist from one of the CT clinics about this procedure, which has just come to the Pacific Northwest (Oregon and Washington State) in the past year or so. They offered to provide the scans "gratis" and we accepted.

Now that I have the results, I don't really understand them! I am confused about the calcium scores. What scale is used? I've read it goes from zero to 7600? What do these scores mean, really -- and what about the suggestion that they don't provide any concrete information to assess risk?

My husband (male, age 68, ht. 5' 8", wt. 162) had a score of 110, which the doctor said put him on the 50th percentile of men his age in terms of chances of having CAD and/or a heart attack. The usual suggestions were to lose weight, continue exercise, diet, asprin and statin therapy. He is currently taking lovastatin (Mevacor) and a daily baby 81 mg. aspirin, and has an overall cholesterol score of 215. No family history of CAD.

As for me (female, age 63, ht. 5' 2", wt. 166(!), my score was 23, which the doctor said put me on the 75th percentile of women my age to have CAD or a heart attack. (LOWER number means HIGHER RISK for women???) Same suggestions as above. I have just increased the Lipitor to 15 mg. daily, take 1/2 of a 325 aspirin and have an overall cholesterol score of 205. Parents and grandparents had heart problems; some died quite young. I am completely asymptomatic as far as I know.

Aside from losing weight and increasing exercise, I think that's about all I can logically do. I did read somewhere that there is an increased heart risk for people who are Type A, hostile, assertive, distrustful and who have a tendency to depression. I'm afraid I must claim all of the above, although I've tried to mellow out to some extent.

Thanks for your opinions and the good work you do to answer people's questions. I wish you were closer! I enjoy reading the cardiology newsgroup but have had so much spam -- probably due to the archiving of posts going back years at Google.com.

Warm regards,

xxxxxx
Date: Sun, 13 Oct 2002 10:11:10 -0500
From: xxxxx@peoplepc.com
To: andrew@heartmdphd.com
Subject: Thank you

Thank you for your response to my "Why take Lipitor?" question on sci.med.cardiology. It opened my eyes to a new way of seeing the issue. Best regards.
xxxxxx
From: xxxxxx@aol.com
Date: Sun, 13 Oct 2002 01:16:47 EDT
Subject: ECHO and Stress ECHO
To: andrew@heartmdphd.com

Dear Dr. Chung,

I am an internist in a small town south of columbus. I am interested in learning and be certified in reading ECHO and stress ECHO. I tried several links to reach department of Cardiology but was unable to. Then I reached your link, I figured you can help me find out who I should the right person to discuss the matter. Thanks in advance for the reply.

xxxxxx, M.D.
To: andrew@heartmdphd.com
From: xxxxxx@canada.com
Subject: Re: mri report
Date: Fri, 11 Oct 2002 09:00:14 -0700 (PDT)

Hi Dr Chung,
How is it going ? I talked to you some time ago about my problems. I was wondering if you wouldn't mind give me your opinion on my mri report. I would reaaly appreciate your feedback. I have a history of chronic muscular and shoulder pain.

History : left shoulder pain
Technique : a routine noncontrast mri of the shoulder was performed

Report :
There are mild degenerative changes in the acromioclavicular joint.

The acromion has a flat undersurface but there is a moderately large enthesophyte related to its anterolateral undersurface.

There are quite marked changes of tendinosis in the supraspinatus tendon and a bursal surface partial-thickness tear approximately 1 cm medial to the insertion on the greater tuberosity. In addition there is a small amount of fluid in the subacromial/subdeltoid bursa. There are also changes of tendinosis in the infraspinatus tendon.

The subscapularis tendon appears normal. The bicep tendon also appears normal and is located within the intertubercular sulcus.

No gross labral abnormality is identified.

Conclusion :
There are changes of tendinosis within the supraspinatus and infraspinatus tendons and in addition there is a small bursal surface partial-thickness tear of the supraspinatus approximately 1 cm proximal to its insertion.
From: xxxxxx@earthlink.net
To: andrew@heartmdphd.com
Subject: Best Doctor list
Date: Mon, 7 Oct 2002 22:38:52 -0400

My Surgeon, Dr. Raymond S. Waters, Hudson Florida is Exceptional. Bayonet Point Cardiac www.bpcardiac.com

Thank You for adding my cardiologist Dr. Eldin, he deserves it.
From: xxxxxx@wi.rr.com
To: andrew@heartmdphd.com
Subject: Question
Date: Wed, 2 Oct 2002 17:34:22 -0500

