I was told that I would be in the hospital between five and seven days and back at work within three months. As yet, I have not been able to return to work.

Prior to the surgery, the only thing that was brought to my attention was that sometimes things “go wrong,” and when I was discharged from the hospital, I was given minimal instructions. For some naive reason, I thought that if I woke up from the anesthesia that things had “gone right.”

While the doctor did mention separation of my ribs, he did not tell me that I would have severe pain for months following the surgery. I was also never told that some nerves would be severed and that both pain and nausea could result.

It is now May 2010, and I am still having problems. I tremble most of the time and have started to feel like one of those dolls with my head bobbing. My bra is very uncomfortable, as the right breast is numb, and I often feel as if barbed wire is being rolled over my skin. This sensation is getting less frequent, and I am starting to notice a slight improvement from a few months ago.

My family physician helped relieve the nausea and pain with two medications. I took both for only six to eight weeks and then weaned off in order to avoid side effects.

To make matters worse, it is questionable that I even needed the surgery. Few options were discussed with me. Because I have had few medical problems in my 64 years, I was not versed in the correct questions to ask. After the surgery, it turned out that I had a mostly self-contained infection and not cancer, which was indicated before the surgery.

I am having difficulty exercising. I seem to strain the muscles on my right side whenever I do even light stretch-band exercises. I walk on a treadmill but am only able to do about 10 minutes at a time before I get winded.

Since leaving the hospital, I have had no more atrial fibrillation, which is a blessing, and I have been able to wean down my Coreg to 6.25 milligrams, which has helped restore some of my energy. When I was on a higher dose, all I wanted to do was sleep for the first several months. I also take extra vitamins A, B and D to help repair the nerve damage and boost my immunity.

How long can I expect these problems to last? Why don’t surgeons tell you what to expect prior to surgery and then later in the hospital-discharge instructions? I was totally blindsided by these complications, many of which happened after my discharge.

Please advise patients to get a second opinion and ask surgeons to be up front about what to expect following any surgical procedure. I encourage everyone to get a second opinion, even if they feel that the surgeon knows his stuff.

I realize that removal of a lung is an intense operation, but I feel that I would have been better prepared to handle the complications if I had known that they could happen.

DEAR READER: Whether or not you were medically naive, it is no excuse for your surgeon to have neglected to inform you what the surgery entailed, both during and after. I am also shocked that you were urged to have removal of a lung without even undergoing further diagnostic testing to determine whether your “lung tumor” was truly a lung tumor. Surgical removal of any organ should be done only when and if there is medical necessity, and there are numerous tests available to determine what type of tumor or other abnormality is present. You have endured months of complications and pain for a lung infection that could probably have been treated with oral medications.

As to your question about why surgeons don’t inform patients, I would certainly hope that this is not the norm. When I was in active practice, patients were always informed about possible complications of surgery and provided with alternative options, as well as the surgeon’s opinion of which would be best. This also held true for diagnostic testing, such as imaging studies that involved dyes, tissue biopsies and more.

I urge you to get a referral to another surgeon or a pulmonologist, who can review your operative report, examine you, and offer suggestions regarding treatment of your complications. You will also benefit from pulmonary rehabilitation, which aids your body in adjusting to having only one lung in a controlled, safe manner. Speak to your family doctor about these steps.

DEAR READER:
I have written many times in the past that I cannot be used as a second opinion for upcoming procedures. I simply provide information to the writer that can be used to receive appropriate medical care from a physician that can examine him or her.

I regret I cannot respond to every letter I receive but due to sheer volume I must limit myself to answering letters that are of interest to the general public or can provide awareness of needy causes.

If you are reading this, you must now realize that it is far past the date of your procedure. Whether you are better or not, I do not know. I would imagine that the atrial fibrillation ablation did little to improve the pulsating in your head as the sensation is often caused by plaque buildup or narrowing of the carotid arteries in the neck.

Ablation is a medical procedure that essentially destroys tissue. In your case it was heart muscle. Atrial fibrillation is an abnormal heart beat and the ablation was used to destroy the area of the heart that was sending out abnormal signals.

You said you had confidence in the physician but couldn’t get an exact answer about the pulsating. I take this to mean that he or she attempted to answer but was unsure if it would help or not. No physician can give an exact answer about a medical procedure because situations and circumstances vary from person to person. What helps one may harm another.

If you continue to have problems, return to your physician and request further testing. Personal physicians are often the best source for information. They know your medical history, current health status and other vital information. I am merely here as a tool to aid patients who are experiencing difficulty in getting straight answers or have hit a brick wall as far as diagnosing a medical condition is concerned. My advice is not to be used as a replacement for appropriate medical care but as an adjunct to it. An outside, fresh perspective can sometimes shed light on a situation and thus leads to a positive finish. I hope that I am that perspective.

To give you related information, I am sending you a copy of my Health Report “Coronary Artery Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

He has had two cardioversions (procedures to reduce the pulse rate) but they didn’t help for long. His rhythm remained normal in the hospital but once home he went back to being abnormal. His heartbeat was rapid so he takes warfarin to prevent a stroke. He has his levels monitored every few weeks.

