Episode 36: Pete Furman’s Push to Get Proper Insurance Acceptance for His Myocardial Bridge

SPEAKER_00 0:00

My specialist down in Tucson talked a good game, but didn't really understand kind of the treatment protocols. And subsequently, I found out that he messed up that provocative calf, didn't follow the procedure, didn't really run it to its proper conclusions. And then his drug therapy regimen just wasn't good. I didn't do well through it. I didn't handle the meds well. He wasn't checking the blood markers after that. I started to have liver failure from one of the drugs. So it's been a disaster.

SPEAKER_01 0:41

Welcome to Imperfect Heart, a place for you to join me, Jeff Holden, in conversations, discussions, and dialogue about our hearts and the impact myocardial bridges have on them. We'll talk with healthcare professionals, those in related fields that support our condition, and others just like us with stories of their myocardial bridge experiences. It's my intention for this content to inform, educate, entertain, and even motivate or inspire you in your personal journey on dealing with a myocardial bridge. Most importantly is to have you leave each episode with hope knowing you're not alone and that what you're experiencing is real. This episode is an Imperfect Heart Journeys episode, as our guest is sharing his experience getting to the ultimate objective unroofing surgery. Any of us who have been unroofed recognize some, maybe all, and in some cases even more than you'll hear, the challenges and obstacles we can run into when we're desperately trying to find the solution to our situation. Imagine working the necessary steps, the education, the procedures, the trips to the ER, the misdiagnosis, and finally getting confirmation of what your problem is. Yes, we know it's a myocardial bridge. Well, you're almost to the finish line, right? Surgery is imminent and you're going to be feeling so much better afterward. Now a whole new set of obstacles present themselves. My guess this episode explains how close he is to a solution. Already had his surgery scheduled with Dr. Guy in a few weeks, only to have it all up-ended by an insurance denial, now leaving him basically starting from square one on the process again. We'll talk quite a bit about the insurance conundrum and steps to take. But let me introduce him now. He's a father of two, grandfather of three, and married for over 20 years. You'll recognize the significance of the relationship with his wife and his life partner Lisa in our conversation as well. He's an engineer by training and was most recently chief of staff to the mayor of San Jose for eight years. He's now retired and living in Arizona, was cycling competitively until his condition ended that pleasure, of which you all know I can relate. And he couldn't resist the call to public life, finding himself now on the Sedona City Council. He brings a lot to the discussion, I'm sure you're going to appreciate. Pete Furman, welcome to the Imperfect Heart program.

SPEAKER_00 3:24

Thanks, Jeff. It's great to be here. I want to thank you for doing this all the time.

SPEAKER_01 3:29

I appreciate that. Thanks, Pete. It's my pleasure. You know, Pete, I don't want people to think that they have to be athletes or have been athletes or competitive fitness experts to get interviewed. But I I think there's an interest to share by those who would have been deemed least likely to have a heart health situation, and that would be somebody perceived to be in great shape. And that would also be somebody like yourself. You're a cyclist, and while I'm a cyclist, I think you're a bit more competitive cyclist than I. And I look forward to riding with you at some point after the surgery. But would you share the start of the awareness of what it was that something wasn't right? You noticed that this isn't right.

SPEAKER_00 4:11

Yeah, you know, truly, I I didn't really get started serious cycling until around 2010. And it was right after that. I don't think it's coincidentally. I was going to say coincidentally, it's not. I started feeling a bunch of tingling in my left hand. And I went to all the docs and we did everything, every test. They diagnosed stuff, they retracted those diagnoses, you know, medical trials, nothing. And in the end, they said it was idiopathic peripheral neuropathy. Idiopathic means we don't know. And so we just kind of gave up and I learned to live with that hand tingling and numbness. And then many years later, here in in Sedona, I went to a doctor talking about a decline in my athletic performance and feeling problems with heart rate and breathing rate, and they diagnosed me with exercise-induced asthma. And it was at the start of COVID, and they said, We'd love to send you to a pulmonologist, but we can't find one. You're not going to get one. There's more serious cases than you. So here's an inhaler, try it. I tried it, it didn't do anything. And then, you know, a little bit later, a year later after that, I complained to my primary care doc about jaw pain. And, you know, she felt there, there's no glands, there's no nothing. We don't have any idea what it is. And you know, we all, I think, get used to people saying we don't know, and we learn to live with what we have.

