Lexiscan®

I just got home from the Lexiscan stress test. My appointment was at 1:00 pm and it took a little over two hours. I had the same test done in 2016 after not being able to get my heart rate up over 160 bpm. That time, I did the test at the St. Joseph Outpatient Pavilion and it was also requested by UCLA Transplant Center. This time, the test was done in the cardiologist’s office.

First the tech/nurse inserted an IV port in my left arm and injected some dye or contrast for taking pictures of my heart. I had to wait 15 minutes for it to circulate and the imaging part took another 15 minutes. Next, he injected the Lexiscan drug into the IV followed by more contrast and some saline. It was weird. At first there was no reaction. Then I felt my chest tighten, breathing became more difficult, and different muscles started to ache. My heart rate went up a bit from 60 bpm to 70 bpm, while my blood pressure (too high) dropped by 30 points. At the same time, he took some 12-lead EKG readings for the cardiologist. Next, I waited for 30 minutes for the contrast to circulate again, and back to the imaging room for another set of pictures. Done.

It’s now 4:00 pm and I am still tired from the Lexiscan. Chest and back muscles are still a bit tight, and I have a headache that wasn’t there before. Even though I’m starving and need to eat something, I’m going to take a nap first and hopefully feel better afterwards. Oh, and fistula is still hurting too.

Walking Outside 9/27/2020

Well, this is a crappy post for #800 but whatever. It’s been a few days since I went walking outside so I decided to do so tonight. It didn’t work out that well. Fitbit said I only walked 0.35 miles total, which means I ran out of breath after less than 1/5 of a mile. I ended up turning around but had to sit down for a bit on the way back. I also felt dizzy and almost fell trying to sit down on the curb.

I’ve been having more difficulty breathing this weekend. My post dialysis weight is super low but maybe I drank too much already? The two scales are different but I left dialysis at 83.2 kg. I just weighed my self at home and the scale said 84.7 kg. Maybe I did drink 1.5 L already and all of it went to my lungs. During a nap this afternoon, the clicking noise and sensation from my chest was super noticeable. Now I’m worried about how it will affect the Lexiscan test this coming Tuesday.

Also, since I felt dizzy, I thought my blood pressure may be low. Nope… it was totally the opposite. When I got home, I also measured my BP and it was 223/105. WTH? Those seem like fake numbers. I just took some medication at dinnertime too. How can my BP fluctuate by over 100 points day-to-day? Is it all fluid overload? I say this as I’m about to drink a Nepro shake. My meals today have been pretty random so I think I need a protein boost.

Peripheral Neuropathy Again 9/21/2020

I’ve been lucky for a few weeks. Each time neuropathy pain occurs, I’ve been able to take some pain medication and sleep it off. Not tonight. I felt some pain at the top of my left foot yesterday. I quickly took some Tylenol and the pain went away. However, it came back to the same spot about an hour ago while I was sleeping. The pain woke me up and I’ve been trying to massage the spot with no avail. I also took another two Tylenol pills but it had no impact this time. The pain feels like it’s coming from just under the surface of the skin but no amount of hitting or putting pressure on the spot has any impact. In fact, due to the neuropathy, I don’t feel anything there at all except the nerve pain.

In addition to the persistent pain attacks, I’ve notice a huge increase in the number of one-off nerve pains. They would be super painful, but only hit once. Next time, it would be in a different spot. I have no idea what’s going on with that. Maybe it’s affected by the edema so hopefully draining some of the fluids will help.

I’m fully awake now. There is no sleeping anyway in the midst of an attack. I’m going to walk up/down my short hallway to see if that helps.

Shortest Dental Appointment

As opposed to the all day excursion last week. This time, it was just to remove the suture from the tooth extraction. I was feeling the thread with my tongue all week. It took me about 30 minutes to drive to the dentist office, and about 35 minutes back. I was actually in the chair for about 3 minutes. He said everything looked fine, and the socket should close up in a few weeks. There is a mesh covering the bone graft material/crystals in the socket still.

When I go to leave the dentist office, the center console of my car wouldn’t come on. This happens sometimes so I reset it and it took 5 minutes to come back. There was also a tire pressure warning light so I pulled out my portable air pump to fill up the tire. Then I noticed that both rear tires are completely bald. The driver side tire is actually showing some steel belts under the rubber. One bad thing about electric cars not needing service is that no one checked the tires (I know, I should have). The front tires seem fine so I have to get two (or four) new tires.