My husband’s heart rate is now at a normal level of 80 but he continues to be short of breath. His heart specialist says he’ll have to live with it. His chiropractor says he had has the same thing for more than 20 years and has learned to dispel it by taking several deep breaths and slowing down for a bit. My husband tried this but it doesn’t seem to work for him.

I have also gotten several emails from a woman who wrote a book and claims to know how to reverse atrial fibrillation but I am doubtful that she knows something doctors don’t.

DEAR READER:
Your husband’s symptoms suggest to me he may be suffering from congestive heart failure (CHF).

I urge your husband to seek a second opinion from another cardiologist. He needs heart testing such as an EKG, stress test and more. The sooner he is diagnosed and treatment has begun, the better his chances will be at a more normal life. If left untreated, your husband will slowly worsen, becoming more short of breath and eventually developing edema (fluid retention and swelling).

Get him to another cardiologist and let me know the results.

To give you related information, I am sending you a copy of my Health Report “Coronary Artery Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I’ve taken Fosamax for almost seven years for mild bone loss and recently read of a scientific study indicating the drug can cause heart abnormalities — including atrial fibrillation, congestive heart failure, blood clots, and stroke! I stopped taking the Fosamax immediately.

Is my atrial fibrillation a chronic condition now or does the discontinuation reduce and eventually end the symptoms? Is there a SAFE bone-loss drug available? Have you any idea why this important information for women is not well known? Is there some sort of pharmaceutical cover-up?

DEAR READER:
Atrial fibrillation is a condition that presents as rapid, abnormal, irregular heart beats. The lower chambers of the heart can beat 130 times per minute while the upper chambers can send out more than 350 electrical impulses per minute. The irregularity results in a decreased amount of blood pumped to the body. The disorganized contractions of the upper heart chambers can cause clot formation.

Now for the Fosamax. I don’t know of any medication, to include aspirin, that does not have the potential for some side effects in some individuals. On the up side, research has shown Fosamax reduces the incidence of hip fracture by 63%. This is a significant finding for post-menopausal women. Now comes the down side. Fosamax appears to double a woman’s chances of developing atrial fibrillation, even if no history of heart abnormalities is present. This was not known when the drug was test marketed, nor was it known for several years thereafter. To my way of thinking, herein lies the problem. New drugs enter the market and promise to cure every condition known to mankind. Long-term effects of drug use are not known for years.

The manufacturer did not conceal the news; the bad press made headlines in newspapers and on television across the country. The drug is still being used and has not been recalled, but doctors are aware of the devastating potential side effect. Many have rightly converted their patients to a different drug without the side effect you experienced. You were wise to discontinue the medication. Hopefully your condition isn’t chronic and you will not experience repeat episodes.

Safer alternatives include calcium and vitamin D, calcitonin, and more. Speak with your physician about your best alternative. He knows your complete medical history and is your best bet for the suggestion of a substitute.

To give you related information, I am sending you a copy of my Health Report “Consumer Tips on Medicine”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

My father seems to be tired a lot, has very little energy and is short of breath. He is seeing a heart specialist who diagnosed him with a fibrillating heart. He never had heart problems before the prednisone. Could the medication have caused his heart problem?

DEAR READER:
Prednisone is an oral corticosteroid and is not an appropriate treatment option for trivial colds. It can, however, be given for severe bronchitis, pneumonia, asthma, arthritis and other inflammatory conditions.

Because you do not give specifics about the dosage of your father’s prednisone I can only give general information. Prednisone comes in 1, 2.5, 5, 10, 20 and 50 mg forms, therefore, you father could have been taking anywhere from 8 to 400 mg of the drug daily. While I highly doubt he was taking anything higher than 40 mg a day, I cannot be sure.

Prednisone has many side effects including muscle weakness, potassium loss, high blood pressure, thin skin, headache, seizure, adrenal unresponsiveness, glaucoma, congestive heart failure, and more. Of these, both low potassium and high blood pressure can be associated with heart rhythm abnormalities such as your father’s atrial fibrillation. This is NOT to say that his symptoms and difficulties are due to the prednisone, but they may be the result of one of the side effects.

Atrial fibrillation simply means that the heart is not beating normally. He has appropriately seen a cardiologist who is the best resource in this situation. While you do not say, I assume that you father is on treatment to reduce his cholesterol (if it is too high), lower his blood pressure and using an anticoagulant, such as warfarin or aspirin to reduce the chance of clots, heart attack and stroke.

I cannot say if your father’s heart problems are directly related to the prednisone if it is mere coincidence that it happened shortly after taking it. Speak to his cardiologist about the possibility.

I should also mention, that prednisone can cause the adrenal glands, which produce natural corticosteroids, to slow or stop production leading to symptoms of adrenal failure. To prevent this frightening, uncomfortable and potentially serious consequence, prednisone taken for more than three or four days should be tapered off slowly until the medication is stopped or a maintenance dose can be reached (such as for fibromyalgia, lupus and others).

