Called AOPA to find out where I can get my $49 CAT scan.....
Now they are all scratching their heads, including the medical director. July issue of the mag suggests you get the scan, since the stress test really doesn't prove anything. Typical AOPA, one division doesn't know what the other is doing, even though they are both medical in nature.
When they call me back, I will post the news. If the good Canadian doctor actually knows a place where we can get such high tech diagnostics for half the price of a hamburger, we should all sign up.
Well, the old geezers anyway. The rest of you can sidle up to the BBQ this summer and live like you are young and carefree. Cheers

I read that and put that on my short list. I wondered if that was for real at 50 bucks or a misprint? My Pop passed at 68 from a massive heart attack in his sleep. Too early to go. I have too much stuff to do yet. Let us all know what you find out.

That reminds me. I'm gonna put a sign on my shop: Mammograms 5c. Should get a laff if no biz!

As a Family Medicine doctor, I am very dubious of this authors claims. I would never recommend to one of my patients that they undergo one of these tests. First, testing for underlying heart disease should be based on risk factors, those controllable , ie diet, smoking, HTN, etc, and those uncontrollable as family history. The standard for testing is an electrocardiogram followed by a stress test ( based on symptoms and EKG findings ) and then an angiogram if problems are found on a stress test.

The USPSTF dose not support ct-scanning for calcium in coronary arteries, not because of economic reasons as the author suggests, but because there is insufficient evidence that this is a safe effective procedure.

Further, I am a little skeptical of the $49 price and that his source for this recommendation is a radiologist who makes more income the more tests like these that he performs...no wonder he thinks it is a safe and effective test.

Lastly I strongly dispute the claim that this is a safe procedure with a "miniscule" radiation dose

"A study based on computer modeling of radiation risk suggests that widespread screening for the buildup of calcium in the arteries using computed tomography scans would lead to an estimated 42 additional radiation-induced cancer cases per 100,000 men and 62 cases per 100,000 women, according to a report in the July 13 issue of Archives of Internal Medicine, one of the JAMA/Archives journals."

"Coronary artery calcification screening: estimated radiation dose and cancer risk

Kwang Pyo Kim, PhD, Andrew J. Einstein, MD, PhD, FACP, and Amy Berrington de Gonzalez, DPhil:

Results

Radiation dose from a single CAC CT scan varied more than 10-fold (effective dose range=0.8 to 10.5 mSv) depending on the protocol. In general higher radiation doses were associated with higher x-ray tube current, higher tube potential, and spiral scanning with low pitch, and retrospective gating. The wide dose variation also resulted in wide variation in estimated radiation-induced cancer risk. Assuming screening every five years from age 45-75 for men and from age 55-75 for women, the estimated excess lifetime cancer risk using the median dose of 2.3 mSv (0.8-10.5 mSv) was 42 cases/100,000 for men (range 14-200) and 62 cases/100,000 for women (range 21-300)."

That is what I really like about this forum. You throw an interesting topic out there and the replies are wide ranging. My focus was primarily on the bogus cost error by the author. Now I have some reservations about efficacy and safety of the CT scans. I thank the doctor for thoughtful writing and even our dear member who has boobies on his mind. A sense of humour keeps one healthy as well.

Interesting - I was referred to a cardiologist about 5 years ago by my primary care doctor. My EKG had an unusual waveform that he was concerned about. Stress test at the cardio's office was negative and he made a remark along the lines that, "EKGs are like fingerprints - every one is a little different". He also recommended this CT calcium screening. It was $200 self-pay(not covered by insurance for the reasons the doc posted above). The cardio was very serious in his recommendation, and I thought, "what the heck, it's $200". It turned up essentially nothing - IIRC, my score was 5. My background at the time was 50ish, overweight with hypertension controlled by medication and total cholesterol slightly over 100; so I guess I can see where he thought I had a couple "risk factors".

Now I'm wondering if he wasn't just padding the radio units revenue or maybe he seriously thought this was an important diagnostic tool? After reading the above, I googled and found this article, which leads me to believe that the radiation exposure concerns might be a bit overstated. That said, if I had read this thread back then, I likely would have saved the $200...

To anyone considering this procedure, I decided to get a "second opinion" and asked Dr. Bruce Chien over at POA what he thought of the procedure. His response was interesting.

On a recent visit to the family physician for some exercise related symptoms he did an ekg. The ekg was abnormal and looked a lot like a condition called hypertrophic cardiomyopathy. An appointment was scheduled for an echocardiogram a week later. Two weeks after that the results came in. The condition is arguably disqualifying so I stopped flying for the three weeks and bought every pilot protection medical service the aopa offered. Turns out 4k later (900 out of pocket) echo showed no heart condition, so I’m fine and can fly. My wife (also a family med resident physician) found it unreal that I was more worried about not being able to fly than the other "symptom": elevated risk of sudden death…

My 2cents: If there is something wrong go to the doc. If there isn’t, why search for a problem when there isn’t one. All you do is raise questions on you next medical.

After getting zapped for 42 sessions when I had IMRT radiation for prostate cancer, I'm not about to get any more zapping than absolutely necessary--I already glow in the dark!

Cary

Papa Foxtrot wrote:To anyone considering this procedure, I decided to get a "second opinion" and asked Dr. Bruce Chien over at POA what he thought of the procedure. His response was interesting.

Dr. Bruce Chien is a great resource for anyone with any medical questions. Aopa medical is a joke from what I have heard. You should consider consulting with Dr. Chien about the consequences of any diagnoses you could get from any doctor visit. He tells me with the changes in the Affordable care act, all diagnosis codes and prescriptions are now at the FAA's fingertips.

http://home.comcast.net/~bbchien/site/