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Just now, the mesh covering the tooth socket came out. I was taking a work call and felt a weird object in my mouth. It’s less than 1 cm x 1 cm but it really stinks. I texted the dentist asking him what to do and he said it’s fine, just be careful not to eat or brush on that side for another week in case I knock out some of the bone graft crystals.

I have another large/deep cavity to take care of along with some smaller cavities. The dentist wisely schedule me for teeth cleaning every three months instead of six. I’ll pay more but probably well worth it for me.

Walking (Outside) 9/16/2020

Not as good today compared to yesterday. I had to stop about 1/4 mile into the walk to catch my breath. Maybe it’s because I have another day of fluids in me. I was going to take a turn-off to cut the walk to about 1/3 mile but decided to press on and walk the 3/4 mile loop like yesterday. I ended up walking 0.74 miles at a pace of 27’09”. It’s a bit slower than what I did yesterday but still slightly above 2 mph.

*You can definitely see where I decided to sit and take a break. Heart rate was up to 113 bpm just from slow walking. Not good. Current heart rate is back down to 65 bpm.*

It will be like an experiment. I’ll try again after dialysis tomorrow to see if the breathing is better and if there’s less pressure on my chest.

Walking (Outside) 9/15/2020

I decided to take a walk outside tonight. The weather cooled down a bit so it was pretty nice outside. I ended up walking 0.74 miles at a pace of 24’54”. That’s pretty close to one of my walks before the whole breathing problem. It’s kinda weird that as soon as I got a CT scan, I started feeling better. There was some pressure and dull pain in the chest area compared to before. Also, I was running out of breath near the end of the walk, but much improved from running out of breath after only 3 minutes. Hopefully this trend continues and the source of the problem is too much fluid. That can be easily taken care of with more ultrafiltration during dialysis. If I’m still having heart issues, then that’s a much bigger problem.

Tooth Extraction, Day 4

I don’t know why this tooth extraction seems more painful than the previous ones. Maybe they’re all the same and things dull with time. Anyway, last night was pretty bad. I took a nap in the afternoon after dialysis and when I woke up for dinner, the socket was hurting pretty badly. It hurt so much that I couldn’t eat anything for dinner, even though it was pretty good take-out from Tasty Garden in Irvine.

After “dinner” which I didn’t eat, I took another Percocet pill to try and dull the pain. I’m down to only 3-4 pills now and they’re pretty much non-replaceable. It took a lot of effort post-surgery just to get these few pills. My mom has a stash of Norco, which is a combination of acetaminophen and hydrocodone. All these pain medications seems to be acetaminophen plus an opioid. I haven’t used her pills yet.

The pain is more manageable this morning. I haven’t taken anything yet, not even regular Tylenol. The sutures are still bothering me as I can feel them with my tongue and I’m afraid they’ll come loose each time I eat anything. I’ve been cutting up food into smaller pieces and using my left side of the mouth to chew. I think this will be the new normal for eating now.

Tooth Extraction, Day 2

So I feel much better today. The sharp pain is mostly gone. There is just a dull throbbing and slight irritation from the sutures. My jaw joint is sure on the right side of my mouth, probably from the force exerted to remove the tooth. Since I’m staying at my sister’s house, I brought my precious Percocet and some Tylenol, but I don’t think I’ll need it anymore.

That side of the mouth feels weird. Unfortunately, I have two molars removed from the bottom right in addition to the wisdom tooth so there’s not much bite left. I think I will have only one full pair of molars on the right to chew. Maybe I’ll need to get that implant after all.

Looking forward to next Thursday when the sutures come out.

Lucky Post #777

I’m not sure what to post here. Since it’s #777, it seems special but I feel like I haven’t had any luck or breaks during the past five years. Scratch that, maybe no luck going back 14 years to the divorce. Some Christians think divorce is a huge sin, while others say it’s just another event in your life. I did feel for a long time that having gone through a divorce was like a scarlet letter on your chest, and indicative of somehow losing God’s blessing.

First few years after divorce was full of depression and loneliness as my sister had moved to Portland and my parents moved to Canada. I was pretty much alone for a couple of years, just working and sleeping. Then I spent a few years traveling to China with my friend to help out his factory with planning and fundraising. It sounded fun but I still was lost and didn’t know what to do next. Then parents moved back to California and we bought a house together, and I switch jobs after 12 years at the same company. Soon after, I found the church I’m attending now then the kidney problems started. From declining kidney function, to signing up for transplant, to dialysis, to today. It seems to be one health calamity after another: kidney failure, dialysis, donor rejections, peritoneal dialysis failure, heart bypass surgery, atrial fibrillation, and now tons of dental work.