SPEAKER_01 5:45

And for the benefit of those, neuropathy is just nerve pain. So they were calling it some nerve sensation thing in your jaw, not necessarily related, or at least nobody was connecting the dots.

unknown 5:59

Right.

SPEAKER_01 5:59

When in fact you put those all together, you realize, okay, decreased performance, some jaw pain, pain and tingling in the arm.

SPEAKER_00 6:08

Yeah, yeah.

SPEAKER_01 6:09

We might have a path to explore here.

SPEAKER_00 6:12

It was after I was diagnosed with my bridge that my primary care physician just shook her head and she said, We would have never thought you came to us talking about hand tingling, jaw pain, chest discomfort, weird sensations, and we never ever thought you were a heart candidate.

SPEAKER_01 6:31

Back to the the opening of somebody who's in great shape. And I I think a good alert for anybody who's experiencing any of these symptoms, you know, angina, chest pain, tingling, don't assume it's not your heart just because you know yourself to be in good shape. To the point of cholesterol and lipid panels and blood workups, all that can be good. And in most cases, for us, it is for many of us. So don't make any of those. If you have this sensation or any of these sensations, do something about it. Don't wait.

SPEAKER_00 7:10

Learn when when they talk about chest pain. You mentioned chest pain. I I ride one of my riding buddies as an ER doc. And he used to ask me all the time about chest pain. I was like, no, I don't have chest pain. And you know, after some amount of time, he said, All right, stop, stop. What are you feeling? And I talked about the pressure, I talked about sensations, and and he just shook his head and he said, in the medical field, that's chest pain. So you really need to be liberal in assessing some of those feelings.

SPEAKER_01 7:41

Something occurs around July of last year, July of 2023.

SPEAKER_00 7:48

Yeah.

SPEAKER_01 7:48

And all of a sudden now you're a frequent visitor to your local ER, and it's a much more significant chest pain. Tell us a little bit about that.

SPEAKER_00 7:59

Yeah, six trips to the ER in in a year. Almost exactly six trips to the ER. My first one was in July of 2023, July 10th, I think was the date. And I was riding with that ER doc buddy of mine, and I denied chest pain, chest pain, and the third episode of it, that's when he really went in to, you know, what exactly? And after telling him, he said, No, we're going to the ER. We're going to the ER. And so, yeah, we went in, and because of my symptoms and my family history, and some, you know, the stuff I had reported in the past, the doctor in the ER said, No, that's good enough for me. We're going to send you down to Phoenix, threw me in an ambulance, and they took me down to Phoenix where I had the first real workup. And I think I'm amongst the lucky cases that I hear reading all our site is, you know, that first serious trip is the same as everyone else. We can't find anything. We can't find anything. Oh, we did see that little plaque that turned out to be proximal to the bridge like everybody else. So they went in there to maybe think about stenting it. But the cardiologist that did that work, that interventionalist, he went a little further and saw the bridge and backed out and didn't do anything, thankfully, and then told me, hey, you have a bridge. I don't know anything about the treatment. Find a specialist. I don't even know one for you. Good luck.

SPEAKER_01 9:22

Wow. The good news is he didn't do anything, didn't shove a stint in there and say, Well, we think we got it.

unknown 9:28

Right.

SPEAKER_01 9:29

Only to find that now you really made a mess and have a serious situation on your hands.

SPEAKER_00 9:34

Yeah, yeah.

SPEAKER_01 9:35

What took place from that July forward in your diagnostic process? How did you get to somebody to identify that there's something else going on here now that you know you had the bridge?