Dr. Chung--
My mother is 83, and takes medicine for glaucoma [she's had breast cancer twice, but the last time was about 7 years ago] and also for occasional high BP [atenolol, 25 mg.]. Ten days ago she had an episode where she almost fainted -- felt lightheaded, and a bit sweaty. They called 911 and took her to the hospital and her BP was high, about 200. However, after about 2 hrs. -- with no treatment -- she was fine, and has not had any further problems. In the hospital they had her overnight and took countless EKG's and blood tests and everything was fine. She also had an echo cardiogram, which was fine, but the cardiologist said there was a very slight valve leak and not to worry about it. He also put her on Cozar [spelling??] for her BP, which was fine by then. He told her to see her doctor when she got home, and she did; he sent her to a cardiologist who could not find anything wrong, but is going to do a Holter monitor test and also a nuclear stress test. What do you think her problem might be? She still feels fine, and is home. Are there any other tests she should be having? Thank you, in advance, for your insights.

xxxxxx
From: xxxxxx@aol.com
Date: Sun, 29 Sep 2002 20:19:54 EDT
Subject: Re: Best Doctors List
To: andrew@HEARTMDPHD.COM

Andrew,

In Atlanta, GA I would highly recommend:

W. Scott Brooks, Jr. MD-Gastroenterologist st Piedmont Hospital..His website is http://www.atlgastro.com

Charles A. Henderson, MD-Oncologist/Hematologist at Piedmont Hospital...his website is http://www.phoc.com.

John Galloway, MD-Surgeon at Emory University

S Houston Payne MD-Hand Surgeon at Piedmont Hospital...Dr. Payne is with Grady Clinkscales, one of the top hand surgeons in the country.....

I have been using these docs for over 10 years, and they all have excellent reputations...I wouldn't use anyone else in those areas of medicine.

xxxxxx
Atlanta, GA
Date: Sun, 29 Sep 2002 12:56:46 -0700 (PDT
From: xxxxxx@yahoo.com
Subject: Re: [Henderson82] Best Doctors List
To: andrew@heartmdphd.com

I have two recommendations for best MD :

1) Dr. Ron Ito, family practioner, Liburn, GA. Great doctor, great guy, great with his patients and extremely smart. He is my PCP and I know at least 10 other people who use him.

2) Dr. Jeffrey Olsen, neurosurgeon, Emory Hospital. Fabulous brain surgeon, good bedside manner, good with his patients, friendly staff.
From: xxxxxx@comteck.com
To: (andrew@heartmdphd.com)
Subject: Re: Request
Date: Fri, 27 Sep 2002 03:41:04 GMT

I will recommend Dr. Clifford Hallam. He's with The Care Group primarily based at St. Vincent Hospital in Indianapolis, IN. He's been my cardio. for over 11 years (my 1st MV repair operation). He has 2 qualities I really appreciate - 1) he lets me take part in my treatment by listening to my comments and suggestions; 2) he's not afraid to admit there's something he can't explain.
Subject: Best Doctors List
Date: Thu, 26 Sep 2002 14:43:47 -0400
From: xxxxxx@earthlink.net
To: andrew@heartmdphd.com

Hello
I am responding to your request on the newsgroup, The Best Doctor List. I would like to add my cardiologist, Adel M. Eldin, MD www.brooksvillecardiology.com, Brooksville Fl.

I'm sure you hear everyone's story, so suffice it to say Dr. Eldin is a good listener. and that saved my life. I am a 41 year old women recovering from a triple bypass getting stronger and looking forward to everyday.

I hope you will consider Dr. Eldin for your List.

xxxxxx
Subject: Best Doctors List
Date: Wed, 25 Sep 2002 18:49:18 +0000
From: xxxxxx@hotmail.com
To: andrew@heartmdphd.com

Dr. Chung,

Good afternoon. I see that you are soliciting recommendations for your "Best Doctors List". I recommend K. Lance Gould, MD., a cardiologist at the University of Texas Health Sciences Center in Houston. He specializes in noninvasive treatment of heart disease and the use of PET scanning for diagnosis and follow up.