To give you related information, I am sending you a copy of my Health Report “Coronary Artery Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I see a primary care physician at a VA clinic, a local internist, urologist, cardiologist, and a neurologist. I have type 2 diabetes and have had episodes of atrial fibrillation in the past. My medications include Metformin, simvastatin, warfarin, flecainide, a daily multi-vitamin, and monthly B12 injections. Further, I had partially successful atrial ablation in 2006 and cryotherapy for prostate cancer in 2007. My blood pressure readings and lab testing for diabetes are always great.

After an MRI I was told I do not have Parkinson’s disease, but Parkinsonism symptoms. Two trials of carbidopa/levodopa gave initial improvement that faded after several days — even with dose increases.

Do you have any thoughts on why my legs have become progressively weak? Any ideas would be appreciated.

DEAR READER:
You appear to be plugged in to the appropriate specialists to handle the plethora of medical issues with which you have had to deal. In spite of this, I will attempt to cover one issue at a time, so bear with me.

Your type 2 diabetes is stable on the Metformin dosage prescribed. The atrial fibrillation is held in check with the Warfarin and Flecainide. You don’t indicate you have high cholesterol readings. I must interpret, therefore, that the Simvastatin was prescribed for both your cardiac condition and diabetes. The B12 injections and multi-vitamins are for fatigue and as a boost for what might be lacking in your diet.

Now on to the biggest issue. Symptoms of Parkinson’s include tremor, rigidity, stooped posture, shuffling gait, fatigue, lack of facial expression, and more. General weakness is relatively common with this neurodegenerative disorder.

You appear to have several symptoms associated with Parkinson’s disease but were not given a diagnosis as such. This leads me to believe that you may have some other condition causing them.

Parkinsonism’s symptoms can be caused by many conditions other than Parkinson’s disease including, drug-induced Parkinson’s, normal pressure hydrocephalus, vitamin deficiency, arteriosclerosis, and more.

You need to have a full neurological work-up including blood testing and a review of your current medications. To the best of my knowledge, there is no test to diagnose Parkinson’s disease but there are tests for other disorders which can be performed to rule out other causes.

Given the fact that you have symptoms of Parkinson’s disease and responded to dopamine therapy (even if for a brief time), I believe you may truly have the disorder despite the fact that your MRI said otherwise. (Again, I don’t believe that an MRI can confirm or rule out Parkinson’s, rather it is based on symptoms, etc.)

I recommend you get a second opinion from another neurologist who may be able to help you more than your current specialist. Let me know what happens.

To give you related information, I am sending you a copy of my Health Report “Parkinson’s Disease”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I’d like your opinion about this medicine, its safety and effects — especially with the elderly. I’m 86. Thank you for your response.

DEAR READER:
Simply put, digoxin helps the heart beat strongly and regularly. It is used to treat atrial fibrillation, atrial flutter, congestive heart failure, and more.

Individuals with thyroid, kidney, liver, or lung disease should check with their physicians before taking the medication. Certain drugs can affect digoxin. They include antacids and laxatives that contain aluminum, some beta blockers, some calcium channel blockers and certain water pills.

Side effects include nausea, vomiting, constipation, diarrhea, visual disturbances, headache, anxiousness, fatigue, weakness, skin rash, palpitations, confusion, and chest pain. Adverse reactions tend to occur at higher doses and often disappear when the dose is reduced.

As you know, there are side effects with any medication, and digoxin is no exception. I am sure your cardiologist carefully reviewed your medical history and current medications before placing you on this drug. If you have read about negative studies, take the article to his or her office and request an explanation. If you feel the drug isn’t appropriate, ask to try another drug in the same category. Start with a limited supply so you are not out-of-pocket a large amount of money for something that could have many more side effects than the digoxin. On the other hand, if your cardiac condition has improved or stabilized and the drug appears to be working for you despite what you’ve read, perhaps you will choose not to make a change. Your primary care physician or cardiologist should be the one to help you make the decision.

To give you related information, I am sending you a copy of my Health Report “Coronary Artery Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 176, Wickliffe, OH 44092. Be sure to mention the title.

I am not interested in doing this if there is any other possible alternative. I would appreciate your thoughts on this matter.

DEAR READER:
Many studies have proven that atrial fibrillation (an erratic, fast pulse rate) can cause a stroke if a clot forms within the heart, breaks off, and is carried to the brain. Warfarin (Coumadin) appreciably reduces this risk. Therefore, I advise you to follow your doctors’ recommendations.

Coumadin is available in pill form, is inexpensive and easy to monitor. To my knowledge, there are no other inexpensive substitutes. Plavix is another pill, but is expensive and may need to be combined with aspirin for optimal effects. Other anti-coagulant drugs (such as heparin) are given by injection, are expensive and are not suitable for home care.

I suggest you take the Coumadin. With proper dosing and monitoring, it is safe.

To give you related information, I am sending you a copy of my Health Report “Coronary Artery Disease”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.