SPEAKER_00 9:50

Yeah, I mean it the bridge was the target right away because there was nothing else wrong, right? Even that diagnostician that I talked about, the interventionalist, he had said, your heart is remarkably clean for your age thanks to your fitness and whatnot. So the only thing that we can even see is this bridge. And my local cardiologist, he also said, Wow, wow, that's very interesting. I've never heard of it. You know, I think we spent 10 minutes on it in med school, and I don't know anything about it, and I don't know anything about the treatment. And that's when my insurance plan, Blue Cross Blue Shield, gave me an internal resource, a complex case care coordinator, I think was the name, her title. The first one I had there, she actually helped me find a specialist in Tucson that knew that knew something about this, knew about spasms primarily, I think, and knew about bridges, and took me through the provocative calf for the first time. But in the meantime, after that first trip to the ER, you know, there were two subsequent ones, pretty close, you know, two more, pretty close together because uh I was really suffering at that point. You know, you learn, you learn to how to deal with the ER staff when you're going that frequently. So I think I know them all now at the ER, except when you know they turn over. And you know, we all establish our own set of criteria of when we decide to go again. And it's like, well, if the pain for me, if the pain was more than ever before, or there was some new type of symptoms, that was my marker to go to the hospital, tell them right away, I've got a bridge, I've got a long history, read my record, we just need to check my EKG and my troponins, and if I'm okay, I'm going home. And so, you know, you learn to manage, you manage that way. But my specialist down in Tucson talked a good game, but didn't really understand kind of the treatment protocols. And subsequently, I found out that he messed up that provocative calf. It didn't follow the procedure, didn't really run it to its proper conclusions, and then his drug therapy regimen just wasn't good. I didn't do well through it, I didn't handle the meds well, he wasn't checking the blood markers after that. I started to have liver failure from one of the drugs. So it's been a been a disaster. And then I went on, I got real serious about it. And that's when I met Dr. Kofidis, Dr. Shaw out at Yale. I I had originally applied to Dr. Schnitker's program way back at the start, but that takes took me 11 months to get in. Did meet her, she's awesome. I met Dr. Henry and Dr. Guy out in Georgia, they're awesome. So there's some really friendly, helpful people that we can find, but you know, you have to be persistent, you gotta be proactive, and you gotta know when your local people are bluffing you.

SPEAKER_01 12:48

So you actually had a locally administered provocative test. Was it the full acetoline and dobutamine challenge test?

SPEAKER_00 12:56

They shortcut some stuff, Jeff, because they saw that I was having a vasospasm right at the start, right when they went in. And so they kind of shortcut some of the process. And when they did the doutamine challenge, they didn't challenge me very much. It only got my heart rate up to 114, I think. And his target was 140. And he bailed out. Come to find out later that he didn't really administer the dose that he should have. And so there was just four or five things that were incomplete. And what what's the all the rest of these doctors? You know, they don't want to criticize someone in their profession, and so they say things like, Well, that was kind of incomplete, or you know, they use very kind words about what the heck happened there.

unknown 13:42

Yeah.

SPEAKER_01 13:42

Right. Was your sensation, did you identify at least through that process, that your sensation was in fact the endothelial dysfunction, the the pain that you got? Because you didn't seem to have the shortness of breath. You had chest pain, correct? And some of the you know, the neuropathy, the the tingling and numbness.

SPEAKER_00 14:00

Yeah, yeah. I mean, uh it's that's certainly for for sure. For me, it started with more like chest discomfort that evolved into burning sensations. And then I would start to, you know, I got that jaw pain, and that's a almost one of the most consistent things that I get is pain on the jawline, radiating pain, the numbness and tingling in the hand, and then it's gotten worse over time. So now it's real chest pain. It feels like somebody reaches out with a hammer and smacks my heart. And I can correlate it. I certainly know that activity causes it, but it's often feels like it's delayed. Or I'll get some version of it when I'm exercising, but then maybe that night, you know, that Prince Metal angina, you get that spasms at night kind of thing. And, you know, I think we, I certainly, being a mechanical engineer, am absolutely convinced that it's a mechanical process, that it's the squeezing of the coronary artery that causes some angina during exercise, but then afterwards it it causes that vasospasm. And and yeah.