My greatest fear right now is that this string of bad luck or whatever you want to call it will continue. I need my sister to pass her health tests later this month, and I need to get past my heart stress test and colonoscopy. Any of those could derail the transplant train for good.

Tooth Extraction (update)

Holy crap, that was difficult. After getting clearance from my cardiologist, I went into the dentist at 4:00 pm. My last extraction (yeah, more than one) was pretty quick so I thought this would be the same. Ha! I was there until after 5:30 pm.

I think this is the third tooth in from the back on the bottom right. Both the dentist and endodontist looked at the tooth and decided it was beyone saving, i.e., root canal and crown. First he hit me with a lot of anesthesia but since there was tooth decay and infection, the anesthesia is not as effective. He had to inject me over and over for me to withstand the pain (I could always feel pain). The tooth did come out in one piece, which was good. He showed me and there was a huge hole at the back of the tooth. Pretty ugly.

Afterwards, he put in some bone crystals in the socket for a bone graft in case I want an implant at the tooth site later. This was new to me since the other molar extraction just left an empty socket. He then put a mesh to cover then several sutures to close off the hole. I need to go back next week to remove the sutures. I think I would have needed to do this before any transplant surgery since the tooth was infected. Not good if they’re giving me lots of immunosuppressants.

I took two Tylenol (I sound like a broken record) pills already since the post-extraction pain is building as the anesthesia wears off. I don’t have any more Codeine but found some leftover Percocet from the chest surgery. I’m reserving that in case the pain becomes unbearable again.

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At first I thought I wanted to keep the tooth, but I have too much junk already. It could be a reminder for better oral hygiene but if all these painful dentist appointments can’t motivate me, one tooth won’t matter. And it was ugly.

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OMG! The pain is like a 9 on the pain scale. So my entire lower jaw is in pain but I can also feel the stabbing pain from the empty socket coming through. Then the lower tooth next to the socket is hurting, probably because the dentist leaned on it with the extraction tool. The molar on top is hurting as well, similar to before. Finally some random front tooth is hurting. There are like five intense areas of pain in my mouth, and the Tylenol didn’t seem to do anything. I tried to take a nap to sleep off the pain, but there is no way I can fall asleep. The pain is 10x worse than when the tooth was in. Of course, that was from a badly infected tooth that had to come out, but this pain now is worse than anything I experienced during heart surgery recovery. The Percocet has acetaminophen in it so I don’t want to overdose having just taken the Tylenol, but I may not have a choice soon.

I also didn’t eat much after dialysis and before the tooth extraction. I really haven’t eaten anything substantial since Tuesday lunch due to all the dental appointments yesterday, the sudden toothache, and the extraction today. I just weighed myself and I’m now at 84.3 kg or 186 pounds. I used to think that to weigh 180 was impossible since I was at 240 but here we are.

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I can’t stand this anymore. I’m going to take one of the Percocet pills. Hopefully the expiration date doesn’t affect the potency. As long as I lay off the Tylenol for 12 hours, I should be fine.

The label says Oxycodone-Acetaminophen 5-325. I guess it’s 5 mg of Oxycodone and 325 mg of Acetaminophen. Label also says generic for Percocet. Warnings include “Caution: Opioid. Risk of overdose and addiction.”

It’s been 5 minutes and there’s no reduction in pain. <sad face>

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Update: 9/11/2020 8:18 am

Still alive. I only ended up taking two of the Percocet pills last night and no more regular Tylenol. I did get woken up at 3:30 am for a bit but managed to sleep until about 8:00 am. That painkiller works great as a sleep aid. Good thing they’re hard to get from the pharmacy.

The pain is subsided somewhat. It’s just a dull throb now so I’m going to try and stick with the OTC Tylenol. Can’t be all drugged up any trying to work today.

Fistula Update 9/10/2020

Did I mention before that I hate this fistula? I know everyone dislikes the chest catheter for being an infection risk but for the patient, it’s much easier. There are no needles to stick in you and zero pain.