I enjoy reading your posts at sci.med.cardiology. Thanks.

xxxxxx
Subject: Best doctor nomination.
From: xxxxxx@drdc-rddc.gc.ca
To: andrew@heartmdphd.com
Date: 25 Sep 2002 11:08:37 -0400

In Newmarket, Ontario, Canada (about 1 hr north of Toronto):

Dr. Peter Watt, OB/Gyn

He's delivered both of our babies and looked after my wife through various gynecological complications. He is straightforward, knows his own limits, explains things in detail, takes whatever time is required to ensure his patients understand their situation and never sugar-coats anything.

I really enjoy your contributions on sci.med! Thank you for your great patience (:-) with that group. I've been on the Net for about 16 years now (just before the Great Renaming) and seen a lot of MDs who contributed significantly to the groups become (justifiably) disgusted with some of the folks and find other uses for their time. The input of some of them, like David Nye the neurologist, was instrumental in my wife and I coming to a better understanding of her fibromyalgia.

Thanks!
xxxxxx
From: xxxxxx@att.net
To: andrew@heartmdphd.com
Subject: Best Doctors' List
Date: Tue, 24 Sep 2002 19:39:29 -0400

A. "Best cardiologist," at least from one man's experience:

Henry M. Greenberg, (MD)
Roosevelt/ St.Luke's Hospital,
Columbia Medical School
and (practice) UMPA,
425 W. 59th Street, New York, NY 10019.

Procedures only. Others do the riskier stuff. He is an author and cardiology consultant, a competent statistician, and former Chairman of the New York Academy of Science, but relatively young (around 50) and possibly not available - yet good for referrals.

Became his patient in 1995: By then, I had nearly memorized various "heart" books, most recently the "Yale Heart Book," yet received nearly the same prognosis/ diagnosis from all cardiologists until the above who (under some persuasion) agreed to 2 tests before would dismiss me as just another "normal" case of an irregular heartbeat (PVCs).

Against his better judgment (1995) he gave me some type of echo cardiogram plus the exercise thing. Lo and behold, I had atrial fibrillation and a scar on a ventricle suggestive of a "silent MI" numberless years ago. He took me on.

B. Nota Bene:

(1) In 74 years, especially the latter half-century, I've been to 10-15 cardiologists, and was even rejected for officers candidate school by the USNR after an examination by a "team" of MDs in Chicago, during the Korean War, because of questionable (PVCs?) heart rhythm factors;

(2) My "best" GP was in Cleveland and I located him by methods of "market research" (my career) which I commend to you:

(a) As a youthful "market researcher," I interviewed about 5 nurses from each of two hospitals (in Cleveland) for the "best" personal physician in their experience; the nurses mostly enjoyed it; and I hit paydirt....

(b) At one such hospital (1974), 5 nurses offered to sit with me during a break of some sort, in a hospital room, and finally agreed that Dr. "X" (I've forgotten his name - an Internist) seemed to be the most competent physician consistent with his ability to get along with other staff and with patients. One participating nurse volunteered to get his detailed credentials from their central file (this was 1974 and such data was not public domain) to see how he measured up to my other concerns: i) name of medical school; and ii) his standing in his class. Amazing help.

He was 5th in his class of perhaps 50 (?) at an Ivy League medical school. (He worked out very well for me.)

Other random thoughts:

(I) It is a mistake to go by a doctor's "ego wall" as any MD can accumulate drug company mock-ups for specialties while on venal vacation(s), etc.

(II) Also there is something like a White-Coat Code of Silence, whereby no *successful* doctor (often dependent on his income from referrals and relationships with peers) is likely to say anything negative about another doctor in the same market. There is no solution for this as it is human nature.

Interesting that this knee-jerk group psyche does not apply to dentists or lawyers. I think of a cartoon I just saw of a battered lawyer who was run over by an ambulance that suddenly backed up.

(III) Nearly every patient thinks his/her doctor is about "the best" even though said doctor may have been last in his class at the University of Tierra del Fuego. Said doctor may even have record malpractice rates at an institution with otherwise nominal rates, and perhaps lost a significant percentage of his patients under anesthesia when surgery was not a clear and present top-2 step;

(IV) Caveat: The only student in my undergraduate class (Haverford College, Haverford, PA) had to repeat 1 year in order to graduate, not being expelled probably because his father was important on the board of managers, but he became a "successful" MD all his life, having gotten his medical degree in a Caribbean or other offshore mill. (At least he passed the Michigan boards).

