tag:blogger.com,1999:blog-18943510.post8921666062596212211..comments2023-08-21T02:57:37.362-05:00Comments on Dr. Wes: The Cause of the PauseDrWeshttp://www.blogger.com/profile/17438019699222125477noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-18943510.post-87097396584396526092008-04-27T01:03:00.000-05:002008-04-27T01:03:00.000-05:00Danimal - can you design software that will someho...Danimal - can you design software that will somehow force people to make better decisions about their own health care and lifestyle habits? 'Cause that would help a lot. :)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-58054249141319238882008-04-26T19:11:00.000-05:002008-04-26T19:11:00.000-05:00danimal. The best thing anyone could do to improve...danimal. The best thing anyone could do to improve the delivery process of medical care is to shadow doctors for one month. Experience all of the inefficiencies first hand and really understand how our jobs are bogged down by incongruent technology. There are so many different ways technology could improve flow but nobody seems to understand how doctors think and create actionable eventsThe Happy Hospitalisthttps://www.blogger.com/profile/14392872203166584371noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-81289440110037203402008-04-26T18:54:00.000-05:002008-04-26T18:54:00.000-05:00He obviously has a highly fragmented hard drive, a...He obviously has a highly fragmented hard drive, and possible spyware infection. He should defrag his hard drive and run ad-aware and hijack this. If that doesn't fix it, he should consider re-imaging his system and starting afresh.<BR/><BR/>Then again, I'm a software developer, not one of you high-falutin' doc types. I have a hammer, so all my challenges look like nails =P.<BR/><BR/>Love your Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-87659990607277589712008-04-26T18:37:00.000-05:002008-04-26T18:37:00.000-05:00Asymptomatic patient with high vagal tone (occurre...Asymptomatic patient with high vagal tone (occurred during night hours and no patient-triggered events on Holter), however the patient must have been having some kind of symptoms in order to get the event monitor in the first place. The pause seems unduly long to just cross it off to "high vagal tone"-- I'd put in the pacemaker before the SSS occurs at an awake time.Anonymoushttps://www.blogger.com/profile/02299338324561194127noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-80211535275404583112008-04-26T07:40:00.000-05:002008-04-26T07:40:00.000-05:00This man was on no medications, but was recently w...This man was on no medications, but was recently with diagnosed diabetes and yes, now newly-diagnosed sleep apnea. Sleep apnea can occur in obstructive (mechanical) or central (neurologic) forms. Any form of hypoxia (no necessarily from Valsalva) can cause sinus slowing or even sinus arrest. His treatment should be to treat the underlying sleep disordered breathing, rather than a pacemaker, asDrWeshttps://www.blogger.com/profile/17438019699222125477noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-49460360857166246782008-04-25T18:58:00.000-05:002008-04-25T18:58:00.000-05:00I forgot to ask what meds he's on. Also why was th...I forgot to ask what meds he's on. Also why was the holter ordered in the first place? Also, maybe he has a sensitive carotid body that compresses when he lays his head on one side or the other causing the Brady/pausesThe Happy Hospitalisthttps://www.blogger.com/profile/14392872203166584371noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-7066958983896108032008-04-25T18:51:00.000-05:002008-04-25T18:51:00.000-05:00The timing sure has elements of sleep disturbance....The timing sure has elements of sleep disturbance. How big is his neck? Is it possible that he takes a beta blocker at bedtime for HTN?<BR/><BR/>EEric, AKA The Pragmatic Caregiverhttps://www.blogger.com/profile/10006690628166460007noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-78820954579587851202008-04-25T18:42:00.000-05:002008-04-25T18:42:00.000-05:00my guess is sleep apnea or the lead fell off. Tha...my guess is sleep apnea or the lead fell off. That seems like a pretty long arrest not to get a pacer even if it was asymptomatic. Three secs i remember is a class Ia indication if symptomatic, if i remember correctly. Maybe a pacer will help the apnea I suppose. I've never met a non smoking trucker without apneaThe Happy Hospitalisthttps://www.blogger.com/profile/14392872203166584371noreply@blogger.comtag:blogger.com,1999:blog-18943510.post-35099893357860918402008-04-25T18:06:00.000-05:002008-04-25T18:06:00.000-05:00I don't know, thats a big sinus pause even if it i...I don't know, thats a big sinus pause even if it is at night mostly. I'd think you call that a sick sinus and slap in a pacemaker for sure but thats why we pay you cardiologists the big bucks :).Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-18943510.post-7836128486035646672008-04-25T16:28:00.000-05:002008-04-25T16:28:00.000-05:00pause from valsalva related to sleep apnea? Needs...pause from valsalva related to sleep apnea? Needs CPAP?Ian Furst https://www.blogger.com/profile/11795888117578055704noreply@blogger.com