Tell us something TRIVIAL about your life

[Tim Digger]

Although, hopefully he'll refer you to a cardiologist who has had some requests for the procedure

All cardiologists have training and accreditation in Echocardiography. Performing the test is not difficult and getting a good video of the whole thing is part of the machinery and routine. It is the interpretation of the result that requires experience, fortunately it is simple to send the echo video once acquired over the internet to someone else. Not all PFOs are equal but it is easy to tell if there is one at all, it is when there is one but small that the question of experience comes in. A bubblecho cardiogram is so sensitive today that seeing a few bubbles crossing the interatrial septum may not be significant. Though given the seriousness of the bend it may well be. Take a USB memory stick with you and see if they will give you a copy of it. It is after all your health record.

[Paulo]

We have had a number of DHL items that were awaiting VAT but DHL "forgot" to invoice us for the tax. We have had at least one item returned to the supplier and back again twice. It seems to be a bit more smooth in operation now but still can be in UK for a couple of days before they invoice us for the VAT so it adds to the overall shipment time.

Sent nephew a £5 xmas gift to Cork and he had to pay 92p import tax before post office would deliver it to him.

Goods to Gibraltar returned to us.

Just 50 years to go for the benefits...

He did well only paying 92p. My aunt sent me a birthday present last year. It cost me about €4 to get it. It only cost her about £7 originally. I have told her not to bother anymore as it just is not worth it with VAT, import duties, handling charges etc

[Chrisch]

All cardiologists have training and accreditation in Echocardiography. ..

The PFO test is transesophageal - when the missus had her tests it was a major PITA to get it done. I don't know if it has changed but at the time there were very few people with the knowledge or who had seen/done it. (London hospital about 20 years back)

[Chrisch]

He did well only paying 92p. My aunt sent me a birthday present last year. It cost me about €4 to get it. It only cost her about £7 originally. I have told her not to bother anymore as it just is not worth it with VAT, import duties, handling charges etc

We sent him a book (no VAT IIRC ??) and I put "gift £5" on the Royal Mail label. It was small enough to go through a letter box. We had tried to avoid exactly what you experienced. I will buy something off the Internet that is within Ireland next time.

[Divemouse]

The PFO test is transesophageal - when the missus had her tests it was a major PITA to get it done. I don't know if it has changed but at the time there were very few people with the knowledge or who had seen/done it. (London hospital about 20 years back)

Nope, now it's on the outside just like the normal one.

[Chrisch]

Nope, now it's on the outside just like the normal one.

That is interesting. How do they get a view of the correct part of the heart?

[Divemouse]

That is interesting. How do they get a view of the correct part of the heart?

Stop harshing my buzz man! I dunno, but they were able to see the right bit yesterday during the ordinary one, but only in one 2D plain.

[Nickpicks]

The PFO test is transesophageal - when the missus had her tests it was a major PITA to get it done. I don't know if it has changed but at the time there were very few people with the knowledge or who had seen/done it. (London hospital about 20 years back)

Mine was done trans-thoracic - basically poking the ultrasound wand between 2 ribs to get a view of the heart.
My diagnosis included the words "large PFO", "spontaneous right to left shunt".

I'm having a trans oesophegal echo as part of the closure procedure next week (they need to do the TOE in order to measure the exact size of the hole and decide what size closure device to use.

I didn't think to ask for a copy of the video!

[steelemonkey]

That is interesting. How do they get a view of the correct part of the heart?

And how did it "see" through the stone.

[graham_hk]

That is interesting. How do they get a view of the correct part of the heart?

My knowledge of this is dated - but transthoracic is easier to conduct but has less resolution. Transoesophegal has better resolution but is more uncomfortable and not without risk (since they stick the probe down your oesophagus). TOE is often done under sedation which is not ideal as you can't increase thoracic pressure and force a PFO open - hard valsalva manoeuvre for example. The cardiologist I consulted considered the TTE inferior to TOE and said that both would detect a large PFO but only the TOE would detect a smaller PFO. Since I hadn't been bent (nor yet fingers crossed) but was wanting a test for more aggressive diving he considered the TOE as gold standard. He also stated that I had a pronounced gag reflex ... its not something I would repeat lightly.