SPEAKER_01 15:08

So, in the conversations that you've had to date, as they're looking at opportunities to treat the vasospasms, have you had any sensation improvement, or I should say, improvement of the pain from the cessation with with any of the medical therapies?

SPEAKER_00 15:25

Yeah, that's a great question, and a question that I've challenged all the doctors on that I've talked to so far, because there has been. I'm not going to the hospital as frequently as I used to. You know, it was three times in a row there in two months kind of thing. I mean, it felt like it was really bad. And then I got on, for me, it was the calcium channel blockers and then some other things that were supposed to help enhance the effectiveness of those. And and certainly the pain isn't as bad as it used to be. But the question I ask everyone is: is it the drugs or is it the lack of not exercising anymore? Am I not agitating it as much as I used to? And nobody really knows the answer to that question. But then July 7th of or 10th of this year, so it was almost exactly a year later, Jeff. I had a very significant episode. And was Dr. Henry said that he was sorry that I had to get through, I got there, sorry that happened to me, but I proved to him that all the drugs trying to treat the endothelial dysfunction and the vasospasms weren't working, and we needed to do the unroofing surgery.

SPEAKER_01 16:38

So you must have gotten to that point that I refer to as that tipping point, because we know the condition never, never improves. It only gets worse, it deteriorates. But because you were masking it with some medication, and and I mean that in a positive way because it's a therapy that we try, so you've now got it masked a bit. You're not exercising, so you're not aggravating it as much. So it just took a little longer to get to its tipping point and say, you can mask and medicate and do all you want and stop your exercise. I'm still gonna irritate you.

SPEAKER_00 17:11

Yep. And it was, you know, right at the end of that, Dr. Henry had asked me, you know, if I felt comfortable to try getting a little exercise again. And so I did three days. I tried to ride my bike super gently. I don't even call it riding my bike. I was on my bike pedaling around the neighborhood, and and so it was just three, three days of that that then re-ignited it in the worst way. It's been significantly worse.

SPEAKER_01 17:40

Yeah, and you had that time in between where it deteriorated. So then you go back on the bike, and boy, brother, can I feel your pain on that one? Because I know what that's like for us when we get on something that we know we're capable of doing prior, what that was like, and here we are now, you know, spinning like a tricycle training, you know, training ride. Right. I almost embarrassed to put the the shoes on and clip in and and go.

SPEAKER_00 18:07

I have a I have a beautiful training app that shows me my power profile, you know, on all the different segments of ride, and and what I did those three days was just this minuscule circle inside it. It was so easy, it was embarrassing.

SPEAKER_01 18:21

Of course you're an engineer. You would have every detail monitored to the nth degree.

unknown 18:26

Yep.

SPEAKER_01 18:27

So you've connected with a couple of doctors now, you've got a good understanding of what your condition and situation is, and you even got past the original diagnosis to the acceptance of the fact that you're probably a good candidate for unroofing. And that that's a lot of work in itself, as many people know. What happens next? Because you get tangled up now in the ability to get the unroofing surgery.

