vaporizer and heart/cardiac issues

Jurdoc, I read your email and will show it to Dave, too. I don't know if he knows your docs, but in answer to your Q, he's an interventional cardiologist, so he's dealing mostly with procedures and medical approaches to people with pipe clogs, the basic arteriosclerotic plumbing problems that the majority of cardiology patients have. He also deals with simple arrhythmic issues that result from those plumbing clogs. You and I are the types of patients who interact first with his type and then have to move into the realm of cardio-electro-physiologists, who treat us offbeat atrio-ventricular types, the smaller minority. I'm lean and long and healthy and fit, with the cleanest pipes and lowest blood lipid levels you could ever want to see, so it doesn't seem fair at all to be labeled as a heart disease patient. But I am one. I wish rhythm patients got equal billing, but I feel they don't. Except by heart electricians, that is.

I have to go spend some time with my own medical books now and won't be able to write you back till later or tomorrow, but I promise I'll show your message to my husband. He'll encourage you to go ahead and tell your doc you're considering cannabis when the time comes that you can. I promise, docs aren't cops, and they need to be told, not only so they can know the full scope of what their patients are into but also so they can begin to get the true picture of how medically significant cannabis is. They are not surprised or shocked when patients tell them they smoke or use or plan to use cannabis. They expect it. They especially expect it in your neck of the woods, I assure you!

Jurdoc, Bird printed off your emails for me, man. Sorry I'm just getting to them.

I don't know your docs personally or their writings. That's not unusual unless they've been published in Circulation or one of the other biggies.

Give serious thought to telling your doc before you vape or eat weed. Unless you're one of those who plans to no matter what you might hear in return. Any responsible cardiovascular physician will discourage any further potential irritation to your cardioelectrcity, especially with the high-dollar Medtronic gadget you've already got installed. (Or Guidant, not sure what they installed.) You've got a built-in backup against further v-tach but not against other rhythm anomalies and not against aneurysmal development or aggravation. Sounds like you had a dramatic response to smoked weed, which is why, even in eaten or vaped form, you need to think hard before taking that risk, even with a backup device in place.

I couldn't tell from what you wrote to Bird, but somewhere along the process of getting diagnosed and treated, you've been getting echocardiograms, right? I want to know what your RV looks like and whether you had any hypertrophy or signs of aneurysm in that RV--and what type of ARVD infiltration you have. Also whether you have any LV involvement. If you're not going in for six-month echocardiograms and checkups, you might ask why not.

Your ARVD doesn't have anything to do with your being an early preemie. It's not a congenital defect that people are born with like an atrial septal defect or valve stenosis. In half the population who have it, it's a tendency for your heart to target out and kill off little areas of its RV wall that results in that propensity for v-tach. The tendency itself is carried genetically, which means it's programmed in the chromosomes you got from your ancestors. Half the ARVD population just get it for no genetic reason, though.

You're a lucky man to be alive, as you must know. Your condition is fairly common, and about a fifth of young folks who keel over from sudden cardiac death do so because of ARVD.

Dave, thanks for your reply man.

I have actually gradually coming to the conclusion that I may not be able to use weed in any form again. Which is kind of a bummer, but there are certainly other ways to enjoy life, without risking life. I would have never believed that it was a dangerous drug, and for 98% of the worlds population I am inclined to say it is, but for me, and with my particular condition, it would seem I just am endangering myself. Thanks again for your thoughts, and yes, I was certainly intending to talk with my doctors about it.

in the meantime, with all the money I'm saving not smoking weed, I can afford very classy scotch whisky! :D in moderation of course

There's a good attitude!

You know, you never know what your own medical team that knows your body and your history will say about the cannabis issue. If your doc has a spirit of adventure, he might not think it'd hurt to try vaping it or eating it. He might know something up there that we don't.