(V) There are other sources such as the one you are creating but they vary by state; and none, to my knowledge, gives med school class standing, papers or similar significant achievements. (I have seen such references but cannot recall them.) Can you identify them and link to them to your web site? Can you hope to do that sort of thing?

Also, superficial medical diagnoses can be done by good software. Have you utilized any such on a PC?

It would be like "walking-on-eggs" but things such as the above are potentially invaluable, desperately needed, and might suit your disposition and drag your profession kicking and screaming into the 21st Century. Get funding from the NIH. Dubya would be proud at the improved mortality, though maybe not the SSA.

Dr. Chung, I have read most of your Internet materials and sites. They seem to sell you "short" slightly, but many of your NG notes are good and I often read them. In fact, a few years ago, we exchanged one or two e-mails, in or out of the NG - not sure. In any case, you're becoming a valued net resource.

Much luck to you,

xxxxxx

From: xxxxxx@aol.com
Date: Wed, 18 Sep 2002 23:20:08 EDT
Subject: Dr. Chung
To: andrew@heartmdphd.com

Dr. Chung,
Would there posssibly be a relationship of a chronic dry, hacking cough and edema to CHF? I am back to 4+ pitting edema again of legs to knees. My next cardiologist appt. is not until 10/16/2002. I had hoped this issue was settled...but now I am not sure.

Thanks,
xxxxxx@aol.com
From: xxxxxx@hotmail.com
To: andrew@heartmdphd.com
Subject: Questions from an italian student about Medicine
Date: Tue, 17 Sep 2002 21:41:36 +0000

Dear Dr. Chung,

I'm an italian student (I apologize for my english...).

I've been lurking on sci.med.cardiology newsgroup, and I think you are *very* helpful person. So I'm writing you to ask your opinion about the following situation.
I have to do a very important choice in my life, i.e.: I'm considering study medicine and becoming a physician. I'm hard-working, and I'm particularly interested in internal medicine. However, situations with "lots of blood" really move me (e.g.: some scenes from "E.R." TV series upset me). I'm not interested in surgery, but in internal medicine (I'd love to become a cardiologist). Do you think that I can't have a career in medicine, because of my "upset" for some lots-of-bloody situations?

Moreover, do you know of italian MDs who did/do their residency in USA? Is it possible for a non-US MD to do residency in USA? After graduation from Medical School, it is possible to immediately afterwards enter the residency, or the routine is to wait some years before entering the residency after graduation?

Thank you *very* much for your time, and for your possible reply (which I'd love to get...)

Yours faithfully,
xxxxxx
From: birthday@crpf.org
To: andrew@heartmdphd.com
Date: Tue, 17 Sep 2002 11:08:10 GMT
Subject: A personal note of thanks from Christopher Reeve

Dear Andrew,

Thank you so much for taking the time to send an electronic card for my 50th birthday! Your support means the world because it demonstrates your concern for me and millions of other people affected by spinal cord injury and other disabling conditions.

As you read, an anonymous donor has pledged to donate $1 to the Christopher Reeve Paralysis Foundation (CRPF) for every card sent, and this will significantly impact our cutting-edge spinal cord research and quality of life programs. I hope that you will stay informed about our progress and help spread the word about CRPF.

With warmth and gratitude,


Christopher Reeve
(dictated, not signed)

_________________________________________________________
-QUESTIONS?
If you have any questions about this message or any other Christopher Reeve Paralysis Foundation issue, please click here:
http://www.christopherreeve.org/feedback/feedback.cfm?MX=146&H=0

Subject: diuretics
Date: Sun, 15 Sep 2002 17:35:09 -0400
From: xxxxxxx@enter.net
To: andrew@heartmdphd.com

My Uncle is in his seventies and has suffered a number of ailments.....among them are hemachromatosis, diabetes, renal failures, heart disease. He has had two heart attacks, has had a pacemaker and a defibrillator inserted. He is on numerous meds, and has been having serious complications with retailing fluids. His fluid retention went from about 24% to 60% in less than one month. Of course, the swelling is causing pain and other difficulties, including coughing, etc.

Are there any physicians we might be able to contact who specialize in diuretics? Can you get me any information that might help him?

Thank you for your time!

xxxxxx

From: xxxxxx@aol.com
Date: Tue, 10 Sep 2002 10:58:27 EDT
Subject: Donation to MSF
To: andrew@heartmdphd.com

I have been impressed by information and available help on your website.