SPEAKER_00 18:58

Yeah. Yeah, you know, I live in Sedona's in northern Arizona, rural northern Arizona, although it's only two hours from Phoenix, but still it's kind of rural up here. And and so the health plan I'm on is, you know, Blue Cross, Blue Shield. It's an HMO plan. And, you know, those are notoriously difficult for getting services out of their network. But I will encourage everyone to know that it's not impossible in everyone's plan. There's an option for that. And I was working with this case manager, and I kept them apprised of every detail and every thought that I was having. They knew right away that I wanted to go to Stanford. I started talking about Dr. Guy and Dr. Henry when I think you had them on your show, started talking to them. And they they knew every step along the way, but they didn't say anything about out of network or in network until Dr. Guy and Dr. Henry decided that it was time. Let's schedule you for surgery. And they submitted the plan to Blue Cross Blue Shields, and it was denied because they found someone in network that could do the surgery. You know, we had a surgery day at 9.5, and now that got canceled. And I have to kind of start the process again of thinking about this new surgeon and whether I feel they're qualified, whether I feel I'm comfortable with them, or, you know, there's the multi-level appeal process that you can work through as well. So it's in it's really important for everyone to truly understand what their health plan is. And it requires reading of detailed contract language, but it's important to do that.

SPEAKER_01 20:34

And to that point, so many of us, we see it on the Facebook group page, people that I've spoken with through the podcast have just had a really difficult time navigating our own insurance policies and understanding what the policy provides, what it doesn't provide, what services are allowed, where they're allowed. Each of the hospital systems have their own concierge person to help support us through that process as well. Did you engage with anybody in the hospital system to help from the back end outside in?

SPEAKER_00 21:08

Yeah, yeah. At Georgia Heart, when they were preparing the plan, you know, they've done this before. They've gone out of network and submitted their plans at other places. And this was the first time that they dealt with Blue Cross Biele Shield, Arizona, and they ran into trouble. You know, they would call in and they would hear that, well, these procedure codes don't require pre-authorization, but they knew they were out of network and they were asking that question and got a bunch of head scratches, and we don't know. And so they got the runaround at first until I asked my case manager to help out, and they finally got the no answer. And the same thing happened to me at Stanford. You know, Stanford submitted, they said it wasn't required, they were confident that it didn't. And I don't know how that's going to turn out yet. I may have to eat the cost of that exam, but I also feel at the same time. But you know, getting Dr. Schnicker's thoughts into the case as well was a useful thing. So we'll we'll see. I don't know yet, but managing the system is very difficult because, especially I think with HMOs, they're just not used to looking outside the plan. But there is a way for everyone to do it. And in every one of these plans, there's a thing called the gap exception agreement. If they, if the plan doesn't have providers in network that provide that service, then they just negotiate an agreement with someone outside the plan to get whatever rates and payment plans and all the rest. And they they can do that, and it's allowed for in the plan. But but it's difficult to get there because the people that first answer the phone call from the doctor to approve or deny stuff, you know, they're not really up to speed on that.

SPEAKER_01 22:52

So let me ask, did you actually have a provocative test done at Stanford as well?

SPEAKER_00 22:58

No, not the provocative test. I had Dr. Schnitker wanted to repeat my CTNGO, and we did another stress echo there.

SPEAKER_01 23:06

Okay. So you did have some testing, you just didn't get all the way through the entire process. All right. And thank you for the definition and the identification of that gap plan because it may work differently for somebody in a different state. We just don't know because so many of these things are unique to the individual case. And we do know that people tend to, and I don't mean us, I mean the people on the other side, on the administration administrative side of the insurance countries, may look for the path of least resistance. They don't see this myocardial bridge thing, but they see somebody out of network that'll take it. You might ease right into it. And I suspect that we've probably spoken to somebody that has had that experience. If if you hear the episode and you have, please reach out to me because I'd like to be able to share it with others. But for the benefit of those, do check and look into your gap plan because some of them aren't quite as visible in the policy as others.

SPEAKER_00 24:03

Yeah, you know, Jeff, I I'm an engineer. And so I when the denials first started being talked about, uh I did a lot of research looking to plans, and United Healthcare actually has their gap exception agreement document on their website. They but nobody else does. No other health plan that I could find talked about it. But, you know, certainly the languages in there in my plan, in the details of it, that talks about if you if there's no in-network provider, then this is a thing that could happen.