The fistula started leaking as soon as it was connected. The tech did miss on the first try for the arterial needle but the venous connection started leaking. I could see a bubble of blood grow under the medical tape. It was slowing expanding and was going to leak blood all over unless the tech changed the tape. Next, the arterial needle started leaking but slowly so we left it until the end. When the tech finally pulled the tape off, there were large chunks of coagulated blood stuck to the needle site. Also, the arterial needle site was hurting the entire session. I tried to sleep but was worried about leaking blood everywhere.

It was a long four hours. At least my cardiologist’s office called me to okay the tooth extraction so the fun is not over yet for today.

Longest Dental Day

And we’re not even done yet…

So I went today at 10:30 am to the crown guy. Since I was getting front upper teeth crowned, my dentist wanted the color to match the surrounding teeth. When the crown is in the back, they can be whatever color. However, if the front crowns are a blazing white, and the rest of your teeth are not, they look super fake. Anyway, the guy is like an artist. He uses an airbrush to add color, then he needs to bake the crowns to set the color. He also took forever to make sure the fit was good. I ended up being there for around three hours to get six crowns fitted and colored. Then it was off the the actual dentist. He placed all my crowns in by about 2:30 pm and wanted to do the tooth extraction. However, his office called my cardiologist for blood thinner clearance but they never called back. I placed a few phone calls too but my actual cardiologist was busy with patients and didn’t get to her message queue yet. I wanted for another hour in my car but the dentist ran out of free time. We rescheduled for tomorrow in case my cardiologist gets back to me tonight. She does use the portal message system and does answer emails late so maybe. I’ve taken two Tylenol pills already since the pain is fading in and out of the bad molar.

I left the house at 10:00 am and didn’t get back home until 4:30 pm. Six and a half hours and I didn’t even get to eat anything.

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Tooth is starting to hurt again. It’s coming as random sharp spike of pain. I’m afraid it’s a prelude of worst things to come. I’m hoping that I won’t be fighting a massive toothache tomorrow during dialysis. I also have to lead a work meeting at 11:00 am so I need to be able to talk.

CT Scanned

Well, that was the fastest medical appointment in a long time. My appointment for the CT scan was at 2:15 pm but the radiology lab asked me to check in at 1:45 pm. I arrive on-time and was checked-in within 10 minutes. It helps to have all my medical appointments in one hospital system; I don’t have to regurgitate all my medical data each time. Instead of making me wait until 2:15 pm, the tech came and got me right away. The actual procedure was only three quick scans in the machine. I was done and back in my car by 2:10 pm, before my actual appointment time. It’s definitely less busy in the clinic with COVID-19. The radiology lab was quite crowded the last few times I was there. Today, there were probably only five people in the large waiting area.

The results will be at the thoracic surgeon’s office after 24 hours. Again, I hope it’s nothing serious and won’t require more surgery.

Toothache, Part II

Ouch…

The tooth started hurting as soon as I woke up this morning. After taking two regular Tylenol pills, the pain kind of subsided until I took a nap in the afternoon. As soon as I woke up, the pain returned. Worse, my mom called us to eat dinner. During dinner, I avoided using that side of my mouth but still felt shooting pain a few times. Otherwise, I can feel the tooth throb along with my heartbeat.

The pain got worse over dinner and after dinner. It became pretty unbearable but at least it was limited to the actual bad tooth on the bottom. I don’t know what was the deal with the top tooth yesterday. I just took another two Tylenol pills. Hopefully I can keep the pain at bay until I see the dentist Wednesday. I probably need to call his office tomorrow to let him know that the tooth is acting up prior to being extracted.

Also, I remember leaving the hospital back in November with a small spray can of numbing agent for teeth. I had cracked one of my left side molars eating hospital food (no joke) and they gave me the spray in case it started hurting before I could get to a dentist. Like an idiot, I actually went to the dentist the next day after being discharged. It’s all kind of foggy now but I remember barely able to walk with a walker, and sitting in the dentist’s clinic getting a temporary filling. Sigh…

Medical Issues 9/6/2020

I just spent the last 15 minutes looking for this post. A friend texted me today asking about my upcoming tests so I thought it would be good for me to do another list. The last list was appended to a dental issues post so it was hard to find. Ironic that I’m having dental issues again today.