I meant to translate a bit for you after I read Dave's post. You may know this, but by RV he means right ventricle and LV left. Those are the bottom chambers of your heart, the ones that do the main pumping duties (the atria up above are the fill tanks). An aneurysm is a weak place in the wall of a chamber like a ventricle or a vessel like a vein or artery. People with your heart condition tend to have aneurysmal signs in their RVs, apparently. I don't know why he was asking about your LV. "Hypertrophy" is overgrowth or abnormal growth or thickening. In heart talk, "tachy" means fast and "brady" means slow. Tachycardia is a fast heartbeat. Ventricular tachycardia is fast beating of the bottom chambers. You probably already know all this, but it was a good review for me. Over the years, either dealing with my own a-fib or listening to him, I've absorbed some basic cardiology info. I wish it interested me more from the standpoint of my own medical ambitions, but it just doesn't call me. Too much to do with pipes and pumps and electricity. Sorta like plumbing and refrigeration and air conditioning. I need more of a girly medical specialty . . . .

Here's an interesting link I just found that seems to have some good info:
Arrhythmogenic right ventricular dysplasia - Wikipedia, the free encyclopedia

yes. I was aware of the majority of the terms he used...he did mention LV with good reason though. perhaps the scotch is affecting me a bit tonight, I had a dram or two, but there was an article (due to the scotch, I cannot supply a link) where it was indicating that LV and RV are not uncommonly related I guess. in response to dave's post, I actually have a St. Jude Model V70 I believe it is. LOTS of juice! I believe a minimum 240J with turbocharge to 300. :D and when it thumps, it whops me on my ass. not pleasant. again, I'd rather not play around with fire, no pun intended. you know the interesting thing my doctor told me, is when symptomatic, people with my condition stand an 11% chance of surviving an episode without an AICD, but a 97% chance of surviving WITH it. sure convinced me!

never be afraid of telling your doctor that you use cannabis. HIPPA protects you. If he drops dime to anybody about what you disclose to him as a doctor, he'll be fined 100,000 dollars and most likely will never practice medicine again.

HIPAA doesn't protect you from the doctor lecturing you. Or from his disapproval, if he's not fully informed on cannabis' risks and benefits, which few are. That's what stops most people from fessing up about weed.

If you've signed any sort of HIPAA release authorization in his office, which you're usually asked to do routinely, the doc can and will release that information if he needs to to others. Chances are he won't. But say you're coming to me for your heart and another doc like an internist or a pulmonologist for your lungs. You tell one of us you suck up a gram of weed a day in a bong. You better believe that's pertinent history that, with your signed release, we'll be sharing between ourselves. Not with your parents or your friends. But with other doctors and even with a hospital if you were about to be treated there, too. You tell me you smoke like a chimney and then suffer sudden cardiac death a week later at home or in the hospital while you're having a procedure. I damn sure want it on the official record between me and my colleagues and hospital that you liked your weed just like I want it on the record if you like tobacco.

So-called "federal health care offenses" defined under HIPAA are the criminal violations where fines can range up to $250K and even carry 10-year jail penalties. A fine for a doctor disclosing information without authorization might be $25K max, if that. Doctors who follow the guidelines and have you sign that authorization form don't have anything to fear.

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Originally Posted by Jurdoc

yes. I was aware of the majority of the terms he used...he did mention LV with good reason though. perhaps the scotch is affecting me a bit tonight, I had a dram or two, but there was an article (due to the scotch, I cannot supply a link) where it was indicating that LV and RV are not uncommonly related I guess. in response to dave's post, I actually have a St. Jude Model V70 I believe it is. LOTS of juice! I believe a minimum 240J with turbocharge to 300. :D and when it thumps, it whops me on my ass. not pleasant. again, I'd rather not play around with fire, no pun intended. you know the interesting thing my doctor told me, is when symptomatic, people with my condition stand an 11% chance of surviving an episode without an AICD, but a 97% chance of surviving WITH it. sure convinced me!

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In some ARVD patients, they find out the LV had some aneurysmal dilation, too. Sadly that's usually at autopsy, and it's unlikely you have that problem. Sometimes, too, the free wall of the LV has some fibrofatty development if you have the fibrofatty infiltrating ventricular cardiomyopathy.