SPEAKER_01 24:37

Yeah, and thank you for mentioning United Healthcare. That happens to be the provider I had. And it's one of the exercises we recognized I had to go out of network, but not out of state. So we were able to find a remedy within state. And by the good fortune in my case, it happens to be Stanford. So it was a good solution.

SPEAKER_00 24:58

And then you also need to understand the appeal process available to you. So you read your plan, right? And so there's three appeals that I am entitled to. Two of them are internal to Blue Cross, and the third one, if you exercise that, has to go outside. And these are ACA, American Healthcare Act plans, and these are ACA requirements that they have to implement these things. So I filed for one appeal already. You know, I'll go see this new surgeon they've offered me, and you know, we'll go from there.

SPEAKER_01 25:29

And let's let's address that now because you are one of our journey patients. You're not unroofed yet. You're in the process, which is why I thought it would be so valuable for somebody to hear the insurance stickiness of it, where it's it's holding you up. You've gone to some of the best cardiac surgeons. You've you've had connection, you've spoken with people at Stanford, you've spoken with people at at Georgia Heart and Atlanta, and here you are now s stuck, and and I I'm gonna say that with quotes on it, because maybe these surgeons have the capability, we just don't know yet. And you did find somebody that's in system that has been referred by Blue Cross Blue Shield, and that's coming up soon, that date is soon, if I'm not mistaken, for you to have that first consultation.

SPEAKER_00 26:20

Yeah. 9-3, week from tomorrow.

SPEAKER_01 26:24

What is it you need to establish with them? And and that's for the benefit of others who are who are there. As an engineer, I know you vetted this really, really well. What are some of the things that you're gonna want to ask and be certain you identify from this new cardiac group?

SPEAKER_00 26:38

Here's my list of questions.

SPEAKER_01 26:41

I I knew it.

SPEAKER_00 26:44

You know, and I'll start kindly by asking them, you know, what they've learned from my record and what they recommend as a procedure for me, but then I want to know about how many they've done and you know, overall in the past year, in the past month, right, to try and get a sense of what their experience is. You know, I think we all understand that, although to us it's mind-blowing that this operation is possible, you know, everyone I've talked to in the field says that technically it's not that complex of operation compared to other things that heart surgeons do these days. But still, if you haven't done it, you know, do you do you want someone to be doing their first or their second one on you? And I think that's a valid question. So, questions about that, asking about what the outcomes are and asking about post-infection rates and and then about their approach. We've learned a lot from Dr. Kofidas and and others about how to do it. And Dr. Guy talks very much too about, you know, I asked about locating the bridge because Dr. Schnitker and Stanford have a very specific way that they go about locating the bridge. But Dr. Guy is like, yeah, I just start at the apex of the heart and I work my way across the whole LAD looking for them. And, you know, that's valuable too. So I want to know what any surgeon what their approach would be, and you know how they think about secondary bridges. Do they look for them? Do they look for them beforehand? Do they look for them during the operation? Right? There's that list of questions like that. And then what their involvement is post-operation. What can you expect from the surgeon in terms of follow-up and you know, watching you through recovery?

SPEAKER_01 28:23

So I know one of the things we're seeing a little bit more prolifically than earlier on on the Facebook page in the support group is pericarditis. It seems a fair number of people are experiencing pericarditis. And the the second part is now that we're getting some time in between surgery and uh healing process, we know that the endothelial dysfunction does seem to ease over time. And many of the surgeons will say it could be even up to three or four years by the time it it dissipates. But it seems to be better for most of us that have had that situation. But the one that I think concerns me at this point, because it's not one that's been talked about much, but it's scar tissue. And could that scar tissue then envelop the artery again to where you may be experiencing some of the symptoms? And while we don't know for sure yet, but some of those people that have been unroofed over the course of the last couple of years, I've noticed, have just popped in and said, Well, I'm experiencing some symptoms. We think it might be scar tissue. So it's it's another question, I think, to add to your list when you you know experience when you're talking to your surgeons about the experience and their experience to see what that looks like. And again, for the benefit of anybody that is and has been unroofed for any length of time, I did I did reach out on the Facebook page if you or anyone you know has had over five years. You know, please try to communicate me if we if you could, because I'd like I want to get some data on the people that have had this and see if there is a frequency of scar tissue or return of symptoms. Because there's not that many people that are out past five years. There's a few can't, you know, a few out there 10, 12 years, we just don't see them because they're off doing their thing. So I'd I'd be curious to see what that looks like. This is an emotional roller coaster, as we all know. At this point in time, you're you're close, you're so close to to getting the surgery, knowing that the surgery has the ability to relieve the symptoms and get you back to a life that you recognize. How are you dealing with it? How's your head? You know, what are you concerned about at this point?