I would like to make a donation to a humanitarian organization but find it very difficult to make it to Medecins Sans Frontieres - worthwhile in their stated mission. In many cases, however, their attention and left wing evaluation of certain world situations are biased in the extreme.

Do you have any other organisations that could take the place of MSF?

xxxxxx
Subject: thallium poisoning
Date: Fri, 6 Sep 2002 10:58:23 +0100
From: xxxxxx@a.dii.mod.uk
To: andrew@heartmdphd.com

My sister went out briefly with an odd chap. He had divorced his wife, who had suffered some paralysis. He had a previous girlfriend, who also suffered an ill-defined illness. Shortly after he began dating my sister, she lost the use of her lower legs, then the upper legs, then her arms, then her sight, her ability to speak, to see, her skin erupted in extremely severe psoriasis, mostly her face; he left, her condition began to steady, she is now paralysed and bed-bound, feet have dropped, swallow reflex gone, eyesight pretty well gone, unable to speak, obviously all there mentally. Process has gone on for years but she was very ill within

eight months of first symptoms. Only through dedicated care she has survived so long. Twenty five when it happened, bedbound for the last twelve years or so.

I think the guy poisoned her, and I think he used thallium.

Have you any advice? She underwent tests under the Liverpool University medical department, but they could find nothing. They were looking for M.S. Now, they have written her off, and classified it sudden onset MS but have no clinical confirmation, just symptoms. They did not check for poisoning as far as I know.

My sister is still alive, but only just. Any advice on diagnosis and trewatment, I'd be very grateful.

xxxxxx
From: xxxxxx@riverrun.com
To: andrew@heartmdphd.com
Subject: post angioplasty complications...need help
Date: Fri, 23 Aug 2002 16:16:53 -0000

Hello Sir

I have seen several articles posted by you on various web sites. I have a question regarding a complication developed by my father after angioplasty (stenting).

Following is a brief description:
My father under went bypass surgery in 1990. Four grafts were applied to LAD and LCX using veins at that time.

Recently (on 29th July) he developed severe engina pain following which he was moved to the hospital. While angiography was being performed, it was discovered that all the grafts had choked again and the remaining RCA had developed about 95% block. Doctor advised to go for stenting on RCA. The stent that was used is a drug coated J&J device. After about 5 days he was discharged from the hospital.
Recently (on 18th Aug) he developed some kind of allergy, which looks like rashes (red in color) or swelling at places or kind of boils at other places. This allergy would crop up at one place (in hands or legs) sometimes then dis-appear at other places. The intensity of the subsequent crops would repmain same or increased. He is also having hiccups for last 5 days.
My father is also a diabetic.

Could this drug coated stent had caused this? or this could have been due to some medicine that were advised to him post angioplasty?

I am extremely confused and don't know where to go for help. Any advice would be of great help.

With lotsa regards

xxxxxx
Subject: Heart Q.- Would you make a comment?
Date: Thu, 22 Aug 2002 14:50:14 -0700
From: xxxxxx@netnitco.net
To: andrew@heartmdphd.com

Dr Chung,

Would you be willing to make a comment? I frequently read you postings on sci.med.cardiology and find the information very interesting and helpful.

As background, I have no ‘medical training’ although I am familiar with basic physiology. I obtain psychophysiological recordings from individuals, and the recordings obtained are of the respiratory waveform, non-invasive blood volume and heart rate changes (cardiosphygmogram), and electrodermal activity. The recordings are obtained ‘under mental stress’ although the person would be sitting slightly reclined and as relaxed as possible. As a matter or routine, I utilize an automated Marshall digital blood pressure device to record the persons blood pressure on the onset of the recordings (I concede the device is not ‘clinical grade’).

I am curious, aside from an indication of High Blood pressure, if the below scenario would be indicators of some other potential heart ‘problem’ of significant urgency? and if so, what would be consistent with the recordings?

The subject is a 57 year old male who weighs 280lb, and is a 2 pk/per day smoker. He c/o severe and frequent headaches upon awakening in the a.m. and periodic numbness to his fingers and toes. He reports his last physical exam was 2 yrs prior, and does not report his physician expressing any concerns to him at that time. He reports on past Dr office visits, his BP was recorded as being ‘high’. He states he is not on any prescribed or over-the-counter medications, (except for taking Excedrin for headache when awakening in the a.m. hours). The subject presents himself as not being in any medical discomfort, other than c/o sinus drainage to the back of the throat. He does not c/o nor reports experiencing heart palpitations, ‘fluttering’ or noticing ‘skipped beats.’