Glad to know St. Jude's watching out for you. When 240 - 300 joules hit you in the chest, you pretty well feel like God's on guard, too, when he checks in through that device. So one of my very spiritual patients tells me. I know that's not pleasant but when you think about the alternative, it's not too bad. Like a nice little cattle prod in the chest to remind you to appreciate life.

Birdie's had five electrocardioversions for her a-fib over the last six or so years. 100j does the trick just fine on her or it did. She's slender and atria convert fairly easily anyway. The last time they zapped her, though, her now former doctor's partner manually turned the defibrillator to 200. He did this after she was under or she'd have squawked. They'd asked me and her dad to step out of the room already (or I would have taken a swing at the dude). The two nurses told me what he'd done. Bird had that feeling like a horse kicked her in the chest for two days after 200j. The unnecessary extra voltage was really aimed at me for some professional jealousy over a new heart hospital most of us have moved to. She'll be having her upcoming ablation at the heart hospital under the care of a colleague of mine who's not a vengeful assclown.

Best of luck to you, Jurdoc. That 97% survival likelihood with the defibrillator in place? It's the remaining 3% you don't want to possibly risk with cannabis. Better to be safe than a statistic, I like to say.

Dave, on your last sentence, I agree comepletely. As I said previously, I have plenty of ways to relax, substance-wise; Kava root, Valerian, Milk Thistle, a long list of pleasant effects from much safer homeopathic herbs. You know, interestingly, just for the hell of telling a story, I have quite a history with my AICDs. I have had 3 replacements in the last 4 years, believe it or not. The first surgery didn't take, the lead did not fully assimilate into my atrial tissue (I think thats right) and it basically shorted out, misreading my heart rythyms. I was shocked about 8-9 times in under 2 minutes, with the last 4 shocks at full blast, it felt like somebody layed a board on my chest and whacked it with a sledgehammer. It was quite painful. (side note; during the first surgery, while I was under, they induced a-fib, which I would not have come out of, so they thumped me with my brand new AICD, and it actually woke me up!, I muttered something to them, in fact, while I was supposed to be out, I actually remember feeling the catheter travelling up my innards and feeling it move past my midsection entrails or what-have-you, as well as the shock.) The doctors felt really bad about this. the second surgery took, but they failed to take into account I was at the time, 22 years old, and muscular, with a strong heart as they said, so they did not have the BPM fibrillation, or dysplasia cut-offs programmed into the onboard computer. As a result, I was having sex with a girlfriend about 2 weeks after the 9 shock episode, when, after 8 minutes of really *good* lovemaking (she was a hell of a kisser) i got thumped TWICE, just at the, ahem "good moment". No lie. I was not wearing a rubber, she had birth control, and as a result, she felt a giant "click" is how she described it, go from her toes to her head. I left her house in an ambulance. now one of my Docs is a Polish fellow I believe, with a very thick accent, and I remember very well, him sitting at my hospital bed saying "you know, Dan, it is very much not funny, but it seems, I'm sorry, it's not like we are trying to....hah hah, you know. Torture you." I wanted to strangle him! Last surgery, I was, uhmm...a wee bit detained, I'll say, by my local government. I was sitting in bed one night, reading a book, and whump! got me with 115J that time I believe, a real low dose. At the time, I had a sub-dermal implant. Now, I'm muscular where it matters, but fairly slender in the chest and pectoral area, and because of this, my doc tells me that it can be cause for lead failure. So another brand new AICD, this time implanted sub-pectoral, all payed for by the state of Alaska. Funny enough, is that, including my quarterly hospital checkup, so multiply that 2 years by $1000 per visit, transport fees, hospital stay, surgery, hardware costs (I believe the St Jude V70 costs in the ballpark of $20,000). So doing all the math, a prison inmate in alaska MAKES the state about $30,000. However, I COST the state about $95,000 per year!!! So, now on probation, it seems they really want to keep me out!!! But I'm reformed so they don't have to try to hard to convince me freedom is worth keeping.

long story short. heart problems suck. prison sucks worse. and I like halibut.