SPEAKER_00 30:40

It is a roller coaster, isn't it, Jeff? I think it is for all of us. And you know, when I first found my diagnosis early, as I talked about, and I found this, you know, our Facebook site and and and all the resources that we have. And you for me, I did a deep dive and learned a lot. And as a mechanical engineer, I went to the conclusion of my own that this is a mechanical problem for me and it's causing these vasospasms, but the primary cause is this mechanical squeezing. And so it's my mind is like, well, yeah, then you just need to fix it. Unroofing surgery makes sense. And then I you go through the you know, the year-long trial of drug therapy talking about vasospasms and feeling this stuff in a different way and feeling the symptoms change, and then I, you know, you start to get skeptical about geez, heart surgery, that's a pretty big thing. And and then, you know, I had this big event back just this past July, and it's like, nope, even Dr. Henry and Dr. Guy are like, Yeah, you need help, we need to do the surgery. So that convinces you again, and then I get the date for surgery 9-5, and then I get scared. It's and then I get the rub pulled down for me, and so wow, has it just been incredible? A roller coaster, and it's difficult. But you know, I've got a great my wife Lisa and my support network here in town of friends, you know, people for me that I'm open with them, and you know, they're open with me and and helpful. Sedona's famous for all this energy in town, and there's a lot of people in town that are sending me positive vibes. So, you know, we'll we'll get we'll get to the we'll get to the surgery, we'll get through it. I look forward to joining you on a bike ride someday.

SPEAKER_01 32:22

And Pete, I can see and I can hear just the the attitude that you've got. And that's that's so, so important. Not to mention, yes, you've got this this circle of support. I feel badly that you've had this this up-down surgery set, not set, insurance, no insurance, because you are so close. And that is one of the most difficult parts is when you've got your mind set to go, you start to shift from it's gonna happen and it's a maybe, and now it's for sure. And then you start dealing with all the consequences of what that mindset is, because it it's different. Of uns from uncertainty to certainty is a huge, huge step. And you you're sitting in the certain certainty part. So and a nine thing.

SPEAKER_00 33:09

All the while when your symptoms are getting worse, right? I mean, they are getting worse. You talked, you know, it's now shortness of breath. I go over and try to pick a weed up out of my yard, and it's like, what the heck?

SPEAKER_01 33:19

Right. Yeah, and and for all of us who are in that position, you don't know. You don't know. I mean, is one of these going to be the last time I get the sensation? And for the most part, no. I don't think we know of anybody that has had that situation where it was. It sometimes would manifest itself in some sort of an ischemic attack. But again, for the benefit of people listening, in all likelihood, it's rare that you would suffer a massive heart attack under the circumstances. So it's a matter of just keep pushing through, you know, get it identified and keep working through to the next step to get taken care of. So 9-3 is your your first consult with these new people, then the new cardiology group. I will be in touch with you and I'm sure you'll probably be posting until you actually have your surgery, which will be wonderful. And then what I'd like to do is post-surgery, there's about three or four people that we've had who we've talked to in the process of who have now been unroofed. And I'd like to gather you all at some point once you've got about 10, 12 weeks post-surgery, and that sternum protocol is behind you, and we can and we can just talk about everybody's experience for the benefit of those who are going through the process.