ESRD: UCLA has made a decision to accept my sister as donor and move forward with the transplant; she has to repeat some tests and so do I; hopefully this is the beginning of the end of this long process
Dialysis access: vascular surgeon performed a fistulagram and fistula seems to be working fine; it looks ugly and sometimes bleeds during the session but the nurses and techs seem happy; chest catheter removed earlier this week
Cardiac rehab: not sure what to do next; UCLA did not mention completing rehab as a condition to transplant; however, cardiologist mentioned she may refer me again if current chest pressure/shortness of breath problems are musculoskeletal
Atrial flutter: seems to be stable 99% of the time; I think the dialysis nurse caught one instance of irregular heartbeat post ablation but it normalized quickly; list price of procedure from St. Jude Hospital was ~$100k
Peripheral neuropathy: each time I update I feel it’s getting worse; there is some edema in my ankles and feet and I think the swelling is making the numbness worse; still trying out the calf/foot massager so don’t know if it helps
Back pain and pressure in chest: back pain just about gone but pressure seems to have increased lately; I’m also hearing sounds and feeling something rubbing(?) in the chest cavity so getting CT scan this Tuesday then seeing the thoracic surgeon that did my surgery
Minimal urine production: same; I think only “fix” is kidney transplant
Insomnia: chest pressure/sounds is making sleeping even harder; don’t think I’ve had a good night’s sleep in weeks/months; fatigued all the time and short naps are the only thing keeping me going
Dental issues: front upper teeth prepped for permanent crowns Wednesday but a few teeth started hurting earlier this afternoon
Endocrinologist: next appointment in three months
Lump in left leg: no change
Constipation: not a problem; now having diarrhea after drinking protein shakes; hopefully it’s just an issue with some improperly stored shakes (near window and sunlight)
Ophthalmologist: appointment last week; things are still fine but under watch; gave me referral to retina specialist again

I think I get overwhelmed when I look at the entire list from far away. When I get closer and focus on one item, it gets a bit better. Also, instead of just updating the existing items, I’m going to start removing items that are no longer issues or in maintenance mode. That will shorten the list so it doesn’t look as bad. Of course one could say I’m just making room for new stuff but let’s not go there.

There are still a lot of medical appointments and tests coming up:

CT scan: diagnostic for thoracic surgeon regarding chest issues
Lexiscan: heart stress test for UCLA transplant center; hopefully not affected by any musculoskeletal issues
Colonoscopy: UCLA is leaving it up to my primary physician; she will likely want me to get one
Retina specialist: ophthalmologist concerned with some minor bleeding on retina so want specialist to look; not urgent but I need to go after 4th year of referrals
Optometrist: need new glasses
Primary physician: heard she was taking long trips to Taiwan to take care of her mom; not sure if I need a referral or just see her when she’s in town
Dentist: I think we’re done with crowns; after he caps the upper teeth, he just needs to take care of some minor cavities on bottom front teeth; also extract lower right molar that’s in pain now

It is a big list, and most of it is my own negligence. As I mentioned before in the stretcher girl post, everything that ails me is manageable. ESRD is probably the worst one on the list but hopefully a transplant is coming. Even if it’s not, dialysis is also manageable. I hope I never have an unmanageable issue like the need for (almost) emergency bypass surgery.

Toothache

A couple of teeth started to hurt on the drive home from work earlier. I had stopped by Panini Kabob Grill in Santa Ana to pick up dinner for myself but ended up eating only a few grains of rice due to the pain. As I wrote before, I think my teeth problems advanced so fast was partially due to my toxic blood while on peritoneal dialysis. Some of it was just sheer fatigue where I would stay in bed all day, and the rest is just general laziness when it comes to dental hygiene. I did at some point, got dental clearance for a transplant but things went downhill pretty fast.

Anyway, I spent a lot of time at the endodontist and dentist early this year for some root canals. One of the tooth that is hurting had a root canal and was crowned. This is the last molar on the top right of my mouth. It’s not the wisdom tooth since all of those were removed. There seems to be another extracted tooth there as well so maybe the third tooth in? Likewise, the bottom molar in the same position is hurting. This one I expected. They did not do a root canal on the bottom tooth since the endodontist said he likely could not save it. It is marked for extraction but my dentist wanted to crown everything else first. Well, I guess I lost the race. The tooth started hurting before we could extract it. I took my last two precious Tylenol with Codeine #3 tablets earlier. I don’t feel it helping that much so maybe it would be hurting a lot more without the drugs. I have an appointment with the dentist on Wednesday to put in some crowns. I don’t know if he was going to do the extraction or send me out somewhere. Hopefully the top tooth is hurting because the nerve is connected somehow, and not that it needs more work.