BP and HR recorded at the onset of obtaining the tracings, and on separate ‘charts (each lasting ~5 minutes).’ The separate 'charts' were recorded over a period of 1 ½ hours on the same day although a brief break occurred between the recordings as well as a "comfort break."

135/105 - 86 bpm; 159/105- 84bpm; 115/94- 66bpm; 147/103- 77bpm; 118/73-68bpm; 164/139- 75bpm. (I find it interesting the two lower BP recordings were obtained)

On the separate‘charts’, there were frequent extrasystoles occurring during the recordings, and in a couple of areas the HR diminished to approx. 35 bpm for periods that lasted from 15 to 30 seconds, and then returned to the 75-86 level.

Respiratory rate ranged 20-24, and was pronouncedly ‘waxing/waning," very similar in appearance to Cheyne-Stokes, but there was no complete periods of apnea (although significant descending tidal volume to near apnea).

As a safety precaution, and based on the BP recordings, change in HR, and extrasystoles, I suggested he may want to consult with his physician and undergo a physical. I did so for concern ‘there may be’ some other heart problem which needed addressed.

Thank you for your time in reading the lengthy email and commenting;

xxxxxx
Date: Thu, 22 Aug 2002 16:40:39 -0500
From: xxxxxx@houston.rr.com
To: andrew@heartmdphd.com
Subject: hard question

well, here's one for you..and only you can tell me. remember the email I wrote asking if a stent could be replaced/cleaned out etc.. on this friend of mine.. well ...
here's the scenario. He was over here a couple of weeks ago all day and told me how much 'chest' pain he had been having the prior 2 days and was just about living on his nitro. Also, the pain was making him very weak. Told him to seek help PDQ .. he did. After testing ( unfortunately, Dr Maislos, was out of town) they did a double bypass. Now, he was 71 years old and in only fair health..and had slowed down a lot. took all his meds, lipitor etc etc etc and diuretic. after surgery.he was in ICU 12 days. Off and on respirator and O2 ..and his kidneys NEVER did start functioning again. He was only semi conscious 2 days and then totally 'out of it' He died 'naturally' ..
now..the 2 hard questions.
When tests show the person is in that bad a condition is a bypass totally necessary ?
and .. IF he had written a directive to physicans.... and a medical POA .. could he have been removed from life support ?
I have both these instructments and I sure as hell know I do NOT want to lie in ICU 12 days on 'display' with no chance to live and not have the 'right' thing done.
You see, I feel very strongly about not prolonging death .. (you sure are not prolonging 'life')
just take your time ..and then when you're ready .. I'd like to hear your thoughts about this.
sorry this is so long ..but ..just HAD to ask you ..

xxxxxx
From: xxxxxx@webtv.net
Date: Mon, 19 Aug 2002 21:30:47 -0400 (EDT)
To: andrew@heartmdphd.com (Dr. Andrew B. Chung, MD/PhD)
Subject: MRI

I had car accident and my attorney wants me to have an heart MRI to rule out acute heart attack as result of accident and any previous MI.On doctor's order request form how should(acute and old MI) these two things be written?Thank you Dr.Chung.
xxxxxx
From: xxxxxx@parker4218.fsnet.co.uk
To: andrew@heartmdphd.com
Subject: Angina?
Date: Mon, 19 Aug 2002 11:43:46 -0400

Hi I am In the u.k, I am very concerned about my brother, he is 46yrs old, on holiday in ireland a week ago after approx nine days of drinking of which I will stress he would be consuming,pints of cider, about 4 a in the day, he would then continue into late evening drinking double whisky,s with ice approx 10 or 15 this happened every day for the nine days, on the tenth day being in the local bar after drinking his first pint he went to the toilets where he threw up the pint he had drank, this he would do regularly the next morning after a skinful, returning from the toilet he developed pains in his chest, he thought it would go away it did,nt he began to panic and walked to the hospital near by(Royal Victoria,Belfast) when there he was given a E.C.G. a drip was put in blood was taken and tablets were given, He was kept there for four days as he was returning home the following day by plane at first we were unsure wether he would be able to travel, his last E.C.G came back normal we were just waiting for a blood result and then he could go . He was given a letter to take to his G.P at home. All was well and he was allowed out under the und