SPEAKER_00 34:40

I look forward to doing that at your uh next in-person gathering in Sacramento a year from now. I'm sorry I won't be able to join you this for this meeting, but I I look forward to in the future. And we'll have a round table of uh people.

SPEAKER_01 34:55

Yeah, and we we will this time too. And I don't know if you saw Dr. Kofitis is actually going to join us at 1030 as a as a virtual event. I'll figure out how best to get that to everybody. I'm working on that now. He's amazing.

SPEAKER_00 35:07

You reach out to him, you send him an email, and he says yes, and then he spends an hour with you on a video call. It's just he's an absolute gift.

SPEAKER_01 35:16

And it's amazing too because here's a gentleman that's in Greece who is a highly regarded and highly demanded surgeon. It's not just on roofing procedures he does. He's a well-regarded cardiac surgeon. So it is amazing that he gives us the time that he does. The medical experts really are not on the Facebook page. They're just there to share their stories. So please don't assume that that's your situation. Every one of us is so uniquely different. Our surgeries become very, very different. Our symptoms are different, our capabilities and capacity of what we can do are different, and our healing processes different. No two of us are alike in in what we see. So just absorb that as valuable information, but don't take it as that's your situation. Let your doctor work with you on that. And you are doing a fabulous job of that because you are an engineer and you know that there's specialists that do these sorts of things. So, Pete, you're you know, in a spot where many of us either have been, currently are, or will be as they go through their journeys. And you you've really shared a lot of beneficial information. You know, we get that disappointment and know that you still have the hope, you know, moving on to the next necessary item on that checklist of yours. But it's that attitude and positivity that is so, so critical. And that's what's gonna carry you through this surgery. So, you know, we're here, we're wishing for you, praying for the outcome that you desire to get this heart function corrected and get this mechanical thing. I will say electromechanical, though. You're gonna have to put an electrician in there at some point, too. But you're gonna get there. And and we're there to support you. We hope to see the continuation of the next steps. And then, like I said, once you're back and out of that sternum, you know, sternotomy protocol, we'll get a group of you together. So, you know, best of luck to you in the process. And you know, from the bottom of my imperfect heart, thank you for sharing your story with us.

SPEAKER_00 37:17

Thank you, Jeff. It's really a pleasure to be here. And, you know, every and you said everyone that's on this journey, it's different. But there's I I I find it great to go through the Facebook site and I thumb, thumbs up, you know, people who are taking the next step. So I'll be posting. I I was reluctant to post in the past because everything was so uncertain, but you know, I'm gonna be a little bit more out there now.

SPEAKER_01 37:40

When I think we benefit from somebody like yourself who is very detail-oriented, who's really gonna do a lot of the homework, not everybody has the willpower to stay with it. You know, it it just overwhelms them in some cases. So having somebody like yourself who will dig and dig and dig and dig, and and thank you for for what you did with the insurance. This is the first real insurance conversation we've had. I think it's gonna help many. Yeah, and so thank you for all that work, Pete. Thank you. Thank you for listening to Imperfect Heart. It's my hope that this information helped in some way to improve your situation or will help you better understand this condition. More importantly, that it gives you hope through stories that there is help and you most certainly are not alone. If you've been diagnosed with a myocardial bridge, please be sure to join the private Facebook group, Myocardial Bridge Support Group. For more information about our program or to reach me directly, visit the website, myimperfectheart.com. If you like what you heard today, please give a positive review, thumbs up, high five, whatever your app likes. And be sure to share with everyone important to you so they understand what it is you're dealing with. Please subscribe as well. Welcome each day with gratitude and positivity. The views and opinions expressed in this program are solely those of the host and the guest and are not intended to provide, nor are they a suitable substitute for professional care by a doctor, therapist, mental health professional, or other qualified medical professional. Imperfect Heart is a production of Hear Me Now Studio.