Chronic Kidney Disease on 23andMe

There was something new on 23andMe today. A report regarding two gene variants that are related to an increased chance of chronic kidney disease. Good thing I don’t have either one. I would hate to develop kidney disease or kidney failure.

Can I show this to my dialysis center? Maybe they’ll let me go home.

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Sigh, I know genetics is mainly statistical. Just because you do or do not have the gene variant has no predictive value on whether an individual will develop chronic kidney disease. I actually don’t know why they bother to tell their customers when it only affects populations. What if someone sees this and cancels their kidney health screening appointment? Maybe if you have these gene variants, you should be more diligent about your kidney health?

Stretcher Girl Walking

I haven’t seen her for a few days but today, she walked into the dialysis center with help. I saw the same leg braces she was wearing when she walked out last time. Hopefully this means she’s on the road to recovery.

Why am I writing so many posts about someone whose name I don’t even know? I guess I’m afraid that whatever happens to the other dialysis patients will eventually happen to me if I don’t get a kidney transplant. It’s easy to ignore on a day-to-day basis but the ugly mortality numbers are always there in my mind. It feels like I’m walking in a minefield blindfolded, not sure when the next explosion will happen. I’m finding out about all these complications from dialysis that my nephrologist never told me about. I doubt it would have made any difference on medical decisions though. I had thought dialysis meant a “normal” life… ha! Dialysis just barely keeps you alive, if alive means exhausted all the time and susceptible to a bunch of new health issues.

Walking Outside 9/5/2020

I’ve been fighting the onset of peripheral neuropathy pain the entire day today. At breakfast, the bottom left of my left foot started hurting, and it continued when I got to dialysis. I popped two Tylenol pills and it seems to reduce the pain frequency somewhat. After dialysis, the pain has mostly subsided. Tonight, while I was sitting on my bed after dinner, the top of the middle toe on the left foot started hurting really badly. I took another two Tylenol pills but this time, they don’t seem to make any difference. Since it was about 9:00 pm and I haven’t walked outdoors in awhile, I decided to walk around the smallest block by my house. It was only 0.32 miles and I averaged a pace of 40’15”. I was doing pretty good for a bit, until I took a drink of water, choked, then had a coughing fit. That put additional pressure on my chest and I quickly became breathless. I had to sit on the curb for a few minutes which didn’t help the pace time. While I was walking, the pain stayed away, but as soon as I walked into my garage and sat down, the nerve pain came roaring back. I don’t know what to do other than wait it out and suffer.

It was also super hot outside. Even at 9:00 pm, if’s still 90 degrees outside. That probably didn’t help my low stamina. While walking, I noticed a lot of pressure on my chest, right above where the heart was located. I also noticed there was a lot more pain and pressures as well when I cough. Not as bad as November/December last year, but definitely noticeable. Hopefully the CT scan will reveal something that is easily fixed and doesn’t require more bone cutting surgery.

Hospital Claim For Cardiac Ablation

Wow, medical costs in the US is both ridiculously high, and super confusing. I just got the statement from my work insurance. The hospital charged $98k for the procedure, and that is not including charges from non-hospital staff, like the cardiologist that did the procedure. However, the Medicare cost is only $24k, and my work insurance only paid $1,500. That seems low if Medicare only pays for 80%. Maybe Part A pays 100% for hospital services and Part B pays 80% for other stuff. So far, I’ve had two insurance plans since April and have not received any third party billing so maybe everything is getting taken care of somehow.

Medical costs are tough. Did my procedure help? Of course it did. My heart rate has been pretty stable for the past two months, except it’s now settling at about 70 bpm. The cardiologist thought it was too slow at high 50’s anyway so this is probably better. It’s just weird that 10 months after surgery, things are still not settled yet. I assume that if I did not have insurance, then my cost would be the ~$100k. Would I pay that? Probably, if the alternative is to have fast heart beat and a-fib all the time. Would I pay $200k? $300k? $1 million? I don’t know. I guess you pay what you can afford to stop the pain and discomfort. Again, I don’t know how medical care reform is going to work in the US when the costa are so high, yet very opaque. I’ll bet the hospital never gets paid $100k for an ablation but yet it’s probably on every claim they send out. Why? Also, with every new doctor expecting to get paid a lot of money, what happens if everyone pays Medicare rates and 90% of the profit in the system disappears?